I purchased Long Term Disability Insurance with CIGNA (LINA) for about 25 years prior to making a claim. The insurance was offered through my employer.
CIGNA covered 2 years of my disability (after the 6 month wait), however now they are performing a two year review for any occupation. An IME (Independent Medical Exam) has been scheduled by CIGNA for me, even though Social Security approved my claim on the first review.
My medical records/history is very extensive, covering multiple surgeries and procedures in an attempt to try and make my conditions manageable; however they just keep getting worse. The pain is excruciating, it affects my sleeping, moods, mobility, relationships, everything in my life. It started out with Endometriosis in my mid early to mid-twenties, which ended up in a total Hysterectomy. The Endometriosis developed into Fibromyalgia, which then also was complicated my Diffuse Small Fiber Neuropathy (diagnosed as a result of a Skin Punch Biopsy). This affects my bladder, causing incontinence which is unable to be helped by Rx medications as I am beyond that point. I can wear heavy adult protection, with a heavy pad, all meant for adults with Incontinence, but when stressed it has gone through all my protection, soaking my blue jeans, causing me to have to put a towel on my car seat to drive home. I have Mental and Cognitive issues, which are in large due to my Physical Conditions which are all predicted to stay the same or get worse. There is NO prognosis for the medical conditions to ever get better, and or improve.
From the voluminous amount of complaints by claimants about CIGNA on the Internet, I fully expect them to deny my claim as this is standard procedure for the company so their CEO, and VP's can make all the money they do being overpaid for denying valid claims as indicated by past State Insurance Department investigations, fines, rulings.
I have a Psychiatric Nurse Practitioner, Primary Care Physician, Rheumatologist, and Neuropsychologist who all support my disability and have written letters explaining the same along with what they are basing it on.
I also have an Urologist who can support my Bladder/Incontinence issues, along with a prior Pain Management Doctor who after several procedures said there was nothing else he could do for me, as everything he could try was exhausted. I also provided a complete record from my prior Rheumatologist who I went to for years prior to my new one.
CIGNA (LINA) has immense amount of test results, history of countless failed procedures performed in an attempt to alleviate my pain and urinary issues with no success, record of past missed work, and medical history which all backs my claim as being legitimate. *It is amazing just how many times CIGNA claims to not have received documentation even though the medical provider or us have included the Incident Number with a cover sheet, and every other place we are sending that information has received it. Also how many times the Medical Examiners reviewing the documentation for CIGNA take only certain words or sentences from a claimants Medical Providers to bolster their case, IE CIGNA Cherry Picks what they want to use, and disregards what does not support CIGNA's case.
For those suffering or those family members and friends going through this:
I strongly encourage using this website as a means to voice your issues/concerns, along with writing your State Insurance Department and the Insurance Department for whatever state your disability policy was written in. Also writing the State Insurance Departments that previously investigated and fined CIGNA in the past Connecticut, California, Massachusetts, Maine, and Pennsylvania, as a means of letting those agencies know even though they cannot address your claim (if the policy and or state you live in is not in their jurisdiction) that things have not changed with CIGNA, so hopefully the States reinvestigate CIGNA and fine them again. Your State Legislature, Local Official's, News Agencies such as Daily Mail, CBS, NBC, ABC, ETC. are all worth writing, along with Social Media and CIGNA's Executives (once you have your handling Reps Email Address then you should be able to figure out the Executive Email Addresses by using the same format). The more people that fight this Mega Company the more chance they will be held responsible for their crimes of greed, dishonesty, and Bad Faith Claims Handling all for The Powerful Almighty Dollar. CIGNA has a massive amount of Lawyers and Lobbyist to make sure the deck is stacked in their favor, so only through a mass effort can we hope to change Corporate America.
The CIGNA rep called previously to advise their doctor (the CIGNA doctor) is waiting for a return call from one of my wife's medical providers, the Neuropsychologist, in the event we wanted to followup to make sure their call is returned. What is amazing is the letter from the Neuropsychologist is very clear regarding the medical issues preventing my wife from working. We feel it is very clear as well that CIGNA contacts the medical providers even if no clarification is needed, in order to skew the statements received in in order to make them support CIGNA's predetermination, that EVERY ONE CAN WORK NO MATTER WHAT. PER CIGNA IF YOU CAN FEED YOURSELF, AND ANSWER THE PHONE, THEN YOU CAN WORK!!! ****Keep this in mind when you are looking into using them for LTD, and consider policies outside of what State Farm offers. Also I read the CEO David C made around 49 Million in 2016.
The IME is over: The Dr. took 1/2 hour, refused to take any of the paperwork/medical records and supports we brought with us. Said he had everything they needed. This was a JOKE. Called the claims rep, she said they (CIGNA) take the limitations given by my medical providers, then reduce THE LIMITATIONS TO WHAT CIGNA FEELS IS SUPPORTED BY THE MEDICAL DOCUMENTATION (MEANING CIGNA CHERRY PICKS WHAT SUPPORTS THEIR STANCE) AND THEN SEARCHES FOR JOBS I CAN DO (EVEN THOUGH I CANNOT USE MY HANDS TO WRITE OR TYPE DUE TO EXTREME PAIN).
My husband does all the typing for the complaints. CIGNA would have paid around $46K for the rest of the claim as the are paying $250 which is the policy minimum based on how much I collect from Social Security. Bottom line: CIGNA Owns many politicians as the have many lobbyists and I am sure make many contributions to political campaigns to make sure the laws are in their favor. Fight so others may not get screwed as CIGNA does not believe in paying what they owe, no more, no less!
CIGNA is a bunch of cowards who denied the LTD claim from this point on as it went from own occupation to any occupation. CIGNA has a high denial rate for such claims even when Social Security approves the claim.
We have requested a complete copy of the claims file under ERISA, and will file an appeal regarding their determination, along with seeking an attorney to see if the case is enough $$ for them to take it.
CIGNA also in many cases does not dispute the medical diagnoses, nor the symptoms, but disputes the restrictions. Per CIGNA they take your medical providers restrictions, then reduce it down to what CIGNA feels is supported by the medical supports, which is almost always in CIGNA's favor.
We will continue to fight this claim which is worth $36K from this point on. CIGNA will pay more than this in administration costs/cost of handling the file.
CIGNA also failed to perform an FCE which per the contact they are able to order.
Bottom Line: CIGNA is a group of "Bottom Feeders", if we could give them a negative start rating we would.
Until then we will spread the word in hopes this will reduce the amount of LTD Premiums they collect from other people in the future.