CIGNA Refuses to pay Disability to City Employee

The O’Ryan Law Firm, on behalf of Plaintiff, Timothy E., recently filed a federal lawsuit against Life Insurance Company of North America (LINA), a subsidiary of Cigna, for their refusal to continue paying disability benefits to a city employee who had been disabled for more than 5 years. The Plaintiff was employed by the City of Bloomington, and became unable to continue working in his extremely physical job from severe back issues and cardiac problems.  He had been employed for the City of Bloomington for more than 20 years when he was forced to stop working because of his medical conditions.  Cigna paid him for 5 years and then abruptly terminated his monthly disability payments saying he had miraculously recovered his ability to return to work, after 5 years.  In the meantime, he had been approved by the Social Security Administration who found him unable to perform any substantial, gainful activity.

Facts of the Case Against Cigna

The Plaintiff was employed by the City of Bloomington from 1987 until he became disabled in June 2010 and unable to work due to coronary artery disease, back pain, COPD, hypertension, fatigue, sleep apnea, and hyperlipidemia. Plaintiff’s treating physicians provided objective medical proof that the Plaintiff was unable to continue working due to these medical conditions.

In 2010, the Plaintiff filed an application for long-term disability benefits offered through the City of Bloomington’s employee benefit plan, which is insured by Cigna.  Cigna approved Plaintiff’s application for LTD benefits for 24 months based on Plaintiff’s inability to perform his “Regular Occupation.” After 24 months of benefits, Cigna again determined Plaintiff was disabled and incapable of performing “Any Occupation.”  After paying the Plaintiff LTD benefits from September 2010 through September 2015, Cigna abruptly terminated Plaintiff’s disability benefits.  This caused great financial stress for the Plaintiff and his family.  In terminating his disability, Cigna cited the following definition:

Definition of Disability/Disabled

The Employee is considered Disabled if, solely because of Injury or Sickness, he or she is:

  • unable to perform the material duties of his or her Regular Occupation; and
  • unable to earn 80% or more of his or her Indexed Earnings from working in his or her Regular Occupation.

After Disability Benefits have been payable for 24 months, the Employee is considered Disabled if, solely due to Injury or Sickness, he or she is:

  • unable to perform the material duties of any occupation for which he or she is, or may reasonably become, qualified based on education, training or experience; and
  • unable to earn 60% or more of his or her Indexed Earnings.

 Lawsuit Filed Against Cigna

The terms of the lawsuit state that Cigna committed the following wrongful actions against the Plaintiff:

  • Breached the provisions of the disability policy
  • Caused serious financial and emotional distress to the Plaintiff due to the denial of long-term disability benefits and other losses due to Cigna’s refusal to pay him disability benefits including the loss of health insurance coverage, life insurance coverage, pension deposits, and tuition reimbursement
  • Did not provide a reasonable basis for terminating Plaintiff’s long-term disability benefits

Plaintiff Seeks Following Relief From This Lawsuit

The wrongful actions of Cigna have caused the Plaintiff to seek the following relief from this Court:

  • A judgment that requires them to compensate Plaintiff for the unpaid disability benefits that are due, along with all accrued interest
  • A judgment that LINA will pay for all reasonable attorney fees
  • A judgment that LINA will pay for damages for their bad faith refusal to pay the disability benefits owed under the policy including the emotional and financial distress caused by Cigna’s abrupt termination of his monthly disability payment.

If your long term disability benefits have been terminated by Cigna or LINA, we recommend that you immediately contact the O’Ryan Law Firm for a free consultation.  We understand the financial difficulties that are caused to individuals and families who lose their disability benefits without any warning and may be able to offer assistance in forcing Cigna to reinstate the monthly disability benefit payments.