Disability Insurance Industry Update

The pressure on disability insurance companies to protect profits is soaring. COVID-19 has impacted the business in numerous ways. There are two things we expect to see as a result:

A dramatic increase in disability claim denials.

We have already seen this trend with the number of claimants calling the firm regarding UNUM disability claims. It began in early June, and we expect it to continue for UNUM and expand to other companies.

Profits come first, and one way to manage profits in a low interest environment is to deny benefits. There’s no downside for insurance companies to deny benefits – they can’t be sued for the financial and personal disasters that happen when benefits are denied.

With no penalties, claim denials are a low-cost way to protect insurance company assets.

Layoffs in the disability claims area, leading to increasing delays in processing claims.

It takes a lot of employees to make multi-national insurance companies work. The overhead costs of such a big payroll is just a starting point. Consider in addition to payroll, the cost of payroll taxes, FICA, health insurance (yes, even for an insurance company), life insurance, disability insurance and retirement contributions. Cutting personnel in claims is almost a solution to preventing claims from occurring. There’s no hurry to process claims, so if more people have their claims delayed because there are fewer employees, it is not a loss seen in the company balance sheet.

The employees feeling this pressure are more likely to seek to find claims for closure, to become more of an asset to the disability unit, and enhance profitability. This is a dangerous combination for claimants.

Cigna Disability Claims & Cigna Disability Appeals

Disability insurance lawyers Frankel & Newfield represent claimants whose disability benefits have been denied by CIGNA or its affiliate life insurance company LINA (Life Insurance Company of North America). Most of CIGNA’s disability coverage is provided to large and small companies, rather than individual policies, which means that they are governed by ERISA, a federal law with many strict procedures.

If your CIGNA or LINA disability benefits have been denied, we recommend that you call us today for a free consultation at 877-LTD-CLAIM (877-583-2524).

Clients Choose Us Because We:

  • Have recovered $200M+ for our clients.
  • Have seen your situation before.
  • Are aggressive in our approach.
  • Know the tactics used by the insurance companies.
  • Hold high AV Ratings & received the Super Lawyers designation each year.

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How do I submit a successful CIGNA Disability Insurance Claim?

Submitting a group disability claim to CIGNA is not as simple as logging into the company's MYCIGNA portal and answering some questions. It is great that CIGNA has a mobile app and a claimant portal, but we caution any disability policy owner to take the application process carefully. Be cautious, be concerned.

What particular concerns should I have?

What is a Disclosure Authorization?

Like many disability insurance companies, CIGNA asks for a Disclosure Authorization and provides one on its website. The expectation is that you will just download it, sign it and send it in. But take a minute before you do to protect yourself:

  • First, look closely at the document.
  • Read it and understand that you are giving CIGNA legal authorization to review nearly everything about you, from your tax returns to medical records to your financial, earnings, credit report and employment history.
  • Here’s the catch: You are told you are not required to complete the form, but unless you do, CIGNA and any of its third-party companies may not be able to “evaluate or administer your claim” and so will deny you any benefits, coverage or services.

So what are you supposed to do? In your mind, you have no choice.

The attorneys at Frankel & Newfield have successfully represented many CIGNA disability insurance policyholders in their quest to obtain or maintain their short term and long-term disability insurance benefits from CIGNA or LINA.

We have you protected

Read a Recent Success Story

We work with clients who have:

  • CIGNA short term disability claims
  • CIGNA long term disability insurance claims
  • CIGNA ERISA denied or terminated claims
  • CIGNA ERISA and Non-ERISA appeals
  • CIGNA litigation nationwide

As shown above, Frankel & Newfield help CIGNA and LINA claimants at various stages of their claim, to help ensure that they are treated fairly and get the short term or long-term disability insurance benefits that they are entitled to.

How Does Frankel & Newfield Help CIGNA Disability Policyowners?

Claim Filing and Monitoring

We help claimants with initial claim processing development and submission, representing claimants for both short term disability insurance and long-term disability insurance claims. By being involved at this early stage of the disability claim process, we can help to ensure that our client's doctors are able to effectively articulate the functional impairments and deficits faced by our clients, to most strongly support the claim.

We also address any requests for physical or psychological examinations during the claim process, or a request for a Functional Capacity Evaluation or interview request.

ERISA Appeals of Denied or Terminated Claims

Frankel & Newfield help claimants whose ERISA or non-ERISA claims have been denied or terminated and are required to undertake an ERISA appeal, before they have the ability to pursue litigation against CIGNA.

Our appeal formula for success in overturning a denied or terminated long term disability insurance claim addresses a myriad of issues including medical, vocational, factual and legal.

We create a robust appeal that has a dual audience. First, we submit the appeal for CIGNA, trying to get them to overturn their claim determination by showing them the egregious nature of the process and decision. The second audience, is the Federal Judge who may ultimately have to decide your claim if CIGNA does not change their mind upon consideration of the appeal.

Our thanks to David, who wrote this review on AVVO:
"As a result of my disability claim with Cigna being terminated I needed to file an appeal to get it restored. After some research on which firm would best handle this case, I emailed Frankel and Newfield, P. C. With a brief description of my case. Within minutes of sending the email I received a call from Jason Newfield. Mr. Newfield was able to answer all my questions and informed me I had a very strong case. As a result of our very informative and cordial call, I decided to hire Mr. Newfield’s firm to file the appeal. Mr. Newfield and his Senior Paralegal "Christina Murray" were amazing dealing with Cigna. They took complete charge of my case and walked me through everything from start to finish and the end result was full restoration of my benefits. I highly recommend their firm!" David

Can You Help Me with CIGNA ERISA Litigation?

ERISA litigation is one of the things we do most effectively for our clients. Frankel & Newfield helps claimants pursue their rights against CIGNA or LINA in Federal Court – and either get resolution to their claims, or closure to their concerns through a settlement.

We have successfully litigated against CIGNA on numerous occasions, and have an intimate knowledge of how CIGNA’s claim handling and ERISA appeals unit works, and its strategies in litigation, to most effectively combat CIGNA in litigation.

How CIGNA Works to Deny Your Claim

Leveraging our experience in litigation leads to the most advantageous results for our clients. We often resolve cases in litigation, or have clients return to claim status. Here are some examples of how CIGNA and LINA have tried to stop paying disability claimants – and why we fight so hard for our clients:

The corporate culture of disability claim denial and termination at CIGNA/LINA 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/LINA 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/LINA were the following:

  • Failing to adopt and implement reasonable standards for the prompt investigation and processing of claims arising under its insurance policies;
  • Failing to represent to claimants’ pertinent facts or insurance policy provisions relating to a coverage at issue;
  • 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;
  • Failing to perform any functional testing or peer review of medical records on file;
  • Failing to consult with health care professionals who have appropriate training and experience in the field of medicine involved in the medical judgment;
  • 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;
  • Failing to provide complete information in the file to the health care expert performing a medical review of the records;
  • 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/LINA thus agreed to adopt various "enhanced" procedures, including the following:

  • Given more appropriate consideration to awards of Social Security Disability Income (SSDI);
  • Gathering and analyzing medical records for the claimant's full medical history;
  • Enhancement of its use and selection of External Medical Resources;
  • Providing full and complete documentation to its various vocational and medical resources.

Your CIGNA claim may be subjected to many of the above-noted deficient claim handling approaches, which have already been found by a court to be handled improperly.

This cannot be overemphasized: Your claim is likely being subjected to the same incorrect processes. That’s why you need counsel to protect your rights.

Contact Us Today to Get Help with Your CIGNA or LINA Claim

All long-term disability insurance claimants on claim with CIGNA or LINA should carefully consider whether CIGNA is upholding its obligations under the settlement in its claim handling.

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 ERISA clients nationwide.

Jason A. Newfield

Written By:

Jason A. Newfield

Disability Insurance Attorney