Why Has a Pre-existing Condition Denial Impact My Claim?

Whether you have had back pain since you were a teenager or a more recent condition has left you experiencing some discomfort, being involved in a long term disability claim with a pre-existing condition can have an impact on your claim.

For example, the insurance company may assert that you are not qualified for disability as your medical issues are connected to a pre-existing condition. However, Share Lawyers may be able to help you receive the compensation you're entitled to, regardless of any pre-existing conditions.

What is a pre-existing condition?

A pre-existing condition is a term used by insurance companies to describe a medical condition that existed prior to your disability insurance coverage. For example, if you started at your job six months ago and now find that you cannot do your job because of asthma or diabetes; your insurance company may argue that your asthma or diabetes existed prior to your coverage and attempt to deny your claim.

If you've received a pre-existing condition denial, you should contact an experienced disability lawyer. Share Lawyers have years of experience helping others in similar situations.

Why does the pre-existing clause become a problem?

Generally, pre-existing medical problems only pose a problem if the disability occurs a short time after coverage begins—usually within one year on a group policy. In cases where a claim of total disability is made in the first year of coverage, the insurer may investigate to see if entitlement to benefits is excluded because of a pre-existing medical condition that existed before coverage began (e.g. in the 90 days prior to the coverage beginning).

The wording of the insurance policy is crucial. Any policy should be carefully examined by a lawyer to determine the specific provisions and how they may apply to you.

If your disability claim has been denied due to a pre-existing condition denial, Share Lawyers can review your case to determine whether you have any chance of avoiding the pre-existing exclusion.


In this video, David Share and Samantha Share detail the confusion around the pre-existing clause in long term disability policies. Pre-Ex is a very common reason for denial of benefits, impacting any Canadian with an LTD policy in the first year of a new job. We share what you need to watch out for so you are able to get the benefits you deserve.

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