free look info on the policy?

[trvlnut]

Are you explaining to your clients how the claims review process works?

Are you talking about the claim appeal process? I haven't spoken about that.

 

[J.R.]

Are you talking about the claim appeal process? I haven't spoken about that.

I was talking about explaining to clients how insurance company handle claims in relation to pre-existing conditions, as well as the information that may or may not be on the application.

 

[trvlnut]

I do speak about pre-existing conditions to my clients. I do tell my clients about the rules that are involved with those claims involving pre-existing conditions

This client wasn't trying to hide anything. It was an honest mistake. When I went to pick up the app, they pulled out a piece of paper that listed all the meds they were taking. The only meds listed at the time was hormones and HBP meds. Apparently, she had stopped taking HC meds some months prior. After the app was submitted, she was put back on meds.

BTW, I spoke with GR and free look is 20 days

 

[J.R.]

I do speak about pre-existing conditions to my clients. I do tell my clients about the rules that are involved with those claims involving pre-existing conditions

Glad to hear it.

This client wasn't trying to hide anything. It was an honest mistake. When I went to pick up the app, they pulled out a piece of paper that listed all the meds they were taking. The only meds listed at the time was hormones and HBP meds. Apparently, she had stopped taking HC meds some months prior. After the app was submitted, she was put back on meds.

I appreciate the clarification that the client wasn't trying to hide anything and I admire the fact you are protecting him/her.

So she stopped taking the meds X number of months prior.......then started taking the meds right around the time the application was submitted. Did she have a pending visit that you did not know about when you submitted the application or did she put herself back on the meds w/out medical advice?

BTW, I spoke with GR and free look is 20 days[/quote]

 

[trvlnut]

When she went to her doc to have the HBP form completed, I believe they checked her cholesterol then. At that point, they put her back on her meds.

I've been working through her daughter because of the language barrier with mom. Her daughter was surprised to hear she was back on the HC meds.

 

[somarco]

GR instituted the HBQ a few months back as a means of finding out additional information about an applicant without a full blown APS. The questionaire asks for a 3 yr BP history along with any meds (not just HBP). It also asks ht & wt, cholesterol & triglycerides, HDL, LDL, blood sugar levels, etc.

Almost like a paramed without the cost.

The good news is this will help GR stay competitive and do a better job of underwriting up front. Leaves less to chance for surprises in the future that could lead to denied claims or rescission . . . an issue some carriers are currently dealing with.

The bad news is it means more delay in underwriting and possibly more riders or declines.

Overall I think it is a good thing.

Did you ask GR where they put the 20 day free look notice? Can't believe it is missing.

 

[trvlnut]

The rep said the 20 day free look notice "must be further back in the policy." I didn't see it. The rep was also surprised that it wasn't on the front page. Maybe they don't want to announce it when there are riders on the policy.