Oxford FE Application
- Thread starter nfl72
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- #12
No. They deviate from the app during the phone interview. Much better options out there. I only use them for med supps because of that
- 2,758
They pay 120% and you can contract directly. I only use them for the healthiest people.
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- #15
stated by Peteybear,
"It is what it is. You would be doing a great disservice to replace it as the contestability is almost over."
I am not sure I agree with that statement. I have been told by 2 or 3 insurance companies that the 2 year contestability period does not negate fraud. In this case if the answers were answered properly, she would not have been covered at all. Therefore they might take the stand no coverage ever existed.
If the wrong answer were to mean they should have been covered under a graded policy, they can calculate the difference and lower the face amount accordingly. I have been told this happens with the tobacco usage question from time to time.
I was thinking I would just write a smaller 3 to 5K policy and suggest she keep the 7K with Oxford. Now, after reading the application I can clearly see the health questions were not answered correctly. I think a replacement with one new policy for a higher dollar amount would be in order.
"It is what it is. You would be doing a great disservice to replace it as the contestability is almost over."
I am not sure I agree with that statement. I have been told by 2 or 3 insurance companies that the 2 year contestability period does not negate fraud. In this case if the answers were answered properly, she would not have been covered at all. Therefore they might take the stand no coverage ever existed.
If the wrong answer were to mean they should have been covered under a graded policy, they can calculate the difference and lower the face amount accordingly. I have been told this happens with the tobacco usage question from time to time.
I was thinking I would just write a smaller 3 to 5K policy and suggest she keep the 7K with Oxford. Now, after reading the application I can clearly see the health questions were not answered correctly. I think a replacement with one new policy for a higher dollar amount would be in order.
- 16,906
The crime of insurance fraud does not end in 2-years. The insurance company does have to pay the claim if it's past 2-years regardless of fraud. But the insurance company is still within their rights to charge them with a crime.
It's unlikely they will do that on small policies but there is a first time for everything.
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- #17
Several years ago I had a claim going with Foresters. I received a call from an investigator asking about the condition of the insured when she applied for the policy.
We spoke at great length about the claim process in general. I was rather new and had lots of questions for her. She led me to believe that if an insurance company suspected fraud was involved, even outside of the 2 years, they could still contest the claim and deny payment, if they chose to do so. Of course getting the same answer from three different people at Foresters can be difficult.
FTR who would they charge with a crime? The insured had to die to start the claim! Can you take a dead man to court?
We spoke at great length about the claim process in general. I was rather new and had lots of questions for her. She led me to believe that if an insurance company suspected fraud was involved, even outside of the 2 years, they could still contest the claim and deny payment, if they chose to do so. Of course getting the same answer from three different people at Foresters can be difficult.
FTR who would they charge with a crime? The insured had to die to start the claim! Can you take a dead man to court?
- 19,035
I've had people at the insurance companies tell me the same thing but I've learned that they are wrong. It cannot be contested after the contestability period is up.
They can go after the beneificiary to and try to get their money back if they suspect fraud. And an insurance company might very well go after a million dollar payout?
Would they spend that kind of time and resources on a $10-15K payout?
- 16,906
I assume they would go after the estate if he was dead or the applicant if they caught it while he is living.
On small policies I doubt they go after anyone. Maybe the agent if there is a pattern.
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- #20
The estate, That's the ticket!
Because most of my TM leads are in the big City ghettos, I don't come across too many estates. This lady lives in a $500 per month high rise. She has a tv, a 15 year old computer, some knick knacks, a bed and two chairs.
When I showed up for our appointment she met me in the hall and stated I was going to have to come back as they had numerous complaints of bed bugs in her building and they were searching room to room to find those critters.
I said that's ok I will only take a few minutes and let myself in. Sure enough About 5 minutes later two men in white uniforms came to the door with a Bed Bug Sniffing Dog. They saw me and said they'd come back in 30 minutes.
It was probably a good thing too; as this lady had the best smelling fried chicken I have ever seen. Between her quadruple bypass, three strokes and my 8 or nine stints, the last thing we should be eating is fried chicken.
Because most of my TM leads are in the big City ghettos, I don't come across too many estates. This lady lives in a $500 per month high rise. She has a tv, a 15 year old computer, some knick knacks, a bed and two chairs.
When I showed up for our appointment she met me in the hall and stated I was going to have to come back as they had numerous complaints of bed bugs in her building and they were searching room to room to find those critters.
I said that's ok I will only take a few minutes and let myself in. Sure enough About 5 minutes later two men in white uniforms came to the door with a Bed Bug Sniffing Dog. They saw me and said they'd come back in 30 minutes.
It was probably a good thing too; as this lady had the best smelling fried chicken I have ever seen. Between her quadruple bypass, three strokes and my 8 or nine stints, the last thing we should be eating is fried chicken.
