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.

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.

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.

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