On March 7, 2011, a federal appellate court ordered CIGNA to pay a claimant long term disability (“LTD”) benefits because its unfair tactics were found to be arbitrary and capricious.
The tactics of CIGNA that the appellate court described in Salomaa v Honda follow the same pattern and practice that I have argued in my cases against CIGNA. Salomaa discussed in detail how: (1) every doctor who examined the claimant concluded he was disabled; (2) CIGNA demanded objective evidence for a medical condition where no such evidence exists; (3) CIGNA failed to consider that the Social Security Administration found the claimant disabled; (4) CIGNA shifted its reasons for denying benefits each time the claimant refuted them; and (5) CIGNA refused to identity what information it would accept to support the claimant’s claim.
Last week, CIGNA upheld its termination of one of my client’s disability benefits. Not surprisingly, CIGNA followed its usual practice and pattern of reviewing disability claims, and employed each of the five tactics identified in Salomaa. The next appeal will highlight the similarities between Salomaa and my client's claim. Notably, when I litigated Alfano v. CIGNA Life Ins. Co. of New York, 2009 WL 222351 (S.D.N.Y. Jan 30, 2009) a couple of years ago, Judge Gerard Lynch, now on the Second Circuit Court of Appeals, ruled that similar tactics by CIGNA were arbitrary and capricious, and ordered CIGNA to pay my client’s LTD benefits and attorney fees.
If you have had an LTD claim denied or terminated by CIGNA, have an attorney review it to see if CIGNA did so in an unfair manner. It is best to allow the attorney to undertake the review before exhausting your appeals with CIGNA.