Recending Policies

[Golddoor]

Ok just spoke with my client and she said it was migraines that was the reason for rescinding the policy. She did not mention the migraines on the app. Would it even be worth the time to fight it? Also she wanted to know if they will be making her pay them back for all the meds and Doc visits they already paid for?

 

[moonlightandmargaritas]

Ok just spoke with my client and she said it was migraines that was the reason for rescinding the policy. She did not mention the migraines on the app. Would it even be worth the time to fight it? Also she wanted to know if they will be making her pay them back for all the meds and Doc visits they already paid for?

Migraines is not the reason.

Migraines are a symtom of something else, not a condition.

She will receive back her premiums paid, less any claims paid.

 

[TXINSURANCE]

Migraines is a very serious problem some people can have strokes, and a high percentage end up in the ER within 12 month period.

I believe migraines is very high up on the claims scale.

Bottom line had they known about it - it would have been a waiver or decline, as they do not accept migraines without waiver or decline. If client smokes this is an auto decline with that carrier.

Bottom line - just write them somewhere else.

They might have a 12 month pre ex (likely) since now they have no prior creditable coverage even if approved without waiver.

 

[Golddoor]

Migraines is a very serious problem some people can have strokes, and a high percentage end up in the ER within 12 month period.

I believe migraines is very high up on the claims scale.

Bottom line had they known about it - it would have been a waiver or decline, as they do not accept migraines without waiver or decline. If client smokes this is an auto decline with that carrier.

Bottom line - just write them somewhere else.

They might have a 12 month pre ex (likely) since now they have no prior creditable coverage even if approved without waiver.

Non smoker. So would it even be worth it to try and fight it? She is also pregnate now as well. 6-7 months worth of prego. So she cant apply with any other companies now any way. She claims she thinks she told me about the migrains when I took the app at the appointment. Its not on the paper app that she signed or would I have left that off an app. As we have other issues that I listed that are on the app.

 

[Crabcake Johnny]

No. If she has migraines and didn't disclose it on the app that policy is toast. The app specifically asks if she has any medical conditions - that's a condition.

The "she claims she thinks she told me..." statement is a bit worrisome. That means she could be gearing up to throw you under the bus.

 

[moonlightandmargaritas]

Non smoker. So would it even be worth it to try and fight it? She is also pregnate now as well. 6-7 months worth of prego. So she cant apply with any other companies now any way. She claims she thinks she told me about the migrains when I took the app at the appointment. Its not on the paper app that she signed or would I have left that off an app. As we have other issues that I listed that are on the app.

Wow, this is a horrendous mess...

She is getting ready to try and blame you.

My advice: sever contact immediately. Nothing you can say or do for this person will help. DO NOT HAVE ANY FURTHER CONTACT WITH THEM DIRECTLY.

#2 - do you have E&O?

 

[Golddoor]

Wow, this is a horrendous mess...

She is getting ready to try and blame you.

My advice: sever contact immediately. Nothing you can say or do for this person will help. DO NOT HAVE ANY FURTHER CONTACT WITH THEM DIRECTLY.

#2 - do you have E&O?

She can blaim me all she wants. She signed the app. If she told me and I didnt put it down why would she sign it? Even if she did tell me that, how would they even prove it? And yes I have E&O!

 

[Crabcake Johnny]

Fantastic advice and listen to Paul. Do not email her or speak with her on the phone again.

She's now likely to tell Unicare that she told you about those conditions and you chose to omit it. In theory she bears the ultimate responsibility because her signature on the app means she agrees with everything stated on the app.

But that's the theory. In practice you'll get a nasty gram from Unicare, may have to respond to the DOI and could be personally sued by her.

This is exactly what one of my agents is going through right now. This is already a cluster f with the DOI and probably will go legal.

 

[Golddoor]

This was her response when I called her. " I'm really not that worried about it. I just want to make sure my baby is covered when its born. I thought I told you about this when I applied though? I wasnt real happy with Unicare anyway. They werent paying for Sons shots or labs. So can you quote me on getting covered with a different carrier after I deliver and with my baby added to the plan?"

 

[moonlightandmargaritas]

She can blaim me all she wants. She signed the app. If she told me and I didnt put it down why would she sign it? Even if she did tell me that, how would they even prove it? And yes I have E&O!

While you may be exonerated, as John P. said - it's a major pain in the ass answering the complaints, etc.