If I have a pre-existing medical condition and I was able to get away without disclosing it, will I get in trouble when I have to file a claim related to the pre-existing condition that I didn't disclose?
thanks in advance for your expertise,
The above is a PM that I received. I thought that it might be worthwhile to someone to post it here.
I assume that you are talking about disability income insurance and not life insurance. There is a very good possibility that by not disclosing it, you have spent/ will spend months/years/decades paying for a policy with limited possibility of collecting on a claim.
Ex. You become disabled and your disability has nothing to do with your pre-existing condition. Let's assume that you have a heart attack and your original condition was arthritis. When they get your medical records they will find out about the arthritis. If they find out when you applied that the arthritis wasn't disclosed and it would have stopped you from getting coverage, the claim most likely will get declined. You'll simply get your premiums returned to you.
In this case, since it is directly related to what you did not disclose, expect the claim to be immediately declined. Not only that, but if the claim gets approved, and then they subsequently find out about your failure to disclose your condition expect them to come after you for what they had previously paid to you.
Everyone, With insurance, you need to be honest. Find a good broker who will give you the best chance to get the best coverage with whatever condition you may have.
Message edited by: InsuranceExpert on 2009-10-31 05:22:33 CDT
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uutxs said:Is there a reason you explicitly mentioned "not life insurance" in your response? Very few people file a claim for their own life insurance, so that probably wasn't the question.
But I assume IE was getting at the point that most life insurance policies become valid despite any underwriting omissions after a certain period of time. I'm sure he can go into more detail. I just had to respond after getting the image of someone filing their own life insurance claim. Except for the guy on here who posted the thread about dying, I can't see how that would work.
OP, excellent point - a simple one, maybe, but one that bears repeating.
A while back, as the ins co's medical person was taking my blood, etc., she filled out a little paperwork on my family's medical history. For an answer to one of her questions, she replied, "oh, i'll just put down <something else>. It won't matter." Well, eventually I realized that it well MIGHT matter. I called my agent, who checked it w the underwriters, who reassured him there wouldn't be a problem in issuing the policy. I think it's all fine now, but the agent told me that his agency will NEVER use that med examiner again.
uutxs said:Is there a reason you explicitly mentioned "not life insurance" in your response?
Only because when I answered the question originally, I didn't read it closely enough and his PM to me came from a thread about life and disability coverage.
Life insurance is incontestable after 2 years. Therefore, if one has 18 different kinds of cancer and does not disclose this information and then dies 2 years and one day after the policy has been in force, the claim will be paid.
there is an insurance code in most states for a reason.
you can be charged in many instances for providing false information in various contexts when dealing with insurance companies.
for example, recently a Water District official lied on a health insurance application and said he was still married to his wife that he had divorce four years prior to get her coverage. he was convicted of insurance fraud and theft of taxpayer property, to wit $4,000... and he was sentenced to four years in state prison.
InsuranceExpert said: Life insurance is incontestable after 2 years. Therefore, if one has 18 different kinds of cancer and does not disclose this information and then dies 2 years and one day after the policy has been in force, the claim will be paid.Interesting... is this a law or ?
ZenNUTS said:InsuranceExpert said: Life insurance is incontestable after 2 years. Therefore, if one has 18 different kinds of cancer and does not disclose this information and then dies 2 years and one day after the policy has been in force, the claim will be paid.Interesting... is this a law or ?
I'm just a bill Yes, I'm only a bill And if they vote for me on Capitol Hill Well, then I'm off to the White House Where I'll wait in a line With a lot of other bills For the president to sign And if he signs me, then I'll be a law. How I hope and pray that he will, But today I am still just a bill.
ZenNUTS said:InsuranceExpert said: Life insurance is incontestable after 2 years. Therefore, if one has 18 different kinds of cancer and does not disclose this information and then dies 2 years and one day after the policy has been in force, the claim will be paid.Interesting... is this a law or ?
I am almost positive that this is true in every state.
you could have done the same without the "PM" quote, and said someone asked you this
However, now people will be AFRAID of asking you stuff in a PM, because you have shown the proclivity to SHARE the PRIVATE part of the message.
**PS sent you a pm with all things I need help with..... NOT!!!!!!!!!***
I'd actually agree with you except for the fact that there is nothing personal in the PM. It's a hypothetical question that someone asked about what happens when a claim is filed with a pre-existing condition. We don't know who wrote the question nor do we know the pre-existing condition nor do we know if the person actually has a pre-existing condition or if it is a question of curiousity. It's a question that could have been asked by anyone.
I answered the question like I did because I have gotten a fair amount of PMs that have been similar in nature. I would never post something that gave the slightest hint about who asked the question.
How do you give MEGA super red? I wanted to give it to you for your condescending post to InsuranceExpert who is merely trying to help everyone on the board with his years of real world experience in the field.
InsuranceExpert said:Ex. You become disabled and your disability has nothing to do with your pre-existing condition. Let's assume that you have a heart attack and your original condition was arthritis. When they get your medical records they will find out about the arthritis. If they find out when you applied that the arthritis wasn't disclosed and it would have stopped you from getting coverage, the claim most likely will get declined. You'll simply get your premiums returned to you.
In this case, since it is directly related to what you did not disclose, expect the claim to be immediately declined. Not only that, but if the claim gets approved, and then they subsequently find out about your failure to disclose your condition expect them to come after you for what they had previously paid to you.In this example...How about if you have arthritis but you are not seeing any doctors (means does not appear on medical records), does it count as pre-existing condition ?
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