Ordering Medical Records - Thx Underwriter

May 16, 2008

  1. indmedins
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    indmedins Guru

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    Just a quick question. Can I apply my client with carrier B while carrier A is ordering medical records? If carrier B takes my client, I will just cancel the app process. Legal?

    It seems my client is lying to me, but certain drugs came up on her medical record and she swears she never took them. I wondered about a typo on her SSN, but I got her SSN correct. Thoughts?
     
    Last edited: May 17, 2008
  2. somarco
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    somarco GA Medicare Expert

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    Some agents submit multiple apps simultaneously. Seems to work for them.

    That is not something I do, but if you are comfortable, then fine.

    However that does not address the underlying issues which will NOT be satisfied by a second or third app.

    Is your client lying?

    An additional app will not help.

    When I have had clients turned down, and it comes as a surprise to me (and them), I tell them we will either appeal or try another carrier once I know exactly why they were declined.

    Until then, you are spinning your wheels and possibly opening yourself up to an E&O claim if the app that is approved is fiction.
     
    somarco, May 17, 2008
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  3. indmedins
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    Thanks for the info, I agree with you. I really don't want to take any chances with her at this point until I know the outcome after her medical records are reviewed. The meds she was called on were serious and she denied ever receiving or taking them. I will call her Monday and tell her the situation.
     
  4. TXINSURANCE
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    It's irrelevant to a large extent, what is relevant is the underlying condition.

    If she never filled the RX - then how did they find it in a script search?

    Someone is leaving something out.
     
  5. indmedins
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    Well, I hope my client is not lying. It seems highly unlikely the Rx search came back with false data though. The underwriter validated her SSN and it was correct. So, time will tell. I will see how evasive she is tomorrow when I request she fills out the underwriting auth to request medical records.

    If she is not willing to allow medical records to be looked at, then we are done.
     
  6. somarco
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    somarco GA Medicare Expert

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    No one is suggesting that MIB or Intelliscripts, or any other data source is 100% perfect. In fact, medical identity theft is something that get's very little press but is a growing concern.

    If your client has nothing to hide, the release form will be no big deal.

    Keep us posted.

    Inquiring minds want to know.
     
    somarco, May 19, 2008
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  7. bill3173
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    I had a lady recently claim that she had no medical history to speak of and hadn't been on any medication, with the exception of a brief period of hbp. After she was declined with the first carrier, and she told me a little more about her med history, we were able to place her with the right carrier. Case is too recent to be any more specific. With some people, "its not a lie if you believe it".
     
    bill3173, May 19, 2008
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  8. somarco
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    somarco GA Medicare Expert

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    So true.

    Can't tell you how many folks tell me they don't have HTN, high cholesterol.

    They used to have those issues, but not any more. The meds cured them.

    Right . . .
     
    somarco, May 19, 2008
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  9. indmedins
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    So true. I hear that from a lot of people too. Mr. Prospect have you heard of the term "rate up"? :spinny:
     
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