New York Life Group Benefit Solutions (Formerly Cigna) Long-Term Disability Denial Lawyer

Ortiz Law Firm’s Extensive Experience with New York Life

At the Ortiz Law Firm, we have extensive experience handling long-term disability claims with New York Life, having represented clients in hundreds of cases involving this insurer. Whether we are appealing long-term disability denials, filing lawsuits, or negotiating settlements, we are deeply familiar with the tactics New York Life uses to deny or delay paying benefits. This gives us a significant advantage in anticipating and countering their strategies.

Attorney Nick Ortiz is not only well-versed in the legal framework surrounding long-term disability claims, but he also has a unique insight into how New York Life operates. Over the years, he has built professional relationships with many of the defense attorneys that New York Life frequently hires. In fact, Nick speaks with these attorneys multiple times each week, and he even has their cell phone numbers—meaning he can reach out to them directly at any time to discuss cases and facilitate negotiations. This level of familiarity and access can make all the difference when fighting for the benefits you deserve.

Our firm’s deep understanding of New York Life’s internal processes and defense tactics allows us to deliver focused, effective representation that is tailored to your specific case. You can trust the Ortiz Law Firm to stand up to New York Life and fight aggressively for your rights.

New York Life Group Benefit Solutions Long-Term Disability Denials

If New York Life Group Benefit Solutions denies your long-term disability claim, you are not alone. We speak with individuals daily who have been denied long-term disability benefits by NYL GBS or are worried that NYL GBS will cut off their benefits. Each week, numerous ERISA disability lawsuits alleging unreasonable claim denials are filed against NYL GBS in federal court. Our disability insurance attorney has helped hundreds of disability claimants with administrative appeals and federal ERISA lawsuits against Cigna/NYL GBS.

Why Does New York Life Group Benefit Solutions Deny So Many Long-Term Disability Claims?

Like any other business, New York Life is trying to make as much money as possible. This means collecting premiums and paying out as little as possible on claims. As a result, NYL GBS disability claim denials have become increasingly common.

Based on our experience, New York Life frequently overlooks details when evaluating disability claims. They have refused disability benefits without physically examining the claimant (the person making the claim). They will give more weight to hired doctors’ opinions than your treating physicians.

Moreover, they sometimes use video surveillance to suggest that a claimant can resume their job. Many NYL GBS denial letters are issued when the definition of disability changes from an inability to perform your “own occupation” to “any occupation.” It’s also common for NYL GBS to cite “lack of objective evidence” as the reason for denial.

Top 10 Reasons for New York Life Group Benefit Solutions Disability Denials

1. The objective medical evidence does not support your subjective complaints.
2. NYL GBS had your records reviewed by an in-house nurse or medical professional who determined that no restrictions or limitations prevent you from working.
3. NYL GBS sent your file to a third-party medical professional who determined you could work without examining you.
4. NYL GBS agreed that you have some limitations but that your disabling condition is pre-existing.
5. NYL GBS sent you for an “independent” medical exam and assigned more weight to the opinion of the hired doctor, disregarding the opinions of your treating physicians.
6. NYL GBS hired a vocational expert who determined that there are other occupations that you can still perform despite your restrictions and limitations.
7. NYL GBS tried to contact your doctor but did not give your physician enough time to respond, or your doctor said something that hurt your claim.
8. NYL GBS hired a private investigator to conduct video surveillance and used your everyday activities to justify a claim denial.
9. The definition of disability changed from “own occupation” to “any occupation,” and NYL GBS came up with another occupation you can perform.
10. NYL GBS determined that you have a limited benefit period because you suffer from a particular condition, like certain mental conditions or musculoskeletal disorders.

What To Do If You Receive a New York Life Group Benefit Solutions Disability Denial

The first step in appealing a New York Life Group Benefit Solutions disability denial is to request a copy of your claim file and policy. You will want to review your file to see what evidence was used to decide your claim. NYL GBS likely had you sign an Authorization to Obtain Information form, but that does not guarantee they obtained all your medical records.

Suppose NYL GBS conducted an in-house review of your medical records, ordered video surveillance, or obtained other evidence while evaluating your claim. In that case, it will also be included in your file, and you will have an opportunity to review and comment on this evidence.

The next step in preparing a strong NYL GBS appeal package is to obtain and submit medical evidence. Your denial letter will help you determine if any specific evidence is needed to support your claim, like missing medical records or a statement from your doctor.

It is also essential that you continue to get medical treatment. It is a good idea to submit any new evidence supporting your claim, such as visit notes from recent doctors’ appointments.

A History of Deceptive Practices

In 2009, the California Department of Insurance fined LINA / Cigna $600,000 and ordered them to re-evaluate thousands of wrongfully denied long-term disability insurance claims.

Then, in 2013, Cigna settled with California, Connecticut, Maine, Massachusetts, and Pennsylvania for improper claims-handling practices.  This settlement came after the insurance departments investigated Cigna’s improper denials of long-term disability claims and wrongful termination of existing benefit claims. Some of the specific allegations against Cigna included:

• Failing to adopt and implement reasonable standards for the prompt investigation and processing of disability insurance claims.
• Failing to disclose pertinent facts or insurance policy provisions relating to coverage issues.
• Unreasonably denying claims where it knew that the information required to approve the disability claim existed, but it did not obtain or review the information before making the denial decision.
• Failing to perform any functional testing of its own or to conduct a peer review of medical records on file.
• Failing to consult with health care professionals with appropriate training and experience in the field of medicine relating to the underlying disabling condition.
• Wrongfully terminating claims during the “any occupation” definition of disability policy period without performing a transferable skills analysis and labor market survey to identify alternate occupations appropriate to the respective claimants based on their restrictions, limitations, education, training, and experience.
• Failing to provide complete information from the claim file to the health care expert performing a medical review of the records.
• Failing to clarify a claimant’s restrictions and limitations when appropriate with the attending physician supporting disability.
• Failing to give due consideration to the medical findings of independent physicians.
• Discounting information provided by Social Security Disability decisions; and
• Failing to consider a claimant’s workers’ compensation records appropriately.

The settlement required Cigna to pay a fine of $1.675 million, improve its claims handling processes, and establish a program to review long-term disability claims that had been improperly denied or terminated in 2009 and 2010 (and 2008 for California residents.)

In December 2019, New York Life purchased Cigna’s disability and life division and rebranded it as New York Life Group Benefit Solutions (NYL GBS). This purchase made New York Life one of the five largest group disability insurance providers in the world.

We have not observed any improvement in claim handling processes since New York Life took over. The letterhead has changed, but everything else has remained the same as it was under Cigna. As such, claimants who understand Cigna’s claim-handling practices before the sale will be better prepared for the disability claim process with NYL GBS.

Learn More About New York Life Group Benefit Solutions Disability Claims and Lawsuits

• You can read about lawsuits against Cigna/NYL GBS nationwide. These cases are summarized here to help claimants understand how Federal Courts handle long-term disability insurance claims.
• You can also read summaries of some of the Cigna/NYL GBS disability claims that our firm has handled.
• Browse comments from those who have filed claims with NYL GBS, ask questions, or share your story about NYL GBS in our private support group. Attorney Nick Ortiz regularly replies to the submitted questions.

Get Help from A New York Life Group Benefit Solutions Disability Denial Attorney

At the Ortiz Law Firm, we believe that no one who cannot work due to an injury or illness should be denied the benefits they are entitled to under their insurance policy. If you cannot work due to a severe injury or disability and NYL GBS has denied your long-term disability benefits, the Ortiz Law Firm will fight to protect your rights. Having represented individuals across the United States since 2005, long-term disability attorney Nick Ortiz has the skill and insight to help you address a wide range of issues relating to your NYL GBS long-term disability claim denial.

Options After a Disability Benefit Denial

Appeal a New York Life Group Benefit Solutions Disability Denial

We work with you and your doctors to prepare a comprehensive NYL GBS appeal.

Sue New York Life Group Benefit Solutions

We have represented claimants nationwide in court against NYL GBS.

Free Resources to Help You Win Your Disability Claim

• Top Ten Mistakes That Will Destroy Your Long-Term Disability Claim
• Disability Insurance Claim Guide & Toolkit
• Disability Insurance Appeal Guide
• Download a Residual Functional Capacity form: Physical RFC and Mental RFC

Request a Free Case Evaluation

If your New York Life Group Benefit Solutions long-term disability claim has been wrongfully denied or terminated, we can help. There are no fees until we win your case. Contact us for a free, no-obligation case evaluation—call (888) 321-8131 today.

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