Insurance Agent Forum

[somarco]

A little over a year ago I picked up a health client. Really nice couple and their daughters from south GA.

Saved them a bunch of money by switching from a BX plan with copays and a $2k deductible to a $10k HSA.

They were very happy.

Then 3 months ago her husband had severe headaches. Taken to the ER by ambulance, admitted to ICU, on life support for 2 weeks.

He was discharged and put on a restricted schedule, both work and activity. His job is in CA and she has a day care business in GA.

Tough situation.

She called last month because Humana had picked her husband's claim for review. Want to make sure it is not pre-ex, blah, blah.

I got him to sign a HIPAA waiver and jumped in. The claim is over $100k and continuing, but not at the same pace.

Earlier today I followed up to see if the claim was still on hold or what. She has provided everything Humana requested and is now waiting on them.

I don't anticipate any problems.

But then she told me about Jimmy. Due to his restricted work schedule he was terminated. His last day is next week.

They have some savings but most of that will go to meet the deductible and other living expenses. They are about to be in crisis.

And I never asked about disability coverage.

Not once.

I feel like crap.

[bluemarlin08]

You come across cases like this that will change how you do business. I bet that you will always ask about disability and, unfortunately, have a real story regarding the consequences. I had to learn some things the hard way, maybe this will be a lesson others won't have to learn

[djs]

Ouch! A bad double whammy for the family, coming up on a triple whammy.

I would suggest the wife check to see if he had disability through work. Maybe not, but I've learned a lot of people don't know they have this.

Also, this is one of my concerns about high deductible plans. Last year they saved money on the plan, this year, they probably didn't. I like to make sure someone can write that deductible check before I go to the higher deductible plans.

Dan

[emptyeternity]

Well atleast you have one HELL of a story to sound convincing enough to tack it on a sale. So good for you, maybe you can take all that extra money and give it to them. Just kidding its not funny, sorry you feel like crap.

[Alston]

I empathize with you Somarco.

I struggle with whether or not to expand the breadth of my agency almost daily. We sell individual health insurance almost exclusively. We don't even do group coverage.

I'm sure that a lot of our clients would benefit from a discussion of other insurance lines, but we are too busy with individual health to do anything else well. Unfortunately, I have no desire to add another agent and am very picky about referring business to other agencies.