Trouble....???

Jan 18, 2008

  1. TonyC
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    TonyC Guru

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    Hi Gang.

    I'm a newly licensed agent and am interviewing with different (health) insurance brokers. Some of these seem to be less than ethical in their business practices.

    What are some of the Biggest (or most common) Items that can get you into trouble with the Insuance Commission or State Regulators ?

    I just got licensed and want to do the right thing...

    Thanks in advance....
     
    Last edited: Jan 18, 2008
    TonyC, Jan 18, 2008
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  2. Chkndinner14
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    Chkndinner14 Super Genius

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    This question could take days to answer. 98% plus of agents are good ethical people. With that being said, you are dealing with a complex product that your customers have a hard time understanding. People also practice selective listening.

    But, I think this is sort of odd question? Are you worried about having problems with the DOI? Most agents never have a problem with the DOI.
    Some have some E & O claims along the way, but the DOI doesn't get involved unless there is fraud or missing money. And if either of those two are present, you have no E & O coverage anyway.

    Here is how to have a trouble free career.

    1. Learn your product.
    2. When you are in front of your clients and you don't know the answer, tell them I don't know, but I will find out.
    3. Most important, never do or say anything that you will be thinking about when you head hits the pillow.

    As far as working for firms, use the smell test. You will know quickly.
     
  3. TonyC
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    Thanks Chkn14,

    I'm not worried about fraud or missing money...but i am concerned about agents who encourage their clients to lie.

    For example, i spoke to one agent over the phone who said that "he will tell a client, (who smokes and is complaining about his high current insurance bill), to put down on the application that ,he doesn't smoke. He then tells the client that he can't go to the hospital for 1 yr." I guess this somehow avoids a voided contract by a insurance company (sigh).
    :sad:
    Another one i heard of is an agent told a friend of mine to use "her brothers address" as her place of residence to push the premium down." Again....agents incouraging their clients to lie...(sigh).
    :no:
    When i heard about these things...i thought to myself...."what else are agents out there doing?"

    Anyway...it kind of gave me the creeps...so i decided to ask "my question" on this forum.


    I appreciate any comments...and more would be welcomed....

    Thanks!
     
    Last edited: Jan 19, 2008
    TonyC, Jan 19, 2008
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  4. CHUMPS FROM OXFORD
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    CHUMPS FROM OXFORD Guru

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    Health Benefits Direct can perhaps provide some insight to this thread.
     
  5. TonyC
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    What's "Health Benefits Direct?"
     
    TonyC, Jan 19, 2008
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  6. Crabcake Johnny
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    Crabcake Johnny Guru

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    "Are you current taking medication? No? Then you don't need drug coverage."
     
  7. TonyC
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    So what you are saying is...you are leading the potential insured through the questionare....

    Is that correct?


     
    Last edited: Jan 19, 2008
    TonyC, Jan 19, 2008
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  8. Crabcake Johnny
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    Crabcake Johnny Guru

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    What their agents are famous for is simply not going over much past the deductible and rate.

    Say I sell you Plan 80 and simply say "it's $245 a month for your family with a $2,500 deductible." The client says "sure, sign me up."

    Fine, but what the agent failed to mention was they weren't adding drug or preventative to the plan. So now the kids to for their wellness exams; not covered. Some one gets put on meds; not covered.

    The family can call the agent back and lay into them "you never told us our plan didn't have drug or wellness coverage." The agent can reply "I never told you it did."
     
  9. TonyC
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    Thanks Health,

    I see what you are getting at....agents fail to tell insureds about the "limits" of their policies....and therefore come out as a cheaper quote then their competitors.

    ....Why not give them (the insured) a choice?

    With and without meds....wouldn't that serve them better?

    OR...is it too difficult to get 2 quotes?



     
    Last edited: Jan 19, 2008
    TonyC, Jan 19, 2008
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  10. Crabcake Johnny
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    The real problem companies or call centers like HBP are causing for GR is horrible placement and persistency.

    Calls centers are shills for GR - although they represent many carriers GR is the only one they recommend because it's the path of least resistance.

    Here's the real problem - call center reps rarely discuss underwriting action whether it be a decline or rider. GR, to their discredit, does not require the client to sign an exclusion before the policy is issued. The policy simply goes active, everyone gets paid and the rider comes with the policy.

    Call center agents exploit this by simply not mentioning exclusions. When the policy is issued the client simply assumed everything is covered.

    The agent never went over the rider, the client gets the policy, tears it open, grabs the cards and never sees the rider. Then they head off to get treatment for an excluded condition. The end result is a cancellation.

    This is why Assurant continues to advance direct 12 months and GR only advances through brokers at 9 months. GR's placement and persistency are in the gutter.

    With Assurant the policy doesn't go active until any adverse underwriting is accepted by the client which means no pay for the agent. Call centers can't stand that and just want the commission.

    GR absolutely needs to change their method of doing business to include client acceptance of exclusions before the policy is issued.

    The bottom line is if a client is on the phone with a call center agent it's gonna be GR recommendation with no mention of exclusions for pre-ex conditions.
     
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