Here's the deal
A young woman in Florida was just a few weeks into a healthy pregnancy and purchased disability insurance from Reliance Standard. 38 weeks into her pregnancy, however, she had to be admitted to the hospital, complaining of headaches and high blood pressure and swelling of hands and feet brought about by preeclampsia. Two days later, physicians induced labor and she gave birth to a healthy baby girl.
There were no complications noted from the childbirth, and so the patient was released home with her child.
Unfortunately, A week after her delivery, she reentered the hospital complaining of headaches. An MRI revealed that she had suffered a severe stroke. She underwent multiple surgeries, but after returning home, she experienced severe pain, confusion, anxiety, dizziness, forgetfulness and coordination problems that prevented her from returning to her job as a medical billing specialist.
Therefore, she filed a claim for disability benefits.
The Insurance Company's Response
Unfortunately, Reliance Standard objected and denied the claim. Their argument was that the pregnancy should be considered a pre-existing condition. The company claimed that the stroke would not have occurred if she had not been pregnant, and she was pregnant before she bought the policy.
Specifically, the company claimed that the insured’s pregnancy resulted in preeclampsia, which caused the stroke. Since the insured was already pregnant when she became insured, by the terms of the policy, the company was entitled to deny the claim because the pregnancy should be considered a preexisting condition.
The lower court agreed with the insurer, and the stroke victim appealed.
Justice is served
On August 31, 2017, however, a three-judge appeals court panel overturned the lower court’s ruling and ruled against the insurance company, forcing the company to pay the claim – affirming that a normal pregnancy is not a preexisting condition that entitles insurance companies to deny an otherwise reasonable claim.
This is very much a pro-consumer, pro-woman decision from the court, but more importantly, it makes perfect sense to us under the law. The insurer issued the policy knowing the customer was pregnant. She would have received benefits for being unable to work due to a stroke had she not been pregnant. And the stroke could not have been reasonably foreseen by the customer at the time the policy was issued.
Preeclampsia
Preeclampsia is a serious threat for women in pregnancy. The disorder affects between 3 percent and 10 percent of all pregnancies worldwide. Among women with chronic underlying hypertension, the risk is between 10 and 25 percent. And preeclampsia is associated with an increase morbidity and mortality among women for decades after the pregnancy. And pregnancy and childbirth are among the biggest causes of claims for women with disability insurance, according to information from the Center for Disability Awareness – ahead of nervous system disorders, infectious diseases, digestive system disorders and respiratory disease.
Don't wait until it's too late
The best time to buy disability insurance is now – before you become pregnant. But as this case shows, there are still significant benefits to buying disability insurance relatively early in pregnancy, before any complications set in, while you’re still an insurable risk.
If you have questions about disability insurance and pregnancy, or any other issue regarding disability protection, call us today at 866-899-7318. Or fill out our online questionnaire at www.doctordisability.com for a free quote, though you can expect to be asked some additional information as we go through the application and underwriting process.
Whatever you do, don’t delay getting the coverage you need, because things can change very quickly – especially in pregnancy – and at that time it may be too late to buy acceptable insurance protection.
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