Understanding the 24/24 Pre-existing Condition Rule


Under a “24/24” pre-existing condition amendment, claims are excluded from coverage when ALL of the following are TRUE:

  • The insured had a pre-existing condition within the 24 months prior to coverage. This is the first number in “24/24”
  • The disability is related to a pre-existing condition
  • The disability begins within 24 months after the coverage is in effect. The second number in “24/24”

Claims are NOT excluded from coverage under the pre-existing condition amendment when the following are true:

  • The disability begins after coverage has been continuously in effect for 24 months, regardless of whether there is a related pre-existing condition(s)
  • The disability begins within the first 24 months of coverage being in effect, but there was no pre-existing condition during the 24 months prior to coverage
  • The disability begins within the first 24 months of coverage being in effect and there was a pre-existing condition(s) within the 24 months prior to coverage, but the disability is not related to that pre-existing condition(s)