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Pre-Existing Condition Limitation Archives

The Pre-Existing Condition Provision in a Disability Insurance Policy

Most employer provided Long Term Disability policies and some individual disability insurance policies include an exclusion for disabilities caused by a pre-existing condition. Generally, a disability insurance pre-existing condition is defined as a mental or physical condition for which you become disabled within the first 12 months of coverage and that existed and for which you received treatment within the 3 to 12 month time period just prior to the date of coverage under the policy. The time periods, however, vary from policy to policy. The purpose of the pre-existing condition exclusion is to prevent individuals who have been insured for one year or less (in most cases) from receiving disability benefits for injuries they had prior to the start of the policy. As such, the disability insurance pre-existing condition may result in a denial of benefits. Most pre-existing condition provisions include two time periods: a "Look Back" period and a Pre-Existing Condition Waiting Period:

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