Q: I have worked at the same place for 11 years buying short term disability insurance through said employer. On 1/1/2016
said employer changed their insurance provider, on 1/12/2016 I had to have knee surgery that left me unable to work at this time. Now this new insurance provider is denying my short term disability claim, they are labeling it as a preexisting condition because I saw a doctor for it on 12/08/2015. I have been paying for this insurance all these years is it legal for them to deny my claim?
A: Unless the knee is a work injury, this is not a workers' compensation question. If the knee is as a result of a work injury, it should not be submitted to short term disability. A workers' compensation claim should be filed.
A: First, look at the policy document. Also look at the old plan. File under that. Then if denied consult a member of the Pa. Assn for Justice that handles insurance bad faith.
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