American Memorial Clean Sheeting

[Todd King]

Had an agent who supposedly doing 400k a yr of premium replace one of my 3 yr old policy's on an 81 yr old with many health problems . Went out to the house and the guy told me he got 3 times the ins for cheaper. I explained contestability at his age and the danger of it. His wife is much younger and disabled. Went in and looked at what he bought. The guy replaced mine and another 3 yr old policy and cashed them in. His was a little more expensive. I told him your 81 and not in good health and this new policy might not pay if you die in 2 yrs. We called both co's and got them reinstated and called the new co and cancelled it. The lady at the new company said he filled out no replacement forms and she was very concerned the old man call the old co's immediately and keep his policy's . I made no money off it and did it because i hate scumbag agents who take advantage of old people. If i turn him into the state will they look into not filling out replacement forms?

No, the DOI won't even look at it if you are the one that reports it. It needs to be either consumer generated or company generated.

 

[me112233]

nyone else run into these issues with American Memorial? I also realize this isn't a carrier problem but An unethical agent one. Problem is, I see this most prevalently with this insurance company and specifically, a particular IMO.

Cleansheeting of final expense and Medicare supplements is relatively common out there. I run into it all the time. The smoker status is one of the easiest to hide, especially if the applicant isn't on any breathing medications that might show up in a script check. American Continental Insurance (part of Aetna) used to boast about the fact that they didn't do script checks or MIB's, and they got buried in bad business via cleansheeting -- agents simply went back to folks who had been turned down before and wrote them with ACI, knowing that ACI wouldn't have any way of detecting the fraud until the claims showed up. Eventually, the brilliant MBA's that had recently taken control of ACI wised up and started doing those basic checks.

I know a smoker who had a final expense policy with 5 Star, and the box for tobacco had big checkmark in the "no" box. The prospect didn't try to hide his smoking from me, so I can't imagine he hid it from anyone else, either. That said, he is the type that probably would lie on the application if some agent suggested he do so. Anyway, back to the issue at hand -- cleansheeting is rampant here in Kentucky because the DOI basically doesn't care; sure, they will SAY they care, yet they can't name you even one agent that they put in jail for doing this sort of thing, not even one -- if you don't enforce a law, then it means the government agency responsible for enforcement doesn't care. It would be sooooo easy to set up a sting on these agents (and applicants) and put them behind bars for insurance fraud, yet, the DOI never seems to have the time to investigate. I'm guessing it is about the same in other states. I think it would be great to see a bunch of grandpas and grannies put in prison -- these are the same people who have fraudulently obtained foodstamps and disability over the years, and got away with it.

 

[fed up]

It is not just our industry but many occupations which depend on a commission generated from the sale. I had a home improvement salesman attempting to get his price est lowered by including a military discount and an AARP discount. I am not retired and was never in the military. He didn't get the business because i wondered what lies he was telling me about their construction.

 

[billyb]

I wrote a man with COPD and rheumatoid arthritis standard with Transamerica. He cancelled before the initial draft so I stopped by to see him. Said he had bought TruStage online. He wouldn't let me see the policy so I obtained one of there applications. It asked about his conditions so he had to answer the questions NO. I highlighted it and the clause where the company explained fraud and not paying a claim if he was not truthful and mailed it to him. Haven't heard from him so I assume he is going to continue to lie to the company. TruStage must not do a scriptcheck because he was using ProAir.

 

[HoosierLife]

I wrote a man with COPD and rheumatoid arthritis standard with Transamerica. He cancelled before the initial draft so I stopped by to see him. Said he had bought TruStage online. He wouldn't let me see the policy so I obtained one of there applications. It asked about his conditions so he had to answer the questions NO. I highlighted it and the clause where the company explained fraud and not paying a claim if he was not truthful and mailed it to him. Haven't heard from him so I assume he is going to continue to lie to the company. TruStage must not do a scriptcheck because he was using ProAir.

Pro air is just Albuterol right? That could be for Asthma. Might be why it will go through.

 

[billyb]

He told me he had been told he had COPD. I originally wrote him with SofN and they declined him.

 

[HoosierLife]

He told me he had been told he had COPD. I originally wrote him with SofN and they declined him.

I'm not arguing with you. I'm just saying if someone answers the COPD question no, then applies and all they see is albuterol, it's likely to go through.

 

[billyb]

I bet ProAir would raise a red flag with Transamerica. Plus if he dies and they write his doctor they will find out that he was being treated for COPD.

 

[HoosierLife]

I bet ProAir would raise a red flag with Transamerica. Plus if he dies and they write his doctor they will find out that he was being treated for COPD.

No doubt. This guy is rolling the dice.

 

[TripleH]

This is definitely something I run into quite frequently and seems like coaching the clients may be occurring during the application process, it is my understanding that they have a phone interview.