Disability Benefit Claims Law Blog : Disability Benefits Lawyer & Attorney : Dell & Schaefer : Disability Insurance Claims Law Blog

Attorneys Seek Information In Order to Prove Conflict of Interest Impacted Claim Denial

Another case appeared recently before the United States District Court, Northern District of Indiana, Hammond Division. It sheds light on motions to compel. We will look at the background behind the motion before looking at how the Court evaluated the need for discovery into a disability insurance company's claims decision process. This case is another example of how a disability insurance company will fight with great effort to hide their potentially unreasonable claims handling activities.

BP Corporation of North America employed Clifford Hall for 27 years as a process operator. On December 1, 2007 he was involved in the motor vehicle accident that caused serious neck and back injuries and a traumatic brain injury as well. He worked his last day at BP the next day.

→ Continue reading Life Insurance Company of North America (CIGNA) ordered to supply information to disability insurance attorneys

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The case we will look at here demonstrates once again how reviewing a disability denial under the abuse of discretion standard can favor an insurance company's disability denial. All the insurance company must prove is that the process used to come to a claims decision was logical and reasonable. As you read the following case, it might seem that Jerry Darvell and his disability insurance attorney had good reason to believe he had been denied benefits wrongfully. You will discover why two federal courts decided otherwise.

→ Click here to continue reading LINA (CIGNA) denies long-term disability benefits to yellowbook Account Executive

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This case is a sad example of how a disability claimant can battle a disability insurance company in an ERISA lawsuit for several years and then have a Judge give the insurance company another opportunity to wrongfully deny disability benefits. 

As an employee of Philips Lighting Company, 55-year-old Ronald E. Cox had been a repairman and tradesworker for nearly 24 years. While he had earned his GED, he had never graduated from high school. His job's duties included installing, repairing, constructing and maintaining plant facilities and equipment. He fabricated and installed frames and supports for the tanks, kilns and other equipment in the plant facilities.

→ Click here to continue reading Life Insurance Company Of North America (CIGNA) wrongfully denies disability benefits to a Kentucky repairman

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Dalit Waissman took sued Life Insurance Company of North America (LINA) when the company terminated her long-term disability payments in May 2006. In arguments presented before District Judge Jeremy Fogel of the U.S. District Court’s Northern District of California, San Jose Division on January 20, 2010, Waissman’s disability attorney did his best to show that the material in Waissman’s claim’s file demonstrated beyond doubt that Waissman was disabled according to the definitions laid out within her former employer’s long-term disability plan.

→ Click here to continue reading Did LINA wrongfully deny disability payments to claimant with multiple sclerosis? (Part II)

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Dalit Waissman, a 53 year old who immigrated to the United States from Israel in 1984, came to her position at SAP, Inc. in 1997 with considerable experience in computer programming and educational consultation and resource coaching. She had spent the previous two years working as an independent contractor providing technical writing services.

SAP hired Waissman as one of their Senior Technical writers. The primary duties of her job according to SAP were to provide “excellent research, interviewing and writing skills: information mapping skills; instructional design skills; knowledge of the business cycles; knowledge of computer software, Windows applications and authoring tools; and HTML/Internet knowledge.”

→ Click here to continue reading CIGNA (LINA) terminates disability payments to woman with multiple sclerosis

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A long-term disability case brought before Lincoln D. Almond, U.S. Magistrate Judge in the District of Rhode Island, brings to light how important it is for a long-term disability attorney to prepare a discovery request carefully and to make every effort to resolve discovery issues without involving the court system. The case we are going to discuss could have gone more favorably for Lorene Roccon Thompson, if her attorneys had paid more attention to the details. Discovery in ERISA disability cases is extremely limited and generally is only allowed to determine the extent of a conflict of interest.

→ Click here to continue reading Discovery requests in ERISA disability cases are found to be limited

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Linda Chavis filed a complaint against Cigna Group Insurance and Life Insurance Company of North America (LINA) on June 24, 2009, alleging that the insurance company had breached two disability insurance contracts by refusing to pay her claims for short-term disability (STD) insurance and for long-term disability (LTD) insurance. While Cigna filed a motion to dismiss the complaint, Chavis stated in her complaint that she and her employer had paid all the required premiums for both policies, but she had been wrongfully denied benefits for both policies.

→ Click here to continue reading Court Finds CIGNA Failed To Follow Proper Claim Denial Procedure, Nurse's Right To Pursue Disability Law Suit Under ERISA Supported

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Mrs. Rebecca Duperry worked as payroll benefits HR administrator for Railroad Friction Products Corporation (RFPC) until April 7, 2006. Mrs. Duperry suffered from rheumatism, and stopped working in April pursuant to the advice of her rheumatologist. The rheumatologist told Duperry to ‘slow her work down’ and that cutting hours was a good idea, although working from home would be an even better idea.

October 16, 2006, Duperry claimed disability from three conditions,  rheumatoid arthritis, osteoarthritis and fibromyalgia. Among the documents Mrs. Duperry submitted to CIGNA Life Insurance Company of North America were two attending physician statements completed by Duperry’s primary care physicians, Dr. Glenn Harris, and her rheumatologist, Dr. Supen Patel. In his statement, Dr. Harris stated that “plaintiff was limited to zero hours per day of climbing, balancing, stooping, kneeling, crouching, crawling, reaching, walking, sitting, or standing, and that plaintiff would "never" be able to return to work.” A statement was made also by Dr. Patel that Duperry was ‘permanently disabled’ and therefore could not return to work.

→ Click here to continue reading Disability Benefits Ordered To Be Paid By CIGNA To HR Administrator Diagnosed Fibromyalgia

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Recently, the California Department of Insurance settled with LINA, a daughter company of CIGNA to the tune of $600,000. What was this penalty for? According to California Insurance Commissioner Steve Poizner, LINA was apparently ignoring certain claims that might have been valid disability claims.

Between January 1, 2005 and December 31, 2007 LINA improperly handled insurance claims. It seems that not only did LINA deny many cases before ever receiving the medical proof those clients were entitled to their insurance payouts but LINA ignored important information that may have reversed the denied claim on a number of accounts.

→ Click here to continue reading CIGNA/LINA Penalized By The California Department Of Insurance

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Our client, a pharmaceutical sales representative, was recently denied benefits by her carrier, Cigna, despite clear medical documentation of several severe medical problems that prevent her from performing the duties of her occupation.

→ Click here to continue reading Attorneys Dell & Schaefer Files Lawsuit Against Cigna In Hawaii On Behalf Of Pharmaceutical Sales Representative

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Cigna attempted to deny lifetime disability benefits for a claimant suffering from a psychiatric organic brain disorder, but the district court of Colorado disagreed. Following a remand from the court of appeals, which ruled the district court had erred by considering evidence outside the “administrative record,” the district court nonetheless reaffirmed its ruling in plaintiff’s favor after carefully considering all of the evidence in the record and analyzing each of the medical opinions presented.

→ Click here to continue reading CIGNA'S Attempt To Limit Claimant To A Maximum Of  2 Years Of  Long-Term Disability Benefits Limitation For An Organic Brain Disorder Such As Bi-Polar Is Reversed  By The District Court

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