Cigna/LINA LTD Insurance Claim Denials

Has your long-term disability (LTD) claim been denied by Cigna or Life Insurance Company of North America (LINA), which is a subsidiary of The Cigna Group? Facing a Cigna/LINA disability claim denial can be an emotionally challenging and overwhelming experience. After paying premiums monthly, individuals rely on their LTD insurance policies to provide financial support in times of need. When your claim is denied, it can disrupt your life and financial security.

LTD insurance providers, like Cigna/LINA, are notorious for employing various strategies to minimize payouts to claimants while maximizing their profits. If you’ve submitted a disability claim to Cigna/LINA, you’ve likely encountered this approach firsthand.

If you’ve recently received a denial from Cigna/LINA for your disability claim and are concerned about covering medical expenses and everyday costs while unable to work, seeking guidance from an experienced Cigna/LINA LTD insurance denial attorney from Kantor & Kantor is a prudent step.

We are people helping people, and our lawyers for Cigna/LINA LTD insurance claim denials are experienced in handling these insurance claim denials and can be your path to achieving the benefits you deserve. Contact us at 818-886-2525 for a free consultation.

We offer a free case evaluation to discuss how our attorneys can assist you. Contact us now at 818-886-2525 for a free consultation.

What Is Cigna/LINA?

Cigna is one of the largest health insurance companies in the United States. The corporation provides a range of insurance policies catering to individuals, families, and businesses, including life, accident, disability, dental, and supplemental insurance.

Cigna completed a significant merger with Express Scripts in December 2018, amounting to $54 billion. This merger solidified Cigna’s position in the health insurance and pharmacy benefits management sector, propelling its growth. In 2019, the company reported total revenues of $153.6 billion, a 28% increase in net income to $5.1 billion, and a 20% growth in adjusted income from operations to $6.5 billion.

Cigna/LINA organizations amass billions of dollars annually through premium payments from their policyholders—everyday working Americans who seek insurance to protect themselves and their families.

Regrettably, when the time comes to fulfill these insurance policies, Cigna/LINA frequently engages in practices such as denial, delay, or reduction of compensation. They achieve this through vague contract language that can mislead policyholders into thinking they are covered for certain events when they are not. Additionally, they employ other bad-faith tactics, including dubious medical reporting.

The truth is that it is more cost-effective for these companies to employ extensive legal teams to contest claims rather than honor their contractual obligations. Ultimately, they count on the assumption that you either will not or cannot challenge them.

If you suspect that Cigna has unfairly denied your LTD insurance claim, contact Kantor & Kantor insurance claim denials attorney today for assistance.

Tactics Used By Cigna/LINA To Deny Insurance Claims

Below are tactics Cigna/LINA may use to deny insurance claims.

1. Ambiguous Policy Language: One common tactic insurance companies like Cigna/LINA employ is vague or ambiguous policy language. Insurance policies are complex legal documents, and the wording can sometimes be open to interpretation. Insurers may use this ambiguity to their advantage by interpreting the policy terms in a way that favors denial of claims.
2. Delaying Claims Processing: Insurance companies are legally obligated to process claims on time. However, Cigna/LINA may intentionally delay the claims process, causing frustration and financial hardship for policyholders. These delays can result from requesting excessive documentation, conducting repetitive interviews, or simply not responding promptly to inquiries.
3. Surveillance and Social Media Monitoring: Cigna/LINA may use surveillance and social media monitoring as tactics to challenge the legitimacy of a claim. Insurers may hire private investigators to follow claimants, gather evidence, or monitor their social media profiles for any activities that could be used as grounds for denial.
4. Using In-House Medical Professionals: To support claim denials, some insurers employ in-house medical professionals who may dispute the severity of a policyholder’s medical condition. These medical professionals may not have the policyholder’s best interests at heart and may provide opinions that favor the insurance company’s position.
5. Biased Peer Reviews: Cigna/LINA may commission peer reviews by third-party medical professionals. However, these reviewers may have affiliations with the insurance company, leading to biased assessments that favor claim denial.

Why Did Cigna/LINA Deny Your LTD Insurance Claim?

Most insurance companies, including Cigna/LINA, typically prioritize denying claims whenever possible as a core element of their business model. Cigna/LINA, in particular, employs this strategy in its claims-handling process.

Common reasons for Cigna/LINA denying your LTD claim may include the following:

1. Insufficient Documentation: LTD claims involve substantial paperwork and documentation. The claim is often denied when essential documents or forms are missing or incomplete.
2. Non-disclosure of a Pre-existing Condition: A favored tactic of insurance companies is to deny benefits based on the existence of a pre-existing condition. This is particularly relevant for Cigna/LINA, as its policies frequently contain robust language regarding exclusions related to pre-existing conditions.
3. Insufficient or Inadequate Medical Examinations: Cigna/LINA mandates comprehensive records concerning visits to healthcare providers and the course of treatment. It’s crucial to ensure that your medical records are up to date and that you diligently adhere to your doctor’s recommendations. Obtaining a detailed statement from your physician describing your condition can be vital.
4. Failure to Meet the Definition of Disability: Cigna/LINA LTD policies specifically define disability, and the company may reject your claim if it determines that your condition does not align with its definition.
5. Missing Deadlines: Timely submission of all required paperwork is essential. Failure to meet deadlines is a frequently cited reason for claim denials.
6. Disagreement Between Their Medical Examiner and Your Doctor: Cigna/LINA might engage their physicians to review your medical records, often under the guise of an “independent medical review.” It is common for their appointed doctor to hold a differing opinion from your treating physician’s diagnosis.

What Can You Do if You Receive a Cigna/LINA LTD Denial?

Here are some steps to take when Cigna/LINA has denied your LTD claim.

1. Review Your Cigna/LINA Denial Letter

Taking the time to read and fully understand your Cigna/LINA denial letter is crucial. Understanding the specific reason(s) behind the denial is essential, as this knowledge will guide you in identifying the necessary improvements to bolster your claim.

2. Request Your Claim File

By law, Cigna/LINA is obligated to provide you with a copy of your claim file. Additionally, you should request your Cigna/LINA LTD plan and policy documents. This will enable you to identify any gaps in your file and ensure that you meet the definition of disability. It is advisable to undertake this step before writing your appeal letter.

3. Write an Appeal Letter

Drafting an appeal letter represents a significant step in contesting your Cigna/LINA LTD denial. It is essential to include the following elements in your letter:

• Your case number
• The reason for the Cigna/LINA LTD denial
• A concise description of your disability
• Corrections for any errors discovered in your initial claim
• Supporting facts explaining why you believe the denial was incorrect
• Copies of your initial application, denial letter, and relevant medical documentation.

4. Compile Your Administrative Record

Building your administrative record entails incorporating as much medical evidence as possible to substantiate your claim of being unable to perform any job due to your disability. Include medical records from all healthcare providers, urgent care facilities, and hospitals where you received treatment for your disability. Additionally, include information from any therapy sessions related to your disability.

5. Gather Letters from Your Doctor and Loved Ones

You might wonder why a letter from your doctor is necessary if you are already submitting medical records. The reason is that while medical records demonstrate that you’ve sought medical attention and have a documented injury or disability, they may not conclusively indicate your inability to work. A letter from your doctor explaining how your disability impacts your capacity to work can carry significant weight. While it doesn’t guarantee success, it is a valuable addition.

Having a friend or family member write a letter can provide insight into how your disability affects your daily life. For instance, a neighbor could explain that they assist you in walking to your mailbox daily, or a niece might detail how she cleans your house twice a week because you cannot bend over.

6. Consider Engaging an LTD Lawyer

Hiring a Cigna/LINA LTD insurance denial attorney can simplify the appeal process. They can assist in filing your appeal, gathering records to bolster your administrative record, and collecting letters from your doctor and friends/family. A lawyer experienced in dealing with Cigna/LINA LTD denials understands the necessary steps to build a strong case.

Additionally, our lawyers for Cigna/LINA LTD insurance claim denials are well-versed in the strict deadlines and guidelines that must be adhered to, making our expertise invaluable in navigating the process.

Our attorneys at Kantor & Kantor will help you gather all medical records and other documentation to help you fight your Cigna/LINA insurance claim denial.

Why Choose Kantor & Kantor?

Facing a denial of your LTD insurance claim can be a distressing experience. If you have a policy with Cigna/LINA, you may find yourself in a challenging situation, wondering how to secure the benefits you rightfully deserve. In such times, choosing the right attorney cannot be overstated. One name that stands out in the field of insurance claim denials is Kantor & Kantor. Here are some reasons to choose us.

Extensive Experience With Cigna and LINA

We have experience dealing with insurance companies like Cigna/LINA. We understand the insurers’ tactics, procedures, and strategies for denying claims. This familiarity gives us an edge when advocating on behalf of our clients.

By choosing Kantor & Kantor, you can access a legal team that effectively can counter the insurance company’s denial arguments. They can anticipate and address potential roadblocks, increasing your chances of a successful appeal.

Consistent Record of Success

One important factor when choosing an attorney for your Cigna/LINA LTD insurance claim denial is their track record of success. We have a long history of achieving favorable outcomes for our clients, often resulting in the reinstatement of denied benefits, lump-sum settlements, and improved claims management.

Our consistent success is a testament to our dedication, legal acumen, and unwavering commitment to our clients’ best interests. When you choose Kantor & Kantor, you align yourself with a law firm with a proven track record of obtaining positive results for clients facing disability insurance claim denials. Some cases we have won against Cigna are:

• Wolf v. Life Insurance Company of North America, 46 F.4th 979 (9th Cir. 2022)
• Sangha v. Cigna Life Insurance Company of New York, 314 F.Supp.3d 1027 (USDC N.D. CA 2018)
• Abdel-Malek v. Life Ins. Co. of North America 359 F.Supp.2d 912 (USDC N.D. CA 2005)

Personalized Legal Representation

We understand that each client’s situation is unique. We offer personalized legal representation tailored to your specific circumstances. Our Cigna/LINA LTD Insurance claim denials attorneys take the time to review your case thoroughly and develop a comprehensive strategy to strengthen your appeal.

Furthermore, Kantor & Kantor prioritizes communication with their clients, keeping you informed about the progress of your case every step of the way.

Legal Resources and Expertise

Our lawyers for Cigna/LINA LTD insurance claim denials have a wealth of resources and knowledge to build a strong case on your behalf. We work with medical experts, vocational specialists, and other professionals to effectively gather the necessary evidence to support your claim and counter the insurance company’s arguments.

How Our Cigna/LINA Long Term Disability Insurance Denial Attorney Can Help

Here are ways our attorneys will help with your LTD insurance denial.

1. Thorough Investigation: Our attorneys will thoroughly investigate your case, gather all relevant evidence, and work with medical experts to ensure that your disability claim is substantiated with compelling medical and vocational evidence.
2. Strategic Appeals: Our attorneys are skilled in crafting persuasive administrative appeals, addressing the insurance company’s reasons for denial and presenting a strong case for approval.
3. Negotiations: Our LTD attorneys will negotiate with Cigna/LINA to reach a fair settlement before resorting to litigation, often achieving a quicker resolution and better outcome for our clients.
4. Litigation: If negotiations fail, our attorneys will file a lawsuit against the insurer, representing your interests in court and advocating for the compensation you deserve.

Contact Kantor & Kantor to Help With a Cigna/LINA LTD Insurance Claim Denial

Facing a Cigna/LINA LTD insurance claim denial is difficult. However, with the assistance of an experienced LTD insurance claim denials attorney, you can significantly improve your chances of overturning the denial and obtaining the benefits you rightfully deserve.

If you are struggling with a denied Cigna/LINA LTD insurance claim, contact Kantor & Kantor to help you navigate this complex and often frustrating process.

We are people helping people, and we can be your advocate and guide in securing the financial support you need during your period of disability. Contact us at 818-886-2525 for a free consultation.

Attorney Glenn R. Kantor

Glenn Kantor is a founding partner of Kantor & Kantor LLP. As a young attorney, Glenn saw the injustice of wrongful insurance denials and created a law firm to represent individuals seeking to obtain their rightful benefits. Glenn is committed to ensure that clients receive the benefits they are entitled to under their insurance policies or group health plans. [Attorney Bio]