NYL Comes Through

The appeals process worked and Mom is able to stay where she is and receive proper care. It was awful, stressful and worrisome to go through these last 7.5 weeks appealing the previous decision. The claims rep apologized for putting us through it, which I thought was very human of him.

Luckily, my mom had her kids to help her fight. What do others do who are all alone?
Who will fight for me when I'm 75 and targeted?

New York Life vs little old lady

New York Life has refused to reinstate Mom's long term care benefits. The nursing home staff submitted documents which should have cleared up any confusion whether Mom needs the care. Her doctor submitted documents outlining her chronic illnesses.

It doesn't matter to New York Life. They are willing to turn a 75 year old woman out on the street. She gave up her home and contents based on the policy, which promised a life time benefit.

She's happy in her little apartment, but New York Life is putting her out on the street in less than 30 days, presumably so her health fails enough for her to qualify, according to them, for the the benefit again.

Mom is incontinent, forgetful, unable to cook, clean, do laundry, take her medicine or drive. She has CHF, diabetes, high blood pressure and some dementia. But New York Life has ruled her unqualified for the benefits for which she's been paying premiums for many years, because she appeared happy and content to their appraiser.

We are starting formal appeals.
The stress is already showing on Mom.
Perhaps that's part of the insurance method. They'll stress out the weak people and hope a heart attack kills them. The insurance company will miss the premium paying capabilities of their clients, but never have to worry about paying them benefits.
I'm sure that makes sense to New York Life executives, don't you?

Mom's Insurance Benefits Canceled

Mom has a long-term care policy with New York Life. Her late husband and Mom both had policies and were religious about paying premiums for many years. Her husband died in 2002 without any claims.

Mom turns 75 on September 11, 2007.

Last year, Mom's health was failing fast and she was in and out of hospitals and nursing homes. Her confusion was pronounced and she was unable to remember to take medicine for serious diseases.
Her home was too much organization for her to maintain. She sometimes left the stove burner on. Her diet was mostly take-out and baked goods.
New York Life sent their representatives out to assess Mom.
Sadly, but not suprisingly, she finally qualified for benefits.

<- Mom and I, October '06, outside her house


In March of 2007, thinking she was guaranteed of benefits for a lifetime once she qualified, she gave up her rights of survivorship to her house and gave most of it's contents to relatives. She moved into a small-but-nice, two room apartment in a new assisted living/nursing facility a few miles away.
She adjusted to life in the nursing residence and got three nutritious meals a day, nursing care for her diabetes four times a day, regular doses of her heart and blood pressure medicine, housekeeping, laundry, and new friends.
For that, she pays around $800 a month. Her insurance policy provided the rest.
She's tried to regain some independence and is proud of doing that. But she is unable to maintain any regime. She cannot drive nor cook.
She had resisted most attempts at help before. Now with the assistance she receives, her health can be a priority, and she takes better care of herself.




Mom, May '07, in her new apartment




Monday, August 27, she received a letter from New York Life. Someone, but not her doctor nor the staff at the home, has decided Mom doesn't need the benefit anymore and New York Life is terminating her benefits. They still want her to pay premiums though.

She is appealing to New York Life, with help from those of us who know she deserves the benefit.
Good luck, Mom!

I am appealing to all good people out there, especially Americans, to support major healthcare reforms to prevent insurance companies from making a profit off the weak, then hanging them out to dry.
I am appealing to Americans to consider what the right thing to do is and truly consider if how much money you make should have bearing on whether you're sick or well.