Can benefits be denied if you became pregnant 55 days before the effective date of short term disability insurance that permits denial for a condition treated in prior 90 days?

The language of the policy determines whether benefits can be denied. Generally, if you became pregnant 55 days before the effective date of short term disability insurance that permits denial for a condition treated in the prior 90 days, your claim may be denied under the following circumstances:

1) Pre-Existing Condition Exclusion: If the pregnancy is considered a pre-existing condition and not covered under the short term disability insurance policy, benefits may be denied.

2) Waiting Period: Short term disability policies often have a waiting period before benefits can be claimed. If you became pregnant before the waiting period started and the policy excludes coverage for pre-existing conditions, benefits may be denied.

3) Treatment Requirement: If the policy defines a condition as "treated" when medical advice or treatment is received within a specified period (e.g., 90 days), and you sought treatment for pregnancy-related issues before the effective date, benefits could be denied.

It is important to thoroughly review the terms and conditions of the short term disability insurance policy to understand the specific restrictions and exclusions related to pre-existing conditions, waiting periods, and definitions of "treated" or "pre-existing." If you have concerns or questions about potential coverage for your pregnancy, it is advisable to consult with your insurance provider or an insurance professional for clarification and guidance on your specific situation.