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Big Win for New York ERISA Disability Claim Denial Lawyer regarding Pre-existing Conditions

Tuesday, July 3, 2007

Congratulations to my friend and fellow long term disability attorney Eve-Lynn Gisonni on her significant victory at the New York State Court of Appeals in Benesowitz v. MetLife.  This decision is a great victory for long term disability claimants who are denied benefits due to a "pre-existing condition clause" in their employer’s LTD Summary Plan Description.  Credit is also due to Eric Dinallo, Governor Spitzer’s new Superintendent of Insurance, who supported Eve-Lynn’s position in an Amicus brief to the Court.

In Benesowitz, the Court ruled that claimants who apply for long term disability benefits in part due to a preexisting condition which was present at the time disability coverage began only have to wait 12 months before they can collect disability benefits.  Up until now, many disability insurance companies, including Unum, MetLife and Cigna , used preexisting condition clauses to unfairly deny claims forever.  Now, the Court has ruled that claimants in these fairly common situations will have a 12 month "waiting or elimination period" before being able to collect benefits.  For a 30 year old with a pre-existing history of cancer which reoccurs and causes permanent disability for the rest of her life, this will be an economic life saver if she is claiming long term disability benefits

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