Last August, a U.S. District Court reversed CIGNA’s termination [Federal Court Reverses CIGNA] of long term disability (“LTD”) benefits. The court found that CIGNA had failed to identify any evidence that the claimant’s condition improved to justify terminating LTD benefits. However, the Court ruled that while the claimant had proven that he was disabled under the LTD policy’s “regular occupation” period, CIGNA had to be given the opportunity to determine if the claimant were disabled under the policy’s subsequent “any occupation” period.
As more than four months had elapsed, and CIGNA still had not rendered a decision, I faxed a letter warning that I would file a new action unless I received CIGNA’s decision by the end of the week. The following day, I was advised that CIGNA would find the claimant unable to perform any occupation, and was approving continuing LTD benefits. As a result, in addition to LTD benefits, my client will also receive coverage under health, life, and dental policies. It seems to me that CIGNA could save a significant amount of money in administering LTD claims and in attorney fees if it would pay patently supported claims.