• Sedgwick Ignores Medical Records and Denies Disability BenefitsSedgwick Ignores Medical Records and Denies Disability Benefits
  • Sedgwick Claims Management Services Disability Benefit ClaimsSedgwick Claims Management Services Disability Benefit Claims
  • Third Party Administrator Role in Disability Insurance ClaimsThird Party Administrator Role in Disability Insurance Claims

Disabled engineer from Philips Electronics North America sue Sedgwick Claims Management Services Inc. for denial of long term benefits claim

In the case of Andrew Gary Sigai V Sedgwick Claims Management Services, Inc. and Philips Electronics North America Corporation, as Administrator of the Philips Electronics North America Long Term Disability Program, the plaintiff Gary Sigai, through a disability attorney, filed a lawsuit against Sedgwick Claims Management Services, Inc (Sedgwick CMS) at the District Court for the District of Kansas.

The Alleged Facts of the Sedgwick Disability Benefit Denial

The plaintiff, a highly qualified individual with a Bachelor of Science degree, a Master’s Degree and a Ph.D. in Chemistry, was an engineer working in the fluorescent product development department Philips Electronics North America Corporation (Philips). One of the perks of the plaintiff’s job included participation in the Philips Electronics North America Corporation Long Term Disability Program (LTD Plan). The LTD plan was administered by Philips with Sedgwick Claims Management Services (Sedgwick CMS) as the Claims Administrator.

Prior to working with Philips, the plaintiff already had a prior history of heart attack. However, towards early 2007, the plaintiff began experiencing more health problems including difficulty in regulating his diabetes and blood sugar levels. He would frequently experience “shakes” and have to sit down at his desk and lower his head. Even slight physical activities like walking through his work area will tire the plaintiff and would require him to sit down. In addition, he had to frequently take naps through his lunch hour in order to be able to complete his work day.

As a result of his health problems, the plaintiff was forced to stop working on April 30th 2007. Subsequently, he applied for social security disability benefits with the Social Security Administration (SSA) and was determined to be disabled and eligible for social security disability benefits by the SSA on February 26th 2010. The Social Security Administrative Judge determined that the plaintiff was unable to perform any past relevant work, and that there are no jobs that exist in the economy which the plaintiff could perform.

The plaintiff’s multiple medical issues prior to him leaving Philips’ employment included Coronary artery disease, Diabetes, Hypercholesterolemia, Hypertension, Lung disease and Sleep Apnea. On May 20th 2010, the plaintiff submitted a claim for LTD benefits under the above mentioned LTD plan. His claim was however denied by Sedgwick CMS on May 21st 2010. In response, the plaintiff submitted an appeal November 12th 2010. This appeal was also denied by Sedgwick CMS on January 17th 2011. With this denial, the plaintiff stated in the lawsuit that he had exhausted all his administrative remedies.

Relief sought by the Plaintiff

The plaintiff alleged in that the actions of the LTD Plan Administrator and Sedgwick CMS constituted a violation under ERISA and entitled the plaintiff to declaratory relief from the Court and/or the enjoining of the actions of the Plan Administrator and Sedgwick CMS which violate the terms of the Plan and properly enforce the terms of the Plan. As such, the plaintiff requests the Court for the following relief:

The plaintiff also requested a trail by Jury and that the trial is held at Wichita, Kansas.

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FAQ

Do you help Sedgwick claimants nationwide?

We represent Sedgwick 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 Sedgwick disability insurance policy?

Our disability insurance lawyers help policy holders seeking short or long term disability insurance benefits from Sedgwick. 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 Sedgwick.

How do you help Sedgwick claimants?

Our lawyers help individuals that have either purchased a Sedgwick 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 Sedgwick:

  • 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.

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It was an excellent experience working with Stephen Jessup, Esq. and Vanessa Arriaga, paralegal, on my appeal claim! They are a great team and did an amazing job to obtain a positive result for my case. They were focused, knowledgeable and efficient – and, they took the burden of dealing with the insurance carrier off of my shoulders. I am grateful to have the opportunity to thank them for their expertise and guidance during a difficult time.

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