Cigna is one of the largest LTD companies offering policies today. If you wish to appeal a denied claim you should seek legal assistance.
Cigna is a global health company that was established through the merger of Insurance Company of North America (INA) with Connecticut General Life Insurance Company (CG) in 1982.
The subsidiaries of Cigna Corporation offer a variety of health insurance services and products to customers throughout the world including:
- Supplemental Plans
- Behavioral Health
- Vision care
- Health coaching and condition management
- Group life
- Short-term and Long-term disability
In 2016, Cigna earned $39.7 billion in revenues and ranked 79 on the Fortune 500 list.
It served 15.2 million global medical customers and processed 163 million medical claims. Its global network included 108,700 participating healthcare professionals and 13,900 facilities and clinics.
Cigna offers group plans specifically tailored to small, medium and large businesses.
In 2016, 8.5 million customers were covered by group disability plans that provided short-term disability coverage for those temporarily disabled and unable to work and long-term coverage for those out of work for an extended period of time.
If you have been denied disability benefits don’t give up! Contact a Disability lawyer at 512-454-4000 for a Free Consultation and get the benefits you deserve.
If you become disabled and are covered by a disability plan written by Cigna you can initiate a claim via fax, mail, or online at Cigna’s website.
Claimants should go to www.myCigna.com to submit a claim form or download a form to fax or mail. First, choose between the Short-term disability claim form or the Long-term Disability Claim form and then print the Physician’s Statement. Complete each form and fax or mail to Cigna at:
Cigna Disability Management Solutions
Paper Intake Team
P. O. Box 709015
Dallas, TX 75370-9015
You should also complete a Disability Disclosure Authorization Form to grant Cigna access to additional information from your employer and medical providers.
Cigna offers several tips for filing a claim:
- Know your policy terms and what is covered and not covered.
- If you become disabled, file your claim promptly.
- Provide complete information and alert your medical providers that you are filing a claim.
- Communicate. Update your disability company frequently with recent medical information (even if it’s not related to your disability) and keep your employer informed.
- Be proactive. Confirm with your disability company that they have received all necessary information; read notices and letters and ask questions.
- Be mindful of timeframes to submit claims and appeals.
If you receive an adverse decision regarding your claim, Cigna encourages you to call them first before beginning the appeal procedure.
In some cases, an issue can be resolved outside the formal appeal process. If you decide to appeal, a Request to Change an Adverse Decision by Cigna is available on its website. Complete and mail the appeal form within 180 days and a decision will be received in writing. Requests should include:
- The appeal form
- A copy of the original claim and explanation of payment or initial adverse decision letter, if applicable
- Any documents supporting the appeal such as statements from medical providers and facilities and medical records
The appeal may also be submitted in letter form, but the letter must state that it is a “Customer Appeal” and include all of the information listed above.
Requests are reviewed by someone at Cigna who was not involved in the initial decision and who can take corrective action. Decisions are based on the terms of the claimant’s benefit plan and a physician will be involved in any review related to medical necessity. If a situation involves urgent care, the review will be expedited.
Cigna long-term disability policies provided by or purchased through an employer are governed by The Employee Retirement Income Security Act or ERISA.
This law was created to protect employees’ rights to benefits, but unfortunately, most attorneys agree it supports insurers instead. Before filing suit, a claimant must “exhaust administrative remedies.” Claimants have 180 days to appeal and insurers have 90 days to consider the appeal which equals 270 days a disabled person is without income. Claimants are advised to file for Social Security Disability Income when filing a claim, but insurers may deduct any Social Security Income from insurance benefits and, if a claimant does not file for SSDI, the insurer may claim the disabled person has breached an LTD policy requirement. ERISA permits insurers to administer their own plans and a denial can only be reversed by demonstrating that the insurer abused that discretion – which is very difficult to do. If an internal appeal is denied, filing suit in U.S. District Court is a claimant’s last option.
ERISA disability disputes can be long and drawn out and few disabled people have either the resources or physical stamina to fight with a large insurance company.
That is why it’s important to have a qualified attorney with extensive experience in LTD disputes and ERISA to organize and manage your case. Partner and long-term disability attorney Lonnie Roach of Bemis, Roach & Reed has successfully overturned denials of disability benefits at the administrative level, in United States District Court, and at the United States Court of Appeals. Presently Lonnie represents clients who have been denied or lost insurance, long term/ ERISA or Social Security disability benefits in all four federal districts in Texas. If you have been denied long term disability benefits, Bemis, Roach & Reed offers a free consultation to determine if we can assist you in obtaining or reinstating those benefits. Call 512-454-4000 and get help today.
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