CIGNA had attempted to terminate our client’s claim for long term disability benefits, a claim in which they had previously terminated, only to voluntarily reinstate benefits while in litigation, back in 2008. Two years later, CIGNA again made efforts to terminate the claim, on the purported basis that our client’s treating physicians no longer supported her impairment.
In order to achieve this result, CIGNA intentionally miscast the doctors’ opinions, and performed a cursory medical review, which on administrative appeal, we were able to destroy medically. We demonstrated that CIGNA’s claim determination had no reliable evidence to support its position, and provided a wealth of additional claim support. Our client’s claim is being re-opened and she will be paid all of the benefit appears.
This is a prime example of an insurer seeking to wear down a claimant’s treating physicians, and why claimants need to remain vigilant in the claim process, even if their claim has been paid for a long period of time, or even where an insurer capitulates in litigation and agrees to pay the claim.
Our effective advocacy of this claim has helped ensure a happy holiday season to our client.