On December 14, 2007 the New York Insurance Department issued a Circular Letter advising that, based on a Court of Appeals Decision in Benesowitz v. Metropolitan Life Insurance Company, the pre-existing condition exclusion in group disability income policies must be reinterpreted to act as a 12 month waiting period for benefits, rather than as an exclusion for all benefits for the affected period of disability.
As directed by the New York Insurance Department, AIG Affinity Benefit Solutions is reviewing all disability claim denials made since June 27, 2004 for New York sitused association groups and certain other disability claim denials. Any of these disability claims denied based on a pre-existing condition will be reconsidered and affected insureds will be notified.
If an insured would like to contact us to request reconsideration of a disability claim that was denied based on a pre-existing condition, as indicated above, please send the request for claim review, in writing, to:
AIG Benefits Solutions Disability Claim Center
P.O. Box 387
Farmington, CT 06034-0387
This notice does not apply to disability income insurance issued to members through an out of state association where the members have the same profession, trade or occupation.
