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New York Life Group Long-Term Disability Insurance Denials

Has your New York Life disability insurance claim been denied? Our disability insurance attorneys have the experience you need to fight for your New York Life long-term disability insurance claim. Call our New York office today at 888-583-4959 to learn how we can help protect you from this powerful insurance company. The disability insurance lawyers at the Law Office of Justin Frankel have successfully represented claimants nationwide whose disability benefits have been denied or terminated by New York Life, CIGNA, and LINA (Life Insurance Company of North America), another large disability insurance company affiliated with CIGNA and now part of New York Life.

Can New York Life Insurance Company Change My CIGNA Disability Insurance Policy?

New York Life Insurance purchased CIGNA’s group life, accident, and disability business in 2020, so all of CIGNA disability claimants have been moved over to New York Life. New York Life employs the same insurance claim-handling tactics of delay, denial, and termination as CIGNA. Therefore, claimants should be concerned about their disability claims and benefits being jeopardized.

Most of CIGNA’s disability coverage is provided to large and small companies rather than individual insurance policies, which means they are governed by ERISA, a federal law with many strict procedures. Thus, these are often called ERISA disability claims. When New York Life purchased CIGNA, your policy, as well as millions of others, became “legacy” policies — disability insurance policies considered part of a book of business and liabilities to New York Life. When such consequential corporate transactions take place, one of the company’s first actions is an internal review of all claims that are being paid benefits to see which ones could be reasonably terminated.

While New York Life cannot legally change the terms of your insurance policy, which is a contract between you and the insurance company, they typically are more aggressive about terminating legacy insurance benefits.

If your New York Life, CIGNA, or LINA short or long-term disability insurance benefits have been denied or terminated, call the Law Office of Justin Frankel today for a free consultation at 888-583-4959.

Pregnancy and New York Life Disability Claims

Pregnancies can have complications, warranting extra insurance coverage if you need to take some extra time off of work. In these cases, you may need short-term disability insurance if you are prevented from returning to your own occupation immediately after the birth. Short-term benefits, however, only last up to a year. Fortunately, employers often help with short-term benefits, as they classify pregnancy as a disability instead of implementing a maternity leave policy.

If you are looking for long-term disability benefits, a typical pregnancy will not qualify. Long-term disability insurance does not cover pregnancy and childbirth, but it does cover any complications that may arise during the process. Keep in mind that this is distinct from maternity leave. Disability benefits cannot be claimed if you are on maternity leave unless your doctor orders bed rest or you undergo a complicated birth. Some common complications include C-sections and Perinatal Mood and Anxiety Disorder (PMAD).

Schedule a free consultation with our nationwide attorneys to learn more about your options.

Common Reasons for a New York Life Disability Denial

New York Life denies insurance benefits for various reasons. The following are some of the most common.

Insufficient Medical Evidence

In order to qualify for New York Life disability insurance benefits, you will need to demonstrate that your disability exists with medical evidence. Having access to your medical records and seeking treatment for your disability is essential in ensuring this evidence is available. Your insurance may request that you receive an independent medical examination (IME). These exams tend to lead to benefits denials, so if New York Life Insurance requests an IME, consult with your long-term disability insurance claims attorney.

Noncompliance With Medical Treatment

If treatment is recommended for your disability, you have to comply with the doctor’s treatment plan. If you fail to do so, you may no longer qualify for disability benefits. Even if you already received disability benefits, New York Life could terminate them if you do not comply with your treatment plan.

Disability Not Covered By Policy

Disability insurance coverage varies, so you’ll need to check your specific New York Life insurance policy to determine whether you are covered. A genuine disability with evidence demonstrating its existence does not ensure coverage if the disability is not covered by your insurance policy or is compounded by a pre-existing medical condition.

Fails to Meet the Definition of Disability in Your Policy

Every disability policy defines disability in its own unique way. Your disability must meet this definition, and New York Life may argue it does not.

Missed Deadlines

You must abide by a particular time frame when filing any kind of insurance disability claim. If you fail to meet the time limit during the appeal process, your New York Life insurance claim could be denied by default.

Dispute of Your Condition or Its Severity

Insurance carriers strive to deny as much coverage as they can get away with. Their business model is based on this strategy. They will try to deny that your condition is serious enough to warrant insurance benefits, or they may even deny that it exists altogether. This commonly happens with disabilities that are not visible, like fibromyalgia and Chronic Fatigue Syndrome. Insurance companies may also use surveillance footage of you to undermine your short or long-term disability claim and deny you benefits.

What to Do When New York Life Denies Your Disability Insurance Claim

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When your insurance claim is denied, you will receive a written copy of the denial in the mail or via email. This will state the reasons why your benefits were denied and let you know how you can file an appeal. The denial letter will also detail the deadline for filing this appeal. The following are the steps to follow when making your appeal.

1. Contact a Long-Term Disability Insurance Denial Attorney

Going up against New York Life can be tough on your own, so you should get assistance from a long-term disability insurance lawyer who’s well-versed in disability insurance law. They will walk you through the process, fight for the benefits you deserve, and even represent you in court if necessary.

2. Review the Reason for the Denial

As a disclaimer, the reason for your benefits denial is key to filing your appeal. Your appeal must be centered around demonstrating why the reason for benefits denial is not valid. An experienced long-term disability insurance lawyer can help make your case.

3. Request a Copy of Your Claim File and Policy

By having your claim file and policy on hand, you can make specific references to your insurance coverage, which will help solidify your case for receiving benefits. You may receive this information from New York Life upon request.

4. File an Appeal

When it is time to file the appeal, you will need to know whether you have an ERISA policy, which is common with group disability insurance. For ERISA policies, you must file an appeal within 180 days. Non-ERISA policies, on the other hand, allow you to either file an appeal or file a lawsuit. You will be better protected with a long-term disability insurance attorney handling your appeal, as these are complex and critical documents.

Tips for Protecting Your New York Life Disability Insurance Claim

When you file a long-term disability insurance claim with CIGNA, there will be some challenges. These tips will help you avoid common causes of long-term disability insurance denials.

Compile Thorough Medical Records

Medical records are an essential piece of evidence, and your doctor will need to be thorough in their documentation of your impairment. This means including details of your condition and how it limits your ability to perform the material tasks of your occupation, rather than a simple diagnosis.  Their response to your New York Life long-term disability claim could make the difference between approved benefits and a denial. A long-term disability insurance attorney will work with your physician to ensure the medical record is robust and supports your claim.

Document Interactions With New York Life Representatives

You’ll also want to be careful about documenting your contact with any New York Life representatives. Every time you interact with a representative from the insurance company or from one of the many subcontractors that New York Life hires to investigate long-term disability benefits claims, take detailed notes. Here are some of the people who might contact you directly at New York Life’s direction:

  • Claims adjusters
  • Nurse practitioners
  • Medical doctors
  • Insurance company lawyers
  • Investigators

Understand You May Be Surveilled

Depending on your age, the nature of your claim, and the value of your benefits, you might be subject to surveillance. These are the professionals you won’t meet — they’ll more than likely conduct video surveillance to track your comings and goings or anything you do outside your home. Yes, it’s creepy, but it’s part of the long-term disability insurance claims management process.

Often, minor activity is utilized by New York Life to attempt to prove you are less disabled than reported. This includes posts on social media. If you make a post or are tagged in a picture that appears to contradict your long-term disability claim, New York Life may use it as evidence to deny your insurance benefits.

How the Law Office of Justin Frankel Helps With New York Life Disability Claim Denials and ERISA Appeals

The attorneys at the Law Office of Justin Frankel have successfully represented many disability insurance policyholders in their quest to obtain or maintain their short-term and long-term disability insurance benefits from New York Life, CIGNA, or LINA. We know the tactics and strategies used by New York Life to delay and deny benefits.

The Law Office of Justin Frankel also helps claimants whose ERISA or non-ERISA insurance claims have been denied or terminated and who must undertake an ERISA appeal before they can pursue litigation against New York Life. Our appeal formula for overturning a denied or terminated long-term disability insurance claim addresses a myriad of medical, vocational, factual, and legal issues.

Our nationwide disability insurance law firm can help you through the entire process, including:

  • Filing your initial claim for benefits with New York Life
  • Reviewing your policy and reason for denial of benefits with a free case evaluation
  • Filing your long-term disability insurance case appeal
  • Communicating with New York Life on your behalf
  • Compiling and submitting evidence and documentation
  • Advising your attending physician on what information to put in their medical report.
  • Representing you in court and/or settlement negotiations

Call our office today for a free consultation at 888-583-4959. We represent New York Life long-term disability insurance and ERISA clients nationwide.

Protect Your Claim Against New York Life

The Law Office of Justin Frankel helps short-term and long-term disability claimants pursue their rights against New York Life, CIGNA, and LINA in federal court so they either get a resolution to their insurance claims or closure to their concerns through a settlement. We have successfully litigated against New York Life many times and have an intimate knowledge of how New York Life’s claim handling and ERISA appeals unit works and its strategies in litigation.

If your New York Life, CIGNA, or LINA long-term insurance disability benefits have been denied, do not hesitate to contact our legal team. There is no obligation, and the call is free.

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