Need Advice, Never Had This Happen Before!

[chp]

This is a first for me. I have a client husband and wife on COBRA with Blue Cross from another state. Due to health reasons, I wrote them on separate policies, him on GR her on Assurant. (she did not qualify for GR). Anyway, they are both approved as of a week ago with a 1 August start date. They can keep COBRA for a few extra months if need be.

Here is the problem. He just called, went to ER, hurt his knee pretty bad. Has MRI scheduled for tomorrow and may need surgery as a result, not sure yet. I dont want to call GR and ask what will happen...yet. Do any of you know how this will play out? If he needs surgery, his current Cobra will take care of it, but what happens on 1 August, say, he needs additional therapy, surgery, etc? Will GR cover it?

Any advice is greatly appreciated.

 

[ABC]

I think you have to contact GR and let them know.


You are in a pickle so I would run this one by the book and by the book I mean being honest with your carrier. You might lose a sale but that better than losing a contract or catching a hit on your E&O

This is a first for me. I have a client husband and wife on COBRA with Blue Cross from another state. Due to health reasons, I wrote them on separate policies, him on GR her on Assurant. (she did not qualify for GR). Anyway, they are both approved as of a week ago with a 1 August start date. They can keep COBRA for a few extra months if need be.

Here is the problem. He just called, went to ER, hurt his knee pretty bad. Has MRI scheduled for tomorrow and may need surgery as a result, not sure yet. I dont want to call GR and ask what will happen...yet. Do any of you know how this will play out? If he needs surgery, his current Cobra will take care of it, but what happens on 1 August, say, he needs additional therapy, surgery, etc? Will GR cover it?

Any advice is greatly appreciated.

 

[STIBROKER]

No one will verify or approve a claim until it is submitted....he might want to carry the cobra and GR for aug....you know cobra will cover it.....

 

[scrabble]

I spoke to the fine folks at COBRA recently (speak to the KS branch whenever possible) and if a payment is made within one month of it's original due date, the policy remains in effect.

 

[chp]

Thanks, that is what I am going to do. Call GR and see exactly what they say...and relay it to my clients.

Thanks again!

 

[DS4]

The question is, "after the signature date of the application, and, prior to the 8.01.10 eff date, will any new health conditions affect the application?".
If not, let everything happen for 8.01.10.
Otherwise, when COBRA expires??, it will be difficult to re-apply with the knee problem.
Just my 2 cents.

 

[WinoBlues]

Thanks, that is what I am going to do. Call GR and see exactly what they say...and relay it to my clients.

Thanks again!

Sure it does not need to be said, However, Document, Document, Document.

 

[somarco]

GR will not allow coverage to go into effect until he is released from his doctor. Since this is a material change in his health prior to the effective date, they also have the right to withdraw their offer.

 

[J.R.]

Let this be a lesson to ALWAYS recommend a quality Accident Insurance plan. Bob is right about GR. Better to be safe and cover your 6!

 

[WinoBlues]

Let this be a lesson to ALWAYS recommend a quality Accident Insurance plan. Bob is right about GR. Better to be safe and cover your 6!

And a fanny pack will not do.