Question

Can Principal deny me for something that has nothing to do with my preexisting condition?

Asked on September 6th 2016 by Rachel
I was diagnosed with breast cancer in 2011 and I had a double mastectomy in 2012. At that time I did not have STD coverage with Principal. However, I did purchase STD in January 2016. I made the sales representative very aware of my pre existing condition and I was told I would be covered as long as my breast cancer didn’t return and cause me to be out of work. On July 20th I was sent to the hospital by my family doctor because they thought I had a blood clot in my lungs. The angiogram was clear. So, extensive blood work was done. I was then referred back to my oncologist because my estrogen level is 4 times the normal limit. My oncologist has scheduled with my Gynocologist to have my left ovary removed. I’ve already had a hysterectomy. So the left ovary is all I have left. I am extremely fatigued, vomitting daily, and very achy. Principal has yet to approve or deny my claim. The representative on the phone said this could be stemming from my breast cancer. I am shocked! This has nothing to do with breast cancer. Yes, I am being seen by my oncologist but at this point I have no cancer diagnosis. Can they deny me for having an ovary removed because its related to breast cancer? I had no idea they would be so hard to work with or I would have never purchased the policy. I have done all the leg work, from faxing in all doctors records to prescription records and giving them the contact number for every doctor. I feel they are searching for a reason to deny me now. The representative originally said I had to provide Oct-Dec of medical records to show 90 days prior to the policy. Now they have decided to go back to Sept, 120 Days. This is just another stall or attempt to deny me. This can’t be legal. Thoughts?

Answer

Answered on September 8th 2016 by Attorney Rachel Alters

Rachel, depending on the language used in the policy to determine the look back period for the policy, Principal would be within their rights to conduct the review they are. However, the extent of same would be unknown without the ability to review the policy and any correspondence they have sent you to date. Please feel free t contact our office so we can review the documents and discuss your rights.