Trying to write my first policy

[michellea]

Go figure.........

I have just gotten my writing numbers (well some of them) and my very first prospect is someone that is a regular at my father in laws restaurant/bar.

(I will need to ask him for more information, what information I have was gotten while I was at the bar so I did not have my guides and since this is my first one I really did not know what to ask, etc., which is luckily ok since this is not your "typical" prospect that you do not know). He is open to both copay and HSA.

He is currently insured through Mega and is paying $400/month. I know usually their premiums are lower then that because they are crap, BUT this prospect is 5'10 and weighs 288 lbs. He does not take any medications. He also said he had a cyst removed from his back last year, but then he said lymphoma tumor.

What questions should I ask about the "tumor"? It looks like Aetna may be the only one he would maybe get through with based on height and weight if nothing else disqualifies him, but then again I am still trying to learn all of the underwriting and may be totally wrong. Oh yea and I forgot to ask his age, ha, go figure. He is around late 40's early 50's.

Any insight on my first prospect which is a HORRIBLE prospect would be wonderful!! (I know I probably will not be able to get him insured, but at least I will learn from this one!)

 

[Alston]

All of the companies I work with will allow me to prescreen clients. You give them the pertinent details about a client and they give you a non-binding answer that tells you whether or not you should submit the application.

Aetna has a prescreen link on their "Producer World." Some companies want a phone call, others want a fax others will want you to complete a form on their website. Contact each company and learn their procedure.

Read the producer's guide for the various companies to see which conditions are always a "no" and then do prescreens for each case you are unsure about.

Eventually you will do fewer prescreens per 100 prospects. Since underwriting is both state-specific and carrier-specific, I wouldn't want to give you advice on any particular case unless it involved Connecticut.

 

[Crabcake Johnny]

At 5.10 288 I currently do not know of a carrier that would take him. He's a 41 BMI and decline for Aenta just based on weight - also a decline for Assurant, GR, World, Humana, etc...

By the way, according to my old Mega guidelines he's also a decline for weight. I'd be interested in knowing how long he's had the Mega plan and whether or not he's gained a lot of weight since applying or if the agent "tweaked" his weight.

 

[moonlightandmargaritas]

I'd be interested in knowing how long he's had the Mega plan and whether or not he's gained a lot of weight since applying or if the agent "tweaked" his weight.

Hmm...I think I would give odds...and hefty ones at that! (no pun intended)

 

[michellea]

At 5.10 288 I currently do not know of a carrier that would take him. He's a 41 BMI and decline for Aenta just based on weight - also a decline for Assurant, GR, World, Humana, etc...

By the way, according to my old Mega guidelines he's also a decline for weight. I'd be interested in knowing how long he's had the Mega plan and whether or not he's gained a lot of weight since applying or if the agent "tweaked" his weight.

BMI 37-42; no smoking/tobacco use for 12 months;
no other health conditions = C in the UW guide for Alabama with Aetna. BUT is the "cyst" considered another health condition?

I am not sure if he has gained a lot of weight or if it was tweaked, but I will surely find out! Thanks for your responses, this will help me figure out the process!!​

 

[OHInsAGNT]

BMI 37-42; no smoking/tobacco use for 12 months;​

no other health conditions = C in the UW guide for Alabama with Aetna. BUT is the "cyst" considered another health condition? ​

I am not sure if he has gained a lot of weight or if it was tweaked, but I will surely find out! Thanks for your responses, this will help me figure out the process!!​

You're going to keep winding up in a grey corner on this one if you try to consult the field manual.. I would take the details you have and contact your carriers for a pre-lim yes or no.

If you get a pre-lim yes, take the full app and send it in to them for underwriting. As a rule of them, it's always a good idea to set client expectations (especially with friends). Let him know it's a difficult case and that it may not get approved. In the end, if it's no he'll understand. If it's yes, you'll be the hero (assuming it's a better deal).

 

[Crabcake Johnny]

Email Aetna's prescreen - weight with this guys health conditions will be a decline - if he's 1 BMI point away from a decline then you add the lymphoma he's out - however, still email prescreen. I've seen Aetna be more desperate than this for business before.

 

[michellea]

Yes I am going to send in info to Aetna for prescreen. Thanks guys.

 

[somarco]

he said lymphoma tumor.

Lymphoma or limpoma?

Major difference.

 

[michellea]

Thank you somarco, I am still very new to all of this and these are the types of things that I do not even know to ask and that I was hoping to get from my post. Heck I guess you have to be half a doctor also to be a wonderful perfect agent! I will find this out before I do a prescreen with Aetna!