CIGNA pays disability benefits for 10 years, offers a lump sum buyout and then denies disability claim

After 10 years of receiving disability benefits and a lump sum buyout offer by CIGNA, this claimant’s disability benefits were denied. This case is a sad example of the fact that a disability claimant can never assume that their disability benefits will continue to be paid indefinitely. Therese Regan was formerly a lab technician employed by the Pactiv Corporation. By virtue of her employment, the plaintiff was, at all relevant time, a participant in the Pactiv Corporation’s long term disability plan which was administered by CIGNA.

The case of Therese Regan vs. CIGNA Corporation d/b/a CIGNA Group Insurance and Pactiv Corporation concerns a former Pactiv Corporation’s Lab Technician who recently, through a disability attorney, filed a lawsuit at the District Court for the Northern District of New York against the CIGNA Corporation for wrongfully denying her claim for disability benefits.

The Claim for Long Term Disability Benefits Against Cigna

On August 16th 2000, the plaintiff sustained an injury due to a fall in her home. As a result of the injuries, the plaintiff was unable to perform the duties required of her occupation. As a result of her disability, the plaintiff filed a claim for disability benefits with CIGNA on January 2001. On February 13th, 2001, CIGNA approved the plaintiff’s claim for long term disability benefits. On April 2001, the plaintiff’s claim for Social Security Benefits was approved and she received $880 monthly payment for herself and $440 monthly payment on behalf of her dependent children.

On April 9th 2007, CIGNA made several overtures to the plaintiff to fully settle her claim for $11,276.00. The plaintiff elected not to accept the offer as CIGNA was obligated to increase her monthly disability payment from $139 to $534 when her daughter attained the age of 18 on June 5th 2008. According to the plaintiff, assuming that the plaintiff remained continuously disabled, CIGNA would then have to pay her in disability benefits over the life of the plan in excess of $93,000.

According to the lawsuit, consequently, CIGNA conducted surveillances on the plaintiff and requested a Functional Capacity Evaluation (FCE) to revaluate her eligibility for continuing disability benefits payments. Although the FCE found that the plaintiff was disabled under the plan, CIGNA conducted a peer review of the plaintiff’s records on January 2010 and made a determination that the plaintiff was no longer eligible for continuing disability benefits payments on February 2nd 2010.

On August 2010, the plaintiff filed an ERISA appeal to CIGNA’s decision to terminate her claim for long term disability benefits. In the appeal, the plaintiff submitted sworn affidavit from her attending physician that the peer review report contained numerous inaccuracies. Nevertheless, despite all efforts by the plaintiff, CIGNA denied her appeal on September 23rd 2010.

Disability Lawyer Sues CIGNA for Wrongful Disability Denial

The plaintiff alleged that CIGNA actions to deny for claim for long term disability benefits were unreasonable and a breach of its fiduciary duty as it maintained its denial of the plaintiff’s claim without any medical evidence to demonstrate that the plaintiff was not disabled. The plaintiff also alleged that CIGNA had relied on patently false information obtained from the peer review report conducted on the plaintiff’s medical file.

Relief Sought By The Plaintiff

Due to the alleged unlawful actions of CIGNA, the plaintiff is seeking from the Court the following remedy:

  • A de novo review by the Court of CIGNA’s decision
  • A judgement holding that CIGNA must pay to the plaintiff the disability income to which she is entitled to.
  • An Award of prejudgement interest
  • An order directing CIGNA to continue paying long term disability benefits to the plaintiff until she is no longer qualified for the disability benefits
  • An award of attorneys’ fees and cost
  • An order preventing CIGNA from terminating the plaintiff’s long term disability benefits in violation of federal laws and the plaintiff’s long term disability plan.

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Cigna

Cigna has not paid me a dime in months

Reviewed by Anne on August 6th 2017   Verified Policyholder
I work for a large company – and they have Cigna for both their long term and short term disability benefits. I have been off on STD since 6/7/17 – and Cigna has not p... read more >
Cigna

Cigna expects me to do a range of motion tests when every time I try to move I want to cry

Reviewed by Bonnie on July 16th 2017   Verified Policyholder
I have fibromyalgia, hashimotos and degenerative disk disease. Cigna just denied my STD claimed because my Dr. did not summit and range of motion report. How is a range of... read more >
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Sent on July 16th 2017 by Attorney Stephen Jessup

Bonnie, if you have a copy of the STD denial letter please feel free to contact our office to discuss how we may be able to assist you in appealing same.

Cigna

Even my employer doesn’t understand why Cigna denied my claim. I don't know what to do

Reviewed by Cheri on April 30th 2017   Verified Policyholder
I have been off on leave since October. My last disability payment was 12-26-17 and it’s now 5-1-17. In February I called Cigna to see why I wasn’t getting my disabili... read more >
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Sent on April 30th 2017 by Attorney Stephen Jessup

Cheri, Cigna is correct in their assertion that the review of the claim could take up to 90 days from the date of the appeal. If your employer was advised the appeal wa... read more >

Cigna

Cigna is not there in time of need Had to go back to work with no surgery and a ruined credit score

Reviewed by Janine K. on April 22nd 2017   Verified Policyholder
This is the second time I had to deal with Cigna. I have elected coverage for STD that is payroll deducted. My company pays for the LTD. I filed STD claim that was to star... read more >
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Sent on April 22nd 2017 by Attorney Gregory Dell

Janine, please feel free to contact our office to discuss your claim as it stands today to determine how we may be able to assist you now to prevent a potential denial.... read more >

Cigna

Cigna says I am well and able to work. I wish my brain and body got their memo.

Reviewed by Lani. A on March 14th 2017   Verified Policyholder
I have been denied long term disability from Cigna. I had a stroke in nov 2013… I have had more tests, procedures, and one profession of Dr. saying that its a central ne... read more >
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Sent on March 14th 2017 by Attorney Stephen Jessup

Lani, have you appealed the denial of benefits? Please contact our office to discuss your appeal and the rights available. Despite Cigna terminating your claim that is ... read more >

Cigna

Cigna thinks it's ok to mess with my life

Reviewed by Candy on February 23rd 2017   Verified Policyholder
Why do these people think that it is OK to mess with my life? It took them a month before I received my first check. In which it was less than half of one of my regular ch... read more >
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Sent on February 23rd 2017 by Attorney Stephen Jessup

Candy, please feel free to contact our office as it relates to the disability claim. With respect to the insurance being $1800 I am assuming this has something to do wi... read more >

Cigna

My experiecne with Cigna has been a complete headache

Reviewed by Sandra on February 15th 2017   Verified Policyholder
I was out on short term disability due to surgeries on both feet. I received a letter from Cigna indicating that I had 14 days beginning January 6 to submit the revised me... read more >
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Sent on February 15th 2017 by Attorney Stephen Jessup

Sandra, unfortunately, the overwhelming majority of claims are denied following a review of the file by a doctor or nurse without ever examining the insured. When you r... read more >

Cigna

What a pathetic company

Reviewed by Pravina on December 7th 2016   Verified Policyholder
Submitted claim in advancement of my problems hoping that Cigna would understand my problems and process my claim accordingly.It has been 9 weeks after I stopped work but ... read more >
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Sent on December 7th 2016 by Attorney Stephen Jessup

Pravina, when was the last time you heard anything from Cigna? Please feel free to contact our office to discuss your claim.

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