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Can COVID-19 Health Effects Be Considered a Pre-Existing Condition by Your Insurance Company?

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Can COVID-19 Health Effects Be Considered a Pre-Existing Condition by Your Insurance Company?

Don’t delay discussing your matter with us to find out how to build a winning case.

Please enable JavaScript in your browser to complete this form.

You don’t pay us unless we win your case. No Out of pocket expenses required.

Note: Your Privacy is Safe with us. We will never disclose your information to external parties.
COVID-19 Pre-Existing Condition Himpro

Is COVID-19 Considered a Pre-Existing Condition?

The answer to this question is based on a few different considerations. The specific wording of the definition of “pre-existing clause” in your insurer’s policy.  Typically an insurance company will not provide coverage, especially for long term disability, if the disability results directly or indirectly from a health condition or illness that existed on or before the date the insurance coverage began.

There are in some cases, exceptions to this rule, for instance, if you were covered by your insurer for at least 13 weeks during which you have been actively working and you have not gone to see a doctor or sought out treatment for any medical condition during that time or if you have become totally disabled after more than one year of coverage.

Unfortunately, the wording of the pre-existing clause can be applied to undiagnosed conditions, which is problematic in the time of COVID-19.

COVID-19 is a New Disease

We do not know enough about the illness and virus to understand how it impacts the population and what the long term effects of the disease could be.  In some cases, children are showing inflammatory syndromes sometimes, months after being diagnosed with COVID-19, or testing negative for COVID-19 but positive for antibodies.  Others have endured heart damage, permanent lung damage, and damage to their livers which was non-existent prior to their COVID-19 diagnosis.

The problem with COVID-19 is that sometimes a recovery from the disease does not necessarily mean your body has fully recovered.  There is a chance the virus has caused undetectable damage to your body which will not present immediately but rather result in impairment or disability later on in life.  If this condition is unrecognized until it presents with symptoms, it is possible your insurer will not consider the symptoms as arising from a pre-existing condition.  However, this is not guaranteed.

Diagnosis of COVID-19 as a Pre-Existing Condition

Insurance companies will likely do all they can to not pay out on your policy.  With the wide spectrum of symptoms and chronic conditions being connected to COVID-19, there is some reason for concern if a disabling health effect of the disease that presents post-infection could fall within a pre-existing condition category.  As such, you should be wary of coverage issues for conditions linked to the past diagnosis of COVID-19 in your medical records.

The timing of your policy also makes a difference.  A pre-existing exclusion usually only matters when a claim is made during the period that the pre-existing exclusion clause applies.  Usually, this time period is one to two years.  Again when it comes to COVID, you may get the disease, recover but not know about the underlying damage to your body nor feel disabling symptoms until a year or so after you have recovered from the illness.  It is possible to be caught in an exclusion clause time limitation with a COVID connected chronic condition.

Impact of the Virus in the Future

COVID-19 is a young disease.  The impact of the virus is still unknown and it has shown that it can interact with numerous physical and mental health conditions in unexpected ways and cause irreparable damage to people’s health or even make an underlying condition worsen.  For some COVID may take months to recover in hospital.  Some people may experience symptoms from an underlying documented condition which prior to a COVID diagnosis was asymptomatic but since being infected by COVID has become symptomatic or even disabling.  In these cases, it is possible an insurance company may try to rely on their pre-existing clauses to deny coverage.

Only time will tell how COVID-19 will impact insurance coverage and future disability claims have given so many unknowns about the disease and its effect on the human body.

Disclaimer: The content of this article is a general guideline made available for educational purposes only and is not intended to be used as legal advice for the reader’s specific situation nor in general. By reading our blog and website content, the reader acknowledges the above and understands there is no lawyer-client relationship created between you and Himelfarb Proszanski through this content. To get specific legal advice, we encourage you to book a free consultation with one of our lawyers to clarify the legal aspects of your situation.

Timing is Critical. Help is Free.

Don’t delay discussing your matter with us to find out how to build a winning case.

Please enable JavaScript in your browser to complete this form.

You don’t pay us unless we win your case. No Out of pocket expenses required.

Note: Your Privacy is Safe with us. We will never disclose your information to external parties.

Timing is Critical. Help is Free.

Don’t delay discussing your matter with us to find out how to build a winning case.

Please enable JavaScript in your browser to complete this form.

You don’t pay us unless we win your case. No Out of pocket expenses required.

Note: Your Privacy is Safe with us. We will never disclose your information to external parties.

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Sherene AlySherene Aly
16:02 23 Mar 24
I was very pleased with my decision to retain David and his team for my case. Melissa Gizzo was simply amazing and was able to secure a fair settlement for me.
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Experienced and excellent law firm. Their lawyers are wonderful, articulate, dilligent, amicable, calm, respectful, responsible, resourceful and have good human and customer relationships Especially DAN HOLLAND 👌 He is an amazing lawyer as regards dealing with any of the Accident case.I was involvedIn an accident in 2019 February. He was God sent as he dutifully and relentlessly worked hard until the case was settled
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I highly recommend Dan Holland as a disability lawyer. His commitment to my case made the process seamless. Dan's clear communication and ability to simplify complex legal matters made it easy for me to understand every step. He demonstrated genuine concern for my best interests, making him not only a skilled attorney but also someone easy to talk to.Dan’s support extended beyond legal expertise; he alleviated my stress during the long-term disability case. His calm approach and unhurried demeanour ensured that there was no rush in our collaboration. This, coupled with his dedication, made the entire experience more manageable, fostering confidence in his ability to handle the case with meticulous care.I wholeheartedly endorse Dan for anyone seeking a lawyer who not only gets results but also prioritizes your peace of mind.
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21:49 01 Jan 24
My mom was involved in an accident impacting her daily life and ability to work. Dan Holland has worked with us during the duration of our case and has been helpful in fighting for her and supporting us, and organizing the things we needed. Our family is incredibly grateful of the outcome Dan was able to obtain for us. I would highly recommend him!
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01:26 22 Dec 23
I'm so happy I chose Mena Brar and her team represet us . We could not ask for a better team she is so kind, loyal, and honest. she spoke to me as an equal and made me feel as if my case was definitely important and that I deserved to be fairly compensated. I appreciate you. Did it for me and how this will help me get back on track with my life. keep helping others. You are doing amazing works, Mena Brar. I wish you all the best.
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23:38 12 Dec 23
Many thanks to Silene Malhao for settling my husband's TORT claim and to Mena Brar for settling his accident benefits claim. These ladies made themselves available any time we had a question. They were very understanding and compassionate. We were completely taken care of throughout this process. We would definitely recommend this team to friends and family!
ShaunaShauna
15:52 06 Dec 23
We are so happy that we had David and his team represent us. We couldn't have asked for a better team. Not only is David incredibly skilled and experienced, he is kind and compassionate and it is clear how much he cares for his clients. Megan was also absolutely amazing to work with and was always on top of everything and there to answer any questions we had! Thank you!
Andrew CoutoAndrew Couto
23:10 21 Nov 23
I'm so happy I chose David as my lawyer. I spoke to a few lawyers before finding David and I noticed majority of them spoke to me in a way that felt demeaning or that my case wasn't big enough or important enough to take. One phone call with David and my opinion on lawyers changed. He spoke to me as an equal and made me feel as if my case was definitely important and that I deserved to be fairly compensated. The whole process was wonderful. From dealing with David's law clerk Ingrid whom is an amazing and kind woman to his legal assistant Melissa whom is another amazing kind and talented young woman. I was so stressed about this case but from day 1 they helped ease that stress and always answered all my questions promptly and respectfully. I couldn't believe David got me to mediation within 6 months of being cut off my LTD and got me a settlement way beyond my expectations. I can't say enough good things about this law firm but I guarantee you that if you need a lawyer to fight for you David is your guy! . Believe me when I say this is the law firm for anyone dealing with personal injuries especially LTD denial claims. Thank you so much to David, Ingrid and Melissa you truly don't know how much I appreciate all you did for me and how this will help me get back on track with my life. Keep helping others you guys are doing amazing work! I wish you all the best!
Rose RegazziRose Regazzi
21:15 11 Oct 23
I sustained a relatively painful injury, affecting me long term.I wouldn't otherwise had pursued it, as it involved a relatively large corporation, but felt it necessary to do so. However, many lawyers were daunted, with one, who actually referred me to HIMPRO.I was connected with Dan Holland, who reviewed the case, provided with me realistic expectations, sound advice and had a willingness to move forward and represent me.His calm and professional demeanor, brought me to a place of reassurance. His ease in addressing all facets of this process, clearly demonstrated a wealth of experience. There was never any hesitation, when being challenged, and felt my best interest was always in the forefront.This case has since been resolved, to my complete satisfaction.Without reservation, HIMPRO (and Dan Holland, in particular), would be the only firm I would recommend for these type of cases.
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