CIGNA denies disability insurance benefits to Engineering Manager with Stage 4 cancer
The plaintiff Bradley Erickson was employed as an engineering manager for BorgWarner. By virtue of his employment, he was entitled to coverage under an employee welfare benefits plan issued by LINA and administered by CIGNA. At the District Court for the Eastern District of Michigan recently, a disability attorney filed a lawsuit on behalf of a client against the Life Insurance Company of North America (LINA) and CIGNA for denial of disability insurance benefits and ERISA violations.
The plaintiff in the case of Bradley Erickson vs Borgwarner Insurance Plan, Borgwarner, Life Insurance Company Of North America, And CIGNA alleged that CIGNA as the claims administrator for the BorgWarner’s employee welfare benefits plan had acted arbitrarily and capriciously in denying his claim for disability benefits.
The CIGNA Disability Insurance Policy Language
Under the plan, the plaintiff was entitled to long term disability benefits if he became disabled as defined below:
The Employee is considered Disabled if, solely because of Injury or Sickness, he or she is either:
- Unable to perform all the material duties of his or her Regular Occupation or a Qualified Alternative; and
- Unable to earn 80% or more of his or her Indexed Covered Earnings.
After Disability Benefits have been payable for 30 months, the Employee is considered Disabled if, solely due to Injury or Sickness, he or she is either:
Unable to perform all the material duties of any occupation for which he or she is, or may reasonably become, qualified based on education, training or experience; and
Unable to earn 60% or more of his or her Indexed Covered Earnings.
The plaintiff suffered from Stage IV adrenocortical cancer. As a result of his medications, he experienced symptoms like fatigue, diarrhoea, decreased appetite, weight loss, shortness of breath, depression, anxiety, headaches, dizziness, tremors, memory loss, loss of concentration. The plaintiff also required assistance with all activities of daily living.
Approval And Termination Of Disability Benefits BY LINA / CIGNA
On October 8th 2008, CIGNA approved the plaintiff for long term disability benefits at a rate of $4308. However, after 26 months, from December 16th 2010, CIGNA terminated the plaintiff’s long term disability benefit. The plaintiff stated in the lawsuit that an appeal was made to CIGNA on February 8th 2011 regarding the decision by CIGNA to terminate his disability benefits. Under ERISA, CIGNA was required to make a determination regarding the appeal with 45 days of the plaintiff appealing. Despite numerous promises, CIGNA failed to render a decision on the appeal in a timely manner. A lawsuit was subsequently filed by a Michigan Disability Lawyer seeking payment of disability benefits owed, attorney fees and cost.
Alleged Legal Cause For Action Against CIGNA
The plaintiff argued that as there had been no determination by CIGNA within the period stipulated under ERISA to render its decision regarding the appeal, the appeal is deemed to be denied. The plaintiff also alleged that the termination of his long term disability benefits was wrongful and breached the terms of the plan. In addition, the denial of benefits was arbitrary, capricious, and unsupported by reasoned explanation because:
- There was no conflicting medical evidence as to the plaintiff’s diagnoses and medical condition.
- CIGNA terminated the plaintiff’s long term disability benefits notwithstanding the uncontradicted evidence that his medical condition had not improved.
- CIGNA had a conflict of interest or self-interest to deny plaintiff’s claim because it was both the decision maker and the payer of the plaintiff’s disability benefits.
- CIGNA adopted the opinion of a consulting physician who was its employee and who did not examine the plaintiff instead of giving consideration and weight to the medical evidence from the plaintiff’s treating physicians.
- CIGNA failed to weigh and give a reasoned basis for rejecting the plaintiff’s Social Security Disability award.
- CIGNA gave no reasoned explanation or any reasons for denying the plaintiff’s administrative appeal.
- The denial of benefits damaged the plaintiff by loss of past and future disability benefits.
Relief Sought by the Plaintiff
Due to the actions of CIGNA, the plaintiff is requesting from the Court the following relief:
- A declaration that the plaintiff was and is entitled to past and future long term disability.
- Enter judgment for the plaintiff and against CIGNA for past due disability benefits.
- An order for CIGNA to pay the future disability benefits as they accrue.
- An order for CIGNA to pay reasonable attorney fees, costs, and legal interest.
Resources to Help You Win Disability Benefits
Submit a Strong Cigna Appeal Package
We work with you, your doctors, and other experts to submit a very strong Cigna appeal.
Sue Cigna
We have filed thousands of disability denial lawsuits in federal Courts nationwide against Cigna.
Get Your Cigna Disability Application Approved
Prevent a Cigna Disability Benefit Denial
Negotiate a Cigna Lump-Sum Settlement
Our goal is to negotiate the highest possible buyout of your long-term disability policy.
Policy Holder Rating
Payment delays!
Cigna (NYL) denied my claim
Hold up on payments!!!
Paid Family Leave
They should all rot in hell
They will constantly come up with anything to delay paying you
Don't count on Cigna!!! You will be very disappointed!!!
They will do anything to avoid paying
Q: Why can Cigna get away with not paying me anything for my disability?
Q: Do I have to be an active employee to apply for LTD?
Q: Can Cigna refuse to give me a copy of my short term disability policy?
Q: Is my plan governed by ERISA?
Q: Can I add a physical disability claim to my mental health one without seeing a doctor (hard to get an appointment with COVID)?
Q: Do you handle CIGNA cases in Florida?
Q: How can Cigna get away with not answering my calls?
Q: Do you handle closed cases only, or open ones as well?
Is Cigna Seeking To Offset Disability Benefit by Social Security Survivor Benefit?
Is Cigna's Denial of Your Appeal Really a Denial?
What Should a Claimant Expect When Suing Cigna or any Other Disability Company for Long Term Disability Benefits?
Are Cigna Short Term Disability Denials on the Rise?
Cigna's latest strategies for handling and denying disability benefit claims
Is a Claimant's Complaints of Pain Enough to Qualify for Short or Long Term Disability Insurance Benefits?
Is My Insurance Company Allowed to Take An Offset of My Monthly LTD Benefit for Social Security Benefits My Kids Receive As A Result of My Disability?
Is My "No-Fault" Auto Insurance Settlement an Offset Under My Long Term Disability Insurance Policy?
Cigna Sued For Failing To Make A Timely Decision on Appeal
CIGNA Overturns a Waiver of Premium for Group Life Insurance Policy
Cigna Admits Error In Denying Disability Benefits
CIGNA Overturned Their Denial of LTD Benefits for Nevada Healthcare Coordinator
CIGNA Denies Technology Manager under the Own Occupation Provision & Dell Disability Lawyers Wins Appeal
CIGNA overturned previous denial of waiver of life insurance premiums
Dell Disability Lawyers successfully appeal denial of benefits to claimant with CRPS/RSD
LINA overturned its previous LTD denial for Medical Technologist
Reviews from Our Clients






