Insurance

Each day, people put their faith in insurance companies such as Cigna assuming that when they purchase health, group disability, dental, medicare, AD&D and other supplemental insurance plans, these businesses will honor their obligations when an insurance claim is submitted. Unfortunately, Cigna has proven time and again that it will fail to quickly approve or even flatout deny valid insurance claims.

If Cigna undervalued, delayed payment, or even denied your disability insurance claim outright, you’re not alone. Call Donahue & Horrow today to fight back against Cigna and the company’s history of putting profits over people.

We’re a Los Angeles-based law firm that has successfully secured millions of dollars for our clients for their denied disability claims from the likes of Cigna and other major insurance providers. 

Call us today if you think that you’ve been treated unfairly or unethically by Cigna: (877) 664-5407.

 

About Cigna – A Fortune 100 Brand 

Cigna is one the largest health insurance companies in the United States, and was recently ranked No. 65 on the Fortune 100 list. The organization offers various insurance policies to individuals, families, and businesses, including life, accident, disability, dental, and supplemental insurance.

Cigna is operated by Life Insurance Company of North America, also known as LINA. In December 2018, Cigna completed its $54 billion merger with Express Scripts, creating a health insurance and pharmacy benefits management juggernaut. This transaction helped Cigna accelerate the company’s growth, with total revenues reaching $153.6 billion in 2019, while net income increased 28% to $5.1 billion, and adjusted income from operations grew 20% to $6.5 billion.

Cigna is swimming in cash, but as a publicly-traded company on the New York Stock Exchange, the business is beholden to its executive board, shareholders, and the bottom line, rather than keeping policyholders’ well-being at the forefront. If you suspect that Cigna has been intentionally delayed paying or has even denied your long-term or short-term disability insurance claim, call the Donahue & Horrow legal team today: (877) 664-5407. We’re available to answer any questions you may have about your insurance policy or delayed or denied insurance claim. 

Donahue & Horrow is based in Los Angeles, but we routinely handle cases throughout California, including in San Francisco, Central California, Sacramento and San Diego. Call us at 877-664-5407. Our legal team is ready to talk to you on the phone or set up an in-person meeting, whichever suits your schedule best. 

 

Cigna Tactics In Denial of Disability Insurance Claims

Every month, Cigna is sued by another policyholder for delaying payment or denying a valid insurance claim altogether. Insurance companies the size of Cigna employ all-too-familiar tactics to deny policyholders’ valid insurance claims by:

• Ignoring the insured’s statements about their actual, everyday occupational demands as an excuse to deny your claim;
• Using biased physician reviews to wrongfully deny or terminate disability insurance benefit claims; and
• Not advising and educating customers about the appeal process after an insurance claim denial. 

 

It may seem daunting to take on an insurance company, let alone one the size of Cigna. These large insurance businesses often resort to “wearing down” policyholders like you in the hopes that you will give up rather than fight for your benefits. If Cigna has tried one or more of these tactics on you, it might be a clear sign the business is trying to fraudulently deny your insurance claim:

• Repeatedly making burdensome requests for more and more documentation, which often duplicates documentation you already submitted;
• Downplaying medical evidence – including objective and subjective data – which supports the disability or entitlement to insurance benefits;
• Resorting to requesting so-called “independent” medical reviews by unqualified physicians or individuals; or
• Lengthy delays in making a decision on a disability insurance claim.

 

LINA and Cigna’s Settlement with The California Department of Insurance

While Cigna is required to treat policyholder’s like you fairly, a recent settlement with the California Department of Insurance and four other states’ Departments of Insurance makes it clear why you may not have received a fair assessment of your claim. The treatment of your claim may be part of a larger pattern and practice of improper claims handling.

Because of Cigna and LINA’s unfair claims handling, LINA was required to pay a $500,000 penalty to the California Department of Insurance, and set aside $77 million for payments to policyholders whose claims were not handled properly.

In addition to paying the fine and re-evaluating previously denied LTD claims, under the agreement with the California Department of Insurance, Cigna and LINA are required to:

• Enhance claim procedures to improve the claims handling process to benefit current and future policyholders like you.
• Establish a program in which the companies’ enhanced claim procedures will be applied to certain previously terminated claims.
• Participate in a two-year monitoring program by five states’ insurance departments.
• Pay fines and fees totaling $1,675,000 to the five lead states.

 

The “enhanced claims procedures” that LINA and Cigna were required to implement include:

• Procedures regarding the weight to be given to awards of Social Security Disability Income benefits;
• Enhanced procedures regarding the gathering of medical information and the documentation of conclusions;
• Guidelines/or Use of External Medical Resources (i.e., following guidelines when utilizing Independent Medical Examinations or Functional Capacity Evaluations and providing claims personnel and outside professionals with all available medical, clinical and vocational evidence, including both objective and subjective evidence of impairment);
• Ongoing objectives (such as the CIGNA Companies’ claim)
• Selection of Evaluation Personnel;
• Professional Certification; and
• Providing Medical, Clinical, and/or Vocational Evidence.

 

Real Examples of Cigna Denying Claims

Cigna has become notorious for the company’s claims denials in recent years, especially as they pertain to the Employee Retirement Income Security Act (ERISA). Practically every month, Cigna is sued a by dozens of policyholders, who were provided disability insurance by their employers, but then Cigna failed to honor the terms of the insurance policy. If this happened to you, call Donahue & Horrow.

In 2018, Cigna was served with its second class-action lawsuit for allegedly conspiring with a claims administrator to overcharge policyholders with hidden medical fees. The case was filed in the United States District Court Eastern District of Pennsylvania. The other class-action lawsuit was filed in California, where a beneficiary alleged that the business passed on administrative costs to policyholders rather than using the premiums and plan fees to cover such expenses.

In 2019, Cigna and American Specialty Health, the insurance company’s third-party claims administrator, settled these two class-action lawsuits for $20 million. Although the organization refused to admit any wrongdoing in these cases, Cigna and American Speciality Health agreed to rectify their practices to make improvements to these shady claims practices. 

 

Claims Processes Have a Timeline – Act Now!

Cigna sees policyholders as a number rather than an individual. If you’re dealing with a denied insurance claim from Cigna, we urge you to take action and don’t delay fighting back against the insurer! All insurance claims have deadlines that must be met if you hope to collect the insurance benefits you’re owed. This is especially true if your claim is governed by ERISA, which Cigna has shown the company doesn’t respect. Call us today at (877) 664-5407. Our legal team will treat you with the dignity you deserve while fighting relentlessly to secure the insurance benefits you’re owed. 

If you have any questions, call us now. Insurance policies are complex and written by lawyers, so it often takes a law firm to interpret the terms of the policy. Each case is unique. We’ll assist you in deciphering your Cigna policy, regardless of the type of insurance policy you purchased. Call us today for a free consultation: (877) 664-5407.