Public Mediation

Tamara Diletto-Leonetti vs. Life Insurance Company Of North America- Cigna

T. D. vs. Life Insurance Company Of North America- Cigna
900 Cottage Grove Rd, Bloomfield, Connecticut, 06002-2920, United States
Amount Involved: $19,536.00
    • Claimant Seeks: View.
    • Claim #: 9742522
    • Amount Involved: 19,536.00
    • Filed On: Aug 17, 2017
    • Posted On: Aug 28, 2017
    • Complaint(s):
      • Bad business practices
      • Failure to disclose facts
      • LTD DISABILITY INSURANCE COMPANY BENEFITS
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Statement of Claim
Complaints Involved (3) - View
"I bought and paid for LTD benefits through my employer. Cigna is their carrier. After over 12 spinal surgeries and in between two surgeries, Cigna denied my LTD benefits. They made me go to one of their paid doctors for a Health Assessment, in which the doctor clearly did not know anything about me or my surgical history. He asked me a few questions and submitted his findings. The DOB on the Assessment is not even mine. I have been on LTD for 4 years and my doctors keep telling them that I am unable to work. During the past 4 years my condition has gotten even worse. Cigna's doctor was basically told how and what to.put on the form as I saw what they submitted to my neurosurgeon. He adamantly rebutted what their doctor stated. Cigna refused to even consider reinstating my benefits. During this time, I was recuperating from a back fusion. Right after they denied my benefits, my doctor discovered that I had a complication from the fusion and actually had an incisionsl hermia resulting in yet another major surgery on my side/bsck, which is a very rare place for a hernia to develop. Cigna was notified of my upcoming surgery and again denied my restoration of benefits. For the last 4 years, all of my doctors have submitted the same Health Assessment Form that the Cigna paid doctor submitted and yet Cigna's doctor put the exact opposite of what all my doctors have been submitting every year. Not only have I lost my LTD benefits, Cigna made me file for social security disability and took over $28,000.00 in retroactive payments made to me for regular social security disability. Social security is not making me or my doctors jump through the same hoops every year at all. How can your company justify this type of action? Is this just to save your company money? I called The Life Insurance Company of North America to provide documentation that Cigna requested twice in the same year and your company tild me that I was on the stable and disabled list so they did not need further documentation. Every time my case was transferred to a new case worker, this same documentation was required. I have had about 6-7 different case wirkers in the last 4 years. I bought and paid for this insurance hoping I would never have to use it. Yet paying for insurance for over 23 years and I get denied by a do tor that had been sued along with Cigna for the exact sane reason, he puts what Cigna wants on the form, not the reality of actual specialists who operate on me and see what all the spinal and cervical surgeries have done to my nerves and body. I have nerve damage in my hands, feet, legs, etc. Not to mention DDD and several other medical codes that support a permanent disability and lack of ability to even have an FCE done. I am unable to function at home and have severe limitations that require assistance in daily living. I am about to lose everything due to Cigna denying my benefits. Why do they send out a letter stating that after two years on LTD that you are considered disabled until you reach 65, if they can just stop paying you regardless of what my specialists have repeatedly told them. I have never in the last 4 years been told I could work again , in fact, just the opposite. I am never going to get better. So please tell me how tbis happens and why you allow this to hapoen and destroy someone's life who is already coping with unwanted disabilities and medical issues"
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What Claimant Wants Hide
1. Compensation: Reinstatement of benefits and back.pay Sep 01, 2017 $6,512.00
2. Recovery of Losses: Reinstatement and back pay Sep 01, 2017 $6,512.00
3. Reinstatement of benefits in back pay Sep 01, 2017 $6,512.00
Cash total : $19,536.00
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Respondent's Counteroffer Hide
The claimant's settlement terms were rejected with the following explanation:

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This claim will remain posted until resolved.

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