Insurance Claim Payment Delay

Summary

If youre facing a delay in your disability insurance claim payment in New York, review your policy to understand your rights. Contact your insurance provider for an explanation of the delay and consider filing a complaint with the New York State Department of Financial Services if necessary. The NYS Fair Insurance Settlement Practices Act (FISPA) aims to protect consumers from unfair practices, but it has not yet been passed. You can sue a disability insurance carrier in New York if your claim is unfairly delayed or denied, but its advisable to exhaust all administrative remedies first. The False Claims Act allows individuals to sue on behalf of the government for false claims of government funds, with potential financial rewards for whistleblowers.

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Yes
To provide more specific guidance, could you share whether you've already contacted your insurance provider, and if so, what their response was? This will help to understand the current state of your claim and what further steps might be necessary.
They state they are still trying to obtain medical records
It sounds like your insurance provider is waiting for medical records to process your claim. You might consider:
- Contacting your healthcare provider to expedite the release of required medical records.
- Confirming with your insurance company which specific records they are waiting for.
- Ensuring all requested documents have been sent and received.
Would you like assistance in contacting local resources for further help?
Can you tell me about NYS Fair Insurance Settlement Practice Act (FISPA)
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The NYS Fair Insurance Settlement Practices Act (FISPA) is designed to protect consumers from unfair practices by insurance companies. It includes:
- Timely processing of claims.
- Clear communication regarding claim status.
- Prohibition of unfair or deceptive acts.

Would you like assistance in contacting local resources for further help?
Has Fair Insurance Settlement Practice Act (FISPA) passed in NYS yet
Case Rating: *
The Fair Insurance Settlement Practices Act (FISPA) is a proposed legislation aimed at ensuring fair treatment of consumers by insurance companies, including timely processing of claims and clear communication. As of now, FISPA has not been officially passed in New York State. If you need further assistance or guidance on this issue, feel free to ask!
Can the insured directly sue a disability insurance carrier in NYS?
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In New York State, an insured can sue a disability insurance carrier if they believe their claim is being unfairly delayed or denied. However, it's advisable to first exhaust all administrative remedies, such as filing a complaint with the New York State Department of Financial Services, before pursuing legal action.
What is the false claims act
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The False Claims Act is a federal law that allows individuals to sue on behalf of the government if they believe someone has falsely claimed government funds. It includes:
- Qui tam provisions allowing private individuals to file lawsuits.
- Potential for substantial financial rewards for whistleblowers.
- Penalties for violators include fines and treble damages.