Scuba Diver - Health Insurance?

[joshril]

Nope.

That's why most carriers have explicit questions about occupation and hobbies - on the app.

You are under no obligation to provide answers to any questions that are not specifically asked on the application.

That's why they have an application...

I disagree. I assure you that if you call an underwriter and ask them this question they will tell you to provide any information you feel is relevant. There is also the agent report. Aetna is a great example of this.

"Are you aware of any information not disclosed on this application relating to the health, habits, or reputation of any person listed on this application which might have a bearing on the risk?"

If the client discloses something to you that you think the company would want to know and there is not a pertinent question on the application, it goes here.

For example, scuba diving is not directly on most of the applications, however almost every company will take some type of underwriting action.

 

[moonlightandmargaritas]

For example, scuba diving is not directly on most of the applications, however almost every company will take some type of underwriting action.

Are you sure?

We run into a fair amount of scuba action here in Florida, as one might imagine...

Golden Rule and Humana together comprise about eighty percent of the new ifp business I write.

Golden Rule has no scuba related question on their application, nor is there any mention of it the Florida Underwriting Guide.

From the HumanaOne Florida application:

"During the next two years, does anyone applying for coverage participate, or plan to participate in any of the following activities: Bungee jumping, private aviation, motorized vehicle racing, rock climbing, rodeo events, scuba diving, or sky-diving?"
- - - - - - - - - - - - - - - - - -

"Are you aware of any information not disclosed on this application relating to the health, habits, or reputation of any person listed on this application which might have a bearing on the risk?"

That's looks like a question on the application to me.

 

[joshril]

Are you sure?

We run into a fair amount of scuba action here in Florida, as one might imagine...

Golden Rule and Humana together comprise about eighty percent of the new ifp business I write.

Golden Rule has no scuba related question on their application, nor is there any mention of it the Florida Underwriting Guide.

From the HumanaOne Florida application:

"During the next two years, does anyone applying for coverage participate, or plan to participate in any of the following activities: Bungee jumping, private aviation, motorized vehicle racing, rock climbing, rodeo events, scuba diving, or sky-diving?"
- - - - - - - - - - - - - - - - - -


That's looks like a question on the application to me.

During pre-screen, GR told us they would take negative underwriting action due to the depths this guy swims... BTW, we have an ocean here in TX too...

Stepping away from scuba for moment, you're telling me on the example I gave about Aetna's agent report, if the client provided information that you thought was relevant that did not "fit" on any questions listed on the app, you would not include it on the agent's report?

 

[ca-ltc-agent]

I understand that we have a responsibility to the insurers that we are with, but we also have an obligation to our clients. If there was a question on the app, I would ask and answer it.

But Josh, it sounds like you are throwing your client to the wolves. Maybe just a little bit. Were you an underwriter in a past life?

Always do what you feel is best though,
Steve

 

[joshril]

I very rarely have a declined application. I am very thorough on underwriting questions and I will never put myself in a position where I could be potentially be sued. Read your appointment contract... you are the insurance company's eyes and ears in the underwriting process. Anything a client tells me will go on the application (whether it is blatantly asked or not) or they won't be a client of mine.

 

[saieddie]

Thats why people always lie to insurance agents. Too much Law and Order has educated people to only admit to what can be proven.

 

[joshril]

Thats why people always lie to insurance agents. Too much Law and Order has educated people to only admit to what can be proven.

It's crazy too... I have several clients that have asked me if they should just leave something off of an application. Once I explain the post claim review process, most understand why it is important to list everything.

Carriers will try to NOT pay a large claim if they can. All it takes is one omission or misrepresentation on the application to get a policy rescinded. It's not worth it and the system can't be beat.

Then, when a $100,000 claim gets denied, guess what happens next... typically a lawsuit, and it's highly likely the agent will be named in the suit. No thanks!

 

[saieddie]

So where do the omissions end? Do you list bad driving habits, clients living in high crime areas, or the amount of tattoos or piercings a person has?
All these have as much impact on future claims as scuba diving.