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Astros sue CIGNA over denial of Bagwell claim

Insurer disputes first baseman was totally disabled

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Astros sue CIGNA over denial of Bagwell claim

HOUSTON--The Houston Astros baseball team has sued CIGNA Corp. for denying a $15.6 million claim related to an injury suffered by first baseman Jeff Bagwell.

In a lawsuit filed last Monday in the 129th Judicial District Court in Houston, the Astros allege that the insurer wrongfully denied coverage from an insurance policy purchased by the team to cover the Astros if Mr. Bagwell were to become totally disabled. The team filed a claim for approximately $15.6 million in January, saying an injury to Mr. Bagwell's right shoulder has left him totally disabled, but CIGNA denied the claim last month.

A key part of the dispute arises from the fact that Mr. Bagwell, who had surgery on the shoulder in June 2005, played at the end of the regular baseball season and in the playoffs in September and October 2005.

"The Astros have not identified anything that changed in Mr. Bagwell's health or condition since they played him last fall," said Ty Buthod, a partner with Houston-based Baker Botts L.L.P. who represents Connecticut General Life Insurance Co., the legal entity of Philadelphia-based CIGNA. "We have denied the claim, and we haven't been provided any reason to reverse our decision in denying the claim."

In the policy, total disability would mean Mr. Bagwell's complete and total physical inability to participate in baseball activities. His injury, while preventing him from throwing, does not prevent him from hitting, Mr. Buthod said. "We believe that the definition of total disability simply is not met," he said. "His inability to throw does not constitute a total disability. There is no partial disability component in the policy whatsoever."

Wayne Fisher, a partner with Houston-based Fisher, Boyd, Brown, Boudreaux & Huguenard L.L.P., who represents the team, could not be reached for comment. Previously, though, the Astros argued that the fact that Mr. Bagwell played in the World Series has no bearing on the legitimacy of its claim, because Mr. Bagwell was diagnosed as being totally disabled on Jan. 12 after being examined by Dr. James Andrews, a prominent sports medicine orthopedic surgeon at the Alabama Sports Medicine & Orthopedic Center in Birmingham, Ala.