UHL Death Claim

[senior-advisor-indiana]

I've had a few contested. Here is my experience:

1. Oxford- decided within a couple weeks but that was because they discovered the applicant had been on a dementia med. Did not pay the claim (justified). Policy was in the 23rd month. (Ouch!)

2. Foresters- took 9-months but finally paid the claim

3. Settlers- one month, paid claim

4. American Continental- took 3- months before they started looking at it. Drug feet. It was actually non-contestible due to KY law. Claims department after consulting with legal department determined that only applied to "internal" replacements. More feet dragging. It finally occurred to me to quit trying to talk sense into their legal department and contact their regional sales manager. Claim paid within 2-hours of his involvement.

5. 5-Star- 1st contestible claim was settled within 30-days but it was pretty clear he was hit by a train. They probably just had to verify that he wasn't suicidal. 2nd contestible claim was paid within 90-days.

I think that's all the contestibles I've had on FE policies.

I had the same exact thing happen to me with oxford. Client passed in the 23rd month and they found dementia in his records...

 

[VolAgent]

That's a really bad taste to leave in your mouth. The company knows they take on a risk with these simplified issue policies which is why they load them to table 4 and then they get a second bite at the policy decision at claim time, obviously now the client has no chance to go a different route like they would have had the carried declined in the first place.

Lots of claims inside two years get paid. The person just needs to be honest in answering the questions. The same thing happens with fully underwritten. In fact, I would say fully underwritten get looked at much harder. First, baring a fluke, someone at standard or better shouldn't be dead in two years. Second, you are talking serious money, 100k+ to millions, versus 10 to 25k.

Also, I would say agents bear a lot of responsibility for contested claims. They see money and start trying to read more into or out of the question than what it asks.

Of course, the companies bear blame too. Read some of the FE threads. What is a maintenance med? Do they mean the initial diagnosis or an ongoing diagnosis? Maybe they were diagnosed and don't take any medications?

 

[GreenSky]

I had the same exact thing happen to me with oxford. Client passed in the 23rd month and they found dementia in his records...

You had a client keep the policy that long? Don't you usually get a chargeback within a few months?

Rick

 

[TwiLight]

UHL will contest and investigate it.....Longest I have seen with them too 11 months to pay and the shortest was 4 months.

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That's a really bad taste to leave in your mouth. The company knows they take on a risk with these simplified issue policies which is why they load them to table 4 and then they get a second bite at the policy decision at claim time, obviously now the client has no chance to go a different route like they would have had the carried declined in the first place.

I disagree with you. Full underwriting is not done with Simplified Issue policies, until a claim is made in the contestable periods. That is why there is quick issue and no APS done. It is cheaper to wait until a contestable claim is made (they will do it anyway) rather than doing APS's on all polices before issuing.

 

[VolAgent]

UHL will contest and investigate it.....Longest I have seen with them too 11 months to pay and the shortest was 4 months.

To be clear, and JD did this as well. They aren't contesting, they are investigating. It is only contesting when they deny it.

Just from my experience, the blame in delay generally belongs with the doctor's staff. They seem completely oblivious to the fact these records and getting them in a timely manner is important. That and the some doctors or hospital systems require their own HIPAA forms and will not accept the insurance company's.

Also, when the insurance company only finds out about another doctor or hospital from the primary doctor's records? That is going to add delay and probably be contested as it is often a oncologist or cardiologist.

 

[TwiLight]

To be clear, and JD did this as well. They aren't contesting, they are investigating. It is only contesting when they deny it.

Just from my experience, the blame in delay generally belongs with the doctor's staff. They seem completely oblivious to the fact these records and getting them in a timely manner is important. That and the some doctors or hospital systems require their own HIPAA forms and will not accept the insurance company's.

Also, when the insurance company only finds out about another doctor or hospital from the primary doctor's records? That is going to add delay and probably be contested as it is often a oncologist or cardiologist.

LOL ------ What he said..... Alot better than me.

 

[Norwayguy]

UHL will contest and investigate it.....Longest I have seen with them too 11 months to pay and the shortest was 4 months.

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I disagree with you. Full underwriting is not done with Simplified Issue policies, until a claim is made in the contestable periods. That is why there is quick issue and no APS done. It is cheaper to wait until a contestable claim is made (they will do it anyway) rather than doing APS's on all polices before issuing.

Oh I know they are on death now doing full underwriting. Just makes it hard when you are in a home talking about how this coverage will be there when you need it and then putting an * as long as you survive for 2 years.

I am more of an annuity guy and most of my life sales have been fully underwritten. I feel the policy is more secure because the carrier had the chance to order APSes and get a paramed exam, Yes I know they will still investigate.

 

[TwiLight]

Oh I know they are on death now doing full underwriting. Just makes it hard when you are in a home talking about how this coverage will be there when you need it and then putting an * as long as you survive for 2 years.

I am more of an annuity guy and most of my life sales have been fully underwritten. I feel the policy is more secure because the carrier had the chance to order APSes and get a paramed exam, Yes I know they will still investigate.

I Agree.....Full underwriting is the way I go. Unless there is an obvious Table Rating situation, that is when the Simple Issue App comes out.

 

[bill3173]

If your client was honest, then you shouldn't have anything to worry about. I had a contestable claim paid by Uhl last year. Client died in first policy year, but had gone above and beyond in the phone interview.

I wanted the policy to be issued, but had to laugh when he was doing his phi. I took the phone from him, when he finished, and confirmed with the interviewer that he recorded everything that was said. Mainly because I didn't know about a lot of that stuff til then. It took several months to settle, but they paid with interest, thank the L-rd.

 

[Norwayguy]

If your client was honest, then you shouldn't have anything to worry about. I had a contestable claim paid by Uhl last year. Client died in first policy year, but had gone above and beyond in the phone interview.

I wanted the policy to be issued, but had to laugh when he was doing his phi. I took the phone from him, when he finished, and confirmed with the interviewer that he recorded everything that was said. Mainly because I didn't know about a lot of that stuff til then. It took several months to settle, but they paid with interest, thank the L-rd.

Are you kidding have you seen the agents on here asking questions about if a med is for maintence or not and if it creates a Yes answer.....If agents are asking that how can you expect a customer to know if he needs to answer Yes or no.

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If your client was honest, then you shouldn't have anything to worry about. I had a contestable claim paid by Uhl last year. Client died in first policy year, but had gone above and beyond in the phone interview.

I wanted the policy to be issued, but had to laugh when he was doing his phi. I took the phone from him, when he finished, and confirmed with the interviewer that he recorded everything that was said. Mainly because I didn't know about a lot of that stuff til then. It took several months to settle, but they paid with interest, thank the L-rd.

Question how many policies do you think we would sell if we said. Oh if you die during the first 2 years expect it to be months before you see the cash, but once they pay if they pay it will include interest.