Denied by Cigna? Take These 3 Steps to Protect Your Rights
As one of the country’s largest insurance companies, Cigna offers health insurance, life insurance, and disability insurance products. Unfortunately, Cigna has a long history of denying valid short-term and long-term disability claims. Cigna recently announced the sale of its disability insurance business to New York Life for $6.3 billion, but claimants shouldn’t expect the company’s practices to change anytime soon.
At Bryant Legal Group, our disability insurance lawyers have helped people fight back against unfair denials from Cigna for years. In this article, we’ll outline three essential steps you should take if Cigna denies your disability claim.
Cigna Has a History of Improperly Denying Disability Insurance Claims
Most people associate Cigna with healthcare insurance due to the company’s massive market share in this area. However, Cigna also operates a robust disability insurance business. In 2018, the company earned $48 billion in adjusted revenue, and more than $5 billion of that total came from disability insurance and life insurance.
Like many insurers, Cigna tries to maximize profits by using aggressive tactics against policyholders and denying as many claims as possible. In the past, state insurance regulators have alleged that the company broke the law when processing disability claims. While reviewing Cigna’s claims procedures, five different state insurance regulators discovered that the company may have wrongfully denied or terminated claimants’ long-term disability benefits.
In 2013, Cigna entered a settlement with the state governments of California, Connecticut, Maine, Massachusetts, and Pennsylvania. As part of this settlement, the company agreed to hold $77 million to potentially pay valid LTD claims it had earlier denied. The insurer also agreed to ongoing monitoring of its claims processes and promised to implement certain improvements. However, Cigna continues to deny many legitimate disability insurance claims.
Denied by Cigna? Here’s What You Need to Do Next
For most Cigna disability insurance claims, the Employee Retirement Income Security Act of 1974 (ERISA) applies. This federal law creates a two-step appeal process.
To begin the process, you must complete an administrative or insurance company appeal. During this phase, you can submit new evidence that supports your claim, including medical records and expert opinions. The insurance company should then review this information and issue a new decision.
While a small number of cases get resolved at the administrative level, insurance companies tend to uphold their initial denials. If this happens to you, then you can file a federal lawsuit. However, there are some limitations at this phase; notably, you cannot submit any additional evidence or request a jury trial.
To give yourself a fighting chance during this complicated appeal process, the team at Bryant Legal Group suggests the following steps.
1. Request Your Insurance Company File as Soon as You Get a Denial Letter
If you didn’t have help from a lawyer during the application phase of your claim, you should request a copy of your administrative or insurance company file. This file contains all of the information the adjuster considered when denying your claim. (If you had a lawyer at the application phase, they should request your file for you.)
Often, these files are incomplete or contain inaccurate assessments from insurance company experts and physicians. During your administrative appeal, you’ll want to fill these gaps and prove you’re disabled.
It takes time to collect medical records and consult with experts. To make sure your lawyer has enough time to build up your case, you should order your Cigna file as soon as possible after the adjuster denies your claim.
2. Keep Getting Treatment
Insurance companies and judges will never rely on your word alone in a Cigna disability insurance claim. Instead, they will demand evidence and information from medical professionals that supports your claim and establishes your disability.
Every time you see your doctors, they will document your symptoms, the progression of your condition, and your limitations. When your doctor orders objective medical tests like CT scans, MRIs, nerve conduction studies, and bloodwork, the results can confirm that you have a specific condition. All of this information is essential to proving your disability insurance claim.
Also, if you successfully appeal your long-term disability claim, you’ll need to show that your disability is ongoing. Again, medical records are vital to this process.
3. Consult a Disability Insurance Lawyer
It’s not easy to appeal Cigna’s denial of your LTD benefits. A successful appeal almost always requires a detailed understanding of disability insurance law and a strong body of evidence. You’ll also need to follow strict procedures, and a single mistake or missed deadline can kill your claim.
Many of our disabled clients struggle with fatigue, mental cloudiness, and rigorous treatment plans. They simply can’t manage a complicated appeal on top of everything else.
When you work with an experienced disability insurance attorney from Bryant Legal Group, you don’t have to worry about appeal procedures, deadlines, or medical records requests. Instead, you can focus on your health and leave the complicated legal details to us.
Bryant Legal Group: We Stand Up to Cigna
At Bryant Legal Group, we help people with disabilities appeal unfair denials from Cigna. We’ve built a reputation as one of the top disability insurance law firms in Chicago and all of Illinois, and we’re ready to fight the insurance companies on your behalf.
Cigna. (2019, March). 2018 annual report. Bloomfield, CT: Cigna. Retrieved from https://www.cigna.com/static/www-cigna-com/docs/about-us/investor-relations/annual-reports-and-proxy-statements/cigna-2018-annual-report.pdf
Cigna. (2019, December 18). New York Life to acquire Cigna’s group disability and life insurance business [press release]. Retrieved from https://www.cigna.com/about-us/newsroom/new-york-life-to-acquire-cignas-group-disability-and-life-insurance-business
Sturdevant, M. (2013, May 22). Cigna sets aside $77 million in a long-term-disability settlement with regulators in five states. Hartford Courant. Retrieved from https://www.courant.com/business/hc-xpm-2013-05-22-hc-cigna-disability-settlement-20130522-story.html
The content provided here is for informational purposes only and should not be construed as legal advice on any subject.