This is a new one to me. Write a lady on 5/4 for a 6/1 effective date. She trips in her yard 5/8 and needs ankle surgery now. I call carrier. They say they accepted her based on her health on 5/4 when she signed the app and there will be no issues with her coverage with them starting 6/1. Anyone experience anything similar? I am trying to get something in writing from the carrier to CYA....
Change in health prior to effective date
- Thread starter jemelton
- Start date
- 2,177
I’ve had it happen and told the client all is well if the date of diagnosis/accident is later than date app submitted. Accident is easier to prove no prior conditions existed than an illness or disease.
The carrier may be able to get you a copy of something from their ops manual on that topic but wouldn’t count on that. The best C you have for YA is the application submit date and documentation of date of the fall.
But your A is likely okay without written info from the carrier. The name of the carrier rep and date/time of call might be good to note, though.
Had something similar come up on an underwritten app. I told client to call the underwriter direct and get a thumbs up / thumbs down from them.
Underwriter told the lady it was not a problem since it happened AFTER the application was signed and would note the file accordingly in case there were ongoing claims.
Same thing, different client, different carrier.
This time the applicant was told by doc that tests needed to be done. Underwriter opted to postpone approval pending outcome of the tests.
Underwriter told the lady it was not a problem since it happened AFTER the application was signed and would note the file accordingly in case there were ongoing claims.
Same thing, different client, different carrier.
This time the applicant was told by doc that tests needed to be done. Underwriter opted to postpone approval pending outcome of the tests.
- 2,619
Is this a life policy or a medical policy?
- 29,464
Medical.
- Thread starter
- #6
I get why you are concerned, but 17 years later, my response is "no problem".
1. She signed the app prior to the fall
2. The claims will have the correct diagnosis and procedure codes. If they pull the medical records, they will say "fall on 5/8".
You're fine.
1. She signed the app prior to the fall
2. The claims will have the correct diagnosis and procedure codes. If they pull the medical records, they will say "fall on 5/8".
You're fine.
