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Misconceptions Concerning Life Insurance Pre-Existing Condition Coverage Denials

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By Scott B. Elkind, Esq.

There is a adage which is constantly applicable in life insurance coverage denials:
“What the big print giveth, the fine print taketh away.”

When a individual applies and pays premiums, it does not mean that benefits are automatically payable. The application form contains a very important question in which an individual must report any medical conditions suffered in the past (usually) ten years.

Over the years, I have received dozens of inquiries from aggrieved individuals who have made claims as beneficiaries only to find out the covered individual failed to disclose that he/she suffered from a medical condition which ultimately resulted in their death.

Although it would seem commonsense that an insurer would not insure an unhealthy individual, the insurer does not always fully investigate the application. Why? In the great majority of cases, the person who has signed up for life insurance coverage will not likely die from any cause. And, if the covered individual should die from a medical condition, the insurer can just look back to the initial application and void the coverage.

So, another adage needs to be remembered when applying for coverage: “Honesty is the best policy.” A person applying for coverage should write down absolutely all treatment they have received over the past decade. Nothing should be omitted under any circumstance. The worst case is that a couple insurers may turn down coverage, but there are plenty of others that could possible accept coverage as well. A universal turndown means that the applicant is not insurable. So, trying to hide medical treatment will not alleviate this problem.

The takeaway from this is that just because you are accepted for coverage does not mean you actually covered. If you complete the application forms honestly, you can be covered and your beneficiaries will be able to receive the benefits they deserve without fearing a pre-existing condition coverage denial.

 

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