Pre-Existing Conditions


Let's move on from our definitions of disability to the principal cause of denied claims -- pre-existing conditions.  In most disability income insurance policies, a pre-existing condition is defined as a sickness or physical condition for which:

medical advice or treatment was recommended by or received from a physician, or
symptoms existed which would cause a prudent person to seek diagnosis or treatment

in the two-year period preceding the effective date of the policy.  

Disability income insurance policies generally do not pay benefits for disabilities resulting from pre-existing conditions during the first two years that the policy is in force unless two conditions are met:

The pre-existing condition was disclosed in the application for the policy and
The insurance company did not specifically exclude the pre-existing condition.

Of course, after the policy has been in force for 2 years, undisclosed, pre-existing conditions are covered just like any other condition.