Waiver of Ins. premium for disability.

[sammiemaso]

I have a cancer policy I took out inMay 26, 1993. I became disabled with cancer Oct. 1994.

I have been totally disabled ever since. My policy has a premium waiver if totally disabled . However I cannot understand the wording. I have talked to the Ins. Co. and still cannot understand why they say I am not elibible for the premium waiver.

This is the statement in my policy: We will waive the premiums which fall due while you are totally disabled. Your total disability must begin before the policy anniversary following your attainment of age 60. My policy anniversary is 7-24-94 and I was 60 years old at that time. I became disabled with cancer Oct. 1994.

However the word anniversary can mean any year, because each year I have the policy , the effective date would be an anniversary date.

Can you explain so I can understand this.
Thank you.

 

[Beth3]

Okay, I've spent much of my career working with group health plans and I've read that sentence at least six times and I can't figure out what it means either.

I'd call the carrier back and ask them to send you a letter explaining IN WRITING why your premiums are not being waived. If that still doesn't make sense, then I suggest you call your State's Insurance Commission and see what they say. My State, and I expect quite a few others, has legislation which requires carriers to put their plan documents in clear easy-to-understand language. If the languge isn't clear, then the benefit of the doubt goes to the interpretation that favors the employee.

Good luck.

 

[CIAA]

Unfortunately, it does not appear that you qualify. You attained the age of 60 on your 60th birthdate. Therefore, based on the language, your disability must begin prior to the next anniversary date which would have apparently been
7-24-94. Since your disability did not occur until after 7-24-94 the option had expired.