Can my employer provided life insurance company legally refuse to increase my spouse’s coverage due to breast cancer?

UPDATED: Oct 1, 2022

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Can my employer provided life insurance company legally refuse to increase my spouse’s coverage due to breast cancer?

A while back, my employer provided life insurance offered the option for additional coverage on employee spouses to equal that of the employee I filled out the necessary paperwork truthfully and sent it to the insurance company. A few weeks later, we received a denial from them, based on the fact that she had been diagnosed with breast cancer. She elected to have the breast removed, was given 3 precautionary rounds of chemo and, for all intensive purposes, was considered to be cancer free. This information was shared with the insurance company via the paperwork. Is this legal or discrimination? If legal, why are they allowed to get away with this?

Asked on May 22, 2018 under Insurance Law, Tennessee


SJZ, Member, New York Bar / FreeAdvice Contributing Attorney

Answered 4 years ago | Contributor

It is legal because life insurance, unlike health insurance, is not barred by law from considering pre-existing conditions or health risks. In fact, eligility for insurance (and how much insurance they will sell you, and the premiums you pay) is explicitly based on the would-be insured's health. Insurers sell insurance not as a public service, but to make money: that means they can refuse to cover if they well the risk of actually having to pay out is too high. Cancer is a valid reason to not increase someone's insurance, especially since even people in remission have a higher rate of cancer (of relapse, or cancer in another body part) than people who have never been diagnosed with cancer. Given that higher risk, creating a higher likelihood of payout, they are allowed to decline additional coverage.

IMPORTANT NOTICE: The Answer(s) provided above are for general information only. The attorney providing the answer was not serving as the attorney for the person submitting the question or in any attorney-client relationship with such person. Laws may vary from state to state, and sometimes change. Tiny variations in the facts, or a fact not set forth in a question, often can change a legal outcome or an attorney's conclusion. Although has verified the attorney was admitted to practice law in at least one jurisdiction, he or she may not be authorized to practice law in the jurisdiction referred to in the question, nor is he or she necessarily experienced in the area of the law involved. Unlike the information in the Answer(s) above, upon which you should NOT rely, for personal advice you can rely upon we suggest you retain an attorney to represent you.

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