Disability Insurance Question!

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PostPosted: Mon Aug 26, 2013 7:03 am   Post subject: Disability Insurance Question!  

I’m in the final stage of getting a disability insurance and was just having a quick question on that.

As a part of the medical test, the insurance company conducted a pregnancy test and since I am actually pregnant, they are claiming that this pregnancy is a pre-existing condition and cannot be covered under the policy. They are also saying that in case any complications arise during the delivery, they’ll not cover any further pregnancies.

I want to know if this is legal here in Iowa. Should I ask my broker to erase such clause from the papers? Any suggestions would be appreciated. Thanks in advance!

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PostPosted: Tue Aug 27, 2013 1:50 pm   Post subject:   

I want to know if this is legal here in Iowa.
It's perfectly legal in Iowa, 49 other states, the District of Columbia, Puerto Rico, Guam, and the other territories and possessions of the United States.

Should I ask my broker to erase such clause from the papers?
Your broker has no authority to change the terms of an insurance contract. Ask all you want, but it cannot happen.

I assume your intent was to be paid for time off work due to the pregnancy you knew about before you applied for insurance. If so, you represent "adverse selection" to the insurance company, and they don't have to insure it. Most companies would decline to cover you until after your pregnancy terminated.

What is "adverse selection"? It is the tendency of persons with known risks or a higher likelihood of filing a claim to seek insurance. In health insurance, the Affordable Care Act has eliminated the "adverse selection" problem from the equation. The belief is that if all persons have to be insured, the healthy ones will outnumber the sick ones, and everything will be OK

Problem with that is that a $95 penalty for not having health insurance in 2014 will probably not cause a healthy younger person to rush out and spend $100-$200 per month for health insurance. But because health insurance companies cannot deny coverage to anyone who has a preexisting condition, the person who would have been denied coverage at any rate in 2013 will have access to guaranteed-issue coverage at a standard rate in 2014.

In effect, Congress has turned health insurance into a new type of welfare program -- at the expense of insurance company profits. When your health insurance company is no longer making a profit, it will close up shop and you will have to obtain health insurance elsewhere.

When all the insurance companies have closed up shop, your only choice for health insurance will be the government. That's not what the majority of people in America want today, but it's what we may all end up with in the next five to ten years.


CA-licensed Life & Disability Analyst. CA Insurance Lic #0596197. Also investigating insurance company abuses, and providing litigation support/expert witness services. Send me your questions, and I'll send you my answers.
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PostPosted: Tue Jan 07, 2014 11:26 am   Post subject: Pregnancy Exclusion  

Any insurance company would exclude pregnancy related disabilities from your policy. You are applying while pregnant, so they won't cover pregnancy. The key is that if you deliver without complication naturally, you can submit a form to have that exclusion reviewed (to be removed) after you return to work on a full time status. You would have your OB send the clinical notes and follow up notes from the pregnancy to the insurance company. If all looks good, they remove the exclusion and a future pregnancy would potentially be covered. If you deliver with a caesarean section or if you have complications, they will leave the exclusion on the policy.

Although pregnancy is excluded, consider all of the other sicknesses and injuries that are not excluded. Scoop that policy up while you can and look to have the exclusion removed later.

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