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New York antidiscrimination insurance law does not require parity in coverage for physical and mental disabilities.

Efforts have been launched across the country to enhance the benefits available to individuals with a mental illness under employer-provided health care plans. Such plans often include long-term disability insurance coverage that provides income or other benefits for an employee that becomes disabled. For a physical disability, this coverage may last as long as the disability continues or until the age of 65 when Social Security and Medicare benefits become available. For a mental disability, however, this coverage may be limited to a given period of time, such as two years, notwithstanding that the mental disability may be chronic and leaves the individual unable to work.

This lack of parity has been the focus of lawsuits, including one in New York. In New York, as in many states, a law exists that prohibits insurers from refusing to provide insurance to an individual with a mental disability or from limiting the scope of that insurance without an actuarial basis for that restriction.

The high court of New York, however, held that the state's insurance law and its antidiscrimination provisions do not require that an employer's long-term disability plan offer the same benefits for both physical and mental disabilities. The court ruled that the New York law does not prevent an insurer from providing different benefits for different disabilities and ailments as long as the plan itself was equally available to both disabled and non-disabled individuals. The court emphasized that such limitations precede the occurrence of the disability and thus there is no discrimination against an employee with a mental disability because such employees were eligible for the same long-term disability coverage at the same premium as all other employees participating in the employer's group plan.

The court noted that courts in several other states, including Maine and Texas, where similar antidiscrimination statutes exist, have also generally declined to interpret these statutes to require equivalent coverage for mental and physical disabilities. The court added that eight federal courts of appeal have ruled that the federal Americans with Disabilities Act, which has similar antidiscrimination provisions, does not mandate equivalent benefits for physical and mental disabilities. The court stressed that to rule otherwise would require a "radical change" in the way the insurance industry does business and such a change requires direct legislative action. In re Polan v. New York Ins. Dep't, 814 N.E.2d 789 (NY 2004).

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Title Annotation:New York
Publication:Developments in Mental Health Law
Date:Jan 1, 2005
Words:395
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