Three Plaintiffs Sue Cigna Corporation For Wrongful Denial Of Long-Term Disability Benefits As Covered By ERISA

Cigna Corporation (Cigna) was sued in the Federal Courts of Maryland, Florida, and Pennsylvania by three Plaintiffs for long-term disability benefit violations under the Employee Retirement Income Security Act (ERISA). All three cases claim that Cigna wrongfully denied the Plaintiffs their deserved long-term disability benefit payments as defined by their respective plans.

The Maryland Case

In Claude M. Vs Cigna Corporation, Plaintiff was employed as a Small Craft Operator by The District of Columbia Water & Sewer Authority (DCWSA), thereby enabling him to participate in their group benefits plan, which was administered and insured by Cigna.

Plaintiff became disabled on June 22, 2006 due to degenerative spinal disorders that caused chronic pain, fatigue, cognitive defects, and other impairments. Plaintiff filed a claim for long-term disability benefits and received them until July 23, 2009, on which the benefits were terminated.

Plaintiff filed an appeal of this termination, but the appeal was denied on February 12, 2010. Along with the denial was appearance of new medical evidence that was never before shown to the Plaintiff prior to the issuance of coverage. Plaintiff, along with counsel, filed a comprehensive response on January 26, 2011, to which Cigna refused to respond. Plaintiff has exhausted all administrative remedies, leading to the filing of this lawsuit.

The Florida Case

In Raymond H. Vs Cigna Group Insurance (Cigna), Plaintiff was employed as a teacher by the St. Johns County School District from August 2001 until January 25, 2007 when he could no longer work due to a back impairment that caused severe and consistent pain. Plaintiff had purchased a Group disability insurance policy that provided disability payments when the policyholder met the definition of “Disability/Disabled.”

On or about November 7, 2007, Plaintiff was awarded disability benefits that would begin as of April 27, 2007. On or about May 22, 2008, Cigna informed Plaintiff that he was no longer eligible to receive benefits due to no longer meeting the definition of disability as defined by the Plan. This denial was appealed, and eventually, Plaintiff’s benefits were reinstated.

On March 24, 2009. Cigna informed Plaintiff that disability benefits would no longer be paid after April 26, 2009, which marked the end of the 24-month own occupation period as defined by the Policy. Plaintiff filed an appeal of this denial on August 18, 2009, but on November 5, 2009. Cigna upheld its original denial and allowed for a second appeal within 180 days of its decision. Plaintiff again filed an administrative appeal, but again, that appeal was denied by Cigna.

Plaintiff was allowed to file one more appeal, and did so. On January 14, 2011, Cigna again upheld its prior denial, but allowed Plaintiff to file another appeal within 180 days of its decision. Plaintiff again appealed the latest denial, adding new and material evidence from his treating physician. On August 1, 2011, Cigna again denied Plaintiff’s appeal, and this time, there was no further administrative remedy to pursue. As a result, Plaintiff has filed this lawsuit against Cigna.

The Pennsylvania Case

In Susan T. Vs Cigna Corporation, Plaintiff was employed as an Office Manager at Babcock, which was the Plan Sponsor of the Long-Term Disability Plan for its employees. Due to her employment, Plaintiff was covered by this Plan, which was administered and insured by Cigna.

Plaintiff had been employed at Babcock since October 17, 2001, but on or about February 6, 2010, Plaintiff became unable to work due to a diagnosis of inflammatory bowel disease and submitted a claim for benefits, which began on or about May 7, 2010.

On or about November 15, 2010, Plaintiff applied for long-term disability benefits through Cigna. On or about December 1, 2010, Plaintiff ceased working as an office manager due to many medical conditions, including inflammatory bowel disease, ulcerative colitis, and nausea. Cigna approved Plaintiff’s long-term disability claim, with benefits being paid between May 7, 2010 and April 15, 2011.

By letter dated April 15, 2011, Cigna informed Plaintiff that her LTD benefits would be terminated beginning April 15, 2011 due to the lack of information that proved that Plaintiff’s condition was an ongoing condition. On or about May 4, 2011, Plaintiff filed a timely appeal of this denial.

Via letter dated June 21, 2011, Cigna upheld its original denial to terminate LTD benefits. Plaintiff filed an appeal of this second denial on July 26, 2011. Cigna did not accept this second appeal because no new medical information was provided in the second appeal. Plaintiff has now exhausted all of her administrative appeals, and as a result, has filed this lawsuit against Cigna.

Plaintiffs Request The Following Relief From Cigna

In all of the previously mentioned cases, the respective Plaintiffs request the following relief be granted by the Court:

  • That Cigna pay the Plaintiffs all of the past benefits due to them, along with accrued interest.
  • That Cigna pay all appropriate attorneys’ fees, associated court costs, and other reasonable costs incurred due to the filing of this lawsuit.
  • That Cigna pay all other relief that the Court deems to be fair and proper.