BASTROP COUNTY — Cristina Wilcox, a Bastrop County resident, is challenging Cigna Healthcare's denial of coverage for nerve graft surgery to repair her right hand, which was injured as she escaped a house fire that killed her 9-year-old son. The fire occurred in the early morning hours of July 27, 2025.

Wilcox was sleeping in her living room with her son, Jude, when she woke up coughing. Unable to escape through the locked front door, she broke a window and fell out of the burning home. A passerby saw the fire and called 911. Jude, who was autistic and nonverbal, died of smoke inhalation. The family's dog, Cocoa, also died in the fire.

She suffered serious injuries to her right hand, leaving her with partial use of it. In September 2025, an orthopedic surgeon recommended nerve graft surgery to repair the damage. In October, Cigna Healthcare denied coverage for the procedure, citing it as "not medically necessary" and "experimental." "In that case, every surgery is experimental," she said.

She said she only heard back from Cigna after the KVUE Defenders got involved. Cigna later identified another doctor to perform the procedure, but no appointment was scheduled. Her policy with the insurer expired in April 2026, not at the end of May as she was originally told, and she must wait out the enrollment period with her new insurance company before seeking coverage approval again.

A Cigna Healthcare spokesperson said, "We recognize that navigating the healthcare system can be challenging, particularly during medical recovery. Due to privacy laws, we are unable to comment on individual customers' situations."

A KFF analysis released in March 2026 found that insurance companies reported receiving nearly 496 million claims in 2024, of which 19% of in-network claims were denied. Out-of-network claims carried a denial rate of 37%. The analysis, which covered only Affordable Care Act marketplace plans, found that denial rates in Texas ranged from 12% to 36%, with the state recording the highest single-insurer denial rate in the country. Denial rates held steady at around 20% in 2023 and 2024. Fewer than 1% of denied claims were appealed, and of those, 66% were upheld.

Patients can dispute a denial through an internal appeal followed by an external, independent review, and can file complaints with the Texas Department of Insurance or the U.S. Department of Labor if their external review is unsuccessful.

Michelle Long, a senior policy manager at KFF, said, "This is a document that you will get after you've received care. It'll tell you how much you're going to pay and how much the plan is going to pay. It'll also have an explanation of your rights on there, your appeal rights as well." She added, "You almost need a Ph.D. in health insurance to understand what's going on. And relying on your memory might not be the best way to go because you will be talking to different people on different dates, receiving different information."

Ten months after the fire, Wilcox said she was still coping with the loss of her son. Jude's urn sits in the center of her new rental home, and she wears a necklace containing his ashes that she has never taken off. "I'm just wanting to get my life back," she said. "It's never going to be the same, I know that."