OK, let's address one question at a time. Determining that you were pregnant at the time you completed your application is easy enough. Your medical records provided through your physician will indicate an estimate delivery date, and therefore an estimated date of conception. Whenever a person applies for health insurance, and soon after shows positive for pregnancy, this sends up a major red flag with the insurance company. They will request medical records, look at the date of conception and compare that to the date of your application. The fact is, whether you were 100% certain or not, you were pregnant when you completed your application. The insurance company has the right to deny this claim. In fact, they will probably even cancel your policy for non-disclosure of important medical information, which they view as fraud. All premiums that you have paid to date will be returned, but you will be left without insurance for yourself and your newborn child. Now, for the issue with the agent providing you with poor advice, and basically advising you to lie on your application. You may have a legal claim against that agent, but it won't change the fact that you will be uninsured. Licensed health insurance agents are required to have liability insurance for instances such as these, but the insurance company will not be liable for their actions. You should contact an attorney to discuss this case. Perhaps the liability insurance of this agent will cover the medical costs associated with your pregnancy. But, there are two problems here, it is your word against his, and you were just as responsible for falsifying the application. In addition to contacting an attorney, you should also file a complaint with your state Department of Insurance. They may open an investigation, and if they determine your claim to be true, may cancel the license of this agent. Agents that advise people to falsify their application, and assure them that there is no risk in doing so, are doing a great disservice to this industry and they should be penalized.
Answered: May 02, 2010