Cigna Long Term Disability Insurance Claims
The attorneys at Frankel & Newfield have successfully represented many CIGNA disability insurance policyholders in their fight to obtain or hold onto their disability benefits. We work with clients on CIGNA short term disability claims, as well as long term disability insurance claims.
CIGNA disability claims disputes led to a $77 million settlement in 2013 following investigations by insurance commissioners from Connecticut, California, Massachusetts, Pennsylvania and Maine regarding improper denials of long-term disability claims and wrongfully terminated benefit payments. The settlement also required Cigna to improve their claims handling processes and establish a program to review long term disability claims that had been improperly denied or terminated.
Some of the specific allegations against CIGNA were the following:
1. Failing to adopt and implement reasonable standards for the prompt investigation and processing of claims arising under its insurance policies;
2. Failing to represent to claimants pertinent facts or insurance policy provisions relating to a coverage at issue;
3. Unreasonably denying claims where it was aware that the information it required for potential entitlement to benefits existed but was not obtained or reviewed prior to making the denial decision;
4. Failing to perform any functional testing or peer review of medical records on file;
5. Failing to consult with health care professionals who have appropriate training and experience in the field of medicine involved in the medical judgment;
6. Terminating claims during the “any occupation” definition of disability without performing a transferable skills analysis and labor market survey to identify alternate occupations appropriate to the claimants based on their restrictions, limitations, education, training and experience;
7. Failing to provide complete information in the file to the health care expert performing a medical review of the records;
8. Failing to clarify a claimant’s restrictions and limitations with the attending physician who was supporting disability.
As a result of its settlement with the numerous insurance departments who investigated these issues, CIGNA agreed to adopt various “enhanced” procedures, including the following:
1. Given more appropriate consideration to awards of Social Security Disability Income (SSDI);
2. Gathering and analyzing medical records for the claimant’s full medical history;
3. Enhancement of its use and selection of External Medical Resources;
4. Providing full and complete documentation to its various vocational and medical resources.
If you have had your LTD claim denied or terminated by Cigna between 2008 and 2010, it is possible that you are among the many claimants entitled to a review of your claim as part of the settlement.
More recent claims may still be subjected to many of the above-noted deficient claim handling approaches, which have already been determined to be problematic. All Long Term Disability insurance claimants on claim with CIGNA should carefully consider whether CIGNA is upholding its obligations under the settlement.
Regardless of when your long term disability insurance benefits were denied or terminated, you need the skilled guidance of an experienced disability insurance attorney that has represented Cigna claimants. Call our office today for a free consultation at 877-LTD-CLAIM (877-583-2524). Frankel & Newfield represents clients nationwide.
CIGNA sells healthcare options to individuals and large companies, but the bulk of its sales of long term disability insurance plans are sold to associations and unions. The policies mostly offer a very limited “own occupation” term, and once that short term expired, the definition of disability shifts to “any occupation.”