OK who Can I STUMP on This?

[1963]

Transamerica Standard - wrote three senior clients in the last year, and all were dealing with significant health and between 75 and 80 years old. All were issued within 24 to 48 hours, one as preferred.

 

[springbokhouston]

Fluid build up around the heart is basically the textbook definition for CHF, especially when taking a med that is typically used for it.

Just because she refuses to say she has it doesn't make it go away.

Also, chronic bronchitis is basically the same as COPD as far as most companies are concerned. Even if you do force it through somewhere, the odds of being rescinded unless written on a plan that accepts these, such as graded with Aetna, is extremely high if she dies in the first two years.

I agree with you on the fluid around the heart thing, but at the end of the day it's up to the client to choose how to answer the questions. We are not doctors, we are there to interview the client. The carrier will make their own decisions depending on med use and dosages, I will let the client know that the first two years have a contestability period if things seem shaky. "Miss Jones, are you sure that you have never been diagnosed with CHF, that's what fluid around the heart normally get's diagnosed as" if she say NO, who the hell am I to make that decision?

PS, Here's RNA's question regarding pulmonary conditions.

9. During the past 24 months, has the Proposed Insured been diagnosed as having, or been treated for:
a. Emphysema, chronic obstructive pulmonary disease (COPD), or tuberculosis (TB)?

Do you take it upon yourself to diagnose them with COPD because they've had bronchitis? I think not.

I'm not trying to be combative, but our roll should end somewhere no? Truth be told, I would decline 50% of these people if I were the underwriter for the company.

 

[BibH]

Lol. Had a dude who took Lasix ,warfin and carvediol. Rna issued him preferred.The only thing i can say is most people lapse their policy before death.

 

[goillini52]

I agree with you on the fluid around the heart thing, but at the end of the day it's up to the client to choose how to answer the questions. We are not doctors, we are there to interview the client. The carrier will make their own decisions depending on med use and dosages, I will let the client know that the first two years have a contestability period if things seem shaky. "Miss Jones, are you sure that you have never been diagnosed with CHF, that's what fluid around the heart normally get's diagnosed as" if she say NO, who the hell am I to make that decision?

PS, Here's RNA's question regarding pulmonary conditions.

9. During the past 24 months, has the Proposed Insured been diagnosed as having, or been treated for:
a. Emphysema, chronic obstructive pulmonary disease (COPD), or tuberculosis (TB)?

Do you take it upon yourself to diagnose them with COPD because they've had bronchitis? I think not.

I'm not trying to be combative, but our roll should end somewhere no? Truth be told, I would decline 50% of these people if I were the underwriter for the company.

I get what you're saying...stick to the app, but some companies group COPD and chronic bronchitis or chronic respiratory disease together. I think I'd look at chronic bronchitis as a chronic respiratory disease.

 

[VolAgent]

I agree with you on the fluid around the heart thing, but at the end of the day it's up to the client to choose how to answer the questions. We are not doctors, we are there to interview the client. The carrier will make their own decisions depending on med use and dosages, I will let the client know that the first two years have a contestability period if things seem shaky. "Miss Jones, are you sure that you have never been diagnosed with CHF, that's what fluid around the heart normally get's diagnosed as" if she say NO, who the hell am I to make that decision?

PS, Here's RNA's question regarding pulmonary conditions.

9. During the past 24 months, has the Proposed Insured been diagnosed as having, or been treated for:
a. Emphysema, chronic obstructive pulmonary disease (COPD), or tuberculosis (TB)?

Do you take it upon yourself to diagnose them with COPD because they've had bronchitis? I think not.

I'm not trying to be combative, but our roll should end somewhere no? Truth be told, I would decline 50% of these people if I were the underwriter for the company.

See what Monkey said below.

I get what you're saying...stick to the app, but some companies group COPD and chronic bronchitis or chronic respiratory disease together. I think I'd look at chronic bronchitis as a chronic respiratory disease.

Exactly, I said most companies treat it the same. It pays to read the app. Many lump it in some manner, RNA does not.

Oh, and Advair is for COPD. My best friend is a drug rep for GSK, and guess what he talks to doctors about all day? Using Advair and other medications to treat their COPD patients. Now, RNA may not have it on their list, but that is the primary reason for prescribing Advair.

And yes, the companies do expect you to do some field underwriting. No, I am not a doctor nor the underwriter, but I definitely would question the woman about this. And I would make darn sure she knew about contestability. Finally, there is nothing that says you can't just walk away from business sometimes. I do not want a reputation for bad business, either in underwriting or claims.

I can't say based on this if I would write it or not. I haven't talked to the woman, but I definitely see warning flags.

 

[goillini52]

See what Monkey said below.



Exactly, I said most companies treat it the same. It pays to read the app. Many lump it in some manner, RNA does not.

Oh, and Advair is for COPD. My best friend is a drug rep for GSK, and guess what he talks to doctors about all day? Using Advair and other medications to treat their COPD patients. Now, RNA may not have it on their list, but that is the primary reason for prescribing Advair.

And yes, the companies do expect you to do some field underwriting. No, I am not a doctor nor the underwriter, but I definitely would question the woman about this. And I would make darn sure she knew about contestability. Finally, there is nothing that says you can't just walk away from business sometimes. I do not want a reputation for bad business, either in underwriting or claims.

I can't say based on this if I would write it or not. I haven't talked to the woman, but I definitely see warning flags.

I agree with what you said, but I've communicated enough with Peter to know that he's honest and a straight shooter. I know for a fact that he's made an underwriter aware of a woman's condition after the app was in UW, even though he followed the app...he didn't want to risk the woman getting it rescinded in the future, so he sacrificed the policy...he walked away from that business.

JD's another one that says to just ask the questions on the app, but you have to read the UW Guide. There're things covered in there that aren't mentioned on the app.

 

[VolAgent]

I agree with what you said, but I've communicated enough with Peter to know that he's honest and a straight shooter. I know for a fact that he's made an underwriter aware of a woman's condition after the app was in UW, even though he followed the app...he didn't want to risk the woman getting it rescinded in the future, so he sacrificed the policy...he walked away from that business.

JD's another one that says to just ask the questions on the app, but you have to read the UW Guide. There're things covered in there that aren't mentioned on the app.

Oh, I'm not trying to say he would or wouldn't. I'm familiar with him.

Now JD is right, you do just ask the questions as they are written. However, the UW guide is very helpful for clarification, especially when the question isn't clear. Assurity comes to mind. The way the app is written, it suggests there are some things they don't accept. However if you read the UW guide, you see they clearly are. COPD is one.

I would probably try to put her with Aetna or Assurity on graded and sleep easy.

 

[jdeasy]

I agree with what you said, but I've communicated enough with Peter to know that he's honest and a straight shooter. I know for a fact that he's made an underwriter aware of a woman's condition after the app was in UW, even though he followed the app...he didn't want to risk the woman getting it rescinded in the future, so he sacrificed the policy...he walked away from that business.

JD's another one that says to just ask the questions on the app, but you have to read the UW Guide. There're things covered in there that aren't mentioned on the app.

I do say that but I also agree about the underwriting guide. One example is KSKJ. If you read their tobacco question as written then they would allow eCigs as non tobacco. But I happen to know that they do not.

That's just one example.

 

[Todd King]

I get what you're saying...stick to the app, but some companies group COPD and chronic bronchitis or chronic respiratory disease together. I think I'd look at chronic bronchitis as a chronic respiratory disease.

So is emphysema, but most companies choose to list it out separately rather than group it under COPD. I never understood that unless they were just trying to get more specific about it.

 

[VolAgent]

So is emphysema, but most companies choose to list it out separately rather than group it under COPD. I never understood that unless they were just trying to get more specific about it.

I would say that is exactly why. Specificity due to either the DOI or past complaints/lawsuits. The more vague or general the question, the more it invites dispute.