Question

How can New York Life claim I have a preexisting condition when they have all of my medical records?

Asked on May 5th 2016 by Angela
I am an RN staff nurse and I bought a New York Life policy at work. In October I developed shortness of breath and was hospitalized. I was after diagnosed with myasthenia gravis and receive IVIG at home. New York Life approved my STD. I have since been diagnosed with anti-GAD stiff person syndrome in addition, which is compassionate SSI I understand. New York Life finished paying my 3 month STD, and has refused to consider my LTD after months now saying they need further info to evaluate my claim. We are getting evicted on Thursday. I filed a complaint with the GA Insurance commissioner and now I have another person handling the claim, and he flat out told me that they are trying to deny the claim based on preexisting condition (which is absurd since they already have all my medical records). I have begun emailing them, and let them know that it is immoral and they are acting in bad faith by deliberately stalling my claim. He apologized and said the claim was not handled correctly, but that it would be now (it has been 4 months). An immoral company that will take your money and give you a paper with a policy written on it, but no actual insurance policy to go with it. How are companies allowed to scam people like this?

Answer

Answered on May 6th 2016 by Attorney Cesar Gavidia

Angela, if a claim for benefits under the policy was made within 12 months of coverage that will always trigger a pre-existing condition evaluation. Please feel free to contact our office to speak with one of the disability attorneys to discuss your claim in greater detail.