“Challenging Insurance Denial: Exclusion vs. Burden of Proof for TBI-Related Conditions”

I hope someone knows and can help me…
Unfortunately, benefits from my BU insurance were rejected. I’ll try to explain it briefly.

My BU insurance has an exclusion which I of course agreed to when I graduated. – Hearing impairment and consequences are excluded (because of hearing damage that has existed for a long time)

Now in 2021 I had an accident with TBI which resulted in an aggravation and tinnitus. I’ve also suffered from chronic headaches ever since. sleep disturbances and severe depression have developed primarily as a result of the tinnitus. A migraine also came, whether it came from the accident, I don’t know of course.

Now, of course, the insurance says the service has been rejected because the exclusion (hearing loss and consequences) are excluded and the insurance says that all complaints can be traced back to the tinnitus.

But my information is that only direct exclusions can be asserted. And there e.g. Neither tinnitus nor depression were ruled out would also need to be provided. I’ve also heard that the insurance company has the burden of proof.

Does anyone happen to know? Or do you think I can’t get any further without a lawyer?

Lg