Submitted by melissa.randall on Wed, 04/14/2010 - 20:34

I may be doing this wrong so please bear with me...

My husband recently passed away and he had life insurance with Cigna through work. I have filed a claim; however his ex-wife has also filed a claim stating it is owed to her due to back child support that was owed as well as marital debt. They were divorced in 2004, it was not stated in their divorce that he had to have a life insurance policy for that. We married in 2006, and the policy was just bought a year ago while we were married. We are residents of Texas and his ex-wife is a resident of Oklahoma. Does she actually have a claim? And yes, I as his wife was named the sole beneficiary. Cigna has since placed the case in the Federal Court systems to decide, but now I have to find a lawyer to assist and they all want 40% if I win, and Cigna wants their lawyer’s fees as well. This just does not seem fair to me.

Any advice?

Posted: 15 Apr 2010 03:05 Post Subject:

I think your best bet is to talk it over with a lawyer.

Posted: 15 Apr 2010 05:08 Post Subject: Interpleader

Have done that with more than a few and they of course want 40% plus costs, which will end up being most of it. Right now, I have nothing, no place to stay, no money at all, no options really, I have lost my car due to this as it was in my husbands name, have lost everything. This is hard enough to deal with now. I have a child I am trying to take care of as well. Every lawyer I have spoken with as well as the insurance comission states that this cannot be done, that they do not understand why Cigna even let her make a claim, however here I am.

Posted: 15 Apr 2010 05:14 Post Subject:

There may be a divorce decree that specifies he must keep the life insurance in force and pay a portion of the death benefit to her. It is possible that he was not allowed to change the beneficiary even if he did, but that's why you need a lawyer. Even if you are right, someone can still take it to court and you get stuck paying the bill. 40% plus costs seems a little high if you ask me....many lawyers will take 1/3, and you might be better off paying someone hourly depending on how much death benefit we're talking here.

Posted: 15 Apr 2010 05:25 Post Subject:

I understand about the divorce decree, however I have a copy of it and there is nothing in the divorce decree that states he must have life insurance in force. In fact, she had taken out a life insurance policy on her own however she let it lapse. The life insurance policy he had was through his employer, purchased within the last two years, I was the sole benificiary. Per Oklahoma, child support ends at death. This is a mess and Cigna will not even talk to me, much less their lawyers. I need to file an answer to the Federal Court however don't know how to do that. We also have receipts where she was paid most the child support and shows that there was no marital debt, yet she still has made a claim for the entire amount.

Posted: 15 Apr 2010 05:27 Post Subject:

Talk to a lawyer who will charge you hourly, see how many hours it will take him to file on your behalf and what the court fees are, and go from there. Sounds like an open and shut case if what you are saying is correct. It's going to cost you some money, but not 40%...

Posted: 15 Apr 2010 05:30 Post Subject:

ok, I will see if a lawyer will do that. So far they all want either 40% or a 3rd, and yes everyone I lawyer I have spoken with wants the case, they say it should be pretty open and shut as well. It juse seems unfair that they get most of the money and then Cigna gets fees for doing this in the first place.

Posted: 16 Apr 2010 01:57 Post Subject:

Melissa . . .

Before you sign any agreements with a lawyer, contact the Texas Dept of Insurance -- 800-252-3439. They may be able to help you sort this out at no cost to you.

If you get an attorney involved, they may be prevented from giving you assistance.

I sincerely doubt the matter is in "Federal Court". This is not a federal matter, it is a state matter. I can't think of any federal "cause of action" that would even allow the matter to reach the federal court. I just think CIGNA is dragging their feet, hoping one party will suspend their claim.

But if the matter was in federal court, you would need an attorney who is admitted to the Federal Bar, and that would be prohibitively expensive.

Contact the TDI as soon as possible. They'll know what to do.

Posted: 16 Apr 2010 04:41 Post Subject:

Thank you for the info, I filed a complaint today with TDI as well as PA Insurance Commission. I was informed by Cigna today not to contact them at all, only their attorney. They are still reviewing the accidental claim and have already referred the basic life claim to the TX Federal District Court.
Could I please have your opinion on a few other items?
On the accidental claim: My husband was drinking and over the legal limit, he crashed his truck but he got out and the cause of death was a fall from an overpass. It was ruled accidental due to a fall by the ME. I am sure that Cigna will deny this, but as the exclusion only states that an accident in a vehicle while under the influence is excluded, I do not believe that this situation falls under this exclusion as the Sheriff's office told me, because there was no one present when the accident occurred, no one can no what caused him to fall from the bridge.

I, as you, believe that this is not a Federal matter, as his ex-wife is a creditor in this case. I am also a life insurance agent in OK and TX and have never heard of such a thing happening, yet here I am. Is it legal what Cigna is doing?
Also, just to let you know I was informed by his ex-wife the day after he died that she would make sure I never, in her words, " see a dime of the money" and that she would keep it tied of for years if she can.

I forgot to add, that Cigna filed this case under the ERISA law, because his insurance was through his employer. I have read through these laws and have not found anything that states that the insurance should be paid to anyone other than the beneficiary.

Thanks for any help you can provide.

Posted: 18 Apr 2010 02:49 Post Subject:

Melissa . . .

An old (1996) ruling from the US Department of Labor concerning the effect of ERISA on group life insurance benefits states that state laws regulating insurance companies are not preempted by ERISA. State laws aimed at employers but not at insurance companies, such as the Minnesota laws in questions, are preempted under federal law.

Since beneficiary designations are a state regulated matter, unless something is not being said, I don't think there is a federal cause of action here. You probably need to hire an insurance bad faith lawyer and go after CIGNA.

And absent her name as a designated beneficiary, the ex- should have no say in the matter.

The link the the DOL ruling is

Additionally, on a website maintained by the University of Chicago, the following information appears:

Enforce Your Rights

If your claim for a welfare benefit is denied or ignored, in whole or in part, you have a right to know why this was done, to obtain copies of documents relating to the decision without charge, and to appeal any denial, all within certain time schedules.

Under ERISA, there are steps you can take to enforce the above rights. For instance, if you request a copy of plan documents or the latest annual report from the plan and do not receive them within 30 days, you may file suit in a Federal court. In such a case, the court may require the plan administrator to provide the materials and pay you up to $110 a day until you receive the materials, unless the materials were not sent because of reasons beyond the control of the administrator.

If you have a claim for benefits which is denied or ignored, in whole or in part, you may file suit in a state or federal court. In addition, if you disagree with the plan's decision or lack thereof concerning the qualified status of a domestic relations order or a medical child support order, you may file suit in federal court. If it should happen that plan fiduciaries misuse the plan's money, or if you are discriminated against for asserting your rights, you may seek assistance from the U.S. Department of Labor, or you may file suit in a Federal court. The court will decide who should pay court costs and legal fees. If you are successful the court may order the person you have sued to pay these costs and fees. If you lose, the court may order you to pay these costs and fees, for example, if it finds your claim is frivolous.

Assistance with Your Questions

If you have any questions about your plan, you should contact the plan administrator. If you have any questions about this statement or about your rights under ERISA, or if you need assistance in obtaining documents from the plan administrator, you should contact the nearest office of the Employee Benefits Security Administration, U.S. Department of Labor, listed in your telephone directory or the Division of Technical Assistance and Inquiries, Employee Benefits Security Administration, U.S. Department of Labor, 200 Constitution Avenue N.W., Washington, D.C. 20210. You may also obtain certain publications about your rights and responsibilities under ERISA by calling the publications hotline of the Employee Benefits Security Administration.

That link is [/b]

I have always found the EBSA (formerly PWBA) to be cooperative and highly effective. When a former employer was fooling around with 401(k) contributions and loan repayments, I filed a complaint and they were on it in a matter of a couple of weeks. Cost the employer some bucks to make it right with DOL. And when he did it again several months later, and I filed a new complaint, then-PBWA came in and froze the entire plan in order to do an audit. That cost him even more!

DOL does not fool around! You can find them in the Government Pages of your local telephone book, or at [b]

Glad you asked, I wasn't entirely sure ERISA applied to group life, but it certainly does. But notice that violations can be pursued in state or federal court. If CIGNA actually has removed the matter to federal court, filing an action in state court is not going to get you anywhere. The state court has to defer to the federal court until there is an outcome.

So the lawyers I mentioned in my PM to you will be able to take that matter to federal court.

Keep us posted! [/b]

Posted: 18 Apr 2010 06:53 Post Subject:

This is a clear and cut situation for a bad faith attorney; you need to seek legal help to resolve this issue. Best of luck!

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