How an insurer deny coverage for a condition that does not exist?

UPDATED: Jan 13, 2014

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How an insurer deny coverage for a condition that does not exist?

I was denied LTD coverage (through my employer). The reason: “A medical history of gestational diabetes in the past does not allow approval to a group rate plan”. For the record, I had gestational diabetes 4 years ago. However, once I delivered twins, the gestational diabetes went away after delivery. My A1C tests and blood glucose levels continue to be normal 3 years later. I do not have diabetes. I shared copies of my tests showing that I do not have diabetes, but they denied my request for coverage. Can I take legal action?

Asked on January 13, 2014 under Insurance Law, Texas


Brook Miscoski / Hurr Law Office PC

Answered 9 years ago | Contributor

You should consult someone with more particular knowledge in the field, but I will point out that a HISTORY of gestational diabetes is not the same thing as saying that you have diabetes now. You were denied coverage because of a past medical condition, not because the insurer is saying that you have acute gestational diabetes.

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