After enjoying a healthy start to her pregnancy, our client became insured through Reliance Standard. Unfortunately, after our client gave birth she suffered a stroke that led to her disability. She was unable to return to work following her stroke, which prompted her to file an insurance claim through Reliance. However, when she turned to Reliance Standard for long-term disability benefits, the company turned down her claim on the basis that her disability was pre-existing. The preexisting condition they referred to was her pregnancy, which, Reliance argued, contributed to her stroke.
According to their policy, Reliance excludes disabilities that were “contributed to by” pre-existing conditions. Reliance Standard argued that preeclampsia, the condition that caused our client to suffer a stroke, was caused by her pregnancy, and therefore the pregnancy “contributed to” her stroke. Because our client was pregnant prior to becoming insured by Reliance, the company considered her pregnancy a pre-existing condition that led to her disability.
Although our client was indeed pregnant when her disability policy through Reliance began, her pregnancy should not have been considered a pre-existing condition for a stroke. Our legal team at Dabdoub Law Firm argued against Reliance Standard’s “but for” explanation. Fortunately, the court agreed. The court said the connection between the pregnancy and the stroke “simply requires too much attenuation.”
The court adhered to the “substantially contributed to” test, which evaluates whether or not the pre-existing condition, in this case the pregnancy, substantially contributed to the disabling condition, the stroke. When the court determined that the pregnancy did not directly cause the disability, Reliance Standard could no longer consider the pregnancy a pre-existing condition and could therefore not exclude our client from long-term disability insurance coverage.
If you or someone you love has been wrongfully denied disability insurance coverage, our firm may be able to help. Contact Dabdoub Law Firm to schedule a free consultation.