Personal Finance

Can disclosing waiving of benefits affect future claims?

  • Last Updated:
  • Aug 9th, 2018 12:31 pm
Jr. Member
Mar 12, 2006
133 posts

Can disclosing waiving of benefits affect future claims?

I have called my insurance company to check how the coordination of benefits will work with my wife's new plan as she has just started a new job.
During the conversation I have mentioned that my wife's plans covers very little for Extended Health and that she is planning to waive extended Health benefits, but opt-in for the Dental benefits.
The CSR has immediately changed his tone and said that I should not have disclosed this to them as it may affect my wife's future Health claims. WTF?
I thought my wife has the right to decide whether to opt-in in the new insurance plan if she already has a better coverage through my plan. Any ideas?
1 reply
May 16, 2017
325 posts
The CSR maybe wrong BUT I'd think it has to do with coordination of benefits and the general term of spouses ELIGIBLE to be covered by each others' plan. I'd interpret "eligible" to mean actually enrolled but the insurance company may take a broader interpretation of that term for their benefit (of course) to minimize their portion of any claim payment.


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