Here are just a few:
Issuing a rider excluding coverage for complications of maternity. Not a problem, except the lady was 56 and had a hysterectomy at age 42.
Declining coverage to an individual who had been on BP meds for 18 months. The carrier wanted 2 yrs of BP history, she only had 18 months from her current doc. Didn't matter, the carrier insisted on 2 years history. Her prior doc is deceased. Didn't matter, the carrier insisted on 2 years history.
Issuing an HSA qualified plan with a 12/20 effective date and a family deductible of $5400. One week later sends a letter (to all clients, not just this one) telling them their new deductible is $5650.
Issuing a policy with an accident rider. No problem, except the rider does not explain what the dollar limit is on the benefit. The rider says "see policy for full details".
Halting sales of a dental product. Two months later send out new brochures with revised benefits & rates. One month after that the policy is pulled off the market.
Changing policy forms after months awaiting approval by the DOI for the new plan design & rate structure. Three months later the new policy is pulled and the agents are told to use the old, non-competitive plans. Seems the product (which had been on the market in other states for almost a year) was under-priced. Six months after that the company sells their entire block to another carrier and it is announced that all of their products will be discontinued within 2 years.
Issuing policies and then giving a rate increase 5 months later because the primary insured moved into a higher age bracket. Four months later the policy renews (total 9 months in force) with (you guessed it) a rate increase.
Issuing a rider excluding coverage for complications of maternity. Not a problem, except the lady was 56 and had a hysterectomy at age 42.
Declining coverage to an individual who had been on BP meds for 18 months. The carrier wanted 2 yrs of BP history, she only had 18 months from her current doc. Didn't matter, the carrier insisted on 2 years history. Her prior doc is deceased. Didn't matter, the carrier insisted on 2 years history.
Issuing an HSA qualified plan with a 12/20 effective date and a family deductible of $5400. One week later sends a letter (to all clients, not just this one) telling them their new deductible is $5650.
Issuing a policy with an accident rider. No problem, except the rider does not explain what the dollar limit is on the benefit. The rider says "see policy for full details".
Halting sales of a dental product. Two months later send out new brochures with revised benefits & rates. One month after that the policy is pulled off the market.
Changing policy forms after months awaiting approval by the DOI for the new plan design & rate structure. Three months later the new policy is pulled and the agents are told to use the old, non-competitive plans. Seems the product (which had been on the market in other states for almost a year) was under-priced. Six months after that the company sells their entire block to another carrier and it is announced that all of their products will be discontinued within 2 years.
Issuing policies and then giving a rate increase 5 months later because the primary insured moved into a higher age bracket. Four months later the policy renews (total 9 months in force) with (you guessed it) a rate increase.
