Question

Can LFG continue claiming I have a pre-existing condition when my doctor says I don't?

Asked on February 1st 2019 by Tammie E.
I need help badly. The company I worked for first lied and said I was laid of to try and get my claim rejected. I had to appeal that then the next step was that it was pre-existing and requested medical records that did have DX of OV which is why I was using it for a Knee replacement. I then had me appeal that denial and had my PCP review and provide his medial opinion to only deny that stating that it was still pre-existing even though he concluded that it could be a world of things. I have everything and just got a definite DX for neck problems which is one of the reasons I was seen previously by an old PCP. How can they pin hole me into a DX when no medical doctor did?

Answer

Answered on February 2nd 2019 by Attorney Gregory Dell

Tammie, you should review your policy language to see how pre-existing condition is defined but it is common for insurance companies to provide a very broad definition making them difficult to get around.