CIGNA Denies Disability Benefits for Insured with MS – We File Suit – Court Orders Benefits Paid

On February 28, 2011, we received a trial victory for one of our clients, overturning a claim denial by Cigna, who had terminated her long term disability benefits. Our client, who suffers from Multiple Sclerosis, was approved for long term disability benefits due to her symptoms of fatigue, pain and cognitive dysfunction. After paying benefits for 23 months, Cigna terminated our client’s benefits based upon surveillance, which showed minimal activity and a report from a physician who had spent 1 hour reviewing the file.

Kantor & Kantor aggressively litigated the case, and during the course of the action obtained information regarding the compensation Cigna pays to its allegedly neutral medical reviewers. We also obtained copies of Cigna’s internal guidelines governing claims investigation and the file it maintained on our client when conducting surveillance of her activities.

Attorney Corinne Chandler tried the case on January 11, 2011. After the trial, Cigna sought to place some of the evidence under”seal” so that other claimants and their attorneys could not obtain our evidence. The Court denied Cigna’s Motion and ordered that the documents be available for public viewing on the Court’s Pacer website.

More importantly, the Court ruled for our client, holding that Cigna acted in an arbitrary manner in terminating our client’s benefits. The Trial Court’s Opinion emphasized that Cigna’s medical reviewers did not adequately review the medical records and that Cigna wrongfully refused to consider plaintiff’s Social Security Award as evidence of her disability. In short, the Court found that Cigna’s financial interest in the claim infected the claim process.

Although we have won benefits for our client, Cigna continues to fight the public’s right to access to the evidence we obtained regarding its internal claims process and its medical reviewers. Cigna has appealed the Court’s ruling holding that the evidence in the case is not confidential and has even suggested that it will file an emergency motion to remove the documents from the public record. We intend to oppose Cigna’s efforts to conceal this evidence as we believe that it can be useful for our other clients.

You can read the Court’s opinion right here:
104_Kreeger – Memorandum & Order regarding bench trial 11-02-28

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