An insurance company can deny your claim if you don't disclose a pre-existing condition. Insurance companies have the right to rely on the accuracy and completeness of the information provided by the applicant while making a decision regarding the issuance of a policy. A pre-existing condition is defined as an injury or illness that existed before the policy was issued. If it is found that you failed to disclose the existence of a pre-existing condition to the insurance company, the company may deny your claim on the grounds of misrepresentation.
This is why it is vital to disclose all pre-existing conditions when applying for insurance coverage. Insurance companies may sometimes ask for a medical examination or require the applicant to complete a medical questionnaire to ascertain their health status. If an insurance company discovers that you knowingly withheld information about a pre-existing condition, they may not only deny your claim, but they may also rescind the policy and refuse to pay any benefits.
There are some exceptions to this rule. For instance, some states have laws that prohibit insurance companies from denying claims due to non-disclosure of pre-existing conditions, provided the condition was not intentionally not disclosed by the applicant. In such cases, insurance companies must demonstrate that the undisclosed condition was material to the risk being insured and that they would not have issued the policy had they known about the condition.
To avoid the risk of claim denial or policy rescission, it is important to be honest and upfront about any pre-existing health conditions when applying for insurance coverage. If you find that your claim has been denied due to a pre-existing condition or any other reason, you may wish to seek legal advice from a licensed attorney who specializes in insurance law.
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