Three recent ERISA complaints were filed against CIGNA in Kentucky, New York and Texas for denying short-term and long-term disability benefits. In each of the cases, with the assistance of a disability attorney, the claimants are suing for claims that were allegedly wrongfully denied. Lets take a look at each case:
Case 1: Fifth Third Bank Employee
In Michelle C. v. Life Insurance Company of North America and CIGNA Corporation, Michelle and her Kentucky disability lawyer filed suit against the insurer in the United States District Court Eastern District of Kentucky Covington Division on August 23, 2011. Suing CIGNA for improperly denying her disability benefits, Michelle and her disability attorney have petitioned the District Court for:
- An Order directing CIGNA to turn over to Michelle and her attorney a “true and accurate copy of the entire contents of any and all files and documents” which the insurers used in making a decision concerning her disability benefits claim;
- Declaratory Judgment stating that Michelle is entitled to short term disability benefits as well as an award of the monetary value of those benefits, including prejudgment and post-judgment interest;
- An “injunction directing Defendants to pay [Michelle ] all future disability benefits as they become due”;
- An Order of restitution;
- Reasonable attorneys’ fees and court costs; and
- “Any and all legal or equitable relief as the Court deems appropriate” according to statute.
At the time of her declaration of disability, Michelle was employed by Fifth Third Bank Corp. as a Relationship Manager Officer. In 2008, Michelle was diagnosed with endometriosis, which caused Michelle to experience severe pelvic pain. After cauterization of the endometriosis, Michelle continued to suffer pain and underwent a partial hysterectomy in March 2009 to address the continuing issue. After the hysterectomy surgery, Michelle returned to her job and began having pelvic pain again, and that pain was increasing in severity and frequency. After 6 months of physical therapy in addition to acupuncture, massage therapy, cranio-sacral therapy and Reiki, during a routine ultrasound it was discovered that Michelle had a large cyst in her ovaries. Unable to solve the chronic pelvic pain and unable to work, Michelle applied for her CIGNA disability benefits.
CIGNA Denies Claimant Disability Benefits
In January 2010, CIGNA notified Michelle that her disability benefits claim was being denied, claiming that her treating physician merely recommended that she stop work to attend to a pain management plan and did not state that she was disabled from working at all. On April 19, 2010, Michelle ‘s physician did provide the insurer with an extensive history of Michelle’s condition, stating that unless Michelle found relief from her chronic pain, she would be unable to work. After exhausting all administrative appeals, Michelle engaged the services of a Kentucky disability attorney to file suit against the insurer to gain her entitled disability benefits.
Case 2: Goldman Sachs Employee
In Manuel A. v. CIGNA Life Insurance Company of New York, Manuel and his New York disability attorney filed a lawsuit against the insurer on September 6, 2011 in the United States District Court of the Southern District of New York. According to Manuel’s disability lawyer, Manuel is entitled to:
- A declaratory judgment that says the insurer violated Manuel’s rights pursuant to ERISA (the Employee Retirement Insurance Security Act of 1974);
- Payment of long term disability benefits from CIGNA from December 2, 2010 moving forward;
- An award of reasonable attorney’s fees and costs of the filing of this suit;
- Interest on unreceived disability benefits payments past due; and
- Other relief as the “Court deems just and proper.”
Claimant has been Disabled since 2004
An employee of Goldman Sachs, Manuel last worked at the company in December 2004. At that time Manuel suffered from osteoarthritis of his left which led to a total left knee replacement , cardiac conditions, and psychological and anxiety conditions. Finding Manuel to be totally disabled from these conditions, Manuel’s physician advised him to cease working. In June of 2005, Manuel was awarded disability benefits through the Social Security Administration which based its decision to award those benefits to Manuel on the merit of the same evidence Manuel presented to CIGNA. Having failed to examine Manuel, the insurer has to date denied Abad’s appeals, precipitating Manuel and his disability attorney to file the subject complaint.
Case 3: Employee of Sikorsky
In Douglas T. v. Life Insurance Company of North America (with CIGNA as the plan administrator), Douglas and his disability lawyer filed a lawsuit against the insurer in the United States District Court for the Southern District of Texas Corpus Christi Division on September 16, 2011. In the lawsuit, Douglas’s disability attorney prays that the Court provide Douglas the following relief.
- Long term disability benefits;
- Attorney’s fees;
- Cost of Court;
- Punitive and exemplary damages;
- Pre- and post-judgment interest; and
- Other relief the court sees fit to provide.
Suffering from multiple back issues, 60-year-old Douglas was a Quality Control Inspector for Sikorsky and his job required activities that Doug can no longer accomplish, such as lifting, pulling, pushing, bending, reaching and other movements that aggravate his back condition and cause severe debilitating pain. With his employer stating that the company could not accommodate Douglas’ disability, he was forced to cease working and apply for disability benefits. And, after appealing to CIGNA to reconsider his claim, which they did and denied, Douglas was left with no other remedy except to hire a disability attorney and go after his disability benefits through litigation.