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The New York State Insurance Department issued a Circular Letter No. 14 on December 14, 2007, which provided guidance and advised insurers of action required in light of a Court of Appeals unanimous June 27, 2007, decision in the Benesowitz v. Metropolitan Life Insurance Company, 8 NY3d 661 (2007) case that affected pre-existing condition provisions in group and blanket disability policies. In the Benesowitz case, the Court of Appeals unanimously held that New York Insurance Law Section 3234(a)(2) establishes a waiting period, rather than a permanent bar for coverage of disabilities due to a pre-existing condition that begin within 12 months of an insured’s effective date of coverage. Accordingly, the Department has directed insurers who are writing group or blanket disability income insurance to take remedial actions that are consistent with the Court's ruling.

As a result of the Benesowitz case decision and in compliance with Circular Letter No. 14, Trustmark Insurance Company has undertaken a re-examination of claims that were denied based upon pre-existing conditions within the two-year period (or longer where applicable) prior to June 27, 2007. Affected insureds will be contacted. Affected insureds may contact Trustmark Insurance Company at the following telephone number, 1-877-201-9373 or 1-800-290-8899 (Trustmark Group Insurance), for questions relating to re-examination of a disability claim previously denied based on a prior interpretation of Insurance Law Section 3234 that the New York Court of Appeals has now rejected.

On a related issue, in the same case the Court of Appeals noted, however, that its interpretation would not prevent insurers from excluding or limiting disability coverage based on an individual’s prior medical history, since Section 3234(b) permits insurance companies to use individual underwriting procedures in determining a person’s eligibility for coverage under a group disability policy.