O’Ryan Law Firm, on behalf of Plaintiff, Brooke W., recently filed a federal lawsuit against Life Insurance Company of North America (LINA) (LINA is a subsidiary of CIGNA). Brooke was an Extension Educator for Purdue University. Purdue’s main campus is located in West Lafayette Indiana and is one of the premiere educational institutions for higher education.
Facts of the Case Against LINA
Brooke was forced to stop working when she became totally disabled due to multiple diagnoses including Diabetes Mellitus Type 1, small fiber autonomic neuropathy, fibromyalgia, Graves disease, migraines and lupus. Brooke’s rheumatologist confirmed the diagnosis of lupus SLE based on a positive ANA screen. She also had an abnormal nerve conduction study of her left ulnar nerve for carpal tunnel syndrome. Brooke’s occupation required her to travel extensively and her cardiologist restricted her from driving because of the precariousness of her medical condition. Objective medical proof was provided to LINA by her physicians, and confirmed that Brooke was unable to continue working as an Extension Educator at Purdue due to these serious illnesses.
Brooke filed an application for long-term disability (LTD) benefits offered through Purdue University’s employee benefit plan, which is insured by Cigna/LINA. Disabled Purdue employees receive not only disability benefits but also medical coverage and life insurance coverage. Cigna denied her application for LTD benefits. Cigna cited the following definition of “Disability” in their denial letter:
“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 12 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 80% or more of his or her Indexed Earnings.”
Cigna claimed that Brooke was able to continue working at her Purdue job despite numerous medical records showing she was struggling with several serious medical conditions and physicians who supported her disability claim.
Lawsuit Filed Against LINA/CIGNA
The terms of the lawsuit state that LINA committed the following wrongful actions against the Plaintiff:
- violated Indiana’s covenant of good faith and fair dealing in several ways, including but not limited to:
- Knowingly denying Brooke’s long term disability benefits without any reasonable basis for the denial.
- Compelling Brooke to initiate this litigation to recover the amount due her under the terms of the policy despite clear medical evidence that supports payment of this claim.
- Ignoring the statements of Brooke’s treating physicians who report that she is unable to work.
Fortunately, Brooke was able to reach a resolution with Cigna after filing the lawsuit without having to go through a jury trial.
If you are a disabled Purdue employee, or if you have been employed by any other Indiana university such as IU or Ball State and are seeking disability benefits, contact the O’Ryan Law Firm to find out the best course of action for pursuing your claim for disability benefits.