Question:

Are Medical Pre-Existing Conditions Considered When Applying for Short and Long Term Disability Insurance?

How Pre-Existing Medical Conditions Affect Your Application for Short and Long Term Disability Insurance

Medical pre-existing health conditions are normally considered when applying for both short and long term disability insurance. There are some variations in the results of having one or more pre-existing medical conditions, however. Much depends on the conditions, insurance company underwriting, and the coverage for which you have applied.

For instance, there are medical conditions that may or may not be serious reasons to offer “rated” coverage (protection at higher rates than for perfect health applicants) or to decline to issue insurance. There may be chronic health issues, prior injuries or illnesses that, while pre-existing, do not project to be a future problem or cause of disability. Certain pre-existing conditions may project a higher risk of short term disability, but not long term disability. Along with these “good news” potential results, there are also pre-existing medical conditions that carry a high risk of future reoccurrence, which may cause insurers to deny coverage at any price. Finally, look for a pre-existing condition “exclusionary period” provision in your policy. If this language exists, you may be denied coverage for only this period of time, possibly six months to one year. After this period, even if your pre-existing health issue rears its ugly head, you may still qualify for benefits.

As a precaution, be very careful about the non-disclosure of pre-existing medical conditions as benefits could be affected should these issues be revealed during a claim filing process. There is often insurance contract language that relieves the insurer from paying a claim resulting from an undisclosed pre-existing serious health issue, particularly if the non-disclosure was an intentional act. Some insurance companies will merely return previously paid premiums and "call it even".

Should you be covered in a group short term disability contract, check the language of your certificate or the master policy. You want to be aware of any pre-existing condition escape clauses that the insurer could invoke to deny coverage should you need it. The most important factor in short term or long term disability insurance coverage: Having benefits available should you need them. This is a strong argument for considering individual coverage since you can build your insurance protection with your security in mind.

Refer to your insurance policy contract for specific information regarding your coverage and for actual terms, conditions and exclusions. The above statements are general in nature and may or may not reflect the actual terms of your insurance policy.