Question
Why can Cigna go against their rule that states if a claimant becomes totally disabled due to a pre-existing condition after the LTD policy with Cigna has been in force for 12 months, they will waive the pre-existing condition exclusion concerning payment of benefits?
Answer
Deb, From the information you provided the Bi-Polar Disorder would appear to be pre-existing. Typically, if you have been working for a company (or covered under a policy) for less than 12 months and you file a claim for disability it will trigger a review by the insurance company to determine if your disability is due to a pre-existing condition. The language then typically reads that if you were receiving care/diagnosed/prescribed medicine for the condition in the 3-6 months (depending on the policy) before the effective date of coverage then the condition would be deemed pre-existing and excluded from coverage. It would not matter if your LTD was still in force while on STD, as your date of disability is the date used to determine the pre-existing condition review.












