Cigna Affiliate Owes Fees After ‘Blameworthy’ Benefit Denial

April 2, 2019, 2:48 PM

Life Insurance Co. of North America was “about as culpable as it otherwise could get” in denying disability benefits to a woman with chronic pain, according to a Sixth Circuit opinion forcing the Cigna-owned insurer to pay the woman’s attorneys’ fees.

LINA repeatedly discounted evidence of Kimberly Guest-Marcotte’s disability without physically examining her and engaged in unfair “goal-post-moving” in the course of handling her benefits claim, a split panel of Sixth Circuit judges held April 1. The panel ordered LINA to pay Guest-Marcotte’s attorneys’ fees, saying the insurer’s bad behavior warranted the “rare” step of reversing a district judge’s decision on fees.

The Sixth Circuit first considered Guest-Marcotte’s benefit claim in 2018. The court ordered LINA to reconsider her claim after dinging the insurer for failing to conduct an in-person examination despite “clear medical consensus” that she suffered from a disease that caused chronic and severe pain.

The court’s unpublished decision on attorneys’ fees was written by Senior Judge John M. Rogers and joined by Senior Judge Alan E. Norris. Judge Amul R. Thapar dissented, saying the majority should have deferred to the district court’s decision-making.

Guest-Marcotte was represented by Karen Smith Kienbaum and Daniel G. Galant. LINA was represented by Miller Canfield.

The case is Guest-Marcotte v. Life Ins. Co. of N. Am., 2019 BL 114546, 6th Cir., No. 18-1948, unpublished 4/1/19.

To contact the reporter on this story: Jacklyn Wille in Washington at jwille@bloomberglaw.com

To contact the editors responsible for this story: Jo-el J. Meyer at jmeyer@bloomberglaw.com; Nicholas Datlowe at ndatlowe@bloomberglaw.com

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