CIGNA, also known as LINA (Life Insurance Company of North America) and New York Life Insurance Company, has a long history of wrongfully denying long term disability claims. In fact, hundreds of lawsuits are filed against CIGNA & New York Life every year by disabled individuals who have been wrongfully denied benefits.
CIGNA and New York Life typically denies claims for the following reasons:
Lack of medical support or documentation
Alleging your disability, injury or sickness is not severe enough to prevent you from working
Argues that your condition has resolved and you should be able to return to work or work in another occupation
On top of these reasons, CIGNA and New York Life also think that you will not appeal. This gives them a great incentive to try to deny claims because they believe people will not put up a fight.
As soon as you receive a call or letter from CIGNA/New York Life informing you that your LTD claim has been denied, you should start preparing your appeal and consult with an attorney to discuss your legal rights and options.
Under your LTD policy, you are given 180 days to file your appeal. This may seem like a long time; however, when it comes to obtaining medical documentation, vocational opinions, and writing the formal appeal, it is much less time than you think, and you want to utilize it wisely.
Before filing a formal written appeal, we typically request a copy of the the claim file, summary plan description, ERISA plan documents, medical documentation, internal communications, work logs and claim notes, all correspondence, and the company claims manuals. After we receive this information, we conduct an in-depth review and investigation to find out specifically why you were denied, and who denied you.
Following this, we then reach out to your doctors and request medical reports and opinions. We also request that your doctor provide a rebuttal or clarification statement against the insurance company's doctor's findings. After receiving documentation from your doctor, we consult with vocational experts and consider whether a vocational opinion would be needed to further support your disability claim.
Finally, only after all of this documentation and support is obtained, we begin to draft your formal written appeal. Our written appeals can sometimes be up to 20 pages in length and include various legal arguments and references to case law precedent, all arguing why your disability claim should be approved.
Once the appeal is submitted, we continue to work with the insurance company along the way to ensure that a proper review is being conducted and that a timely decision is being made.
If the appeal is again denied, you may have the option of filing a second appeal, or filing a lawsuit against the insurance company in Federal Court.
An attorney is not required to file an appeal, but we highly recommend to at least consult with one so you can be informed of your legal rights and options. After a final decision by your insurance company has been made, it may be too late to provide additional evidence and documentation, which hurt your chances if you decide to proceed with a lawsuit.
Operana Law is always happy to provide a free consultation and appeal strategy guide at no cost. If you decide that you want an attorney to help, we never charge any fees unless we are successful in recovering your benefits.
Send us a message or give us a call at 855-999-1969 today.