CIGNA Group Insurance and Subsidiaries sued in Alabama, New York and Michigan for allegedly acting arbitrarily and capriciously in denying claims for long term disability benefits
Recently, the CIGNA Group Insurance and its subsidiaries (CIGNA) faced a barrage of disability insurance lawsuits filed against the company and its subsidiaries across the country allegedly for denying long term disability (LTD) benefits by ignoring overwhelming medical evidences that supported the plaintiffs’ disabled condition.
The Plaintiff v Cigna Health and Life Insurance Company:
The case of The Plaintiff v Cigna Health and Life Insurance Companywas filed by a disability attorney at the District Court for the Eastern District of Michigan. The plaintiff participated in a LTD insurance policy that was issued by CIGNA. Under the terms of the policy, the plaintiff who suffers from lupus, fibromyalgia, and severe depression was supposed to be entitled for LTD benefits if she was rendered unable to work due to a debilitating medical condition. Nevertheless, the plaintiff’s claim for LTD benefits was denied by CIGNA. And despite several appeals to CIGNA’s decision to deny LTD benefits the plaintiff, CIGNA remained steadfast in its decision to reject the plaintiff’s claim for LTD benefits.
In the lawsuit, the plaintiff alleged that CIGNA’s denial of benefits was arbitrary and capricious and that the termination of the plaintiff’s LTD benefits amounted to a breach of the contract for insurance. Having exhausted all her administrative remedies, the plaintiff is resorting to bringing a civil action against CIGNA to compel CIGNA to comply with the provisions of the Employee Retirement Income Security Act (ERISA), resume payment of LTD benefits to the plaintiff and to recover past due LTD benefits in addition to costs, interest and attorney fees.
The Plaintiff v Cigna Life Insurance Company of New York:
Filed by a disability attorney at the District Court for the Northern District of New York, The Plaintiff v Cigna Life Insurance Company of New York also concerns the denial of a claim for LTD benefits by CIGNA. The plaintiff was employed as a Fabricator Specialist at Schonbek & Co, Inc. through her employment at Schonbek & Co, Inc, the plaintiff participated in an employee benefits policy issued by CIGNA.
On March 31st 2009, CIGNA determined that the plaintiff was disabled from her own occupation due to spondylosis and Iumbosacral radiculopathy. Under the terms of the policy, CIGNA paid out LTD benefits to the plaintiff. However on January 22nd 2010, the plaintiff was informed by CIGNA that it would terminate the plaintiff’s LTD benefits on January 25th 2010. According to the lawsuit, CIGNA based its decision to terminate the plaintiff’s LTD benefits on the grounds that it no longer considers the plaintiff to be disabled. This conclusion was reached by CIGNA despite the fact that the plaintiff shows no medical improvement in her condition that would have allowed her to resume her previous employment.
The plaintiff alleged that CIGNA not only committed numerous errors in handling her claim for LTD benefits, it had also reached its decision to terminate the plaintiff’s LTD benefits without basing it on any medical examination. Hence, the plaintiff argued that CIGNA had violated the provisions of ERISA by acting arbitrarily and capriciously in terminating her claim for LTD benefits. The plaintiff’s lawsuit is demanding the following relief from CIGNA:
- Reinstatement of the plaintiff’s LTD benefits.
- Payment of all LTD benefits withheld.
- Continued payment of LTD benefits.
- Interest on all long term disability benefits withheld by CIGNA at the statutory rate.
- Attorney’s fees and costs and expenses of litigation.
The Plaintiff v. Honda Manufacturing North America, LLC, Cigna Group Insurance:
In The Plaintiff v. Honda Manufacturing North America, LLC, Cigna Group Insurance, the plaintiff filed the lawsuit through her disability attorney at the District Court for the Northern District of Alabama. In the lawsuit, the plaintiff also alleged that CIGNA had acted arbitrarily and capriciously in the handling of her claim for LTD benefits. The plaintiff was formerly an employee at Honda Manufacturing North America, LLC.(Honda) but stopped working with Honda on March 6th 2007.
Through her employment at Honda, the plaintiff participated in an employee welfare benefit plan in which CIGNA acted as the claims administrator. According to the lawsuit, the plaintiff’s claim was initially denied by CIGNA. After going through the administrative appeal process, the plaintiff’s claim was again denied on March 4th 2009. The plaintiff argued that this was despite the fact that she was “unable to perform any gainful occupation for which she is reasonable fitted by training, education or experience.”
As such, the plaintiff alleged that CIGNA’s decision to deny her claim for LTD benefits was erroneous as it was not supported by evidence but instead based on an arbitrary and capricious determination. Having exhausted all her administrative remedies, the plaintiff is seeking from the Court the following relief:
- The Court’s review and reversal of the denial decision;
- Seek such additional relief as permitted by law;
- All retirement/pension due;
- Declaration of the plaintiff’s’ rights and CIGNA’s obligations under the plan;
- Clarification of the Plaintiff’s rights to future benefits under the plan;
- Recover any and all benefits Plaintiff is due under the plan that have not been paid;
- Enforce the plaintiff’s rights under the said plan;
- Damages as may be permitted by law;
- Reasonable attorneys’ fee and costs.
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Answered Questions by Our Lawyers
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Q: I filed an appeal and lost. Is it worth pursuing?
A: Kim, in my opinion, yes. If you are still within your timeframe to file a lawsuit you have little to lose in t... Read More >
Q: Do I have a case for STD? I was denied twice because a) I hadn't been a fulltime employee for 6 months and b) I had ben on FMLA since Febury.
A: Frank, we would need to see a copy of the denial letter and the policy. Please feel free to contact our office... Read More >
Q: How can I appeal Cigna's decision if there are no written communications explanation the reasons for claim termination?
A: Tret, Cigna will be required by law to provide you with a written denial letter setting forth its reason for t... Read More >
Q: Is there a process for appeals not being responded to in the time given? Also, how do I access my records?
A: SB, ERISA provides 45 days to render a decision on appeal with the possibility of a 45 day extension- basicall... Read More >
Q: Is it worth is to go to court over $2500?
A: Mark, If you have no additional appeals your only option would be to find representation to file a federal law... Read More >
Q: How long will it take Cigna to get back to me? Will my military retiree pay be held against my policy 60%? Will Cigna exploit the disparity in the medical community over my illness?
A: Craig, Unfortunately it can sometime take up to 45 days to receive a decision from Cigna as to your entitlemen... Read More >
Q: Do I have any options to void an agreement I signed? Can Signa offset my SSDI benefits?
A: Donna, I do not know if you would have any avenues to void the agreement you signed. Regardless of agreeing th... Read More >
Q: Can I sue Cigna even if they do end up paying me?
A: Linda, If your policy is governed by ERISA you will need to go through the administrative appeal process prior... Read More >
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