Staying in touch with clients = helping with claims

Feb 14, 2007

  1. Crabcake Johnny
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    Crabcake Johnny Guru

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    We had a post here not too long ago about how agents can help their clients. Since this happened about 1 minute ago I figured I'd post it.

    My client is an attorney and his wife fell in their house. Days later her knee swelled and after a MRI the diagnosis was a torn meniscus. Surgery followed and total charges were just over $10,000.

    After a claims review it was denied due to it being pre-existing. Client called claims dep't and claims said they had the doctor records and the claim is in fact declined. Now, the wife didn't have any pre-ex conditions and this was an accident, so how could it be pre-existing?

    Well, as an attorney he was ready to "sue everyone" - including possibly me. But he had my February newletter so he decided to call me. He also had the doctor records which he faxed me.

    The problem, as it turns out, was a wrong date of the accident. The doctor mistakely put that the accident occured in Feb of 2006, but they didn't have coverage then. They didn't get covered until a few months later. So the company, thinking the accident occured before coverage began simply declined the claim.

    The doctor admitted his error - I called claims and let them know the scoop. The doctor is faxing a letter correcting his mistake and the claim should be paid within 10 days.

    Staying out of touch would have meant my client probably would have lost my number and just dealt with claims. Claims had no way of knowing the doctor's records were incorrect so they just kept telling the client "it's pre-existing." The actual error probably wouldn't have been caught until a lawsuit was filed.

    A lot of BS avoided. Now instead of having a pissed client and a policy lapse I have a thrilled client who's gonna be on the books forever. And by the way, the first full 5 minutes of the conversation was him chewing me out.
     
  2. STIBROKER
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    STIBROKER Like My post and enter the DRAWING,,,, Moderator

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    I get those all the time....then you got to call the doctor....then ya gotta call claims...real pain in the butt......but it does lock your client in for life.....
     
  3. Crabcake Johnny
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    I actually just spoke with the doctor - he needed to know specially what he needs to send. His comment: "When you deal with 50 patients a day this happens all the time."
     
  4. Frank Stastny
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    John,

    That is an excellent example of why it is so important to stay in touch with your clients. I stress this to agents I talk with all of the time and they all agree with me but in reality very few actually do it.

    It seems that the agents who do receive training are only taught to sell, sell, sell. That seems to be all that insurance companies and large agencies are concerned with. They get the agents all pumped up at meetings, they "wave the company flag and sing the company song" and then say "go get um".

    "Training" never seems to go beyond making the sale. Posting "big numbers" each week makes one a hero. It apparently doesn't matter that those "big numbers" don't do much more than replace the agent's business that has cancelled. If you have ever attended one of those meetings you know that the current weeks hero's cancellations are never mentioned.

    The most successful agents I have worked with were the ones who stayed in contact with their clients on a regular basis. They sent birthday and news letters, promptly returned phone calls and were always willing to help in any way they could.

    Staying in touch builds trust. If your client trusts you it is going to be very difficult for another agent to replace your business.

    It isn't uncommon for my clients to call me to ask me what I think if they are contacted by another agent who is trying to replace my policy. (What do you think I tell them?) I still have med supp clients that I wrote in the early 1990's.

    It is much easier and less time-consuming to keep the business you write than it is to go out and write a new policy.
     
  5. Crabcake Johnny
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    Crabcake Johnny Guru

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    My wife used to get upset that I was "on duty" all the time. When I leave the house I transfer calls to my cell. If my business line rings at 9pm and it's a client I answer it. She's chilled about it now since she understands the deal.

    Imagine when you're really pissed off about something and you call to get voicemail. Now how pissed are you? Now your call isn't returned - so how mad are you now?

    And we can debate this - I've found that people who put in an abnormally high amount of production are omitting many things about the plans they sell. They loathe when the phone rings and notice it's one of their clients because they can best bet the conversation is gonna go like this:

    "You piece of crap, I just got off the phone with the insurance insurance company and you never told me....."

    I'd rather write $10,000 a week and be able to keep in contact with everyone then write $30,000 a week and get a nervous tic everytime the phone rings.
     
  6. cadylou
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    cadylou Guru

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    yes

    One thing about being independent is that you actually do have an opportunity to do good business--treating customers the way you'd like to be treated.

    After years in big corporate, where the way the company treated customers was downright embarrassing, it's nice to have an opportunity to provide service.

    I think it's the only way to operate & builds satisfying client/agent relationships. I'm glad to see that many agents on this board like to operate the same way.
     
  7. Frank Stastny
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    Frank Stastny Guru

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    Fifty patients a day, that is ridiculous.

    In a nine hour day that means that he is probably spending less than seven minutes with each patient. If the average office call charge is $70.00, he is making $3,500.00 per day. That's even better than selling insurance!

    Those kind of mistakes are relatively harmless, except financially, and usually easy to fix. However, if that is so common in his practice what other mistakes are being made regarding treatment, tests, drugs, etc?

    That's pretty scary.

    I have a very low level of tolerance for people whoÂ’s only motivation is greed regardless of their profession.
     
  8. realistagent
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    realistagent Expert

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    It's nice to know I have become associated, through this forum, with professionals that truly care about their clients and peers. I agree with being on call for my clients 24/7. When you help a client at 10:00pm the last thing that he thinks about is you and how you helped him. Client for life!

    Too many people out just to make a buck. As I was taught by my father years ago. Take care of the client,the client takes care of you. This can't happen unless you have given the client a quality product in the first place.

    Oh, and J.P. I didn't realize all the help you have given me over the last couple weeks was all a recruiting ploy.

    LOL
     
  9. Jenananda
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    Jenananda Expert

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    Thanks for the post. I have just received my first ever 'dumping' case. I do stay in touch with my clients and they called me and told me what happened. I've been trying to help them but doesn't look likely.

    Also, I found once a doctor puts an error in a record it's very hard to get it corrected unless it's recent. I found an error in my own medical record as I requested a copy of it and they updated the record but it still shows I have arthritis of the spinal column but had 'recovered' from the condition. I do not have the condition. Think of the poor people we are trying to help who have improper info in their records.

    Jen
     
  10. Crabcake Johnny
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    Crabcake Johnny Guru

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    Let it be known that everyone should go to http://www.mib.com and request a free copy of their report.
     
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