Appealing a Declined Case-suggestions?

SuperWoman

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Atlanta
I have a client declined for ltc by Mutual of Omaha due to a compliant of being forgetful in June 2016. She was going through a stressful event - retirement, relocation and family illness.
So my case manager says that was the reason for the declination.

This client was just underwritten for $200k life (term) rated Preferred plus. So, her health is excellent, at age 60. I want to appeal this decision but need advice on how to begin.

1. Is it appropriate to contact the UW directly? Ask her to walk me through the decision?

2. May I request her APS from MoO to see the memory complaint?

3. IF the decision was made strictly on that one complaint, would a documented letter from her Doctor explaining it suffice?

4. Would a full Neuro exam be required - including MRI, labs etc, to prove no organic disease?

I appreciate all thoughts.

Thank you
 
I have a client declined for ltc by Mutual of Omaha due to a compliant of being forgetful in June 2016. She was going through a stressful event - retirement, relocation and family illness.
So my case manager says that was the reason for the declination.

This client was just underwritten for $200k life (term) rated Preferred plus. So, her health is excellent, at age 60. I want to appeal this decision but need advice on how to begin.

1. Is it appropriate to contact the UW directly? Ask her to walk me through the decision?

2. May I request her APS from MoO to see the memory complaint?

3. IF the decision was made strictly on that one complaint, would a documented letter from her Doctor explaining it suffice?

4. Would a full Neuro exam be required - including MRI, labs etc, to prove no organic disease?

I appreciate all thoughts.

Thank you


in most cases like this the applicant will need to have a full neuro-psych evaluation at her own expense. They generally run about $4,000.

Or, you could submit the app to Genworth... if she passes the cognitive quiz they will likely approve her. :yes:
 
I think you know how I feel about Genworth :no:

But darn, now that I think about it, I may have to consider it. I feel like a car salesman trying to sell a Ford Pinto.
 
I think you know how I feel about Genworth :no:

But darn, now that I think about it, I may have to consider it. I feel like a car salesman trying to sell a Ford Pinto.



that "pinto" has paid, and continues to pay, more LTCi claims than any other company. that "pinto" has over $20B in LTCi reserves.
 
I hear you, Mr Ed. And I see you sell a lot of GW. And, if that's her only option, we both should be grateful.

She is not in a position to pay for a full Neuro exam at this time. My BGA offers Genworth, but could give me no info on their cognitive quiz or if she could get approved even after her MoO decline.

I assume the GW app has the standard "have you been declined for LTC" question, no? That won't kick her app to the can automatically?
 
I hear you, Mr Ed. And I see you sell a lot of GW. And, if that's her only option, we both should be grateful.

She is not in a position to pay for a full Neuro exam at this time. My BGA offers Genworth, but could give me no info on their cognitive quiz or if she could get approved even after her MoO decline.

I assume the GW app has the standard "have you been declined for LTC" question, no? That won't kick her app to the can automatically?

one, she's not an autodecline.
two, i don't sell a lot of gnw and i never have.
three, underwriters don't bite. call a gnw directly and tell them what happened.
 
4. thanks, I will. :)

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I called and spoke to a GW underwriter. She suggested the PI request a letter from the doctor to whom she complained of her forgetfulness to explain his interpretation of the complaint.

Meaning, did he determine it's cus of stress, and he made no further testing recommendation. She said to attach the letter to an app and quote her select.

So, thanks Mr. Ed!
 
I've had a lot of experience with this and in my opinion there's no carrier that will approve someone who has a complaint of memory issues in their medical records without extensive testing. Normally, they are looking for a comprehensive memory exam like Wechsler Memory Scale. I had a client get declined as a result of a memory concern comment he made to his doctor. It cost him just under $2,000 for the test but he passed and was able to get approved. This was a Genworth case.
 
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