CIGNA Terminates Claim, DIY Appeal Fails, We Get Settlement
Wednesday, May 22nd, 2013
An AV technician was disabled due to cervical spinal stenosis and post-surgical chronic pain. CIGNA paid him monthly benefits for nearly two years, and then terminated his claim. The employee filed an appeal on his own, without benefit of legal representation, and CIGNA denied the appeal.
At that point, Frankel & Newfield was retained to file a lawsuit against CIGNA for wrongful termination. It’s not our favorite time to be brought into the case, because so many of the problems that we know to address further upstream are already embedded into the matter. But our experience and knowledge of CIGNA gave us the ability to bring this case to a successful conclusion.
We started by attacking CIGNA’s failure to consider the physical limitations that our client suffered. CIGNA had erroneously reviewed only select medical records, and also failed to have those medical records reviewed by qualified and trained personnel. CIGNA relied on a flawed vocational analysis of the duties and tasks that his job required, and completely overlooked the decision of the Social Security Administration to award him benefits, which uses a far more rigorous standard to determine if someone is disabled.
We were able to reach a resolution with CIGNA so that the litigation was resolved in a reasonable period of time, and at a value that our client was very happy with.
The take-away from this case – long term disability insurance claims are not easily navigated by claimants. Whether that is deliberate or not does not matter – what matters is taking steps to ensure that you and your family are protected in the event of a claim.