Cancelling a Policy

Cancel a Policy

To cancel a Disability Benefits policy, policyholders must complete NYSIF Form UDB-89 and return it to NYSIF at least 30 days before the intended cancellation date.

Please print the Form UDB-89 and complete it in full, being sure to provide the following:

  • Policyholder’s name and current address
  • Policy number
  • Reason for cancellation or non-renewal
  • Effective date of cancellation
  • Policyholder signature

Return Form UDB-89 to NYSIF

You can fax Form UDB-89 to NYSIF at 518-437-5278, or mail the completed form to the address below:

NYSIF
PO Box 66699
Albany, NY 12206

After Cancellation – Final Payroll Report

Once your policy is canceled, on the next business day following the effective cancellation date, we will send you a letter requesting a final payroll report. Your account will then be adjusted accordingly, and a final statement will be issued.

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