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Increase in coverage for LTD
Nov 28, 2005

Hi Lynn, I was diagnosed with HIV in August 2005.

During my company's annual enrollment period this Fall, I elected to increase my Long Term Disability coverage. As part of that process I received a form that I must complet from MetLife of NY in order to have my request approved.

One of the questions on the form is "Have you ever been diagnosed or treated by a member of the medical profession for AIDS, ARC or HIV infection".

My question is - should I answer yes and if I do, what is the probability that I may be rejected for the higher coverage.

I have been employeed with the same company for over 10 years, sero-converted this year, am not on any medications though I am seeing an HIV speciality for the typical 3 month blood work routine.

My Tcells are over 1,000 and my current VL is 43,000.

Thank you.

Response from Ms. Franzoi

You have to answer yes. If you answered no and then became disabled, the LTD carrier would request full medical history and assuming your visits to the HIV specialist, including the routine 3-month blood work, are in your medical records, the carrier could deny your LTD claim based on insurance fraud. By answering yes, they might deny you an increased level of coverage. However, you would still have your existing coverage.

HIPAA for domestic partners
Physician's Mutual and Mutual of Omaha

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