A condition will no longer be considered pre-existing after a person has been treatment free for a period of 180 days or enrolled in the plan for a period of 12 consecutive months. This limitation applies only to the condition for which treatment was received as stated above. The pre-existing clause is liberalized to provide benefits for such conditions when a group transfers into this plan from a previous plan without a lapse of coverage. Benefits will be provided with no loss of coverage, providing the condition has been listed on the Health Statement and considered a covered expense. Omitting to list a pre-existing condition will be cause for denial.
Defendants appear to assume that there is.
However, they cite us to no general exclusion of pre-existing medical conditions as covered expenses in the plan document, and we are unable to find one in the record provided us. Plaintiff filled out his enrollment form on December 10. No facts indicate plaintiff had at any time visited a doctor concerning any cardiovascular or respiratory disorder in the period prior to filling out the enrollment form. Plaintiff's doctor concluded that his breathing problem was the result of an abdominal aortic aneurysm. Respiratory failure complicated his recuperation from the surgery and necessitated his total dependency on a mechanical breathing device.