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What is a 3/12 pre-existing condition limitation? This is a common look-back period found in many disability policies. It means that for disability claims filed within the first 12 months of owning your policy, insurance companies will look back three months prior to your effective date— to determine if your disability is due to a sickness or ...
The above pre-existing condition provision is called a 3/12 provision – date of disability within 12 months after the Effective Date of Coverage of the policy, and 3 months prior to EDOC called “the pre-existing look-back period”.
A pre-existing condition limitation period or an exclusion is a clause in an insurance contract that an insurance company uses to avoid paying for conditions you had before you were covered under a new policy.
Your policy has a pre-existing condition exclusion with a look-back period of 3 months. You began treating for “muscle weakness” and “vision problems” in the three months prior to your effective date of coverage. You are then diagnosed with multiple sclerosis in September 2021.
So, a 3/12 pre-existing condition limitation would mean that during the first 12 months of the policy, if there’s a claim by the insured, the insurance company will look back 3 months before the insured took out the policy to see if a pre-existing condition led to that disability.
Pregnancy is considered a pre-existing condition if you are a newly enrolled in your disability plan and most likely will be excluded. Try and plan ahead and make sure you enroll when first eligible or the year before to get around the pre-ex clause found in most group disability plans.
A pre-existing condition exclusion period is a window of time, after a health plan takes effect, when a pre-existing condition (or multiple pre-existing conditions) will not be covered by the plan.
The pre-existing condition exclusion period is a health insurance provision that limits or excludes benefits for a period of time. The determination is based on the policyholder having...
Unum - Long Term Disability Plan: 3/12 Pre-existing condition limitation. If an insured becomes disabled within the first 12 months from his/her/their individual effective date of coverage, Unum will conduct a pre-ex review to determine if the disability is the result of a pre-existing condition; any condition for which symptoms existed that ...
While it’s not uncommon for policies to have limitations, it’s important to understand how a pre-existing clause can affect a long-term disability claim later on when you need benefits. Here’s how pre-existing conditions work in long-term disability cases.