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COLORADO WOMAN WINS LAWSUIT

May 14, 2012

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A client of ours filed a lawsuit against Connecticut General Life Insurance Company, the subsidiary arm of CIGNA Group Insurance which provides group life insurance coverage, claiming that her life insurance coverage was improperly terminated. Her claim was governed by the Employee Retirement Income Security Act of 1974 (“ERISA”).

Ms. C. was a former employee of Martin Marietta (now Lockheed Martin) and was a participant in Lockheed Martin Long Term Disability Plan (LTD Plan and the Lockheed Martin Group Universal Life Plan (Life Plan). Ms. C. has been disabled since 1993 and has continuously received LTD benefits since that time. As is true with most group life insurance plans and policies, Ms. C. enjoyed the benefit of a “waiver of premium” (LWOP) provision which provides for continued life insurance coverage if the participant is disabled. Connecticut General, as the insurer of the Lockheed Martin Life Insurance Plan, found Ms. C. to be disabled as that term is defined under the waiver of premium provision and continued her life insurance coverage until that coverage was unceremoniously terminated on June 9, 2009. Ironically, the LTD benefits provided by Life Insurance Company of North America (LINA), also a subsidiary company of CIGNA, continued to be paid in an uninterrupted fashion.

With the assistance of the disability and life insurance attorneys at the Law Office of Shawn E. McDermott, LLC, Ms. C. filed suit on March 30, 2010. Because the issue seemed so clear-cut that the denial of coverage under the waiver of premium provision was wrongful, it was decided not to pursue any discovery and to proceed as quickly as possible to judgment. The disability attorneys for Ms. C. provided CIGNA with the opportunity to simply reinstate coverage under the life insurance plan and, if so, the lawsuit would be dismissed. In our opinion, this would have been a reasonable approach to the dispute since, after all, life insurance benefits would only be payable under the life policy if in fact Ms. C. were to die prior to the age of 65, which is of course not likely. In other words, the reinstatement of coverage by CIGNA would not actually cost the insurance company anything. No benefits would become payable under the life policy unless and until death occurred.

Surprisingly, the insurance company refused this very reasonable offer, requiring plaintiff to move forward with litigation, and the matter was fully briefed and submitted for the judge’s determination. (Remember, there are typically no trials in ERISA benefits dispute litigation). Due to the case being transferred between judges on two occasions, the decision by the court was significantly delayed. After waiting nearly 17 months for a ruling, the newest judge assigned to the case issued a decision on April 26, 2012 concluding that the “evidence considered as a whole does not support the conclusion that Ms. C. is capable of successfully performing gainful employment within the meaning of a reasonable and appropriate interpretation of the disability clause in the life plan.” Thus, Connecticut General’s decision to deny the LWOP benefit was reversed, and the insurance company was directed to reinstate the life insurance policy without the payment of premiums for so long as Ms. C. remains totally disabled. We are also very satisfied to report that our client was also awarded her reasonable attorneys’ fees and costs.

This case has been reported at Croll v. Connecticut General, 2012 WL 1439172 (D. Colo. 2012).

The ERISA disability attorneys at the Law Office of Shawn E. McDermott, LLC have represented hundreds of individuals whose short term disability and long term disability claims have been denied. We have also handled ERISA life insurance denials, appeals and litigation matters on behalf of many clients. Throughout the years, we have had many former Lockheed Martin employee-clients whose benefits were denied or terminated by Life Insurance Company of North America (for LTD claims) and Connecticut General (for life insurance claims), both of whom are considered part of the CIGNA Group of companies. Our office has handled claims against every major disability insurance company issuing individual and group disability and life insurance policies. Please feel free to contact us for what is typically a free initial consultation if your claim has been denied.

Categories: Colorado, Disability, ERISA Claims, Insurance, Life Insurance

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