New York Life is one of the largest providers of group disability insurance offered to individuals through private sector employers. These benefits and claims are governed under the Employment Retirement Income Security Act of 1974 (ERISA). In 2021 New York Life completed its purchase of CIGNA’s group life, accident, and disability business for $6.3. billion, adding nine million customers and creating a new division called, “New York Life Group Benefit Solutions.” Many of the same employees who had adjudicated claims at CIGNA moved to New York Life.
New York Life used to sell individual disability insurance policies but closed out that business more than two decades ago. Those claims are administered by the Unum Group. In January 2000, New York Life transferred its closed block of individual disability income business to the Unum Group pursuant to a sale and purchase agreement, a 100% modified coinsurance reinsurance agreement. Today, if a New York individual policyholder files a claim, her claim will be handled by the Unum Group.
When faced with an injury or medical condition that hinders your ability to work, long-term disability (LTD) insurance from companies like New York Life is meant to provide vital financial support. Unfortunately, New York Life has been known to deny legitimate claims, leaving many deserving individuals without the much-needed benefits they deserve. New York Life’s
Why New York Life Denies Disability Claims
Understanding the reasons behind New York Life’s denial of disability claims helps navigate the appeals process effectively. One reason that individual disability claims may be unfairly denied is that the claims are handled by the Unum Group. The Unum Group has a checkered history of claim denials. The behavior was discussed by the leading ERISA law scholar at Yale Law School in 2007. Langbein, John H., “Trust Law as Regulatory Law: The Unum/Provident Scandal and Judicial Review of Benefit Denials Under ERISA,” 101 NW. U.L. REV. (2007). Professor Langbein exposed what he called Unum Group’s deliberate program to deny meritorious claims.
Here are some common reasons for claim denials:
- Lack of Objective Medical Evidence: Failure to provide substantial medical evidence supporting your impairment may result in denial.
- Policy Exclusions: Some disability policies have specific exclusions, such as preexisting conditions, which could lead to a denial.
- Inability to Prove Disability: If you can’t demonstrate that your disability prevents you from performing your occupation or any job, the claim might be denied.
- Hired Medical Opinions: New York Life may employ its medical professionals who claim you are fit to work, even without examining you.
- Claiming Ability for Sedentary Work: The insurer might argue that you can perform sedentary work, leading to denial.
- Pending Medical Procedures: If you have a pending medical procedure, New York Life might not wait for its completion before denying your claim.
How Our Attorney Can Help
If your long-term disability insurance claim has been denied by New York Life, we’re here to offer assistance and support. To start the process, please provide us with the denial letter through fax/email/mail for a free review and detailed strategy for moving forward. Remember that time is of the essence, as there is a limited window to appeal.
Before applying for disability, consider scheduling a call with our long-term disability attorney. During the consultation, we will evaluate your disability policy, discuss medical issues, and assess your job-related challenges. This will provide you with a well-informed plan of action.
For those still researching, explore our free online resources, including a downloadable disability guide, informative articles, FAQs, and videos, all designed to answer any questions you may have.
Wrongful Denial of LTD Benefits by New York Life
New York Life often relies on claimants giving up during the appeals process, which boosts their profits. Yet our experienced long-term disability attorney knows the tactics used by insurance companies like New York Life and will fight to protect your rights and reinstate your benefits.
Appealing a New York Life Denial
Appealing an LTD denial is complex, and it’s highly advisable not to go through it alone. Our long-term disability attorney can navigate the appeals process for you, ensuring all necessary documentation reaches the insurance company within the strict deadlines.
Expectations While Your Claim is Being Paid
Although your claim might be first paid without issues, it’s essential not to become complacent. New York Life may later request updates from your attending physician or outright deny your benefits. Vigilance is necessary to protect your rights.
Steps After a Claim Denial
Upon receiving a denial, New York Life must provide written notice with justifications and information about the appeal process. Obtain a written copy of the decision and contact us for a free review of your denial letter.
Navigating ERISA Appeals
Filing ERISA appeals requires expert guidance, as insurance companies often benefit from this federal law. Our nationwide ERISA-trained disability lawyer can help you prepare the necessary documentation and legal arguments for reversing the denial effectively.
Gather all relevant medical records, letters from treating doctors, reports from experts, and personal accounts to strengthen your appeal. The sooner you begin this process, the better your chances of success.
When faced with a wrongful denial of LTD benefits by New York Life, seeking professional assistance is essential. Our long-term disability attorney is familiar with dealing with insurance companies and can help you navigate the appeals process effectively. Don’t let a denial deter you; reach out to us for a free review and robust representation in your appeal. Let us fight for your rights and the benefits you rightfully deserve.
Navigating an Individual Disability Policy Appeal.
The strategy is like appealing a claim governed under ERISA. But the process is more forgiving. That doesn’t mean you should tackle this alone. Your financial future and peace of mind is on the line. Getting help from a knowledgeable disability attorney, such as Jonathan Feigenbaum is to your advantage.
