I Reappled For Long Term & Short Term Insurance At Work And Once Again Was Denied. Is This LEGAL?
A few days ago, I received my letter denying me long term & short term insurance coverage. The letter stated, “As you know, the insurance you are applying for is medically evaluated and certain health standards must be met to be eligible for enrollment. Another review has been made of the insurability applications you completed. Based on your condition of insulin dependant diabetes diagnosed 1989, it has been determined that our original decision to deny Short and Long Term Disability insurance coverage cannot be changed. Other pertinent health history includes high blood pressure and acid reflux.” The letter goes on to state I have 90 days to appeal this decision. I must say I HAD this insurance and dropped it shortly after starting at The State of Texas. Does this mean I will never be eligible or should I fight this with an appeal? I can brag and say I don’t call in sick (very often) and do a great job at work. I work 13 hour days and have a 2 year old son!!!!!!!!!
Answer
When the employees pay all of the premium or part of the premium (and employees can waive out making participation less than 100%) then the insurer will usually require proof of good health in order to become insured. This is perfectly legal and common practice. Whenever you have a pre-existing medical condition, you should never drop coverage until you are approved in writing for new coverage. Coverage is not guaranteed and worse, you now have a denied code registered with MIB which is a warning to other insurers. Any way to get that other coverage reinstated?
