Low Rating from Guardian.

[whyme]

Hi,
I have been waiting for Guardian underwriting to get my medical records and get my class rating. Well after 8 weeks underwriting came back as Non-smoker w/ out being eligible for waiver of premium!!! I am thinking WTF! I was thinking Preferred Plus.
So I ask the agent and he comes back "Your history of anxiety and toe neuritis". Now I am completely gobsmacked!
I have never been treated for anxiety and what does a sore toe have to do with life insurance? The only thing I can think of is about 3 years ago I had an inner ear virus which was accompanied with ~ 3 weeks of insomnia. The doctor tried ambien which didn't work, so she prescribed amitriptyline and Xanax(I had 1/2 a pill and tossed the rest). Am I screwed now because the doctored gave me anxiety meds, telling me they would make me sleepy, even though I didn't take them for anxiety? All my health stats are good to great; blood pressure, chol, weight etc.

Thanks

 

[VolAgent]

There are two likely scenarios here.

1. Selective hearing. You doctor did mention anxiety and your toe being more than just sore. You just tuned it out and heard what you wanted to hear. This is a raging epidemic with no end in sight, just ask any mother or wife about it.

2. Your doctor told you one thing and wrote something completely different in your chart. This is a recipe for disaster if the doctor is consistently failing to relay the proper diagnosis to his patients even as he charts it.

Take your pick.

You can also speak with your agent and have him screen the case with other companies to see what offer you can get. Ultimately, non-tobacco isn't bad, it is the rating for which most of the country would qualify.

 

[whyme]

So basically a doctor could write anything in my "chart" (regardless of what I tell them) and be completely wrong, but I would still be screwed by the insurance company. I seem to remember a Seinfeld episode similar to my situation.
Do life companies have any type of underwriting review processes?

Tnx

 

[WinoBlues]

Get a copy of your medical records. See what the underwriters are seeing. I have had several cases flat out declined due to errors in the medical records. Some times it is just one word like "chronic" Many times it is simply a matter of getting a letter from the doctor addressing the issue. We have gone from decline to Prd+. We have also seen where the client did not know he had a serious issue.

You want to know if there are any errors in your records. Regardless of what you do with the life insurance. This may also be in the MIB from this point forward.

Hi,
I have been waiting for Guardian underwriting to get my medical records and get my class rating. Well after 8 weeks underwriting came back as Non-smoker w/ out being eligible for waiver of premium!!! I am thinking WTF! I was thinking Preferred Plus.
So I ask the agent and he comes back "Your history of anxiety and toe neuritis". Now I am completely gobsmacked!
I have never been treated for anxiety and what does a sore toe have to do with life insurance? The only thing I can think of is about 3 years ago I had an inner ear virus which was accompanied with ~ 3 weeks of insomnia. The doctor tried ambien which didn't work, so she prescribed amitriptyline and Xanax(I had 1/2 a pill and tossed the rest). Am I screwed now because the doctored gave me anxiety meds, telling me they would make me sleepy, even though I didn't take them for anxiety? All my health stats are good to great; blood pressure, chol, weight etc.

Thanks

- - - - - - - - - - - - - - - - - -

So basically a doctor could write anything in my "chart" (regardless of what I tell them) and be completely wrong, but I would still be screwed by the insurance company.
Do life companies have any type of underwriting review processes?

Tnx

We did a case earlier this year where the wife emails Kaiser through her husbands in. Mentions that he is forgetful. The insurance company then wants to see Memory (dementia) work ups. All emails go in the file.

BTW, you are not being screwed by the insurance company. They are in the business of insuring people. You are being screwed by your doctor or your own health.

And yes, you can go back to the underwriters with more information.

Lee

 

[whyme]

Thank you for the suggestion. Something I never thought I would have to do!
What do the records look like that UW looks at? Are they short paragraphs written by the doctors?

I meant "screwed" in the sense that the doctor may make an observation and be wrong, but the under writer doesn't bother to look at all the files or what ever they do. Perhaps "lazy" is the better word.

O, Can I get the records from the life insurance company, so I have the exact paper work they are looking at?

Thank you

 

[WinoBlues]

Thank you for the suggestion. Something I never thought I would have to do!
What do the records look like that UW looks at? Are they short paragraphs written by the doctors?

I meant "screwed" in the sense that the doctor may make an observation and be wrong, but the under writer doesn't bother to look at all the files or what ever they do. Perhaps "lazy" is the better word.


Thank you

Depends on what they ordered. They could order a summary. The ones I have seen are full records. The underwriters and case managers are pretty good at finding stuff. If you have never seen your records it may be surprising at what all is in there. People check their credit report but never their Med records. What is your agent telling you?

 

[VolAgent]

Thank you for the suggestion. Something I never thought I would have to do!
What do the records look like that UW looks at? Are they short paragraphs written by the doctors?

I meant "screwed" in the sense that the doctor may make an observation and be wrong, but the under writer doesn't bother to look at all the files or what ever they do. Perhaps "lazy" is the better word.

O, Can I get the records from the life insurance company, so I have the exact paper work they are looking at?

Thank you

Whoa, time out. The underwriter didn't screw you. He made the decision based upon your medical information. If your doctor has the information wrong, whose fault is it, the underwriter or the doctor?

Remember, underwriters are not medical doctors. They are basically relying on the doctor's notes and diagnosis. They also use tables to review your charts and make sure the numbers are in order. There is a medical doctor on staff the can refer cases to if need be. However, that is on borderline cases where the company may not even issue coverage. They don't typically review cases that come back standard. An underwriter's job is to approve applications for coverage while protecting the company from bad risks. They actually want to give you coverage. Assuming this wasn't a case of selective hearing, the blame almost certainly goes to the doctor.

I had a very similar case recently. The applicant swore one thing and the doctor wrote something very different in the file. Ultimately the insurance company had to take the doctor's diagnosis into account and decline the person for coverage. They wanted to take him, but they just couldn't with what the doctor had written.

 

[whyme]

I guess what I am getting at is if the under writer sees one mention of something ratable they will go with the low rating? I am wondering if they are spending time to figure out that I am actually very healthy or if they just filed me and went on to the next case ;*) Image of a desk stacked full of cases and an over worked person.

I'll see how it goes!

 

[VolAgent]

I guess what I am getting at is if the under writer sees one mention of something ratable they will go with the low rating? I am wondering if they are spending time to figure out that I am actually very healthy or if they just files me and went on to the next case ;*)

There is a very big source of confusion I will address right now. What a doctor or patient thinks is healthy and what an underwriter thinks is healthy are two very, very different things. Also, underwriters are supposed to cautious in their ratings, they should go with the lower rating unless they can find something to suggest a higher rating is in order. Finally, if your agent had you convinced you were getting preferred plus, he did you a huge disservice. Most people don't get preferred plus, those are walk on water rates. Not only do you have to be extremely healthy, your parents and siblings have to be extremely healthy.

 

[moonlightandmargaritas]

I guess what I am getting at is if the under writer sees one mention of something ratable they will go with the low rating? I am wondering if they are spending time to figure out that I am actually very healthy or if they just filed me and went on to the next case

Life insurance underwriters generally use an emotionless process of a worksheet with debits and credits to score it.

They really don't try to "figure out" that you're actually very "healthy".

As several have suggested, I'll bet the problem is in your doctor's notes -- a disconnect of what they told you versus what they wrote down. Very common.