The latest surge in COVID-19 cases has caused a corresponding surge in our COVID-19 claims. As we do our best to get through the avalanche of claims quickly, we wanted to highlight the most common errors we see when filing these claims. Follow these quick tips to help your claim avoid unnecessary delays and other pitfalls which occur when we receive an incomplete or inaccurate claim.
Here’s our top 5 expert tips to help ensure smooth processing of your ShelterPoint COVID-19 Quarantine claim:
Make sure you’ve met overall NY DBL/PFL eligibility requirements first!
There are many layers to determine eligibility for Emergency Paid Sick Leave benefits. But, the first step is always to ensure you’ve met overall eligibility requirements for NY Disability/Paid Family Leave (DBL/PFL) benefits. This means:
- Full-time employees: 26 consecutive weeks at current employer prior to the 1st requested Emergency Paid Sick Leave day to qualify for PFL benefits, and 4 weeks for DBL benefits
- Part-time employees: 175 days worked at current employer prior to the 1st requested Emergency Paid Sick Leave day to qualify for PFL benefits, and 25 working days for DBL benefits.
Download this infographic with more eligibility details – recently updated for 2022! This will help determine if you may be eligible and, if so, who will provide wage replacement: your employer or your employer’s Disability Benefits/Paid Family Leave (DBL/PFL) insurance carrier (like ShelterPoint).
- If your employer is supposed to pay benefits, then there is no need to file a claim with us. Contact your employer directly.
- If you are supposed to file a claim for benefits through your DBL/PFL insurance carrier for partial wage replacement, then read on!
Review updated quarantine guidance BEFORE filing a claim
Find the latest information by going to our COVID-19 Resource Center, or more importantly, the New York Department of Health’s Isolation & Quarantine table which will help you determine if and for how long we can provide partial wage replacement.
Remember, we are held to the NY Emergency Paid Sick Leave law and we can pay on a claim only if it meets the law’s requirements including the NY Department of Health guidelines.
Use our ShelterPoint COVID-19 claim forms instead of NYS’s forms
While you may use the NYS COVID-19 Emergency Paid Sick Leave forms to submit your claim, our ShelterPoint claim forms include additional questions that we will need answers to before paying your claim. So, we highly recommend using our claim forms instead of NYS forms to help cut down on unnecessary back and forth – which in turn, helps get your claim processed quicker. It also includes a checklist with all the additional documentation we require to process a claim. Download ShelterPoint Claim forms here.
Be sure to include an Order of Quarantine or self-attestation form as provided by the New York Department of Health.
You can find the form here, drill down to your county and then follow the page to the COVID-19 Resources where you will find the Order of Quarantine form or self-attestation form. However, please note: alternatives to the Order of Quarantine/Isolation such as the self-attestation form (Affirmation of Isolation for COVID+ individuals, or Affirmation of Quarantine for exposure to COVID+ case), or a lab-confirmed positive test for the individual requiring leave are also accepted. Self-attestation forms for Isolation and Quarantine as published by NYS are available in our COVID-19 Resource Center. Your claim cannot be processed without this required documentation.
Only submit your claim ONE TIME!
Submitting more than once will almost certainly delay the time we need to process your claim. If we see a duplicate claim we will pull it out of the processing queue and try to match it with the duplicate claim. Send the claim one time, by one method only. Once your claim is registered, you will receive a claim#.
Please note: Currently there is no confirmation email for when you submit a claim, so please don’t submit a claim a second time because you were expecting a confirmation email and/or just to be sure we received it. This will cause your claim to get pulled from the processing queue while we attempt to match it up with the duplicate claim!
Still have questions? Contact our customer service firstname.lastname@example.org and one of our reps would be happy to assist you!
This blog post is for informational purposes only and is not intended to provide legal counsel. Please consult with an appropriate professional for legal and compliance advice. Any PFL information is as of the blog post’s date stamp; it is based on the applicable statutes and regulation, and may change as regulations evolve or NY State issues guidance regarding Paid Family Leave regulations.