Appealing a Denial of Disability Benefits from New York Life Insurance
If you have been denied disability benefits from New York Life Insurance, you may feel discouraged and overwhelmed. However, it is important to remember that you have options. New York Life insurance can be difficult to work with if you do not understand your legal rights as a policyholder. Understanding the nuances of your policy and your personal situation can be challenging for anyone, including attorneys who do not specialize in this area of law.
Working with an experienced and skilled attorney often determines whether you can win your appeal or whether you will be forced to sue the insurance company. Our attorneys understand you are frustrated, and we want to help you win your fight with New York Life. Below are some important items you need to consider when dealing with a appeal of denial benefits from New York Life Insurance.
This article will guide you through the process of appealing a denial of disability benefits from New York Life Insurance.
- Understanding Disability Insurance
- Reasons for Denial of Disability Benefits
- The Appeals Process
- Gathering Evidence for Your Appeal
- Writing an Appeal Letter
- Working with an Attorney
- The importance of persistence
Disability insurance is designed to provide financial support to individuals who are unable to work due to a disability. New York Life Insurance is a well-known provider of disability insurance policies. Unfortunately, not all disability claims are approved. If you have been denied disability benefits from New York Life Insurance, it is important to know that you have the right to appeal the decision.
Understanding Disability Insurance
Disability insurance is designed to replace a portion of your income if you become unable to work due to a disability. Policies can vary widely in terms of coverage, premiums, and eligibility requirements. Some policies may cover only specific types of disabilities, while others may cover a broader range of conditions. It is important to review your policy carefully to understand your coverage and eligibility requirements.
Reasons for Denial of Disability Benefits
There are many reasons why a disability claim may be denied. Some common reasons include:
- Insufficient medical evidence supports the claim.
- Failure to meet the policy’s definition of disability
- Failure to provide complete or accurate information on the claim form
- The claim was filed after the policy had lapsed or been terminated.
- The policy does not cover the type of disability claimed.
- The policyholder did not meet the waiting period before making a claim.
- The Appeals Process
If your disability claim has been denied, the first step is to understand the appeals process. The appeals process can vary depending on the insurance company and policy, but typically involves several steps:
- Request an internal review: The first step is to request an internal review of your claim by the insurance company. This involves submitting additional medical evidence or other information that may support your claim.
- File an administrative appeal or request for reconsideration: If New York Life initially denies the claim, in many cases you may not file suit immediately. Depending on the terms of your policy and the governing law, you may have to ask New York life to re-review the matter in an “administrative appeal” (if your claim is governed by ERISA) or a request for reconsideration (if it is not). This is the most important step in your claim and where a disability expert attorney can do the most good. For the reasons why – see here.
- Consider legal action: If your claim is still denied after an external appeal, you may want to consider taking legal action. This can involve filing a lawsuit against the insurance company or working with an attorney to negotiate a settlement.
- Gathering Evidence for Your Appeal: When appealing a denial of disability benefits, it is important to gather as much evidence as possible to support your claim. This can include medical records, physician statements, and other documentation that demonstrates the severity of your disability and your inability to work.
- Writing an Appeal Letter: One important step in the appeals process is writing an appeal letter to the insurance company. Your appeal letter should include a detailed explanation of why you believe your claim was wrongly denied, as well as any additional evidence or documentation that supports your claim.
- Working with an Attorney As noted here, it is almost always a mistake to try to handle your own appeal. You should consider at least speaking with, if not hiring, an attorney who specializes in disability insurance claims. An attorney can help you understand your legal rights and options, as well as provide guidance on how to navigate the appeals process. Remember, too, that most attorneys will provide a free consultation as to your initial phone call.
- The Importance of Persistence: Appealing a denial of disability benefits can be a long and frustrating process. However, it is important to remain persistent and not give up. Keep track of all correspondence with the insurance company, and follow up regularly on the status of your claim. With persistence, you may be able to successfully appeal the denial of your disability benefits.
If you have been denied disability benefits from New York Life Insurance, it can be a stressful and challenging experience. However, it is important to remember that you have options. By understanding the appeals process, gathering evidence, and working with an attorney if necessary, you may be able to successfully appeal the denial of your disability benefits. Don’t give up, and remember that persistence can pay off in the end.
- What should I do if New York Life Insurance denies my disability claim? – You have the right – and possibly the legal obligation – to appeal the decision on a timely basis. The appeals process typically involves marshaling additional evidence to prove the validity of your claim and requesting an internal review by New York Life.
- What kind of evidence should I gather for my appeal? – You should gather as much medical evidence as possible to support your claim. This can include medical records, physician statements, and other documentation that demonstrates the severity of your disability and your inability to work.
- Do I need an attorney to appeal a denial of disability benefits? – Appealing on your own is dangerous. We have reviewed many claims where an unrepresented person did irreparable damage to their claim – even where the disability should have been winnable with expert help. While you are not required to work with an attorney, it an attorney can do the most good during, not after, the appeals process. An attorney who specializes in disability insurance claims can help you understand your legal rights and options, help to arrange testing and medical opinions, and generally provide guidance on how to navigate the appeals process.
- How long does the appeals process typically take? – The appeals process can vary depending on the insurance company and policy. It may take several months or even years to successfully appeal a denial of disability benefits.
- Is it possible to receive retroactive benefits if my appeal is successful? – Yes, if your appeal is successful, you may receive retroactive benefits for the period your claim was denied.
If you are reading this before your appeal is due, then now is the time to contact an ERISA expert for a free phone consultation. The attorneys at Robinson & Warncke have a 95% success rate in getting benefits paid when we can prepare the administrative appeal. Call our firm today, we will fight for you.