Denied: Fighting For Insurance Coverage

After GMA Gets Answers report, many share stories about Cigna denying benefits.

ByABC News via logo
June 26, 2008, 7:34 PM

June 27, 2008 — -- After a "Good Morning America" Gets Answers story in April about a breast cancer survivor's battle to get disability insurance benefits from Cigna Group Insurance, we received a flood of e-mails from viewers who were struggling with similar problems.

Our first story featured Susan Kristoff, from West Palm Beach, Fla., who spent two years trying to get those benefits.

"It was a daily eight hour job just trying to fulfill the informationthat Cigna was requesting," Kristoff said.

During our investigation into Susan's case, Cigna reversed course and paid her claim.

After Kristoff's story aired, "GMA" received a flood of e-mails from people across the country who said they too had been unfairly denied disability benefits from Cigna, despite submitting extensive medical evidence that they were too sick to work.

Kristoff and her lawyer, Alicia Paulino Grisham, blamed her troubles with Cigna on an industry-wide practice of deliberately delaying benefits, which Grisham and other critics call "slow walking."

"The insurance companies know if they deny and deny claims that many ofthe claimants will never pursue their claims," Grisham said.

Cigna wouldn't talk to us about Kristoff's case, but the insurance trade group, America's Health Insurance Plans, said cases like hers were the exception, not the rule.

"What I do know is there is a process, it's designed to be fair," Susan Pisano, a representative for the trade group, told us then.

But dozens of people wrote in to share stories similar to Kristoff's.

Lorie Bailey, a former police fingerprint analyst, has been fighting Cigna for nearly three years.

"This fight has caused me to go deeply into debt and I have losteverything I worked hard for my whole life," Bailey said.

Others like Bob Eklund, complained Cigna denied he was disabled, despite mountains of medical evidence the former engineer submitted.

"I can't explain it," Eklund said. "You know, what do you do then when your company says, 'You can't come back to work.' ...What can you say?"

After several years, Cigna also cut off car wreck victim Eugene Czachor from his disability benefits, saying he should be able to return to work.

"I have to struggle from day to day, as to which I can afford - my utilities, my food, mortgage or medication."

Janine Pendley suffers from a debilitating lung disease.