OK who Can I STUMP on This?

[springbokhouston]

SNL - Rx Guide

Advair Diskus - Asthma COPD
Preferred
Graded

Foresters Financial

Advair Asthma
COPD / Emphysema
N/A
N/A
Level
Graded

Would you write this as COPD even though the client says they use it for Asthma?

There are many many more examples like this.


Just pointing out that different companies look at underwriting and medications differently, as they should. RNA is very good about asking for a list of medications and what they are used for. If the client mentions chronic bronchitis and they issue preferred then you have absolutely done your job.

Insurance companies specifically leave lots of gray area to play in is my belief. I definitely do not try to push clients into deceiving the carrier, but I am a firm believer in following their application and UW guide as literally as possible.

----------

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.

I 100% agree with this, but in my example RNA asks the following.

"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)?"

Chronic Bronchitis isn't on that list.

 

[VolAgent]

SNL - Rx Guide

Advair Diskus - Asthma COPD
Preferred
Graded

Foresters Financial

Advair Asthma
COPD / Emphysema
N/A
N/A
Level
Graded

Would you write this as COPD even though the client says they use it for Asthma?

There are many many more examples like this.


Just pointing out that different companies look at underwriting and medications differently, as they should. RNA is very good about asking for a list of medications and what they are used for. If the client mentions chronic bronchitis and they issue preferred then you have absolutely done your job.

Insurance companies specifically leave lots of gray area to play in is my belief. I definitely do not try to push clients into deceiving the carrier, but I am a firm believer in following their application and UW guide as literally as possible.

----------



I 100% agree with this, but in my example RNA asks the following.

"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)?"

Chronic Bronchitis isn't on that list.

I thought we weren't going to argue this.

She didn't say asthma, she said chronic bronchitis. And if you will recall, I said that it pays to read the app. RNA does not lump chronic bronchitis in with COPD or other respiratory diseases. I've pushed plenty of edges on underwriting.

 

[goillini52]

SNL - Rx Guide

Advair Diskus - Asthma COPD
Preferred
Graded

Foresters Financial

Advair Asthma
COPD / Emphysema
N/A
N/A
Level
Graded

Would you write this as COPD even though the client says they use it for Asthma?

There are many many more examples like this.


Just pointing out that different companies look at underwriting and medications differently, as they should. RNA is very good about asking for a list of medications and what they are used for. If the client mentions chronic bronchitis and they issue preferred then you have absolutely done your job.

Insurance companies specifically leave lots of gray area to play in is my belief. I definitely do not try to push clients into deceiving the carrier, but I am a firm believer in following their application and UW guide as literally as possible.

----------



I 100% agree with this, but in my example RNA asks the following.

"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)?"

Chronic Bronchitis isn't on that list.

And like you say, different companies look at conditions differently. I think you have Settlers. On page 14 of their UW Guide, under COPD they include Black Lung, Chronic Asthma, Chronic Bronchitis, Cystic Fibrosis and Emphsema.

Before I responded to your earlier post I looked at apps from 3 different companies(Sentinel Security, KSKJ and Settlers) and all 3 group COPD with other conditions.

No, I wouldn't write the Foresters as having COPD if they have Asthma, but they do group COPD and Chronic Bronchitis together.

That's where those cheat sheets come in handy.

 

[springbokhouston]

Screw it, I'm just going to write everyone Gerber from now on

 

[goillini52]

Screw it, I'm just going to write everyone Gerber from now on

Hahahaa, there was somebody on here last year that said they did that. Even put the healthy ones with Gerber because it was easier.

 

[VolAgent]

Screw it, I'm just going to write everyone Gerber from now on

Can we argue about which GI company to write now?

 

[goillini52]

Can we argue about which GI company to write now?

I didn't know that we were arguing...I thought we were debating.

 

[VolAgent]

I didn't know that we were arguing...I thought we were debating.

Why are you debating what we are arguing?!?

 

[goillini52]

Why are you debating what we are arguing?!?

Because I'm so confused.

 

[springbokhouston]

We have so many involved it could be considered mass debating at this point.