We make sense of pre-existing conditions exclusions.
Most long term disability claims contain a clause that gives insurance companies the right to deny your claim based on a pre-existing condition. These exclusions and limitations for pre-existing conditions are legal for the insurance company to incorporate into their policies, but the way in which they’re interpreted can vary widely. Because the interpretation of your policy can be broad, so it’s important to review your policy thoroughly and get the facts before filing a claim.
What defines a pre-existing condition?
During the months immediately before your effective date of insurance, the insurance company will review certain facts related to your illness or injury to determine if it’s pre-existing. This is also known as the “look back period.” While generally three months in length, some look back periods extend to six months or more. Medical treatment, consultations with medical professionals, and prescription drugs administered for the condition will typically be assessed.
Sometimes, insurance companies make mistakes.
Errors in diagnoses aren’t uncommon. Some insurance companies may even attempt to say that the illnesses and injuries in question aren’t severe enough to impede job performance. And while some pre-existing conditions are relatively clear-cut, things get complicated when multiple injuries with overlapping symptoms occur over time. With the help of your medical providers and records, the disability benefits attorneys at Andalman & Flynn can help make sense of confusing pre-existing exclusions when they arise. We’re happy to answer your questions and explain what you can expect while your appeal and denial are pending. You can count on our legal acumen and compassionate presence to guide you through the challenging disability benefits process.
If you have a pre-existing condition, count on the knowledgeable attorneys at Andalman & Flynn to explain your options and enforce your legal rights. Please contact us today to schedule a consultation.