If you were fine when you applied for coverage then had some problems but no diagnoses can your insurance say you had a pre-existing condition?

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Asked July 13, 2010

1 Answer


The key to this will be whether the insurance company can prove that you misrepresented the facts on your insurance application. As long as you gave them the correct information, then you should be covered. At that point, it is up to the insurance company to prove that you lied on the application, and it may not even be worth them trying to pursue. In your situation, though, it might do well to look closely at those problems.

Failure to receive a medical opinion does not negate a preexisting condition. If you had problems or symptoms that are directly related to the condition, and did not receive medical attention to diagnose them, then you have been negligent in your own health, and an insurance company might argue that you resisted medical diagnosis expressly to avoid disqualifying yourself for medical coverage. Again, the burden of proof will lie with the insurance company, and diagnosing minor symptoms after the fact is a difficult process.

Always fill your insurance applications out completely and accurately. You may think you are helping yourself by omitting certain details, but the fact is that if anything about the application is later found to be false, you may lose your insurance even if the dispute is completely unrelated to the errors in your application. Additionally, deliberately lying on your application can be considered an attempt to defraud the insurance company and leave you liable for criminal charges.

Answered July 13, 2010 by Anonymous

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