At Disability Insurance Law Group, our national claims attorneys know New York Life Insurance Company became one of the largest group disability insurance companies when they purchased Cigna’s disability income and life insurance division for $6.3 billion.
Operating since 1845, New York Life is no stranger to the insurance business and is the largest mutual insurer in the U.S., with over $300 billion in assets under management.
Before purchasing Cigna, New York Life handled long-term disability insurance claims, but they were almost exclusively individual disability policies and not employer-provided disability coverage. With Cigna’s portfolio, New York Life offers employer-provided disability policies governed by the Employee Retirement Income Security Act of 1974 (ERISA).
While many workers believe that because New York Life policies are offered by their employers, the insurer will provide little to no resistance when employees need to pursue their disability benefits. Unfortunately, it takes very little time to learn this is untrue.
That is why we are here. Our disability insurance attorneys represent New York Life policyholders nationwide — no matter where they live or work in the U.S. — with only their best interests and true success in mind so our clients can pursue the benefits they are entitled to from their employer-provided coverage or personal policies.
ERISA is often viewed as a pro-insurance company federal law governing all employer-provided benefits. When employees pursue ERISA disability insurance policies, no matter where they live or work in the U.S., they are typically met with resistance from the insurer – no matter how complete their application.
Some factors contributing to ERISA claims being denied more often than private disability insurance claims include, but are not limited to:
ERISA disability claims are often subject to a “deferential” or “arbitrary and capricious” standard of review by the courts. This means that, in legal challenges, courts may give deference to the decisions of the plan administrator unless those decisions are found to be unreasonable.
This standard may make it more challenging for claimants to overturn denials compared to the “de novo” standard often applied in private disability insurance claims.
ERISA claims involve a complex and specific set of procedures for filing claims, appeals, and legal challenges. The administrative process for ERISA claims can be intricate, and failure to adhere to the procedural requirements may result in a denial. Individuals may find it challenging to navigate these procedures without legal assistance.
ERISA imposes limitations on the remedies available to claimants. In most cases, the remedies are restricted to paying benefits owed, and punitive damages are unavailable. This may reduce the incentive for insurers to settle claims and increase the likelihood of denials.
ERISA preempts many state laws related to insurance, and this can limit the legal remedies available to claimants. State laws that provide additional protections or allow for certain types of damages may not apply to ERISA claims, potentially placing claimants at a disadvantage.
Many ERISA plans grant discretionary authority to the plan administrator in making claim determinations. Courts may defer to the administrator’s judgment unless deemed unreasonable. This discretionary authority can make it more challenging for claimants to challenge denials successfully.
ERISA claims often involve limited discovery during legal proceedings. This limitation can restrict the claimant’s ability to gather and present evidence in their favor, potentially affecting the outcome of legal challenges.
It is important to note that the perception of ERISA claims being denied more frequently does not imply that private disability claims are always more successful. Individual circumstances, the specific terms of the insurance policy, and the nature of the disability all play crucial roles in the claims process.
Whether you are considering applying for benefits, are waiting for a claim’s decision, or have been denied, we can assist you with your New York Life disability claim anywhere in the country, starting with a free consultation.
We are fully dedicated to providing transparent legal services that allow us to pursue real results for real people who need our help – no matter where they live or work in the U.S.
If you are receiving resistance from New York Life for your U.S. disability claim, or if your claim has already been denied, contact our dedicated disability insurance attorneys nationwide at 954-989-9000 or online to schedule a free, confidential case assessment without delay.
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