Cigna-Life Insurance Co. of North America Complaint - Cigna Sham--Disability Buyers Beware! You Are Not Protected
LOCKHEED MARTIN CORPORATION -- Where to even begin.
I have been fighting Cigna for 4 long years regarding my short and longterm disability insurance.
Like others who have testified on this site, my benefits were abruptly shut off and then I experienced a continual denial on each appeal for various different reasons starting with "We don't doubt that you have suffered from various medical problems, but believe they do not constitute total disability" to that of a "preexisting condition". Cigna utilizes an in-house nurse to rubber stamp rejections as their supposed medical review process.
I suffer from Interstitial Cystitis, Fibromyaglia, Depression, IBS, Degenerative Back Disease, Vulvoldynia, and Migraine Headaches. My medical records contain letters from 4 different urologists that state I must undergo longterm narcotic theraphy for chronic pain due to an incurable disease which causes intractable pain. My pain management doctor has attested to my inability in maintaining employment due to both physical and physcological limitations.
Like others on this site have stated prior to my review, Cigna ignored my doctors reports and medical records which declared me disabled. They also ignored the fact that the Social Security declared me disabled and incapable of any performing any occupation. In addition, Cigna has never even requested a physical examination performed on me by a doctor of their choice.
I appealed Cigna's denial decision to the State Medical Board. The State Medical Board required Cigna to have an "outside" (Cigna paid) medical doctor review my case. Cigna's doctor reviewed my medical records. There is no surprise that he denied my claim. The doctor was blatantly unfamiliar with my primary disease (IC), and he could not even read my diagnosis reports. The State Medical Board could not require Cigna to pay my claim, and they suggested that I hire a lawyer and take legal action against Cigna.
I hired an attorney who works on a 40% retainer with $400 down. At this point, Cigna came thru with a chump change settlement offer which I declined. Cigna only offered to pay my entire claim/policy off for just 2 years of payments which would constitute the lookback period of whether I can work "any occupation". The case is now in court awaiting the judges decision.
According to the policy, the question to the court now is not whether I am disabled, but whether Cigna's administrator was "arbitrary and capricous" in making their denial decision. Of course they were "arbitrary and capricious" in their decision. but this is huge hurdle to prove and really irrelevant, I am disabled and deserve my money.
From reading comments made on the reviews posted, the majority of people do not understand their employers disability policies or ERISA law. You cannot sue for or collect punitive damages (pain, suffering, mental anguish) against the insurance company. You may only collect what is due to you under the policy adjusted for cost of living and interest. That includes the fact that I cannot recoup my doctor and prescription costs which I paid out of pocket during the 4 years that my insurance and prescription benefits were also denied. With all this being so, there is absolutely NO incentive for Cigna to pay ANY claim.
WARNING: Therefore, it is best NOT to pay for disability insurance thru your employer (which falls under ERISA laws), but protect yourself and family by buying outside independent insurance. Paying thru your employer is just flushing good money down the drain. DON'T DO IT.
At this time, I am hoping for a favorable ruling from the court. If so, as I state above I will be out 40% to the lawyer and will not recoup any out of pocket doctor's office or prescription expenses occurred over the past 4 years.
My lawyer has informed me that if we Win the case he expects Cigna to appeal. My lawyer has also told me that if Cigna appeals he will not continue to work the case on a contingency basis but need upfront payment.
This entire process of dealing with Cigna has been a nightmare. I have exhausted my 401K in medical bills and living expenses.
FYI-God forbid that you should ever find yourself in a similar situation. If so, my best advice is to ask for a copy and review your disability file from Cigna regularly. Make this request in writing sent certified. You will find that Cigna purposely ommits information that bolsters you case, and Cigna purposely inserts information that makes you appear unavailable and unresponsive to their requests.
This employer insurance is a SHAM and need serious reform. I am at a loss as to why this is not covered in detail by the media and news programs. Someone somewhere is making BIG money and must be paying others to keep hush.
You have now been warned. Consider yourself lucky and protect yourself and your family appropriately.