Widow sues over denial of accidental-death claim

A Vashon Island woman filed a lawsuit Thursday in federal court against CIGNA Group Insurance, claiming the company wrongfully denied her $500,000 in accidental-death benefits after her husband died in 2006.

Attorneys for Jodi Scanlon say her case is the first major lawsuit of its kind since Washington voters in November approved Referendum 67, which allows policyholders to sue for triple damages if an insurance company "unreasonably" denies a legitimate claim.

Scanlon's husband, Michael, 56, was suffering from multiple sclerosis and living part time in a Beacon Hill nursing home, where he fell and struck his head in November 2006, court records show.

The fall led to a traumatic brain injury from which he never recovered, according to court records, which cite an autopsy report ruling the death an accident.

Michael Scanlon had been out of work for years because of his illness, his wife said, so she put him on her accidental-death-insurance policy through her employer, King County.

She submitted a claim to CIGNA five days after her husband's death, but ultimately was told his death was not accidental because it was caused by a heart attack, she said.

"What this is really about is fraud ... fraud committed by insurance companies," said Mike Nelson, Scanlon's attorney. "They came up with a reason to deny [the claim]."

CIGNA officials released a two-sentence statement Thursday in response, saying:

"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. CIGNA Group Insurance will fully explain its position within the context of the litigation."

Jodi Scanlon met her husband in 1977 at a science-fiction convention, she said. They married in 1990 and had two children.

Her husband, once an active man who worked for United Way, started to show signs of multiple sclerosis in 1994 and slowly started to decline, she said.

He was still receiving Social Security checks until his death, she said, which helped supplement her income working in the King County traffic-records division.

She paid the policy premium for 10 years, and was stunned to receive the rejection letter from CIGNA on April 6, 2007, she said.

It stated that a physician adviser, who reviewed her husband's medical records, determined the fall was caused by a pre-existing heart condition, court records say. The condition was made worse by the blood-thinning aspirin he was on, which contributed to his death, documents say.

Under the new Insurance Fair Conduct Act, Scanlon could be awarded $1.5 million if she wins in court.

But, she said, "there's no way they [CIGNA] can ultimately take away the pain they have put me through."

Sonia Krishnan: 206-515-5546

or skrishnan@seattletimes.com