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Pre-Existing Medical Condition? You May Still Have a Valid Claim.
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PPI and Pre-Existing Medical Conditions.
PPI (payment protection insurance) is just like other insurance policies when it comes to pre-existing medical conditions. Most insurance policies don’t include them, and this means that generally speaking you won’t be covered for any medical problems you’ve had in the past. This matter should have been discussed when you bought the policy, and if not, then you may be eligible to file a PPI claim.
So does this mean you’re eligible to reclaim your PPI payments? To answer that, let’s examine the pre-existing medical conditions aspect in greater detail.
Defining a “pre-existing medical condition”
Each provider has its own definition of “pre-existing conditions”, although it’s safe to say that these definitions are generally very strict. Their decision to pay your insurance claim will be based on what they think you should have known about your health before the insurance policy took effect. If you press an insurance claim on the grounds of health, the insurer may ask for medical proof or records that you didn’t have the problem when you took out the policy. The insurer will in all likelihood reject your claim if you’ve had a similar medical problem before.
This is probably the main reason why insurance claims for health reasons are rejected. Insurers generally adopt a very general definition of what “similar health problems” mean. For example, if you have had problems in your lower back they may reject your claims even though they may be unrelated.
Was the topic of “pre-existing condition” even brought up?
Insurance sellers are not required to hold a medical discussion in great detail. At the same time, if the topic of medical exclusions did not come up at all then the insurance policy may be void and you may be able to reclaim successfully. Questions like “Have you had any illness, accident, or other treatment which caused you to miss work for two weeks or more?” should have been brought up during this discussion.
If you have experienced medical problems in the past, that doesn’t automatically disqualify you from making a PPI claim. The most important point here is whether or not you were informed that this was a crucial part of the insurance policy and if you were asked to confess if you have had any medical issues in the past.
Some insurance providers also offer medical coverage if you were free of symptoms for several years before you took out the policy. This means that you need to check your policy carefully to see if this applies in your case.
Other issues relating to health
Most insurance policies exclude other general health problems in addition to pre-existing health conditions. You will need to inspect the terms of your PPI policy carefully and check if there are any conditions which are not covered. Your PPI policy would have been improperly sold to you if you were mis-informed about these conditions, if you weren’t told about them, or if you weren’t told you had a PPI policy at all.