• Cigna & New York Life  Strategies & Tips for a Disability Benefit Lawsuit After an Appeal DenialCigna & New York Life Strategies & Tips for a Disability Benefit Lawsuit After an Appeal Denial
  • A Disability Lawyers' View of Cigna Disability Claim HandlingA Disability Lawyers' View of Cigna Disability Claim Handling
  • Cigna Disability Appeal Tips Following Disability Benefit DenialCigna Disability Appeal Tips Following Disability Benefit Denial
  • Cigna ERISA Disability Benefit LawsuitsCigna ERISA Disability Benefit Lawsuits
  • Watch Out For a  Disability Benefit Denial Strategy Used By Cigna Insurance Co.Watch Out For a Disability Benefit Denial Strategy Used By Cigna Insurance Co.
  • 3 Important Steps to Take Following a CIGNA / LINA Disability Denial3 Important Steps to Take Following a CIGNA / LINA Disability Denial
  • Colorado Court Reverses Cigna Disability Denial of Geico EmployeeColorado Court Reverses Cigna Disability Denial of Geico Employee
  • Cigna Disability Benefit Denial Won on Appeal by Alex PalamaraCigna Disability Benefit Denial Won on Appeal by Alex Palamara
  • CIGNA Long-Term Disability Insurance Company (Ep. 6, part 1/2)CIGNA Long-Term Disability Insurance Company (Ep. 6, part 1/2)
  • CIGNA Long-Term Disability Insurance Company (Ep. 6, part 2/2)CIGNA Long-Term Disability Insurance Company (Ep. 6, part 2/2)
  • Cigna Disability Insurance Denial to Woman with Sjogren's DiseaseCigna Disability Insurance Denial to Woman with Sjogren's Disease
  • CIGNA Ordered To Pay Disability Insurance Benefits Beyond 24 Month Mental Nervous LimitationCIGNA Ordered To Pay Disability Insurance Benefits Beyond 24 Month Mental Nervous Limitation
  • Cigna Lump Sum Buyout & Settlement Disability Claim AssistanceCigna Lump Sum Buyout & Settlement Disability Claim Assistance
  • Cigna / LINA Long Term Disability Insurance Settlement Agreement InformationCigna / LINA Long Term Disability Insurance Settlement Agreement Information
  • Attorney Alex Palamara wins disability appeal against Cigna for Lockheed Martin employeeAttorney Alex Palamara wins disability appeal against Cigna for Lockheed Martin employee
  • We Win Long Term Disability  Appeal Against Cigna For Cardiac Cath TechnicianWe Win Long Term Disability Appeal Against Cigna For Cardiac Cath Technician

Cigna’s Termination of Disability Benefits was Arbitrary and Capricious

The case of Lani Kyle Moar v. Cigna Corporation, et al., demonstrates the lengths insurance companies will go to avoid paying long term disability benefits. This Plaintiff’s perseverance resulted in the Court ordering Cigna to pay past due benefits, but also gave Cigna a new chance to deny benefits in a way that will not be arbitrary and capricious.

It began in 2000 when Plaintiff, a flight attendant with United Airlines, was first awarded long term disability benefits when she developed lupus and congestive heart failure. Initially, she received benefits for 24 months when Cigna found she was disabled from working in her own occupation. Benefits continued even after the definition changed and Cigna agreed she was disabled from working in any occupation for which she was qualified.

In conjunction with Cigna paying her long term disability benefits, another policy issued by a company under the Cigna umbrella, also found she was eligible to maintain her life insurance policy, but not have to pay premiums under a waiver of premium (WOP) benefit for those found to be disabled.

Everything went well until March 2012 when Cigna terminated all benefits under both policies. On administrative appeal, after reviewing all medical records and conducting a three-day surveillance, both long term disability benefits and the WOP benefit were reinstated. This lasted until September 2015 when, once again, Cigna terminated all benefits. Her administrative appeal was denied and she filed this ERISA lawsuit.

The U.S. District Court for the Eastern District of Michigan ruled that the decision to terminate benefits was arbitrary and capricious and ordered the defendants to “pay Plaintiff any past-due benefits and commence paying the quarterly waiver of premium benefit and the monthly LTD benefit.”

Cigna’s Termination of Benefits was Arbitrary and Capricious

The Court did an in depth review of Plaintiff’s medical records and the reports of Cigna’s reviewing doctors and commented that “the case turns almost entirely on which doctors’ opinions should be privileged.” The Court also determined that Cigna’s reviewing physicians overlooked the conclusions that the Plaintiff’s lupus interfered with her ability to work, indicating the “denial was arbitrary.”

The Court acknowledged that “an insurer may change a disability determination based on [medical records], even if the claimant has received benefits for a long time…But, there must be a reason for the change.” In this case, there was “very little” to indicate that anything changed and that Plaintiff was no longer disabled.

The Court concluded that the reviewing doctors considering Plaintiff’s long-term disability benefits and her WOP benefit “relied on a fraction of the relevant medical evidence and failed to acknowledge the fluctuations that Moar’s lupus created. For those reasons, the denial was arbitrary and capricious.”

The Remedy

The Court ordered Cigna to pay Plaintiff past-due benefits. Unfortunately, the Court concluded that its ruling “does not confirm that Moar is or was disabled under the policies. Rather, the Court finds only that the decisions to deny Moar’s benefits were arbitrarily and capriciously made.” It essentially gave Cigna another opportunity to further review whether or not Plaintiff is still entitled to benefits.

This case was not handled by our office, but we feel it can be instructive to those who have received long term disability benefits and suddenly find themselves cut off by their disability insurer. For questions about this case, or any aspect of your disability claim, contact our disability attorneys at Dell & Schaefer for a free consultation.

DISABILITY INSURANCE COMPANY INFORMATION
Videos, Questions, Resolved Cases, Lawsuit Summaries & Company Reviews

disability insurance companies complaints

Leave a comment or ask us a question

FAQ

Do you help Cigna claimants nationwide?

We represent Cigna clients nationwide and we encourage you to contact us for a FREE immediate phone consultation with one of our experienced disability insurance attorneys.

Can you help with a Cigna disability insurance policy?

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.

How do you help Cigna claimants?

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
  • ERISA and Non-ERISA Disability Benefit Lawsuits
  • Applying For Short or Long Term Disability Benefits
  • Daily Handling & Management of Your Disability Claim
  • Disability Insurance Lump-Sum Buyout or Settlement Negotiations

Do you work in my state?

Yes. We are a national disability insurance law firm that is available to represent you regardless of where you live in the United States. We have partner lawyers in every state and we have filed lawsuits in most federal courts nationwide. Our disability lawyers represent disability claimants at all stages of a claim for disability insurance benefits. There is nothing that our lawyers have not seen in the disability insurance world.

What are your fees?

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.

Do I have to come to your office to work with your law firm?

No. For purposes of efficiency and to reduce expenses for our clients we have found that 99% of our clients prefer to communicate via telephone, e-mail, fax, GoToMeeting.com sessions, or Skype. If you prefer an initial in-person meeting please let us know. A disability company will never require you to come to their office and similarly we are set up so that we handle your entire claim without the need for you to come to our office.

How can I contact you?

When you call us during normal business hours you will immediately speak with a disability attorney. We can be reached at 800-682-8331 or by email. Lawyer and staff must return all client calls same day. Client emails are usually replied to within the same business day and seem to be the preferred and most efficient method of communication for most clients.

Dell & Schaefer Client Reviews   *****

Dawn H.

I am an attorney myself and I have been extremely impressed with the quality of the representation at Dell & Schaefer. Even though at the onset of my claim I lived in California working with the firm based in Florida was absolutely no problem. Their expertise in this area and the quality of their written appeal was outstanding and ultimately successful. My husband who is also an attorney and I are happy to recommend Rachel Alters and her firm to anyone who needs assistance with a disability insurance claim matter.

Read 424 reviews

Speak With An Attorney Now

Request a free legal consultation: Call 800-682-8331 or Email Us