Another judge has criticized CIGNA for its claim handling of long term disability insurance claimants, determining that the decision to deny benefits to a man suffering from significant orthopedic impairments was an abuse of its discretion. The Court rested its determination upon a number of commonly seen tactics from CIGNA, and ultimately found that the claim review process was flawed and that the claimant was not afforded a full and fair review of his claim.
The Court focused upon the failure of CIGNA to give appropriate consideration to the consistent opinions of impairment of the claimant’s numerous doctors, finding such conduct to be problematic. The Court also was troubled by CIGNA’s failure to properly consider the occupational duties of the claimant, focusing instead on a generic definition of the claimant’s occupation, and not considering any of the specific job duties which the claimant engaged in.
Lastly, the Court was concerned that while CIGNA indicated objective evidence of impairment was required, it chose to ignore the objective evidence submitted by the claimant. Thus, despite the fact that the claimant’s award of Social Security benefits was not considered by the Court — as it was not within the administrative record, there was sufficient evidence to support impairment, and evidence to demonstrate that CIGNA abused its discretion.
The Court thus awarded payment of benefits, with pre-judgment interest and attorneys fees.
Rucker v. Life Ins. Co. of N.Am.