Doctors Notes Disqualified from Coverage
- Thread starter ksigmtsu
- Start date
- 9,744
Many would have more success and less frustration if they took the time to think like an underwriter - instead of thinking like an agent...
To the underwriter, a "possibility" strong enough to document is as bad as, if not worse than, something diagnosed. It's a wildcard - which they hate!
- Thread starter
- #13
- 2,024
Yeah. Completely undiagnosed. 20 minute doctor appointment she saw the doctor 1 time, not in the APS, in his notes. No medication, no treatment.
I've had similar situations on boarder line diabetes, oh I dunno 4 times this year. Not someone being diagnosed with diabetes, but a doctor put in their notes to monitor them for possible diabetes in the future, with no high blood sugar test ever, no medication, and advised them to change their diet.
Had 2 people declined that go to the same doctor because he had written that in his notes. He did not appreciate my friendly advice that he shouldn't write that in his notes if he hasn't diagnosed it because it makes his patient uninsurable for the rest of their life with 7 out of 8 companies if the insurance company sees his notes.
Had a couple senior market cases declined because someone had prescribed type 2 diabetes medication to patients that had NEVER had a high blood sugar test, because their parents were diabetic and they thought the prescription was a precaution to diabetes in the future.
I've had similar situations on boarder line diabetes, oh I dunno 4 times this year. Not someone being diagnosed with diabetes, but a doctor put in their notes to monitor them for possible diabetes in the future, with no high blood sugar test ever, no medication, and advised them to change their diet.
Had 2 people declined that go to the same doctor because he had written that in his notes. He did not appreciate my friendly advice that he shouldn't write that in his notes if he hasn't diagnosed it because it makes his patient uninsurable for the rest of their life with 7 out of 8 companies if the insurance company sees his notes.
Had a couple senior market cases declined because someone had prescribed type 2 diabetes medication to patients that had NEVER had a high blood sugar test, because their parents were diabetic and they thought the prescription was a precaution to diabetes in the future.
- 9,744
His notes are part of the APS.
I'm sure as soon as you complete medical school he'll be happy to take your counsel.
Like they do, or should, care? Dude, they don't give a rat's behind about "insurability". They care about documenting stuff thoroughly in case THEY get sued.
- 1,926
Go to another doctor and get a new evaluation, easier than getting the doctor to recant .
- 9,744
Sounds like you're going through the newbie underwriting learning curve.
When you find out they're taking a diabetes med, understand that to the underwriter that means they have diabetes. Period. There aren't going to be any "stories" or explanations...
Underwrite 'em tighter on the front side - it will save you time and trouble!
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- #17
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Yeah, I learned that about 5 months ago. Just recounting the fun times. This newest one was an oddity. Really at this point just feels like a waste of time financially, but I'm going to keep trying to help the lady.
- 3,863
I am sure the doctor put possibly bi polar for no reason...
Something else triggered the APS. Script search or other conditions.
I can't say who is right or wrong but like most of these situations there is more to this story.
Something else triggered the APS. Script search or other conditions.
I can't say who is right or wrong but like most of these situations there is more to this story.
Could also be something in the phone interview. More than once I have had clients spill their guts during the inquisition. Most of the time it is nothing. The underwriting assistants are trained to put pressure and offer up leading questions that would not be allowed in a courtroom.
Have you ever had back problems?
Well, now that you mention it I do have problems some times.
What do you think it might be?
It could be a nerve or maybe a disc problem. Hard to say.
And off we go to the land of the APS . . .
I tell clients to answer the question as asked. Don't volunteer anything that is not specifically requested, don't speculate.
Even still, some of them get religion and go off on wild tangents that screw everything up.
Have you ever had back problems?
Well, now that you mention it I do have problems some times.
What do you think it might be?
It could be a nerve or maybe a disc problem. Hard to say.
And off we go to the land of the APS . . .
I tell clients to answer the question as asked. Don't volunteer anything that is not specifically requested, don't speculate.
Even still, some of them get religion and go off on wild tangents that screw everything up.
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