Do Med Supps ever revisit app re conditions AFTER approval?

[somarco]

I don't know if the client ever sued the agent but they surely could have.

Lawsuits normally go after deep pockets. Most agents don't have a lot of money laying around but they should have E&O

Whether or not it will pay is another question.

If the agent COLLUDED with the applicant to help in fabricating the answers, E&O won't pay and the agent would be in a lot of trouble.

 

[vic120]

If the agent COLLUDED with the applicant to help in fabricating the answers,e.

It all hearsay anyway

the point is is one lies on app it can come back to them at the worst times or when least expected

 

[PK12]

I had 1 rescission - the client lied to me when we went through the questions. He thought it wouldn't come up. However, when he had surgery less than 1 year after effective date, the company checked medical records and found the prior condition and surgery. When I asked the client about it, he told me he didn't think it would matter that he had had the surgery the year before. This was a new client referred to me by a life agent who should have known better. I confirmed the medical info with him and he agreed all was correct before I sent in the app. Moral to story - be sure the client understands that it is fraud to lie on an application. If there is any doubt about how to answer a medical question, the client should email his doctor and get an answer in writing from the doctor related to that question.

 

[Rick441]

If there is any doubt about how to answer a medical question, the client should email his doctor and get an answer in writing from the doctor related to that question.

Which suggests that you believe I shouldn't worry about any issues down the pike if I do pursue and successfully complete a switch from N to G, since that is exactly what I did (see Original Post). Right?

 

[thomasm]

Yes.

How do YOU answer it?

Stents do not cure the disease, only relieve some of the side effects and symptoms.

Some people tell me they don't have HBP.

Then why are you taking (HCTZ, amlodipine, lisinopril . . . pick one or more)?

To lower my blood pressure, but I don't have high blood pressure.

Edit: Thanks for clarifying! T-65 biz has me a little rusty on underwriting. Diabetes with any complications is pretty much a DECLINE with every carrier except CIGNA Substandard and UHC level 2 rates.

Good point! I ask the health questions on the application and put down the answer they tell me. But I always put detailed notes on the application for the underwriters to determine a decision. I'll call and talk to the underwriters if I'm not sure either. If there's any chance of a rescission down the road, they are better off on the plan they current have guaranteed renewability with.

 

[somarco]

Diabetes with any complications is pretty much a DECLINE with every carrier except CIGNA Substandard and UHC level 2 rates.

Diabetes + complications is always a decline for me. If I don't think they qualify for std or pref rates I move on. Don't have the time to waste trying to sell them on paying 2x+ for a new plan.

The point of my response to the stents was not in relation to insurability or not, just pointing out how I would complete the app . . . IF I was going to take an app.

The stents MAY be outside of the scope of the application but you can almost bet they are on an anti-coagulant Rx . . . which is another reason to decline.

I ask the health questions on the application and put down the answer they tell me. But I always put detailed notes on the application for the underwriters to determine a decision. I'll call and talk to the underwriters if I'm not sure either. If there's any chance of a rescission down the road, they are better off on the plan they current have guaranteed renewability with.

If I get to a question you described AND they tell me about the stents, I stop the application at that point. Going further is a waste of their time and mine.

I am not picking on you, just making a point that many of the application issues can be dealt with BEFORE completing the application. I am perhaps a bit more detailed than most agents. But I also have very few declined or rated applications. And only a couple of rescission's.

 

[bill3173]

just making a point that many of the application issues can be dealt with BEFORE completing the application.

On an individual basis, the commission is so low, and the potential for outrageous costs are so high, hiding something for a client seems beyond ridiculous to me.

Some of them will insist that you leave stuff off of the app. I've had a few every year that want me to clean sheet the app, even though I tell them the consequence if it possibly got approved.

I refuse, they get a little ruffled, but call me back next year. It's not like they're going anywhere else, unless they're willing to do MAPD.

 

[somarco]

On an individual basis, the commission is so low, and the potential for outrageous costs are so high, hiding something for a client seems beyond ridiculous to me.

Some of them will insist that you leave stuff off of the app. I've had a few every year that want me to clean sheet the app, even though I tell them the consequence if it possibly got approved.

I refuse, they get a little ruffled, but call me back next year. It's not like they're going anywhere else, unless they're willing to do MAPD.

THIS^^^^^^

 

[yorkriver1]

I have seen claims experience with someone on a Plan N, and aside from the need to watch billing of small office visit fees, the plan will pay well on the "big stuff". $0 hospital, and office fees no more than $20. Physical therapy, cardiac rehab therapy, not office visits, $0 out of pocket once the Part B deductible is met.
I bring this up because for the risk of a policy being rescinded, it's not so bad maybe to keep Plan N. Surgery, echocardiograms, hospital stays, all $0 out of pocket. True, some risk of encountering a non-participating provider, haven't seen it. Smaller risk than dropping a plan for a new one based on somewhat shaky ground.