O’Ryan Law Firm, on behalf of our client, recently settled an accidental death insurance claim filed against Cigna, and the client’s employer, after Cigna refused to pay her accidental death insurance claim upon the accidental death of her husband. The insurance coverage was purchased through her employer and insured by Cigna. Shortly after she was hired, our client Ms. Y enrolled in accidental death insurance coverage for her husband through her employer and paid the premiums for the coverage through payroll deductions.
Unfortunately, several weeks after she started her new position, Ms. Y’s husband was killed in a traffic accident when he was struck by multiple motor vehicles while attempting to cross the street. After her husband’s death, Ms. Y completed and submitted all paperwork provided to her by her employer in order to submit a claim to Cigna under the group accidental death insurance coverage which she had been paying for through payroll deductions. Cigna denied Ms. Y’s claim, contending that her husband had died before our client was considered to be in a “Covered Class.” She was never told that there was a 90-day waiting period for the accidental death benefits coverage to begin and nowhere in her company’s handbook and recruiting materials does it mention a waiting period for accidental death benefits coverage.
Despite everything that indicated our client was properly enrolled in the accidental death insurance coverage, Cigna denied her claim, contending that she was not eligible for the coverage because of an alleged 90 day waiting period found in small print in a multiple page insurance policy that was never given to our client. Apparently only Cigna was aware of this alleged 90 day waiting period, because the employee relations manager and other employees were baffled by the reason Cigna had denied the claim.
In this case, the employer had some responsibility for what occurred because the employer assisted Ms. Y in enrolling in the accidental death coverage, represented to our client that she had the coverage, and deducted the premiums for the coverage from her paycheck every two weeks. Neither Cigna nor the employer informed our client that she was required to wait 90 days after her hire date before she was eligible for the life insurance coverage. To the contrary, our client’s employer actively participated in enrolling our client in the accidental death plan by encouraging her to enroll in the coverage, assisting her in enrolling in the coverage, repeatedly representing to her that she was enrolled in the coverage, and deducting premiums from her paychecks for the AD&D coverage.
Our client did everything asked of her to obtain the life insurance coverage and was lead to believe that she had properly enrolled in this coverage. Through no fault of her own, her claim for accidental death benefits was denied.
Our client was able to successfully settle her claims with Cigna, and her employer, ending many months of intense briefing and litigation. If you have a life insurance claim that has been denied because of a technicality that was never explained to you, or your family member, please contact the O’Ryan Law Firm to discuss your rights under the policy and the law.