After Being Offered $20,908.56 in Back Benefits and Interest, Attorney Alex Palamara Helps Disabled Nurse Receive $450,213.86 plus $5,000/mo going forward Due to Regulatory Settlement Agreement
A former employee of the Visiting Nurse Association contacted our office after the Life Insurance Company of North America (aka CIGNA) sent her a letter in May of 2015 advising her that after a new review was conducted on her claim they now agreed that she was disabled and eligible for benefits for the limited time period of 09/04/2009 through 12/03/2009. As such, CIGNA told her it would pay benefits in the amount of $10,878.00 plus interest in the amount of $10,030.56 (a total of $20,908.56).
With this letter, a check was enclosed and the letter stated that by “cashing the enclosed check, you agree to accept this payment as full satisfaction of all claims you may have that, in whole or in part, arise out of or relate to (your disability insurance policy) during the Remediation Period and to forgo litigation and release Life Insurance Company of North America from any further liability regarding the denial or termination of benefits under the (policy) during the Remediation Period.”
After receiving the aforementioned letter, this disabled Nurse contacted Dell Disability Lawyers for information and advice as to this offer and the Regulatory Settlement Agreement. Prior to speaking with our law firm, this former Visiting Nurse Association employee was tempted to cash this check immediately as she was still disabled and any such funds would be an immediate blessing to her family. After speaking with Attorneys Gregory Dell and Alexander Palamara, the disabled Nurse was convinced that more could be done and more money could be a possibility.
Regulatory Settlement Agreement
In 2013, the Life Insurance Company of North America entered into a voluntary settlement agreement with participating state insurance regulators whereby it agreed to review certain previously denied or terminated claims made by residents of those states between January 1, 2008 through December 31, 2010. This period is known as the “Remediation Period.” CIGNA agreed that it would review claims it denied during that time period under enhanced claim procedures. Basically CIGNA agreed that it did a terrible job on some disability claims in the past and now agreed to give a new and proper review of those denied claims.
Dell Disability Lawyers Gets Involved
After being hired by the former employee of the Visiting Nurse Association, Attorney Alexander Palamara immediately investigated the claim. Attorney Palamara ordered a copy of the claim file from CIGNA. The claim file contains all the documentation CIGNA has obtained or created with regards to this Nurse’s claim. A quick review of the claim file showed not only that this Nurse should have been found disabled in 2009 when she first stopped working, but it also showed that CIGNA had enough information to justify continuing benefits through the present day. In fact, the Claim File contained a recent review by a doctor hired by Cigna. This independent doctor agreed that our now client remained unable to perform the material duties of her own occupation and any occupation. In his revaluation of April 24, 2015, Dr. Randal Wojciehoski found that our client would be completely functionally limited from 09/4/2009 forward. Furthermore, Dr. Wojciehoski stated that “(c)onsidering the complex comorbidities, it is my opinion to a reasonable degree of medical probability that (the claimant) remains completely and totally impaired from 09/04/2009 and beyond.”
Administrative Appeal Filed by Dell Disability Lawyers
Now armed with support not only from her medical records and her treating physicians, our client was also supported by CIGNA’s own medical reviewer. As such, an administrative appeal was filed outlining why CIGNA should determine that our client has been and continues to be disabled and how much money she should be paid above the $20,908.56 previously offered. Beyond supportive medical records, we offered financial proof that benefits should be paid from 09/04/2009 through the present.
The appeal was filed on August 21, 2015.
Cigna Agrees to Pay More Money
On October 14, 2015, we received a letter indicating the CIGNA now agreed with our assessment. At first CIGNA only agreed to pay through October 11, 2010 as it wanted to review updated medical information and get more information into her earnings from that time to the present. After being provided the requested information, CIGNA had no choice but to pay benefits through the present and agree to continue paying a monthly benefit until our client is no longer disabled.
Although it has been a tough and long fight that continues to this day, our client is happy that CIGNA finally agreed that she was disabled and is now paying her claim. Although one could question whether the initial offer of $20,908.56 was made in good faith and within the spirit of the Regulatory Settlement Agreement, our client’s receipt of over $450,000 shows that CIGNA is able and willing to correct a wrong it previously created.
Our client also knows that with the help of Attorney Palamara and Dell Disability Lawyers, she will continue to receive benefits as they will do whatever it takes to see that she remains on claim until she is able and ready to return to work.
If you have been offered money from CIGNA due to the Regulatory Settlement Agreement based on a past denied claim, although it may be tempting to immediately cash the check, please contact our office for a free consultation before you do so. First, the initial offer may only be a fraction of what is owed. Secondly, cashing the check may result in your losing your ability to challenge the amount paid and to get additional money. So please contact us as soon as such a letter is received. We will do whatever it takes to get you what you deserve.
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Answered Questions by Our Lawyers
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Q: I filed an appeal and lost. Is it worth pursuing?
A: Kim, in my opinion, yes. If you are still within your timeframe to file a lawsuit you have little to lose in t... Read More >
Q: Do I have a case for STD? I was denied twice because a) I hadn't been a fulltime employee for 6 months and b) I had ben on FMLA since Febury.
A: Frank, we would need to see a copy of the denial letter and the policy. Please feel free to contact our office... Read More >
Q: How can I appeal Cigna's decision if there are no written communications explanation the reasons for claim termination?
A: Tret, Cigna will be required by law to provide you with a written denial letter setting forth its reason for t... Read More >
Q: Is there a process for appeals not being responded to in the time given? Also, how do I access my records?
A: SB, ERISA provides 45 days to render a decision on appeal with the possibility of a 45 day extension- basicall... Read More >
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A: Donna, I do not know if you would have any avenues to void the agreement you signed. Regardless of agreeing th... Read More >
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Our goal is to get your application for disability insurance benefits approved. Applying for disability insurance benefits can be a difficult process and the information you provide is critical. Most disability insurance companies look at your application in hopes of finding a reason to deny your claim. Your disability company will ask you to complete numerous forms, interview you, request lots of information, speak with your doctors and possibly request to have you examined by their hired gun doctor.
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Preparing a strong disability appeal package is an art that requires you to understand how the courts interpret your disability policy language, ERISA regulations / laws, and how to strategically present evidence in support of your definition of disability. We encourage you to contact any of our long-term disability attorneys for a free immediate review of your disability denial.
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We have recovered hundreds of millions of dollars for our clients and we would like the opportunity to provide you with a free review of your disability benefit denial. There are many complex factors in a disability benefit lawsuit and the legal battle to win long term disability benefits can be fierce.
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Approval of long-term disability is a continuous process as every disability insurance company will evaluate your eligibility for benefits on a monthly basis. You can never let your guard down and assume that your disability company will continue to pay your benefits for as long as you think you need them.
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Who are Dell Disability Lawyers?
We are disability insurance attorneys that know how to get your short or long term disability benefits paid. As a nationwide law firm we have helped thousands of disability insurance claimants throughout the United States to collect hundreds of millions of dollars of disability insurance benefits from every major disability insurance company.
Our attorneys have been able to either get our clients paid monthly disability benefits or obtain a one-time lump-sum settlement in more than 98% of our cases. Our disability insurance lawyers have seen it all when it comes to disability insurance claims and we know exactly what it takes for your disability claim to be approved.
We offer disability insurance attorney representation nationwide and we welcome you to contact any of our LTD lawyers for a free immediate review of your disability claim. We also invite you to visit and subscribe to our YouTube channel where we have more than 900 videos and regularly provide tips to help protect your disability benefits.
Who do you help?
Our disability insurance attorneys help individuals that have either purchased a long term disability insurance policy from an insurance company or obtained short or long term disability insurance coverage as a benefit from their employer. We have helped individuals in almost every type of occupation with monthly disability benefit payments ranging from $1,500 to $50,000.
Our clients include all types of employees ranging from retail associates, sales representatives, government employees, police officers, teachers, janitors, nurses, pilots, truck drivers, financial advisors, doctors, dentists, veterinarians, lawyers, consultants, IT professionals, engineers, professional athletes, business owners, and high level executives.
A strong understanding and presentation of the duties of your occupation is essential for securing disability insurance benefits.
Do you work in my state?
Yes. We are a national disability insurance law firm that is available to represent you regardless of where you live in the United States. We have partner lawyers in every state and we have filed lawsuits in most federal courts nationwide. Our disability insurance lawyers represent disability claimants at all stages of a claim for disability insurance benefits. There is nothing that our lawyers have not seen in the disability insurance world.
What are your fees?
Since we represent disability insurance claimants at different stages of a disability insurance claim we offer a variety of different fee options. We understand that claimants living on disability insurance benefits have a limited source of income; therefore we always try to work with the claimant to make our attorney fees as affordable as possible.
The three available fee options are a contingency fee agreement (no attorney fee or cost unless we make a recovery), hourly fee or fixed flat rate.
In every case we provide each client with a written fee agreement detailing the terms and conditions. We always offer a free initial phone consultation and we appreciate the opportunity to work with you in obtaining payment of your disability insurance benefits.
Do I have to come to your office to work with your law firm?
No. For purposes of efficiency and to reduce expenses for our clients we have found that 99% of our clients prefer to communicate via phone, email, fax, or video conferencing sessions. If you prefer an initial in-person meeting please let us know. A disability company will never require you to come to their office and similarly we are set up so that we handle your entire claim without the need for you to come to our office.
How can I contact you?
When you call us during normal business hours you will immediately speak with a disability insurance attorney. We can be reached at 800-698-9159 or by email. Lawyers and staff must return all client calls same day. Client emails are usually replied to within the same business day and seem to be the preferred and most efficient method of communication for most clients.