§ 88.52. Definitions.

 The following words and terms, when used in these § §  88.51—88.53, have the following meanings, unless the context clearly indicates otherwise:

   Preexisting condition—A condition for which medical advice or treatment was recommended by a physician or received from a physician within a 5-year period preceding the effective date of the coverage of the insured person.

Notes of Decisions

   Construction; Ambiguity

   The fact that State insurance regulations contain a definition of ‘‘preexisting condition’’ that is virtually identical to that contained in an insured’s policy does not conclusively demonstrate that the policy definition is unambiguous. Lawson v. Fortis Insurance Co., 146 F. Supp.2d 737 (E.D. Pa. 2001); affirmed 301 F.3d 159 (3rd Cir. Pa. 2002).

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