Application for Overpayment Waiver . Complete this form if any of the following applies: You think that you are not at fault for the overpayment and you cannot afford to pay the money back.The expenses of litigation generally shall not be allowed as a part of the damages; but where the plaintiff has specially pleaded and has made prayer therefor. In the event that you have received overpayment, please return the funds to Cigna Healthcare SM at: Cigna Healthcare PO Box 188012 Chattanooga, TN 37422. To ensure we apply the refund correctly, please include a copy of the explanation of payment you received. We are paid out of the settlement as a percentage of the total recovery amount. The amount the State may recover in a tort settlement is the amount that is allocated for past medical expenses.