How Could this Be Avoided?

[keith365]

Thanks for all of the help on this case guys. I called the insurance company, Aetna. I couldn't believe that they told me why she was declined. When I took the app, all of the health questions were "no". when Aetna called, she told them she was currently going through physical therapy. So I called her, and she admitted that she told Aetna that, but she hasn't been to pt in over a month. She's not on a schedule or program for therapy, she just thought that she may need tp in the future for the condition she went through pt for last month. She should have answered "no". I even prepped her for the call. Anyway, now Aetna says that if she gets a doctors letter saying that she is no longer under his care, Aetna will reconsider. Her doctor told her that she should apply with UHC, as they are "the best supplement money can buy", which must mean that they pay her doctor quickest. So, final question...get the doctor's letter and reapply with Aetna plan G, or apply with UHC (there isn't a pt question on the app), probably plan N to stay competitive in price. And, she doesn't want to get the letter from her primary doctor, the only doctor on the app. She wants to get it from her specialist, who isn't on the app. I don't know how Aetna will feel about that. Her specialist should have been on the app under "specialists seen in the last 24 months". Another issue, her declination will be in the MIB. Can UHC decline her just for seeing that she was declined with another company? Thanks again!

 

[junkman]

A decline opens up another line of questioning in many areas of insurance and is never helpful. You're in it now so you have to fix it. You generally need to start by looking at the application(s) then find out how any "yes" answers will affect things. Do this before submitting the app on a "hypothetical" basis. You don't want to waste time or get any more declines. Now underwriting will likely want information on the reason she was declined.

Look at the app, gather information but don't volunteer information. Only give information as asked for and NEVER lie - but note the difference between not lying and volunteering. They are not the same.

Underwriting rule #1: Ask for only the information needed. Use all of the information you have.

You as agent can't take something back once it is disclosed.

 

[Northeast Agent]

I'm looking at some agent handbooks. Looks like IAC will give an instant answer and policy number at the end of the telephonic interview.

 

[goillini52]

I'm looking at some agent handbooks. Looks like IAC will give an instant answer and policy number at the end of the telephonic interview.

So will Equitable and the companies they're TPA's for. Besides IAC, LCBA and GCU.

 

[Northeast Agent]

Thanks, I thought GCU is too, but hadn't dug that far yet. I'm appointed with all of them, so this is very helpful.

 

[senior-advisor-indiana]

A decline opens up another line of questioning in many areas of insurance and is never helpful. You're in it now so you have to fix it. You generally need to start by looking at the application(s) then find out how any "yes" answers will affect things. Do this before submitting the app on a "hypothetical" basis. You don't want to waste time or get any more declines. Now underwriting will likely want information on the reason she was declined.

Look at the app, gather information but don't volunteer information. Only give information as asked for and NEVER lie - but note the difference between not lying and volunteering. They are not the same.

Underwriting rule #1: Ask for only the information needed. Use all of the information you have.

You as agent can't take something back once it is disclosed.

I have never had any supp carriers ask about a previous decline. I have had plenty of declines that I re wrote with other carriers with no problems.

 

[somarco]

GTL pulls an MIB report that will show if the person has been declined. I have never known another Medigap carrier that used MIB.

And yes, they used it to decline an application. Only took them 3 weeks to review and reach a decision.

Placed it with another carrier the next day.

 

[goillini52]

GTL pulls an MIB report that will show if the person has been declined. I have never known another Medigap carrier that used MIB.

And yes, they used it to decline an application. Only took them 3 weeks to review and reach a decision.

Placed it with another carrier the next day.

Damn...they're UWing differently than they did with UNL. UNL was a breeze. To heck with that sh*t. They aren't available here, but if they are in the future, I won't even consider them after your experience.

 

[vic120]

I have never had any supp carriers ask about a previous decline. I have had plenty of declines that I re wrote with other carriers with no problems.

I have as well, The only one I know asks on app is cigna, But no other APP I do asks and I have placed enough that were declined and got approvals that I am not concerned if its not asked

 

[jdeasy]

Thanks for all of the help on this case guys. I called the insurance company, Aetna. I couldn't believe that they told me why she was declined. When I took the app, all of the health questions were "no". when Aetna called, she told them she was currently going through physical therapy. So I called her, and she admitted that she told Aetna that, but she hasn't been to pt in over a month. She's not on a schedule or program for therapy, she just thought that she may need tp in the future for the condition she went through pt for last month. She should have answered "no". I even prepped her for the call. Anyway, now Aetna says that if she gets a doctors letter saying that she is no longer under his care, Aetna will reconsider. Her doctor told her that she should apply with UHC, as they are "the best supplement money can buy", which must mean that they pay her doctor quickest. So, final question...get the doctor's letter and reapply with Aetna plan G, or apply with UHC (there isn't a pt question on the app), probably plan N to stay competitive in price. And, she doesn't want to get the letter from her primary doctor, the only doctor on the app. She wants to get it from her specialist, who isn't on the app. I don't know how Aetna will feel about that. Her specialist should have been on the app under "specialists seen in the last 24 months". Another issue, her declination will be in the MIB. Can UHC decline her just for seeing that she was declined with another company? Thanks again!

I take it you didn't do the phone interview at the POS?