Cigna Disability Insurance Claims Attorneys
Cigna Corp. is a Connecticut-based global health service company that provides health, pharmacy, dental, and supplemental insurance, as well as Medicare, plans to individuals and businesses. Cigna was the result of a 1982 merger of the Connecticut General Life Insurance Company (CG) and INA Corporation.
In January 2011, the California Nurses Association reported that Cigna denied 39.6 percent of its claims in the first three quarters of 2010, a 5.3 percent increase from its 2009 rejection rate. On May 22, 2013, the Hartford Courant reported that Cigna was setting aside $77 million to cover potential claim payments as part of a settlement with insurance regulators in California, Connecticut, Maine, Massachusetts and Pennsylvania after regulators claimed Cigna denied initial claims and ongoing claims that should have qualified for payment.
Do you or your loved one need assistance with a Cigna disability insurance claim? Do not think that you have to deal with all of the complicated issues on your own.
Abell and Capitan Law helps clients with all kinds of disability claims and knows how to help people obtain the benefits they are entitled to. Our lawyers can explore all of your legal options as soon as you call (267) 419-7888 or contact us online to set up a free consultation.
Do I Need A Cigna Disability Insurance Claims Lawyer?
Many Cigna plans are regulated by the Employee Retirement Income Security Act of 1974 (ERISA), which is the federal law establishing minimum standards for voluntarily established retirement and health plans in private industry. If your Cigna claim has been denied, you may need to file an ERISA appeal before you can pursue litigation against Cigna.
ERISA actions are incredibly complex, and they also involve very sensitive time limits. You do not want to wait to get an attorney involved in your case.
As soon as you hire a lawyer, they are going to be able to complete their own independent investigation into your case. The attorney can determine when Cigna may have committed an error in the administration of your benefits and fight to help you recover what you are entitled to.
You do not want to attempt to handle a Cigna claim on your own because Cigna may ask you or your doctor to complete several complex forms. In some cases, Cigna may assign an independent investigator to conduct surveillance on you and attempt to film you partaking in activities demonstrating that you are not disabled.
Why Choose Abell and Capitan Law To Handle My Case?
You will want to work with Abell and Capitan Law because our representation will come at no cost to you unless you receive your benefits. We charge no upfront legal fees.
Joe Capitan is a member of the Pennsylvania Bar Association, Pennsylvania Association for Justice, and Philadelphia Bar Association. Super Lawyers named him a Pennsylvania Rising Star every year from 2013 to 2017.
Erik Abell earned a Bachelor of Arts at the University of Kentucky and received his Juris Doctor from the Louis D. Brandeis School of Law at the University of Louisville. He litigates ERISA governed disability claims in federal courts all over the United States.
Our firm has three Pennsylvania offices in Newtown Square, Chadds Ford, and Philadelphia as well as a location in Louisville, Kentucky. Abell and Capitan Law will negotiate for a fair and full settlement to your case or take the matter to court when necessary.
Types of Cigna Disability Insurance Claim Cases We Handle
Cigna provides many kinds of group insurance, including short term disability and long term disability benefits. Short term disability covers people who are temporarily disabled for a limited period while long term disability applies to individuals who are disabled for extended periods. Most often its policies are underwritten by Life Insurance Company of North America, which is principally headquartered in Philadelphia, PA, the same location as one of our law firm’s offices.
People who are eligible for Cigna’s short term disability program will have to go through a waiting period before their coverage begins, so it is best to apply as soon as possible so you can be covered if you become disabled. Cigna will consider an injury or illness a disability if it makes a person unable to perform the material duties of his or her occupation. Each policy can define a person’s occupation differently.
A person will need to have proof of disability from a physician to obtain benefits, which can be more or less than 60 percent of a person’s weekly paycheck. Other income benefits, such as Social Security disability benefits can impact the number of benefits you receive from Cigna.
You will typically receive short term benefits for 13-26 weeks. An employer can ask for continued proof of disability.
Cigna’s long term disability insurance has a more extended elimination period, and more significant benefits are paid monthly. Most Cigna long term disability policies have an elimination period of three to six months and pay a monthly disability benefit of between 50%-66.67% of one’s pre-disability income. Most policies also contain a pre-existing condition exclusion and limitations for various types of disabling medical conditions, most often for disabilities due to mental health impairment.
The disability application process typically has three sections – the employee’s sections, an employer’s section, and the medical forms to be completed by an attending physician. More paperwork such as authorizations and an Activities of Daily Living Questionnaire will also commonly follow the filing of a short term disability or long term disability claim.
When you believe that your claim is taking too long to be resolved, you should contact your case manager. A case manager may not give you a satisfactory reason for your delays, and you will want a lawyer to speak to the case manager to get real answers. An attorney may be able to compel real action.
Cigna is required to provide written notice of denied group short term disability or long term disability claim by mail. The claim determination letter you receive should state the reasons for denial but should also inform you of your right to appeal, and it should also list the deadline you have to file an appeal.
Frequently Asked Questions (FAQs)
You might if you continue to satisfy Cigna’s definition of disabled. Cigna considers a person disabled when they suffer a covered injury or illness that leaves them unable to perform the material duties of their occupation or unable to earn 80 percent or more of their regular earnings. After you have been paid benefits for 24 months, you will be considered disabled if you are unable to perform the material duties of your occupation or you are unable to earn 60 percent or more of your indexed earnings solely because of your injury or illness.
During the first 24 months, your benefits can be reduced, so the combination of your benefits, earnings, and other benefits do not exceed 100 percent of your pre-disability earnings. Benefits are reduced by 50 percent of your actual work earnings after the first 24 months. If you receive benefits, return to work, and become disabled again from the same or a related cause, you will not be required to fulfill another elimination period if you have worked less than six consecutive months and you earn less than the percentage of your indexed earnings used when determining your disability during at least one month. When a second disability recurs beyond this limit or is unrelated to the first, a person has to file a new claim and fulfill a new elimination period.
Cigna plans pay no benefits for any disability resulting from a pre-existing condition unless the disability occurs after the person has been insured under this plan for 12 consecutive months. Pre-existing conditions are one of the most common reasons claims are denied, and are defined as conditions for which individuals have incurred expenses, taken prescription drugs or medicines, received medical treatment, care or services, or for which a reasonable person would have consulted a physician during the three months immediately prior to the most recent effective date of insurance.
Cigna also limits benefits for periods for mental or nervous disorders such as anxiety-disorders, delusional (paranoid) or depressive disorders, eating disorders, mental illness, and somatoform disorders (including psychosomatic illnesses) as well as for alcoholism and drug addiction or abuse to a lifetime limit of 24 months. Cigna does not pay benefits for a disability that results directly or indirectly from suicide, attempted suicide, or purposeful injuries to self, wars or any acts of war, active participation in a riot, commission of a felony, and the revocation, restriction, or non-renewal of a license, permit, or certification necessary for a person to perform the duties of their occupation unless solely due to injury or sickness otherwise covered by the policy. Cigna also does not pay disability benefits for any period of disability, during which a person is incarcerated for any reason.
Contact a Cigna Disability Insurance Claims Attorney Today
If you or your loved one are struggling with a Cigna disability insurance claim, you can give yourself a lot of relief by making sure you retain legal counsel. An experienced lawyer will know how to make sure your claim is properly filed and can help you exercise all appeal options if you are denied benefits.
Abell and Capitan Law understands that every person’s medical condition is different and tailors its strategies to each individual’s unique case. Call (267) 419-7888 or contact us online to take advantage of a free consultation.