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Long Term Disability / Life /
Accidental Death / ERISA

Our past years of representing insurance companies taught us a thing or two about how they work behind the scenes. Let our experience work for you.

Preexisting Condition Exclusion for Disability Insurance in Louisiana

Disability insurances premiums may be a hassle to pay for, but insurance is designed to give individuals a peace of mind even if they may not wish to rely on it. Oftentimes, insurance companies do not live up to the guarantees of coverage they originally promise, and you may have a valid reason to think your faith was misplaced.

Insurance companies may attempt to deny long term disability claims on the basis that the claimant had a pre-existing condition. This is a legitimate concern if you have recently started employment. It may be prudent to Speak with a Louisiana ERISA disability claim denial lawyer if you want to review your policy or have questions about a preexisting condition exclusion for disability insurance in Louisiana. A compassionate insurance lawyer could provide you the aid and representation you need to manage your insurance affairs.


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Receiving a bill should never be the first step in getting help. Our firm knows that when dealing with an ERISA, long term disability or insurance claim, what you need is answers, and we are here to provide them free of charge.

Our firm welcomes telephone calls or the opportunity to visit with you in person to answer any questions you may have. We also provide FREE comprehensive case reviews. There is no obligation to hire us as your ERISA attorney.

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Helping People Like You…

Too much is at stake to guess about the best approach and strategy for fighting your denied insurance claim — years and years of financial security.

After spending years representing insurance companies, we don’t guess. We know their playbook and how they work behind the scenes. Using that knowledge, we’ve developed our own Clear Advantage Process for fighting claims.

It’s personally satisfying to use what I’ve learned as an insurance company insider, now for the good — helping families reverse unfair denials of insurance benefits they paid for, need and deserve.


About J. Price McNamara

Price McNamara began his law practice in 1990 representing insurance companies.

In 1995, Mr. McNamara founded McNamara Law Offices, where he represents people across the U.S. who are wrongfully denied long-term disability insurance, life insurance, and accidental death insurance benefits, with special focus on ERISA claims and lawsuits.

His is a member of the Louisiana and Texas Bars, with office locations by appointment only in Baton Rouge, Metairie, and Houston. He lives in Baton Rouge, Louisiana with his wife and their three children.

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Proving the Need for a Disability Claim

According to Louisiana Revised Statutes §23:1221, an employee must provide clear and convincing evidence that they are physically unable to engage in any employment in order to qualify for a disability insurance payout under ERISA. This could be done through medical records or the testimony of doctors and specialists since there must be proof of the need for medical disability, other than the claimant’s statement of symptoms.

Insurance carriers may usually wish to see a medically determinable physical or mental impairment. These impairments are the result of anatomical, physiological, or psychological abnormalities that could be proven with clinical and laboratory diagnostic techniques.


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Baton Rouge Office

10455 Jefferson Hwy,
Suite 2B
Baton Rouge, LA 70809
Phone: (225) 201-8311
Fax: (225) 201-8313
(By Appointment)

New Orleans Office

4141 Veterans Memorial Blvd.
Suite 212
Metairie, LA 70002
Phone: (504) 458-8455
Fax: (225) 201-8313
(By Appointment)

Houston Office

363 N Sam Houston Pkwy E
Ste 1100 PMB, #114
Houston, TX 77060
Phone: (713) 439-0339
Fax: (225) 201-8313
(By Appointment)

Defining a Preexisting Condition Exclusion

Unfortunately, it may be common practice for insurance carriers to have a clause that allows them to deny coverage based on preexisting medical conditions. This is referred to as the preexisting condition exclusion. To the advantage of the insurance company, a preexisting condition could be broadly defined.

When a disability claim is submitted, insurance companies might typically review the current and prior medical records of the claimant searching for reasons to deny the claim. If they find that the records contain information about prescriptions, referrals, or complaints that are similar to the condition causing the claimant to apply for long term disability, they could use this as a reason for denial. A dedicated and experienced lawyer could help you better understand what conditions may exclude you from coverage.

Exclusion Period

Claimants in Louisiana who are denied ERISA coverage should check for the preexisting condition exclusion for disability insurance in their policy’s contract. This time frame might vary from one policy to the next.

If a claimant is past the exclusionary period, the insurance company may be unable to use this as a valid reason or denial. However, if the insurance company finds medically related information that was documented in the medical record during the exclusionary period, they most certainly could deny the disability claim.

What to Do About Exclusions

The good news is, you may not have to simply live with the denial of the insurance claim based on a preexisting condition exclusion for disability insurance in Louisiana. You may have the right to obtain an attorney for legal representation and appeal this rejection. You may also have the right to take the matter before a judge.

Discussing the details of your claim with a lawyer could help you decide how to best resolve the issue. They could review the claims process for your policy and may be able to work with you to find out if your disability was caused by a preexisting injury or illness. Call today to meet with a seasoned insurance attorney who may be able to help you get your disability claim approved.

Attorney Advertising. This website is designed for general information only. The information presented at this site should not be construed to be formal legal advice nor the formation of a lawyer/client relationship. Testimonials are not a guarantee, warranty, or prediction of the outcome of your case. By providing certain contact information herein, you are expressly authorizing the recipient of this message to contact you via the methods of communication provided.

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