Health insurance hasn’t contacted me about my appeal after the 30 day deadline. Do I contact a lawyer?

I received a claim denial back in March for two treatments I received. I downloaded and filled out appeal paperwork for each denial with the help of my doctor and sent them to my health insurance (Cigna) in April. I then contacted them about 4 weeks after to inquire about the progress. The agent said that the appeals were received, but since it took a week for it to arrive at their office (Cigna only accepts appeals through snail mail) it was technically still in the 30 day decision deadline. No big deal. I waited several more weeks.

I contacted them near the end of June to inquire again. I was told that no decision was made yet, and the agent I spoke to was perplexed by how long it was taking. I asked them if they would contact me if a decision was finally made and they said "yes" so once again I figured a little more time wont hurt. Fast forward to now, almost 3 months past the "30 day deadline," I've never been contacted once, and I'm worried that they will attempt a carpet pull on me as I have a 180 day deadline to file the appeal, and if that date passes I might be on the hook for treatment that they legally have to cover under the ACA and according to their own coverage documents (which I cited in the appeal).

I am thinking about calling them again, and if there is no progress still, I will politely inform the agent: "I know this isn't your fault, but I would like you to inform your higher ups that if no progress is made on this appeal, I am not afraid to pursue legal action, I expect this to be taken care of before the 180 day deadline." I don't know if this is the best approach though, any advice would be appreciated.

TL;DR Filed a health insurance appeal and have not received any information about its progress even though it is pass the 30 day deadline. Considering legal action if necessary.

submitted by /u/Pizzanomnommer
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