CIGNA - also known as the Life Insurance Company of North America or LINA - is one of the largest disability insurance companies in the country with more than 180 million customer and patient relationships in more than 30 countries and jurisdictions with a global workforce of more than 70,000 employees.
Being one of the world’s largest insurance companies means that their bottom line is usually their main priority. How else did they get so big?
Most insurance companies are only after their own interests and that often means that they will try to avoid any type of financial loss. One way of doing this is to try to delay or deny your claim.
Insurance company CIGNA is no exception when it comes to using these tactics.
How to Appeal Your CIGNA Long-Term Disability Benefits Denial
1. Pay Attention to Deadlines!
Read your denial letter carefully and write down any and all deadlines. Failure to meet a deadline is the best way to sink a worthy claim.
2. Start Early
Properly preparing an appeal can sometimes take months. In most cases, you will only have 180 days to file your appeal. Some policies only allow 90 days.
Start gathering medical records as soon as you receive your denial letter. Medical records offices can sometimes drag their feet so don’t wait until the last minute.
3. Get a Copy of Your Claim File
Getting a copy of your claim file from CIGNA will help you to understand the reasoning behind their decision. Go over each reason and see what holes you can fill in.
An experienced long-term disability attorney will be able to examine CIGNA’s internal review and come up with a winning strategy.
Based on this internal review, you or your attorney will be able to determine if some of these questions need to be addressed:
- Did CIGNA inaccurately state your job functions, duties, and responsibilities?
- Were CIGNA’s findings based on an in-house medical review?
- Did CIGNA take your doctor’s recommendations into account?
- Were you under video surveillance?
- Was your social media monitored?
4. Obtain Medical Evidence That Supports Your Claim
Talk to your doctors and be honest about how you feel. Saying you feel “fine” does not give the doctor a full understanding of your condition and limitations.
Be as detailed about your pain/limitations as possible. Be sure to ask your doctor and any attending specialists or health care providers to document any limitations that you may have in your medical record.
The more documentation you have supporting your illness or injury claim, the better chance you have of winning your denial appeal.
The point of this step is to prove that your illness or injury has caused you to be disabled. Once your administrative record is closed, no new evidence to support your claim can be submitted. In addition to medical records, be sure that the following are included in your file:
- Accurate job descriptions and information about work experience
- Statements from your employer
- Vocational expert reports
- Residual functional capacity reports
5. Assume You’re Being Watched
Be aware while doing every-day activities like getting groceries or walking your dog. Cigna has deep pockets and will almost certainly hire a private investigator in hopes of catching you doing something that your disability should prevent you from doing.
Sometimes it’s worth consulting an experienced long-term disability (LTD) attorney because they will best be able to explain to the insurance company that the 10 minutes you were filmed having a “good day” is not indicative of your disability as a whole.
It is also best to avoid posting pictures or comments about your injury on social media. It may be hard to prove that a photo taken before your injury isn’t recent and comments may be taken out of context.
How Can a Long-Term Disability Attorney Help You After CIGNA Denied Your Claim?
If you decide to file your claim on your own, be aware that the applications for LTD claims are often written to elicit responses that result in a denial.
Or perhaps instead of an outright denial, they will claim to have not received needed medical records or send you requests for more information, delaying desperately needed benefits month after month.
Having a long-term disability makes you vulnerable to the long-term disability insurance company giants and CIGNA knows this.
Gathering medical records from all of your doctors and remembering deadlines can be extremely difficult when all you feel is constant pain.
When you’re dealing with a disability, you need someone in your corner.
Someone who knows the claims process and whose only interest is your best interest.
As your long-term disability lawyer, we will ease the burden of hunting down medical records and filing reports.
We’ll keep track of CIGNA’s deadlines and fight for you to get the long-term disability benefits you rightfully deserve.
