The perils of retroactive date exclusions
Unfortunately, it is not uncommon for insurance carriers to use a retroactive date exclusion to deny policyholders from their claims. If you or someone you know has received a denial letter, it is important to understand that this does not mean that nothing more can be done; you may have the claim re-examined and negotiated, and won.
In fact, it is possible to win a multimillion dollar settlement if it can be proven that an insurance company wrongfully denied a claim by falsely stating that the claim occurred beyond the retroactive date exclusion. It is not an easy process however, as you may have already learned. It is not in the insurance company’s best financial interest to continually pay out claims, so they will look for and cite reasons to deny your claim, often illegally.
Insurance contracts are incredibly dense, long and hard to decipher. This is an intentional tactic often employed by insurance companies to bury relevant information in such a way that it is difficult to find. To further complicate things, information such as endorsements may be issued at different times, often nullifying or changing the status of previous information.
As you can see, overcoming a claim denial is not an easy process. Considering that a victim is already suffering from a disability makes things even more difficult. At these times, it may be in a victim’s best interest to reach out to a law professional familiar with wrongfully denied claims of disability insurance policies to determine the best way to proceed.
Source: Mondaq, “Retroactive Date Exclusions: Commonly Alleged, But Seldom Applicable,” By Brian Friel, Dec. 30, 2017