Disability Insurance Attorneys Dell and Schaefer filed a Federal Lawsuit against Life Insurance Company of North America (LINA), which is part of CIGNA Corp (CI.N). The lawsuit was filed after Cigna refused to pay disability benefits to a Florida teacher forced to stop working due to mental health issues such as depression, bipolar disorder and schizophrenia.
According to the disability lawsuit, filed in the Middle District of Florida, Orlando Division, the teacher has been disabled since May of 2008 under the terms of the policy which state an employee is disabled if “he or she is unable to perform the material and substantial duties of his or her occupation, or solely due to Injury or Sickness, he or she is unable to earn more than 80% of his or her Indexed Covered earnings.”
Due to the legitimacy and severity of her condition, LINA approved the plaintiff for short term disability benefits. When the plaintiff submitted her claim for long-term disability benefits, LINA disapproved the claim, in clear violation of the policy’s stated terms and conditions. The plaintiff appealed the initial denial of benefits and LINA once again denied their claim.
As part of its review, LINA demanded additional medical records which the plaintiff provided. Although, In a May 20, 2010 letter to the plaintiff, LINA wrote, “At this time your claim has been closed and no benefits are payable.” LINA claimed the additional medical records do not provide any restrictions or limitations. LINA never had plaintiff examined by a doctor and relied on a paper review to deny disability insurance benefits.
The lawsuit states that LINA’s failure and refusal to pay the plaintiff for disability benefits constitutes a breach of LINA’s contractual obligations under the Disability Policy.
The plaintiff seeks judgment against LINA for damages including but not limited to past due contractual benefits, future benefits, interest, and attorney fees. This case is ERISA exempt. The plaintiff will be entitled to a jury trial.