Renton, WA

Back in October, we in WA state passed R67, which makes it illegal for an insurance company to “unreasonably” deny a claim. And now, the first test is coming to court.

Cigna Life insurance provided accidental death insurance for a man who died, apparently accidentally. He had multiple sclerosis and died after a fall. According to Cigna, however, their team of doctors decided that the man had a heart attack which caused his death. I believe the cause of death is decided by an autopsy, not insurance lawyers - I watch CSI so I know these things - but at any rate, I would expect that having a heart attack would be accidental as well. However, technically a heart attack doesn’t count as an accident, and wouldn’t be covered by the accidental death policy.

Jodi Scanlon has obtained an attorney. They feel that Cigna has looked for excuses to unreasonably deny the claim, first by blaming a heart attack, and then his medication, as not covered under the terms of the policy. “Cigna Group Insurance determined, based on extensive medical review, that the unfortunate circumstances of Mr. Scanlon’s death were not covered under the terms of the accidental death insurance policy,” said Gloria Barone with the company.

Now a jury will decide if an insurance company unreasonably denied a family’s claim and whether Cigna will be the first to pay triple damages. I imagine that no jury is sympathetic to insurance companies when they deny claims, so it may be hard finding a impartial jury. Watch this precedent-setting case. Cigna says it will give a more detailed explanation for denying the family’s claim in court.