Question
Can Aetna deny my claim due to a "war exclusion" on my policy?
Looking for some information about a disability claim. In July 2018, I started having issues with work and couldn’t stand it anymore. I took FMLA due to personal ideations and put in for STD/LTD through my employers (FedEx Ground) insurance (Aetna). I also put in for social security disability and unemployment. Turns out, I was denied on all of them. The social security makes sense because I failed to provide documentation to support my claim, but everything else I put effort into. Aetna refused my claim due to a “war exclusion” on my policy. A policy that I never received since I working at FedEx from August 2015-July 2018. At the time, I was rated 90% from the VA and just recently received a permanent and total disability rating of 100% for PTSD, TBI and other physical issues that was back-dated to five months before all this work stuff started. I also believe I have a FMLA violation against my previous employer because the station manager was telling contractors about my issues. Issues that I shared with him out of respect and confidentiality. Just wanted to get some opinions and how to approach this. I have a family of four and this issue had a explosive impact on my finances and credit score. I’m not the kind of person that would throw myself out there like this, but I feel that my case was neglected and I want this to be made right. What options do I have with possibly fighting these claim denials? Is it worth it? Any information would be great! Thanks in advance.
Answer
Phil, I am sorry to hear about your difficulties. Have you filed an appeal of the denial? All disability insurance policies will contain an exclusion that will not pay benefits if the disability is caused or contributed by an “Act of war, declared or undeclared.” There have been situations where you can get around this exclusion, but there are just as many where the policy provision will hold if the basis for filing disability from your employer were due to medical conditions connected with military service. It is incredibly unfair, but unfortunately legal. In order to determine if we can assist you please feel free to contact our office to discuss your situation in greater detail.
