What Do You Mean It's Not Covered: How One Policy Defined "Sickness" to Exclude Coverage

First, the policy defined sickness as: disease or illness, or more than one disease or illness, resulting from the same or related causes or conditions, including all complications thereof and all related conditions and recurrences resulting in medical expense insured under the Policy or otherwise resulting in a claim for benefits while the Policy is in force with respect to the Insured Person for whom claim for benefits is made. Second, the policy excluded coverage for sickness resulting in medical expenses incurred before the inception of the policy. It included in this exclusion: expenses incurred in connection with any distinct bodily injury or sickness for which an Insured Person received medical treatment...within the previous twelve months.... This language was unambiguous. The appeals court held that the preexisting condition exclusion of the policy barred coverage for hospitalization caused by her exposure to environmental pollution. For support, the appeals court cited a 1986 Florida decision -- American Pioneer Life Ins. Co. v. Parks -- In that case, the court also supported an insurance company's exclusion. The policyholder had a diseased condition before the inception of policy coverage. She claimed entitlement to coverage, however, "on the basis that [she] suffered no 'sickness' within the contemplation of the policy until she was first made 'sick' by the hemorrhaging of her varices in January 1982."