ComplaintsforNew York State Insurance Fund

• Initial Complaint

  08/13/2024

  Complaint Type:

  Order Issues

  Status:

  Answered

  More info

  I submitted mileage and transportation expenses to my workers compensation carrier representative, ********************************* by email on March 04, 2024 that covered ***** miles from February, 2023 to February, 2024, for visits to all of my treating medical doctors, hospitals, surgery performed and ongoing medical treatment and care that I continue to receive. ***** has failed to reimburse or provide the reasons why it has not been paid. I have continually requested that this payment be made because I can not afford to continue going to my doctors without being reimbursed for previous trips. The price of fuel continues to rise and lets face it what I am normally paid is peanuts in comparison. In another matter, my workers compensation claim entitles me to be paid $210.00 per week for the rest of my life, ***** has not paid me $420.00 that was due and payable on June 21, 2024 by direct deposit. I had updated and changed my direct deposit information on June 12, 2024 on NYSIFS website and I see no intelligent reason why I have not been paid in accordance with my workers compensation claim. I depend on these payments to pay my bills, purchase food and survive and not receiving this payment left me in severe financial difficulties because I was unable to pay my bills or purchase food and groceries. I do not think it is right or fair that Im still waiting almost 3 months for this check. Its bad enough that I had foot surgery on March 19, 2024 and NYSIF failed to raise my weekly benefit rate from $210.00 to $300.00, which reflects total disability. ***** continues to act in bad faith with my claim. I have respectfully requested help from the workers compensation board to adjudicate these matters because I am truly suffering without this money. No one should be playing Russian Roulette with people lives or livelihoods. The workers compensation board has totally failed me and no emergency help or assistance has been provided. Payment history attached.

  Business response

  08/28/2024

  ****** *** **** ****** ******** ****** * ************ ****** *** **************** *********************************** ********************* *** *** *** ***************** ******************************** ***** **** *** ************
  Better Business Bureau:

  
  This letter is in response to a complaint by the claimant ******************************** has been forwarded to
  me for a reply.

  
  The claimant raises numerous issues which I will answer. The first issue is that ************** stated that
  he emailed mileage and transportation, ***** expenses for the period February 2023 till February
  2024 ********************************* which has not been addressed. There are 2 problems with this. The first is
  that his case manager, ********************************* has been out for months. ************** has been made aware
  of this prior occasions. Also, per the *** rules, *** has to be submitted on form C-257 and
  submitted to ****** post office box. We cannot accept this form by email. The correct address is
  *****************************. Also, due to security concerns, we are unable to access any of
  ****** staff email. So, if an email was sent it cannot be viewed.

  ************** also is questioning the amount of *** and wonders why his rate hasnt been increased
  from PPD to total since the date of his surgery. Please be advised that mileage and transportation
  can only be reimbursed for causally related treatment and surgery as well as travel for treatment
  related to same. The claimant had surgery for curly toe. The claim is established to the right-ankle,
  left-ankle, right-knee and other internal organs. The toes are not an established site. Surgery was
  also not authorized. As such, no reimbursement can be made for treatment, not can there be an
  increase in wages.

  
  ************** also noted problems that he has with the *************************** which I cannot
  comment on.

  
  For future information, *** ****** new case manager is *******************, ****************.
  ************.

  
  Sincerely

  ********************************* ****** ******* ************* ****** ******** * *** *************************

  Customer response

  08/28/2024

  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID# ********, and have determined that my complaint has NOT been resolved because:  I feel ****************** is a bold face liar.  I emailed him personally and ********************* back in June when my check never was received.  Neither ****************** or ******************** responded.  In fact I only found out about *** ********* absence in an email last week.  I find it extremely disturbing that ***** does not bother to assign a new claim representative when your regularly assigned one doesnt work.  With regards to my surgery it was approved by the board so this is further proof that ****************** doesnt know how to manage his way out of a paper bag opened at both ends.  With regards to my * * * it is normal and customary to email it to my claim representative and have been doing that for years, I find it funny that now they make excuses and continue to lie to cover there behinds for acting in bad faith with my claim.  I noticed ****************** never mentioned why my check from June 20th was not processed or paid in a prompt professional or efficient manner.  I had to wait several months simply because he could not be bothered back in June.  I find it also funny that I submitted requests to multiple claims representatives that were supposedly assigned my claim and not one of them responded or took care of the issues that I raised and brought to there attention.  I personally feel that I continue to be discriminated against and treated unfairly by employees that are extremely racist and severely prejudiced against me.  Just by there lack of communication and resolving the situation and issues I raised snd brought to all of there attention including ****************** proved and justifies my complaint and concerns.  I intend to pursue legal action against NYSIF for discrimination. 

  ******************************
  

  
  
  
  
   
  

• Initial Complaint

  06/28/2022

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  *********************** ***** ********************************** New York State Insurance Fund ********************************************* (P)************** | ************** wc quote#****** without matching any ID information,just because same name but different person of our officer ***************,they add someone else debt on our company,after a month of negiotation and we spend a lot money and time to provide all our ID and documents,they still dont remove someone else debt from our company.

  Business response

  07/05/2022

  **** *** ****  ****** ******** ****** ********* ****  ** ********************************************************************* *****  *** ********* *** ******* **** *********************** 
  Better Business Bureau: 
  ***** has received the correspondence sent to you regarding the ***** quote mentioned above. 
  ***** Quote # ******* was received on June 10, 2022. ***** underwriter matched the two Principal names to two cancelled policies with a balance. *************** from ********************* policy # ********, with a balance of $3424.28 and *********************** from Home ************************ policy # ********, with a balance of $2003.44. 
  On June 13, 2022, the Quote # ******* was rejected for incomplete documentation and money owed on a prior policy. 

  On June 14, 2022, the broker ************* emailed the underwriter to let her know *************** from Home ********************** is not the same Principal *************** from *********************  ***** underwriter requested a copy of her drivers License and an affidavit stating *************** is not related to *************** from ********************* Underwriting also requested corporate papers documenting when *************** became a Vice President of Home **********************. That name was not listed on the prior policy for Home ********************** 
  (Pol # ********). 

  
  ***** underwriter has been in contact with the Principal, *********************** and the Broker ************* to help resolve the matter from the start. An incomplete affidavit was submitted on June 17, 2022. Subsequently a completed affidavit was emailed and received on June 24, 2022. 

  
  On June 28, 2022, a quote # ******* was replicated by Underwriting for the applicant to resubmit. ***** is still awaiting the legal documents, minutes of incorporation showing the officers of the corporation before a quote can be issued.  
  As of June 30, 2022, there have been several phone calls and emails from the applicant inquiring about the quote. ***** is waiting for the legal documents that have been requested. 

  
  Once all documents are received, ***** will review and issue a decision. Thank you for bringing this matter to our attention.

  
  Sincerely,
  *****************
  Underwriting Manager
  Downstate New Business Small Markets

*Some consumers may elect to not publish the details of their complaints, some complaints may not meet BBB's standards for publication, or BBB may display a portion of complaints when a high volume is received for a particular business. ↩