Disability Claim Denied Because Insurance Company Says They Don’t Cover Pre-Existing Conditions

Disability Claim Denied Because Insurance Company Says They Don’t Cover Pre-Existing Conditions

By David Share L.L.B.

President, Share Lawyers

If your disability claim has been denied because the insurance company says that they don’t cover pre-existing conditions, you may still be able to do something about it.

Most Group Long-Term Disability Policies have a pre-existing exclusion that will disqualify entitlement for individuals who submit a disability claim for a condition that arose in the period prior to them being covered under their employer’s group benefit plan.¬†Historically, the pre-existing exclusion period has been for the 1st year after coverage commences, and it appears that the maximum pre-existing exclusion period should be 2 years, as set out in s.311 of Ontario’s Insurance Act.¬† Our office was recently involved in a case where the pre-existing exclusion was 60 months, or 5 years.¬†The case was recently settled, and the issue of the pre-existing exclusion was largely ignored on the facts of this particular case.

So, if your LTD claim has been denied, based on a pre-existing exclusion that exceeds 2 years, you should definitely consult with a disability insurance lawyer, to examine whether the denial of your claim was lawful.

Has your disability insurance claim been denied? Contact Share Lawyers and put our experience to work for you.

All initial consultations with our lawyers are free and there are no fees until we win your case.