New York Life

My experiecne with New York Life has been a complete headache

Reviewed by Sandra on February 15th 2017   Verified Policyholder
I was out on short term disability due to surgeries on both feet. I received a letter from New York Life indicating that I had 14 days beginning January 6 to submit the revised medical records, and after that it has been a complete headache. New York Life did not honor the 14 days that I was given. Instead, my disability was suspended right on 1/6. During those 14 days I kept calling to learn what was missing, what else was needed, but got no help at all. Since that date, I have left 9 voicemails for my claim manager and not once has he called me back. Every time I get someone live, the first answer I get is that my medical info is missing. As soon as I let them know that I have confirmation the fax went through, then they acknowledge the medical info is in fact in the database. After multiple conversations with many Customer Care individuals, I learned on 2/7 that my claim was denied because my job was considered sedentary and they did not have information to decide otherwise. So, I had my manager resend the document he had already sent (and I have proof) describing my job. Today, I learned from a Customer Care person, that my case was still denied. I asked her to please include the fact that I have left 9 voicemails, etc, in my file and she kept interrupting and defending their actions. I asked her to please let me finish and she said “I could just hang up and close this file, everything was done within guidelines...” She said I was sent a letter on 2/7 but I have not received anything in the mail. The nurse case manager never spoke with me, nor examined me so I don’t understand how it can be decided that I was in condition to work when the medical restrictions were so extensive (feet elevated above hip level, no flexing, icing 20 minutes every hour, no more than 10 minute weight-bearing per hour, I was on surgical shoes, even today I am on a no-drive restriction still, etc.) he nurse case manager never spoke with me, nor examined me so I don’t understand how it can be decided that I was in condition to work when the medical restrictions were so extensive (feet elevated above hip level, no flexing, icing 20 minutes every hour, no more than 10 minute weight-bearing per hour, I was on surgical shoes, even today I am on a no-drive restriction still, etc.) The person I talked to today says my only option now is to file an appeal. Does your team offer service to file appeals with New York Life? At this point, I think I need legal help.
Reply
Sent on February 15th 2017 by Attorney Stephen Jessup

Sandra, unfortunately, the overwhelming majority of claims are denied following a review of the file by a doctor or nurse without ever examining the insured. When you receive your denial letter please feel free to contact our office to discuss how we may be able to assist you in appealing the denial.