Should I write or stay away?

SocalAgent · 10-24-2007, 08:38 PM

I have a customer that wants health insurance. Im hesistate to write her because she will eventually needs prosthetic surgery. She had an accident while she was a kid and one of her eye is shrinking as she grow older. She wants to have this fix. If this even possible?Is prosthetic surgery considered cosmetic?
Please give me advise on this situation.

Mr. Bill · 10-24-2007, 11:41 PM

Ummmm....did she receive a settlement as a result?

djs · 10-25-2007, 12:46 AM

I'm not sure who you would place it with, but I would call underwriting and ask them if they would take the case, and what, if anything would be covered.

I would then fully disclose everything on the app.

I'd probably simply say 'NEXT'.

Dan

thebeacon · 10-25-2007, 10:50 AM

Prosthetic surgery is definitely considered cosmetic. The way I look at the insurance is if there is any possible expense for the insurance company with a specific client in the future they are not going to take that person. I was recently at the underwriting meeting for Blue Shield of California and the basic idea is if there is any possibility that any thing that could possibly cause expense for the insurance company in the future, is a decline. Even if there is a condition that in 99.9% of cases does not cause the expense for the insurance company and that 0.01% people with that condition can be a large expense. None of those people will get approved. Although Blue Shield of California is probably has one of the most strict underwriting in California. It might seem brutal but it kinda makes sense, since some of those surgeries can cost hundreds of thousands... that is a lot of premiums.

SocalAgent · 10-26-2007, 12:07 AM

Yea, any commission is not worth my career and family members.. I told her I could write her but if she was lookign to fix her eye, I dont think this would be covered.