I have a HUGE problem, How do i fix this? no coverage!

[James]

I met a couple who was with pyramid on a medicare supplement. They wanted to switch to get a lower premium. The husband couldn't quailify. So i wrote her a new policy and cancelled hers. Well a month later i get a phone call from the client saying her husband's policy lapsed.... he has HIV!

I called pyramid and they said that It was one policy with the husband as the dependent. So when she cancelled hers it cancelled both. He had a surgery that is unpaid. Is there anything i can do? I did sign him up on a MA plan yesterday so that i can switch him to a med supp in 2 months with no health questions.

The Problem is that the agent that wrote the policy wrote the husband as a dependent. How can they make the husband drop his policy? what if she died, or they got divorced. I hope i can do something because i am at fault to for assuming that he would be able to keep his policy. I have never ran into this EVER! I have never had a cmplaint against me either. I'm not a scammer i really am there to help people and I was trying to do the right thing.

Did they ever explained to you why he was a dependent on her Supplement? I'm wondering why and how that came to be?

 

[senior-advisor-indiana]

There is no such thing as a dependent under medicare supplement policies.

Thats what I thought. But half the time you call you are talking to someone you can't unerstand and it seems like they don't know anything either. I called and the said he was a dependent, therefore his policy was cancelled. What actions can I take to get this resolved?

The clients filed a complaint with the department of insurance because I couldn't get anywhere with them( pyramid) on the phone.

 

[senior-advisor-indiana]

Did they ever explained to you why he was a dependent on her Supplement? I'm wondering why and how that came to be?

Thats how the agent set it up. I have no idea why. It was not because of health reasons. He didn't know he had HIV when the purchased the policy.

 

[johnrocks]

booyah!!! perfectchoice you are so right on every count.

 

[senior-advisor-indiana]

Maybe it was so they couldn't change if one of them had health problems?

 

[Guest]

I did sign him up on a MA plan yesterday so that i can switch him to a med supp in 2 months with no health questions.

That might not work...
He did not leave his medicare supplement plan because he wanted to try out the MA plan...in which case he could get back into his supplement. His supplement was cancelled with a lapse in coverage so I think you will have a hard time getting him back into a supplement based on that rule. Two questions and I will try to help you out...

1. How did you cancel their policies?
2. How much time lapsed before you enrolled him in a MA plan?

 

[policy doctor]

Years ago those kind of apps were common. I remember writing business like that for Pioneer Life and maybe National Foundation, Kanawha...and the first name on app was owner and second was the dependent. Life ins apps were like that too,and some still are. Best, just write everyone their own app. since this man is covered by medicare, they pay majority of bills anyway (80%) and the rest is negotiable. See if dr takes assignment(20%) and will negotiate lower to get paid off quicker. NEVER advise them to drop anything until new coverage received.

 

[midwestbroker]

I have never seen that situation before either.

At least they will have defaulted back to Medicare, so there is some coverage.

I thought that they would have 30 days to re-instate the policy if they left it by paying the past premiums.

 

[johnrocks]

this is what I was getting at with annuities,you have to make sure that the product fits the client's best interest. forget about commission when your at their home,the money will come.

 

[James]

Depending, maybe this couple needs an attorney to challenge that the man's supplement was wrongly taken away. Then again you did mention lapse? Did they not attempt to pay his portion of the Supplement? If they did I would think they would of knew of the potential pitfall they now find themselves in.