Insurance Law
Pre-Existing Disease Exclusion
A clause in health insurance policies excluding or limiting coverage for medical conditions the insured already had before the policy was purchased.
Insurers typically apply a waiting period before covering pre-existing conditions, and disputes frequently arise over whether a condition genuinely qualifies as "pre-existing" and whether it was properly and adequately disclosed by the insured at the time of purchase.
Non-disclosure of a genuinely pre-existing condition is one of the most common grounds insurers cite for repudiating a health insurance claim.
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