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:

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:

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Our disability insurance lawyers help policy holders seeking short or long term disability insurance benefits from Cigna. We have helped thousands of disability insurance claimants nationwide with monthly disability benefits. With more than 40 years of disability insurance experience we have helped individuals in almost every occupation and we are familiar with the disability income policies offered by Cigna.

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Our lawyers help individuals that have either purchased a Cigna long term disability insurance policy from an insurance company or obtained short or long term disability insurance coverage as a benefit from their employer.

Our experienced lawyers can assist with Cigna:

  • ERISA and Non-ERISA Appeals of Disability Benefit Denials
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Since we represent disability insurance claimants at different stages of a disability insurance claim we offer a variety of different fee options. We understand that claimants living on disability insurance benefits have a limited source of income; therefore we always try to work with the claimant to make our attorney fees as affordable as possible.

The three available fee options are a contingency fee agreement (no attorney fee or cost unless we make a recovery), hourly fee or fixed flat rate.

In every case we provide each client with a written fee agreement detailing the terms and conditions. We always offer a free initial phone consultation and we appreciate the opportunity to work with you in obtaining payment of your disability insurance benefits.

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Pat (Florida)

My experience with Dell & Schaefer, especially attorney Cesar Gavidia and his staff was excellent. I contacted Dell & Schaefer when I needed help as my disability insurance carrier terminated my benefits at the 2 year mark of my disability. I spent about 2 months putting together what I thought may be a decent appeal of that decision. However, the further I got into the workings and gaining some understanding of how the appeals worked under ERISA, I realized there was a lot at risk and only had one shot at it. I sought advice from an immediate family member who is also an attorney and was advised “get a firm that specializes in this type of work, then get the best”. Hence my decision to chose Dell & Schaefer.

Upon acceptance of my case, I felt that I was the center of attention for Attorney Gavidia. I had already used up 1/3 of the 180 days allotted to file the appeal working on my own so we were in a bit of a time crunch. Hundreds of pages of medical records the detail of the termination of benefits, my disability policy and several other different documents were delivered to attorney Gavidia. In short order those documents were reviewed and our strategy of appeal was discussed and developed. Necessary appointments and evaluations were coordinated and our appeal was submitted before the 180 days had expired. At the 45 day mark my insurer requested a 45 day extension on the decision. I was advised by Mr Gavidia’s assistant Michal who reassured me that this happens in most appeals. At the 90 day mark we received a favorable decision on the appeal, benefits were reinstated and back pay was awarded, but the story was not over.

After the initial termination of benefits by my insurer, I was alienated and expressed my desire with attorney Gavidia to try and find an amicable separation for all parties. Attorney Gavidia tactfully used some facts and disputes of the initial claim to open conversation with the insurer’s attorneys. He developed a dialog proposing, although I remain totally disabled as defined by my plan, a lump sum buy out of my future monthly disability benefits. Attorney Gavidia was successful in reaching an agreement that was acceptable to all parties and made sure that I had the final say on acceptance or not.

Thus, working with Dell & Schaefer I had my benefits, which had been terminated, restored, received back-pay for benefits that were withheld and missed, and successfully and satisfactorily “divorced” from my insurance provider in the form of a lump sum buy-out of my future disability benefits.

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