Is this Legal...???

Apr 23, 2008

  1. TonyC
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    TonyC Guru

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    Forgive the question from a Newby...

    l lost a prospect to an agent who sold someone 2 policies.

    I don't know if its legal but this is what she was sold.

    1. a Policy by GR that has a pregnancy rider (this covers pregrancy right away with a very high deductable).
    2. a Policy by Assurant that covers Major Medical (with a lower deductable).


    It seems like there is overlapping coverage....but i'm sure this is legal....

    Can anyone give me some constructive input on this?

    thanks!
     
    TonyC, Apr 23, 2008
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  2. somarco
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    somarco That Medicare Expert Guy

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    Don't know that it is illegal, but which carrier will be primary?

    Seems like a lot of extra premium for nothing (literally).
     
    somarco, Apr 23, 2008
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  3. Crabcake Johnny
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    Crabcake Johnny Guru

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    The GR apps specifically asks:

    "Within the last 62 days, has any applicant been covered by, or has application been made for, any type of medical insurance?"

    The agent would have needed to check "yes" to that and state that application has been made for another major medical policy.

    GR would call the applicant upon submission and I'm guessing after the client disclosed that he also filled out an Assurant app GR would kill the deal.

    Just a guess - I'll call to confirm this morning. and the carrier.
     
  4. TXINSURANCE
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    TXINSURANCE Guru

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    There is no coordination of benefits is your answer.

    And while it is not illegal the carriers do not permit this.

    Also your information on the GR maternity rider appears to be inaccurate at first glance.
     
  5. TonyC
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    Bob....i think she got Azzurant as her primary....and GR as her secondary. Again...another agent got her the coverage and i lost it.

    Ok...i got the full scoop now...

    She had a miscarriage before....so she got the United to cover the maturnity (she wants to have another baby)....and She got Azzurant as her primary to cover her if she has another miscarriage.

    Apparently Azzurant will cover you for prior miscarriages...




     
    TonyC, Apr 23, 2008
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  6. jbage007
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    At least one of those two companies was lied to in the application process.

    But heavens sake, why not just take the matenity rider with Assurant?

    Makes no sense that GR would sell her a maternity rider under full disclosure but Assurant would not.

    No sense at all.
     
    jbage007, Apr 23, 2008
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  7. joshril
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    joshril Guru

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    It just sounds like a really confused agent to me...
     
    joshril, Apr 23, 2008
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  8. Crabcake Johnny
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    This will not work. She will not be able to bounce around and whip out one carrier's card for "this" event and another carrier's card for "that" event. Claims review will pick up on it.
     
  9. CHUMPS FROM OXFORD
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    CHUMPS FROM OXFORD Guru

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    I always assumed that you can not have two policies (not the goofy discount plans) in force at the same time. On a standard app, you are always asked when any prior coverage terminates. That date must never occur after the proposed effective date.
     
  10. Crabcake Johnny
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    Crabcake Johnny Guru

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    Two calls today both confirmed that if you were to write "dual applications" it would need to be disclosed that coverage is also being applied for by "carrier B" in which case the carrier would not proceed with underwriting.

    Bottom line is this cannot be done.
     
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