Getting Health Insurance Coverage for a Pre-Existing Condition

**rckymtn80112** · 05-31-2011, 08:17 AM

My question involves insurance law for the state of: Colorado. My wife began working at a large company (1500 employees) about 7.5 years ago. During the health screening prior to employment she noticed a large sign in the room stating, "No pre-existing conditions allowed". She was not required to complete a pre-existing conditions questionnaire or asked about whether she had these issues. Prior to applying for her position she was diagnosed with Glaucoma. At the time of the screening her Glaucoma was under control and she had not had any procedures for many years. She was seen by her Ophthalmologist twice a year to monitor her pressure. Is there a possibility either the insurance company or her employer can take legal action against her for claims she filed during her employment for Glaucoma-related claims? What is the statute of limitations for a situation like this?

**cbg** · 05-31-2011, 09:10 AM

Previous to her starting employment with this company, had she had group health insurance coverage through either your or her previous employment? If so, when did that coverage end with relation to her employment with the company in question, and for how long had she been covered under the prior plan?

There is a very specific reason I am asking this, that has a direct relationship to the answer to your question - I'm not just being obstructionist. I am trying to establish if one specific law applies.

**rckymtn80112** · 05-31-2011, 09:32 AM

Thank you for your response. Current employer since 2003. 1997 - 2003: insured via individual/private family policy. 1994 - 1997: insured via group policy from employer. As of 2009 her current employer changed insurance carriers. Please lmk what other info would be helpful.

**cbg** · 05-31-2011, 09:56 AM

I need you to be quite specific about the year 2003. Was there a gap in coverage between the end of the individual policy and the start of the group policy, or did the one start immediately after the termination of the other? If a gap, how long was the gap? (Exact number of days needed here.) Who was the individual carrier with? (Which insurance company)

**rckymtn80112** · 05-31-2011, 01:04 PM

There was no gap in coverage. Does the carrier matter in terms of interpreting the law? I'm hesitant to disclose their name.

**cbg** · 05-31-2011, 01:30 PM

In your specific circumstances, it might. Can you PM it to me? If she'd gone from group coverage to group coverage it wouldn't, but since she went from individual coverage to group coverage there's a chance the carrier can make a difference.