Question on Great Western

[shonceman]

Personally, I only use them in the extreme niche situations where I cannot get them level or graded coverage elsewhere. Examples would be congestive heart failure, some cardiac issues, and combination health problems normally only qualifiable for modified-type products. There is no good reason to write your bread and butter business with Great Western because: 1) Advance business is limited to 50%. 2) Max dollar advance per case is limited to $500, and 3) Onerous beginning charge back provisions cause your as-earned income to be repayable if the policy lapses within the first 90 days. Basically, I instruct my agents to use Great Western for the screwball cases we can't get placement elsewhere.

I only took them on as a replacement for NGL GI. The main reason for NGL was that they took DE cards, which they've stopped. I also didn't like Vantis extreme chargeback provisions. I've got Gerber as an option, but their chargeback provisions, while better, are still hefty. GWIC is a good compromise. The only reason I'm asking is because I was quoting a guy with CHF who's been under control on same meds for several years, and if they'll take him on immediate ben, so much the better. If not, then so be it. I just wish they weren't so vague about it!

 

[sirherbie]

The underwriting guide is the most confusing I've ever seen.Example is high blood pressure. They say its ok if controllable. Then they explain controllable is the same or less dosage in the past 2 yrs.So if somebody gets level and they die in the 2 yr contestable period and had increased their dosage will Gw deny the claim saying it was"uncontrollable" The underwriting guide only lists a few ailments that are Gi like Aids,Cancer in last 2 yrs etc. Then it lists the definition of all the different ailments to each of the questions like disorder of the lungs,Heart etc. For instance it lists Chf. Does that mean if the clients medicines for Chf have been level for 2 yrs its ok?Does that mean Kidney Dialysis is Ok if treatment has been level for 2 yrs?What about pulmonary diseases such as Pulmonary fibrosis were treatment hasn't changed? There will be huge temptation to write the level benefit as no mib or rx means everything gets approved. But an agent must think of the potential headache of 2 yr contestable claims. Basically the company is banking on agents will be wary of writing the level benefit on questionable cases that some carriers would take level and they'll write them the Gi which is still 20% plus higher premiums than Gerber.

 

[rousemark]

The underwriting guide is the most confusing I've ever seen.Example is high blood pressure. They say its ok if controllable. Then they explain controllable is the same or less dosage in the past 2 yrs.So if somebody gets level and they die in the 2 yr contestable period and had increased their dosage will Gw deny the claim saying it was"uncontrollable" The underwriting guide only lists a few ailments that are Gi like Aids,Cancer in last 2 yrs etc. Then it lists the definition of all the different ailments to each of the questions like disorder of the lungs,Heart etc. For instance it lists Chf. Does that mean if the clients medicines for Chf have been level for 2 yrs its ok?Does that mean Kidney Dialysis is Ok if treatment has been level for 2 yrs?What about pulmonary diseases such as Pulmonary fibrosis were treatment hasn't changed? There will be huge temptation to write the level benefit as no mib or rx means everything gets approved. But an agent must think of the potential headache of 2 yr contestable claims. Basically the company is banking on agents will be wary of writing the level benefit on questionable cases that some carriers would take level and they'll write them the Gi which is still 20% plus higher premiums than Gerber.

If I were going to write them, there is no way I would ,write anything other than the GI. The medical question is all encompassing and with the exception of high blood pressure they give no definition of treatment. Contestable disaster waiting to happen.

 

[jdeasy]

If I were going to write them, there is no way I would ,write anything other than the GI. The medical question is all encompassing and with the exception of high blood pressure they give no definition of treatment. Contestable disaster waiting to happen.

I doubt their contestable rescission percentage will be any different than the other companies. There's a reason companies won't give out the percentage of contestable claims they pay.

 

[sirherbie]

Obviously Fe carriers have much higher rescission rates than fully under written carriers due to ease of issue and ability to not disclose some medical history. Read an article from a few yrs ago that in 2010 Aig had the most recissions among big carriers with 89 and mass mutual had the least with 8

 

[jdeasy]

Obviously Fe carriers have much higher rescission rates than fully under written carriers due to ease of issue and ability to not disclose some medical history. Read an article from a few yrs ago that in 2010 Aig had the most recissions among big carriers with 89 and mass mutual had the least with 8

When I first got into FE fulltime I had my first rescission on a policy that was 4 months old.

In talking to the claims dept. they said they found something in his record that wasn't disclosed. I asked what question on the app was answered incorrectly. They said it wasn't "technically" on the app.

Then she said they "jokingly refer to it as the 50-50 gamble" in the claims dept. I told her I was shocked that they only pay 50% of contestable claims and that was new to me since I had come from fully underwritten business into this. She said she was referring to FU and SI, "no difference".

I asked how that could be if there was an exam and APS, etc. She said, "oh, we can always find a specialist or something that they forgot to mention".

That was my introduction to FE claims processing. I have since found that she wasn't telling the truth. That company pays no where near 50% of contestable claims.

 

[Rearden]

The underwriting guide is the most confusing I've ever seen.Example is high blood pressure. They say its ok if controllable. Then they explain controllable is the same or less dosage in the past 2 yrs.So if somebody gets level and they die in the 2 yr contestable period and had increased their dosage will Gw deny the claim saying it was"uncontrollable" The underwriting guide only lists a few ailments that are Gi like Aids,Cancer in last 2 yrs etc. Then it lists the definition of all the different ailments to each of the questions like disorder of the lungs,Heart etc. For instance it lists Chf. Does that mean if the clients medicines for Chf have been level for 2 yrs its ok?Does that mean Kidney Dialysis is Ok if treatment has been level for 2 yrs?What about pulmonary diseases such as Pulmonary fibrosis were treatment hasn't changed? There will be huge temptation to write the level benefit as no mib or rx means everything gets approved. But an agent must think of the potential headache of 2 yr contestable claims. Basically the company is banking on agents will be wary of writing the level benefit on questionable cases that some carriers would take level and they'll write them the Gi which is still 20% plus higher premiums than Gerber.

...Which is why one would only write Great Western when no other carriers will definitely write them full coverage from the first day.

Plus, I am not sure why you are confusing the underwriting more than necessary. Follow what the application says. Then reference the Agent Guide for clarification.

When I read both with Great Western, what is acceptable and is not acceptable is pretty clear. Basically, if you want level coverage with niche cases like COPD, CHF, tougher cardiac cases, etc., then they (a) need to have been diagnosed longer than 2 years ago, and (b), need not to have elevated dosages for medications or introduced new medications for two years or longer.

If they can't pass those requirements, then they are to go modified.

However, given the understandable concern for what the application may or may not say, I advise my agents not to write Great Western in "bread and butter" scenarios, in the best interest for both the client and the agent.

 

[sirherbie]

I have no interest in them as a "bread and butter" carrier. But I run into a lot of cases were 2 blood thinners and 2 water pills are used and they can be useful to the tune of 30 plus cases a yr. We both know the power of no mib/Rx check . What about all the clients on dialysis ? There's a huge mkt for it if you can understand truely what's acceptable . I was talking to a lady at the co the other day and she said a few days a they got near 2k apps. If they have a niche I can exploit then I will.

 

[rousemark]

...Which is why one would only write Great Western when no other carriers will definitely write them full coverage from the first day.

Plus, I am not sure why you are confusing the underwriting more than necessary. Follow what the application says. Then reference the Agent Guide for clarification.

When I read both with Great Western, what is acceptable and is not acceptable is pretty clear. Basically, if you want level coverage with niche cases like COPD, CHF, tougher cardiac cases, etc., then they (a) need to have been diagnosed longer than 2 years ago, and (b), need not to have elevated dosages for medications or introduced new medications for two years or longer.

If they can't pass those requirements, then they are to go modified.

However, given the understandable concern for what the application may or may not say, I advise my agents not to write Great Western in "bread and butter" scenarios, in the best interest for both the client and the agent.

Sorry, Dave.. I think you are reading something into the app that is not there. The app says in the last two years has the applicant been. "been diagnosed wit, been prescribed medication for or been treated by a healthcare provider for any of the following conditions:" The lists the conditions without clarification. When you go to the UW guide, it really expands those conditions. No where do they use the language you are applying except for high blood pressure in the UW guide. If they intended that definition to apply to other conditions other than HBP, then they would not have limited it to and specified HBP.

Even if you are correct on the diagnosis and the medication, you still have the "treatment" statement. Medication is treatment no matter when it was originally prescribed. I go on a regular basis for tests to keep an eye on my heart conditions and to see if there is a recurrence of the cancer. Is that treatment? The providers that pay the bills consider it to be so. The FE companies usually give some direction as to they consider treatment. For example, Settlers makes it very plain in their UW that checkups and maintenance medication is not treatment. GW has not seen fit to make that clarification in writing. Is there a reason for that?

 

[Rearden]

Sorry, Dave.. I think you are reading something into the app that is not there. The app says in the last two years has the applicant been. "been diagnosed wit, been prescribed medication for or been treated by a healthcare provider for any of the following conditions:" The lists the conditions without clarification.

Continuing on Question 3 is the clarification:

Maintenance medications are not considered treatment if the prescription has remained the same (or generic equivalent) at the same or decreased dosages over the past two years.

If Bertha goes from 40mg lasix to 80 mg lasix to treat her CHF within the past two years constitutes a "yes" answer to Question 3.

If Bertha continues her medication treatment at the same level for two years or longer to treat CHF, then she can answer a "no" to the question.