What is Cigna disability company trying to hide from its own insured? Why would Cigna refuse to release all video surveillance and fail to release information about its relationship with a hired physical therapist? It’s unfortunately either an intentional act or the product of unqualified Cigna employees that are being asked to make the claim decisions on short term and long term disability claims.
It is not uncommon for a disability insurance company to conduct video surveillance during the course of a disability insurance claim, and use that surveillance to deny long term disability benefits. Disability insurance companies are also known to send claimants, who file disability claims, to independent medical examinations, also known as IMEs, and functional capacity examinations, often referred to as FCEs. One would hope that the doctor or therapist selected by the disability insurance company, or its third party vendor, would be truly independent, objective and not bias, however, this is not often the case.
Did CIGNA Fail To Release Copies Of All Video Surveillance Tapes?
In both ERISA and private disability insurance cases it is important for the attorneys representing the claimant to obtain from the disability insurance company, all of the surveillance tapes, as well as information relating to the relationship between the insurance company and its hired guns/expert consultants. Of course, most insurance companies do not easily volunteer this information or simply hand documentation and information over on a silver platter. Sometimes, as occurred recently in a case involving CIGNA, the disability insurance company will deny that it has further surveillance video of the claimant, when it in fact did, and should have produced same to the claimant upon request.
In Brice v. Life Insurance Company of North America, the claimant/plaintiff, Charles Brice, was employed as a general manager with Northwest Airlines at San Francisco International Airport. While at work one evening he slipped and fell on a concrete floor reinjuring and exacerbating a spinal condition for which he had undergone three previous unsuccessful back surgeries. Unfortunately, after his fall, Mr. Brice’s pain and discomfort were so severe that he was unable to return to work and was forced to file a claim for long-term disability benefits through his employer’s group long-term disability insurance policy with CIGNA.
Initially, CIGNA approved Mr. Brice’s long-term disability claim and paid his claim for a period of nearly 8 years before it decided to hire a private investigator and place Mr. Brice on video surveillance. CIGNA also demanded that Mr. Brice undergo a functional capacity examination (FCE) conducted by a physical therapist of their choice. Following its review of the video surveillance and the results of its therapist’s FCE report CIGNA decided to terminate Mr. Brice’s long-term disability benefits after 8 years.
Cigna Refuses To Release Video and Other Information During the Disability Appeal Process
Upon submitting his ERISA administrative appeal with CIGNA, Mr. Brice requested, amongst other things, any missing surveillance videotapes and information regarding CIGNA’s relationship with Select Physical Therapy, specifically the number of referrals made by CIGNA to Select Physical Therapy and the percentage of those referrals in which the therapist or doctor’s recommendation was to deny or grant benefits. CIGNA denied that it possessed any further surveillance video of Mr. Brice beyond what it had already produced, and refused to provide any of the information requested concerning Select Physical Therapy. Unfortunately, CIGNA also denied Mr. Brice’s appeal and upheld its decision to terminate his long-term disability claim.
Court Orders Cigna To Produce Additional Video Surveillance Tapes And Information Regarding Its Relationship With The Physical Therapist It Hired To Conduct FCE
Shortly after CIGNA denied his appeal, Mr. Brice filed a lawsuit in US District Court seeking that CIGNA pay the disability benefits owed to him. Mr. Brice’s California disability insurance attorneys also sought production of the surveillance videotapes which they believed CIGNA possessed but would not produce, as well information relating to CIGNA’s relationship with the physical therapist that it had retained to conduct the FCE. Interestingly, after Mr. Brice’s lawyers filed a court motion to conduct discovery, CIGNA produced additional surveillance tapes, however, did not provide any explanation as to why it had not previously provided the tapes upon request, and did not explain why it had misrepresented that it did not possess additional surveillance tapes of Mr. Brice.
The Court also required that CIGNA produce any documents regarding CIGNA’s relationship with the surveillance facility, as well as depositions concerning the taking any evaluation of the surveillance video. The Court also allowed Mr. Brice to obtain the information and discovery he sought regarding the relationship between CIGNA and the physical therapist it hired, in order to uncover the possibility of any potential bias by the physical therapist.
The conduct and questionable claims handling practices described above are not exclusive to CIGNA, and is actually something frequently encountered when dealing with disability insurance companies. It is not uncommon to request a claim file after an initial denial, and then request it again following a subsequent appeal denial, and discover that there was information or documentation that should have been produced by the disability insurance company following the initial denial but was not.
Sometimes information is mistakenly omitted or left out, but sometimes, as in Mr. Brice’s case, the disability insurance company simply refuses to cooperate and provide information which is the claimant’s right to obtain. This case was not handled by our law firm, but we continue to report all of the cases nationwide so that the unreasonable claims handling actions of disability insurance companies can be stopped.