Insurer Ordered To Pay Fees After Denying Disability Benefits

Many people in Florida and elsewhere in the country have faced serious hardship after their applications for disability benefits were denied by their insurance companies. One firm, Life Insurance Co. of North America, was found to be liable in its treatment of a woman with chronic pain to whom it denied disability benefits. The insurer is a subsidiary of Cigna, a larger life and health insurance firm with customers across the country. A U.S. Court of Appeals for the 6th Circuit decision ordered the company to pay the woman’s attorney’s fees after she was wrongfully denied benefits.

According to the court’s ruling, the company failed to physically examine the woman but discounted evidence she provided of her chronic pain and other disabilities. The company also changed the targets that she needed to meet in order to be deemed eligible to receive disability benefits. A lower court had previously ruled that each party was responsible for its own legal costs, but the panel of the higher court said that the insurance company’s behavior was so bad as to warrant reversing that decision.

The case first came before the 6th Circuit in 2018, when the court ordered the insurance company to review the woman’s claim. It noted that the firm failed to provide an in-person medical examination despite being given multiple professional reports and evidence indicating that the woman had a disease that caused chronic, severe pain. She was one of many customers who have experienced a wrongful denial when dealing with private insurers that provide disability insurance individually or through an employer.

People who have had their private disability claim denied may wonder what they can do. An insurance lawyer can help people dealing with disability benefit claim denials to handle their case according to the terms of their contract and work to protect their rights.