Group Benefits Guide: Can I Get Disability Insurance With A Pre-Existing Condition?

Group Benefits Guide: Can I Get Disability Insurance With A Pre-Existing Condition?

When planning for the future, it is best to remember that life sometimes includes unfortunate, unforeseen circumstances. Participating in group benefits with long-term disability coverage gives you peace of mind and protection for future uncertainties. Disability insurance in Canada can cover up to 70% of your income if you become ill or injured and cannot work. 

Unfortunately, some people face an issue claiming long-term disability benefits due to pre-existing conditions. You may ask yourself, “Can I get disability insurance with a pre-existing condition?” The short answer is yes, but some stipulations could cause an insurance company to deny you benefits.

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What Is a Pre-Existing Condition?

When you’re wondering, “Can I get disability insurance with a pre-existing condition,” you must first understand what a pre-existing condition is and how it could apply to you. A pre-existing condition is a term insurance providers use for a health problem or injury you have before obtaining disability insurance. 

Under the “objective standard” definition, insurers can determine any condition for which you have previously received medical treatment or advice to be a pre-existing condition. If you have a disability that requires medical care, the insurance agency may try to deny your claim by arguing that your situation predates the start of your insurance coverage.

How Pre-Existing Conditions Affect Long-Term Disability Law

Purpose of Pre-Existing Condition Exclusions

Importance of Applying for Group Insurance with Disability Coverage

Participating in group benefits with long-term disability protects you financially if you lose your income. You would receive monthly payments to replace a significant portion of your potential earnings. Without this insurance coverage, you may have few options for long-term financial support.

Questions to Ask When Applying for Group Insurance Coverage for Long-Term Disability

Group Long-Term Disability and Pre-Existing Conditions

If you develop a condition or injury that prevents you from earning a living, you can file a claim through your employer’s group long-term disability insurance. However, if your claim could fall under the pre-existing condition exclusion, the insurance provider may investigate your medical history before your policy’s start date.

The insurance company likely won’t explore your entire medical history. They may investigate a specific period, such as 90 days before your coverage’s effective date. If you did not receive treatment for the disabling condition during that period, the exclusion does not apply.

Can You Appeal a Denial for Long-Term Disability?

If the insurance company denies your long-term disability claim, you have a right to an appeal. The appeal process lets you ask the insurance provider to reconsider its decision after denying your claim. You may go through an internal appeal process in which the insurance company’s employees handle your written request to appeal.

If the company denies the internal appeal, you could request an external one. The process allows an independent agent like a provincial judge or arbitrator to address your claims. Filing this appeal involves bringing a lawsuit against the insurance company to negotiate a settlement or approve your claim.


Choose Group Enroll for Essential Group Disability Benefits

Life-changing illnesses and accidents can happen at any time. Your employees may ask, “Can I get disability insurance with a pre-existing condition?” Though many long-term disability coverages through group benefits include pre-existing condition exclusions, Group Enroll can help you select the most appropriate insurance plans for your workers. 

At Group Enroll, we help business owners find affordable group health, life, and disability insurance coverage by providing quotes from some of Canada’s leading insurance agencies. As an insurance broker, we make it easy to compare rates and find reliable coverage.

Begin your search today by completing our online quote form. You can also send correspondence to or 10 Great Gulf Drive, Unit 5, Vaughan, ON, L4K 5W1.