Notice to Certain Persons Who Incurred Claims under Group Disability Policies Issued in New York
January 2008

The New York Court of Appeals recently issued a decision in the case of Benesowitz v. Metropolitan Life Insurance Company, 8 NY3d 661 (2007) which construes New York Insurance Law Section 3234(a)(2) relating to pre-existing condition limitations in disability policies issued in New York. The Benesowitz decision establishes that, under a long-term disability policy issued in New York, benefits cannot be excluded permanently due to a pre-existing condition. However, insurance carriers may impose a 12-month waiting period before beginning to make payments for disabilities due to pre-existing conditions. The 12-month waiting period begins on the effective date of a person’s coverage under the group policy. After the 12-month waiting period ends, benefits are payable for a disability resulting from a pre-existing condition, subject to all other policy provisions, terms and conditions, including the requirement that the claimant still be disabled.

As a result of this decision, by February 29, 2008 First Reliance Standard Life Insurance Company will make a good faith effort to identify and review all claim denials for disability benefits based upon pre-existing conditions where such denials were made after June 27, 2004. With the exception of changes to effectuate the Benesowitz decision, normal rules and requirements for claims reviews will continue to apply, including the requirement that claimants furnish adequate proof of loss.

By April 30, 2008, we will make a good faith effort to notify affected insureds in writing of the results of this review and pay all benefits due with interest from the commencement of the period for which we would have been liable had we applied the Benesowitz interpretation at the time the claim was initially submitted. If additional information is required to determine whether benefits are payable, we will attempt to request this information on or before April 30, 2008. No later than 60 days from our receipt of all information necessary to complete our re-examination of a claim, we will reach a determination and if applicable, pay any benefits owed, with interest.

If you have any questions about this notice or if you feel that your claim was impacted by this decision but you have not been notified that your claim is under review, contact:

First Reliance Standard Life Insurance Company
Attention: FRSLIC Claim Review
P.O. Box 8330
Philadelphia, Pennsylvania 19101

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