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Denied Claim For Postpartum Depression

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courtm

Junior Member
What is the name of your state? Michigan

In January 2008, I filed a claim for postpartum depression against my short term disability policy. Under limitations and exclusions, it state "..complications of pregnancy will be covered to the same extent as a sickness" Later on in limitations and exclusions, it states "Becoming Totally Disabled due to any of the following: neurosis, psychoneurosis,psychopathy, psychosis, or mental or emotional disease or disorder. ” Being that postpartum depression is a very prevalent complication of pregnancy, shouldn't this be covered as a complication of pregnancy? When I contacted the insurance company, they stated that postpartum depression was not a complication of pregnancy. Please advise.What is the name of your state?
 


cbg

I'm a Northern Girl
If yuo are looking for a law that will force the disability carrier to pay the claim, you're not going to find one.

What I think or what you think ought to be covered cuts no ice. It's what the disability policy says is covered that matters. If a particular condition is excluded by the policy, then in the absence of a state law that requires coverage for that condition they are not obligated to pay it.

You have nothing to lose by appealing the decision.
 

ecmst12

Senior Member
it state "..complications of pregnancy will be covered to the same extent as a sickness"
You do not understand your policy. Complications of pregnancy will becovered to the same extent as a sickness, means that if the sickness is covered when it is NOT related to pregnancy, then it will be covered if it IS related to pregnancy in the same way. Mental illness is excluded from coverage, whether it is due to pregnancy or not. They do not have to provide coverage for an excluded condition just because it is related to your pregnancy. Postpartum depression is not treated differently then any other kind of depression.

Of course, whoever you talked to at your insurance company was a moron, and gave you the incorrect REASON as to why it was not covered.
 

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