Cigna Policyholder Sues for Past Disability Insurance Benefits

Kathleen Castelli says that although she continues to be unable to work, she is no longer issued monthly benefits she should have received since 2012, according to a disability insurance claim denial lawsuit filed August 8, 2013.

The disability insurance lawsuit notes that Castelli was covered by a long-term disability insurance policy issued by the Life Insurance Company of North America, a Cigna subsidiary, when she became unable to work due to numerous medical conditions in May 2009. At the time, claim denial specialists found no issue with her records which included diagnoses of co-morbid spinal conditions and back pain. 

However, beginning in 2012, the company refused to continue paying benefits, and denied her appeal on June 28, 2013. Castelli’s disability insurance lawyer argues that the benefits provider has a history of committing similar acts. Citing two reports from the California Department of Insurance, the disability insurance claim denial lawsuit alleges that the insurance company fails to provide benefits without litigation and fails to request medical records before its claim denial specialists deny policyholders’ disability benefits.

In addition, once a policyholder appealed, the state report noted that the defendant failed to consult with doctors regarding the disability. Specific to Castelli’s case in Pennsylvania, the disability insurance claim denial lawsuit alleges that the company failed to note her inability to complete her own work duties or those of a similar vocation. Castelli also alleges the firm applied a too-general standard, failing to meet “higher than marketplace” standards reportedly required by past court precedent.

While many disability insurance claim denial lawsuits argue that there is a conflict of interest regarding a company’s goal of making more revenue versus adequately assessing claims, the California Department of Insurance noted that the company “failed to effectuate prompt, fair and equitable settlements of claims in which liability had become reasonably clear” and made other attempts to limit its fiduciary duties. 

The disability insurance claim denial lawsuit is Kathleen Castelli v. Life Insurance Company of North America, Case No. 13-cv-04596, in the U.S. District Court for the Eastern District of Pennsylvania.

Regardless of the long-term disability insurance policy provider, many men and women believe they have been subject to wrongful disability claim denials. If you have a policy with UnumProvident disability insurance or other companies, you may be able to seek back payments. The first step is to establish your eligibility through a free consultation. Get one by filling out the short form at the Unum/UnumProvident Disability Insurance Claim Denial Class Action Lawsuit Investigation today.