Legal Question in Insurance Law in New York

Pre-existing conditions

My insurance (and therefore, that of my son's) was terminated because I was not automatically billed for insurance this semester by NYU and hence did not pay it. I did not realize that if I went below six credits per semester I would not automatically be billed. (I had no idea that I hadn't been billed annually in September when I paid for my son's entire year of insurance). As such, both our insurance coverages were terminated February 9, 1998 without any notification or attempt to refund the amount not used for my son. His entire annual insurance was paid for in September.

My question:

If the insurance company agrees to add us on to their insurance at this time (I filed a petition) is their claim that they do not have to cover any pre-existing conditions as detailed in their Insurance Handbook legal?


Asked on 4/20/98, 3:22 pm

1 Answer from Attorneys
Steven Murray Steven W. Murray, APC

Re: Pre-existing conditions

The insurer is on the risk for your son since they

received the premium and did not refund it.

As for notification, the university is the "agent"

for the insurer, and if mistakes were made by either

the insurer or the school, the insurer would be

responsible.

Pre-existing conditions may not be allowed as

exclusions if the policy never was legally

cancelled. Most states have notification requirements

which must be met before cancellation for non-

payment is allowed. The policy continues under

those circumstances, and thus legally was never

cancelled.

Steven Murray

Steven W. Murray, APC

16055 Ventura Blvd., Ste. 900


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Answered on 3/27/99, 1:32 pm


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