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He might have sold them ROP because he knew they had COPD, but he forgot to tell them there was a 2 year ROP. They thought it was immediate coverage.
He probably said something to the effect of, "Your coverage starts immediately." Which it does, just not the way they think it does.
A lot of the GI plans sold on TV use similar verbiage and then disclaim it away in the fine print both on the ad and what the people actually receive.