Exclusion Riders—Not Always Too Exclusive

Updated: Sep 13, 2020

Occasionally I take an application from a doctor who has a history of an injury, disease, or other disorder that has a higher than normal risk of causing future problems. Rather than decline the application, often insurance underwriters will agree to issue a regular policy that covers everything except that problem. This allows the applicant to still get a policy and have everything else covered at a fair premium rate.

These exclusions are not always completely exclusive, however. The intent of many of these riders is to exclude just the preexisting condition – not all situations that involve the affected area.

For example, suppose a physician had a knee injury and repair before applying for his disability insurance. The policy might exclude any injury or disorder of that knee. However, if the doctor got in a car accident that injured the knee, and the accident would have injured the knee in spite of the pre-existing condition, the insurance company would probably still pay the claim.

For some types of riders, we can even get the company to write a letter to the applicant explaining this. The letter will say something like, “If the pre-existing condition is not a contributing factor toward the disability involving the knee, then it would be a paid disability.”

If you were hesitant in the past to consider a policy because of a pre-existing condition, let’s talk. They policy that works best in your situation may surprise you.

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