Jean Pentecost and her Montana disability lawyer file a complaint against CIGNA
On June 6, 2011, Jean Pentecost sued CIGNA for her disability benefits under the Employee Retirement Income Security Act of 1974 (ERISA) in the United States District Court of Montana, Butte Division. Seeking long term disability benefits as well as attorney fees, Pentecost and her disability attorney ask the Court in Pentecost’s disability insurance lawsuit to force CIGNA to pay her disability benefits as promised by her plan, award her reasonable attorney fees and Court costs, prejudgment interest and any other relief the Court sees as just and proper.
The Facts of Pentecost’s Lawsuit Against Cigna
In June 2009, Pentecost’s son and daughter-in-law were involved in a fatal motorcycle accident caused by a drunk driver. A traumatic event, the death of her loved-ones caused Pentecost to suffer major depression which ultimately lead to a depressive disorder and anxiety/panic disorder. Consequently, Pentecost became unable to perform her duties as a senior engineer for PPL Montana. Pentecost’s medical providers have verified that she is currently unable to perform her duties at her occupation.
Becoming eligible for long term disability benefits in January 2010, Pentecost applied for disability benefits to CIGNA and was told her disability coverage would be terminated in August 2010. CIGNA determined that Pentecost’s medical record did not “support a psychiatric impairment” that would prevent Pentecost from working. In addition, CIGNA used surveillance techniques on Pentecost and determined that her documented activities from July 15-17, 2010 were “inconsistent with her reported deficits.” And, according to CIGNA, the surveillance indicated that Pentecost was tending bar, which suggested that Pentecost was employed. According to Pentecost’s complaint, the statements about Pentecost tending bar were totally incorrect as Pentecost was attending her brother-in-law’s funeral on the dates in question.
Jean Pentecost Exhausts Her Administrative Appeals with CIGNA
As for the record of Pentecost’s pursuit of her CIGNA benefits, Pentecost appealed CIGNA’s decision to deny her disability benefits. According to her CIGNA disability plan, Pentecost qualifies for long term disability benefits so long as she cannot perform her regular occupation as a senior engineer, which she is unable to do. After denial after denial, Pentecost exhausted all her appeals for her CIGNA disability benefits.
In her complaint, Pentecost and her Montana disability lawyer have noted that CIGNA “failed to pay [Pentecost’s] benefits from February 10, 2011, to the date of trial, in violation of the terms of the Summary Plan Description.” As a result, Pentecost asks the Court to order CIGNA to pay her ongoing long term disability benefits.
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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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