The University of Notre Dame is a Catholic research university located near South Bend, Indiana. Notre Dame’s Catholic character is reflected in its commitment to the Catholic faith, numerous ministries funded by the school, and the architecture around the campus. Notre Dame rose to national prominence in the early 1900s for its Fighting Irish football team, especially under the guidance of the legendary coach Knute Rockne and is well known for “Touchdown Jesus.”
Cigna is an American worldwide health services organization, whose policies are underwritten by Life Insurance Company of North America (“LINA”). Cigna’s insurance subsidiaries are major providers of medical, dental, disability, life and accident insurance and related products and services, the majority of which are offered through employers and other groups.
In June 2015, U.S. health insurer Anthem Inc. announced an offer to acquire Cigna for more than $47 billion in cash and stock. Anthem confirmed it had reached a deal to buy Cigna on July 24, 2015.
Cigna/LINA provides disability coverage to Notre Dame University employees. Cigna disability claims by Notre Dame employees are exempt from the Employee Retirement Income Security Act because the disability plan is considered a “church plan”; therefore, the lawsuit is filed under state law with breach of contract and bad faith counts.
The O’Ryan Law firm recently represented a Notre Dame employee who was diagnosed with trigeminal neuralgia or glossopharyngeal neuralgia. The employee applied for and was approved for Short Term Disability benefits. Because she was unable to return to her position at Notre Dame, she applied for long term disability benefits available to her under Cigna/LINA’s long term disability policy. According to the LINA policy, LINA must pay disability benefits “if a covered employee solely because of Injury or Sickness, he or she is: 1. unable to perform the material duties of his or her Regular Occupation; and 2. unable to earn 80% or more of his or her Indexed Earnings from working in his or her Regular Occupation.”
LINA denied her claim contending that “based on the medical information received, the information is insufficient to support functional deficits to substantiate your inability to return to your previous work capacity.” The O’Ryan Law Firm compiled a substantial appeal for the client and submitted the appeal to LINA.
When LINA failed to make a timely decision on the appeal, the O’Ryan Law Firm filed a lawsuit against LINA demanding that they pay the disability benefits. LINA ultimately reversed their decision to deny the benefits and the Notre Dame employee was paid back benefits by Cigna and currently continues to receive her monthly disability benefits from Cigna.
If you are a Notre Dame employee whose disability benefits have been denied by Cigna, please contact the O’Ryan Law Firm for further assistance.