Several carriers, including Aetna & Humana are migrating toward automatic (robo) underwriting. Based on recent experience with Aetna it appears the wheels have come off.
Now I have a problem with Humana.
Short version is this. Lady with migraines submitted an app. We had gone over everything in advance, and I pre-screened the conditions before we ever submitted.
Question 13 asks "In the last 5 years have you ever had, been diagnosed, . . . migraines".
Answer is yes.
Drop down box on e-app asks about meds (Sumitriptan 50mg PRN), how often you have migraines (8 - 10 per year) and have you had a neuro work up (not in the last 5 years).
H1 never did a phone interview and declined her. After much back & forth I finally found out it was because she had 4+ migraines per year and had not had a neuro exam.
Migraines started in 1993 when she went into menopause. Her PCP referred her to a neurologist who determined they were related to hormonal changes. He prescribed a medication. She has been on the same med for 5+ years. When the migraine starts she tries Excedrin migraine formula. If the headache does not subside in 30 minutes she uses Sumitriptan. She only takes 1 tablet and that knocks it out until her next attack in a month or so.
Of course H1 would never know this since they did not do a phone interview. All they know is, per the question, she has over 4 migraines a year, takes a med and has not had a neuro exam in the last 5 years.
This case is on appeal now and I hope to get a change of heart very soon. If not, the case will go to UHC.
I have noticed a dumbing down of underwriters for some time but this idea of automating everything is nuts. Even if you hold their hand thru the process (as I do) you can still get tripped up because robo-underwriter will shoot your apps down in flames.
Now I have a problem with Humana.
Short version is this. Lady with migraines submitted an app. We had gone over everything in advance, and I pre-screened the conditions before we ever submitted.
Question 13 asks "In the last 5 years have you ever had, been diagnosed, . . . migraines".
Answer is yes.
Drop down box on e-app asks about meds (Sumitriptan 50mg PRN), how often you have migraines (8 - 10 per year) and have you had a neuro work up (not in the last 5 years).
H1 never did a phone interview and declined her. After much back & forth I finally found out it was because she had 4+ migraines per year and had not had a neuro exam.
Migraines started in 1993 when she went into menopause. Her PCP referred her to a neurologist who determined they were related to hormonal changes. He prescribed a medication. She has been on the same med for 5+ years. When the migraine starts she tries Excedrin migraine formula. If the headache does not subside in 30 minutes she uses Sumitriptan. She only takes 1 tablet and that knocks it out until her next attack in a month or so.
Of course H1 would never know this since they did not do a phone interview. All they know is, per the question, she has over 4 migraines a year, takes a med and has not had a neuro exam in the last 5 years.
This case is on appeal now and I hope to get a change of heart very soon. If not, the case will go to UHC.
I have noticed a dumbing down of underwriters for some time but this idea of automating everything is nuts. Even if you hold their hand thru the process (as I do) you can still get tripped up because robo-underwriter will shoot your apps down in flames.
