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.