Kids Health Insurance Cancelled Because of Ear Infections?

Jan 31, 2007

  1. Golddoor
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    Golddoor Guru

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    I sent some Unicare quotes to a lead that was requesting quotes on her 2 children, one being 3 and the other 2 years old, and the lead called me and told me that Unicare just cancelled the plan that she had on them because of ear infections. They told her that the ear infections were pre existing and so Im guessing that maybe she didn't disclose that they had been seen before for ear infections and so cancelled her plan. If this is true can they do that? Thats crazy because I have 3 kids and kids get ear infections like several times a year. Its common!!
     
    Golddoor, Jan 31, 2007
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  2. somarco
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    somarco That Medicare Guy

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    Ear infections are common.

    So is the surgical procedure to place tubes in the ears to prevent or lessen the ear infections. Sometimes the procedure is repeated.

    Carriers are quite touchy about misrepresentation on an application. Based on what you have posted, I am not surprised they cancelled the coverage.
     
    somarco, Jan 31, 2007
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  3. Crabcake Johnny
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    Crabcake Johnny Guru

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    If anyone on the application has sought medical treatment/advice for anything in the past "X" years (depends on the carrier) is must be put on the app. Some carriers like Assurant will state that they don't care about single occurences of a cold of flu.
     
  4. somarco
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    somarco That Medicare Guy

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    Plural, as in more than one infection.

    You don't know? You did not assist in completing the app? You don't have a copy of the app?

    Carriers look for 2 things in medical history. Something that is chronic & potentially expensive to treat. Something that is serious and either ongoing or has potential to return and is expensive to treat.

    You & your client apparently failed to take this into account when completing the app.

    I still can't believe you don't have a copy, and did not assist in completing the app.

    You have a tough road ahead in this business.
     
    somarco, Jan 31, 2007
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  5. Crabcake Johnny
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    Interesting: http://law.freeadvice.com/insurance_law/insurers_bad_faith/blue-cross-post-claim-underwriting.htm

    What lawmakers fail to realize is insurance companies don't have the resources to pull medical records from every doctor every patient has seen. Underwriting would take 6 months.

    Also, the insurance companies need to be able to rescind a policy for people who have not yet sought treatment yet plan on burning the company. Imagine someone without insurance starts having severe back pain and is savvy enough to not see a doctor and instead just grab health insurance first.

    You cannot have a system that rewards people for being good liars. I hear "Oh, I forgot about that emergency room trip" but that doesn't pan out with auto insurance - "Oh, I forgot about that DWI four years ago."
     
  6. STIBROKER
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    STIBROKER Like My post and enter the DRAWING,,,, Moderator

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    Yea UC will put a waiver on ear infections (thats the first question I ask when I have kids going on a application either by themselves or with parents)...tubes can run about $6,000 and if they find that the kid had ear infections and not on application they will get their money back and policy rescinded....have had this happen about twice in 10 years with UC.....oh...it was not for ear infections on my rescinds....time to take that one to Aetna...
     
  7. Crabcake Johnny
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    I've had 5 policies rescinded since I've been independent and it's not pretty. It every case the client lied or "forgot" about a medical condition to me and the company. Heaven forbid your client has a policy rescinded, told you about a condition and your reply was "that doesn't need to go on the app."
     
  8. James
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    I am sure there are more than a few attorneys laughing at that statement!
     
    James, Jan 31, 2007
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  9. Crabcake Johnny
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    Like OJ's entire defense team?
     
  10. James
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    James, Jan 31, 2007
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