Clients Vs. Carriers

Phillip Arnn · 02-08-2009, 08:57 PM

I want to have a thread where new agents can see from the experience of senior agents which carriers have been the worst for not paying claims for specific events, denying drug coverage on certain prescriptions, stalling, haggling, having poor internal claims review or accounting.

An example: Woman goes in for cesarean; surgeon damages organ (can't remember which), child is delivered, woman must go into emergency surgery. Carrier refuses to pay anescethiologist (does pay for surgeon) because they don't cover maternity. Takes two years to win battle.
An example: brand name allergy prescription claim refused.

I am not wanting to start a 'bash the carriers' campaign. I am as serious as a heart attack (of which I have had two) about finding out who might be the most likely to give poor service to my clients based on their (carrier's) real life track records with you over the years you have sold their products.

Phil

I would like to start with Aetna.

Jim · 02-08-2009, 09:25 PM

I personally have had problems with anthem blue cross blue shield not paying clams would avoid them.

Originally Posted by Phillip Arnn

I want to have a thread where new agents can see from the experience of senior agents which carriers have been the worst for not paying claims for specific events, denying drug coverage on certain prescriptions, stalling, haggling, having poor internal claims review or accounting.

An example: Woman goes in for cesarean; surgeon damages organ (can't remember which), child is delivered, woman must go into emergency surgery. Carrier refuses to pay anescethiologist (does pay for surgeon) because they don't cover maternity. Takes two years to win battle.
An example: brand name allergy prescription claim refused.

I am not wanting to start a 'bash the carriers' campaign. I am as serious as a heart attack (of which I have had two) about finding out who might be the most likely to give poor service to my clients based on their (carrier's) real life track records with you over the years you have sold their products.

Phil

I would like to start with Aetna.

CHUMPS FROM OXFORD · 02-08-2009, 09:28 PM

I have to admit that I don't have any particular carrier that I have a major beef with.

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GreenSky · 02-08-2009, 09:34 PM

Originally Posted by CHUMPS FROM OXFORD

I have to admit that I don't have any particular carrier that I have a major beef with.

Thank you for that unbiased information.

Rick

CHUMPS FROM OXFORD · 02-08-2009, 10:11 PM

Thank you. And now...some biased information:

Assurant! Ugh! Where do I begin!

ABC · 02-09-2009, 01:15 PM

I think your topic is a good idea.

Clients always come first.

I think its important to look at plan designs of the carriers your writing. The new products that are coming out for the individual market have a lot of holes in them.

Now the example that you gave about the child birth. That is an example where a good broker is fighting all the way for the client so it does not have to become a legal battle.

All of the carriers I do business with I know will pay the $100,000 claim with no problem.

Currently I have Gold Rule/UHC trying to recruit me to sell there new line of individual products. I have a lot of experience with UHC on the group side and know they can be a pain in the ass to get claims paid. So I am not real sure I want to sell their individual product even through they are offering me a higher commission structure.

LGilmore · 02-09-2009, 01:30 PM

I haven't had the claims problems with carriers that were present in the old days. However, Washington is a stripped down state as far as health carriers go. Just a handful. I haven't had anybody have a problem in a long long time. That said, I avoid those carriers who do have problems.

Anthem, Aetna, united and great west (if they're still around) were the carriers I learned to stay away from.

Phillip Arnn · 02-09-2009, 02:52 PM

The examples I opened with are real cases with Aetna.
We have two more carriers on the table now. Anthem and UHC. Does that include GR? ABC mentioned a problem with their group claims. I like the GR plans. Women seem to like them also with the preventative upgrade. Can I get some imput from somarco, moon, John, Sti, TX, Peeler?
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Chumps - what about Assurant?
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Ok, since everybody is in such a positive frame of mind, which carriers are best by client age, conditions some carriers will take and others won't, speed of claims payments/commissions payments (that should get some feedback), best coverage/worst coverage.

I have gone through scores of posts on specific carriers to put together carrier specific files, i.e. World, GR, Humana, it took hours. I thought it would be good to have some of that carrier specific information all in one spot for us new agents.
Am I the only one who thinks so?