Underwriting Question ?

Deepsea

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I have a 70 year old client.
He had a heart attack 14 years ago.

In good health now. Looking to 1035 a small whole life policy to buy a bigger death benefit with a new policy, a UL--new policy.

He got the paramed exam, and the company requested a APS. Not sure if the APS was already presented or has yet to be presented.

Anyway he texted me that 2 days ago he had a heart attack, and the doctor said their was no damage, confirmed by tests, but he is going in for a stent on Monday.

No premium was collected while the policy is being underwritten.

Is it possible that the policy would be approved concurrently with the sent procedure ?

Is this a guaranteed decline ?
The illustration was for one better than standard, but now it would surely be table rates.

Any chance this policy gets approved ?
Death Benefit less than 250k.

35k is initial 1035 dump in, and yearly premium was $ 6500.

Thanks
 
I have a 70 year old client.
He had a heart attack 14 years ago.

In good health now. Looking to 1035 a small whole life policy to buy a bigger death benefit with a new policy, a UL--new policy.

He got the paramed exam, and the company requested a APS. Not sure if the APS was already presented or has yet to be presented.

Anyway he texted me that 2 days ago he had a heart attack, and the doctor said their was no damage, confirmed by tests, but he is going in for a stent on Monday.

No premium was collected while the policy is being underwritten.

Is it possible that the policy would be approved concurrently with the sent procedure ?

Is this a guaranteed decline ?
The illustration was for one better than standard, but now it would surely be table rates.

Any chance this policy gets approved ?
Death Benefit less than 250k.

35k is initial 1035 dump in, and yearly premium was $ 6500.

Thanks

Yes, you will need to contact the insurance company and inform them. They will want you to withdraw the the app or it will be declined.
 
Typically after a MI (heart attack) there's a 3 month postpone even for a small one with minimal damage. Since there will be a statement to be signed upon delivery that his health hasn't changed since the initial application, he cannot sign that without lying.

Subject to the cardiac testing, in a best case scenerio for a fully underwritten product, you may want to look at what a T-2 rate looks at now whe he can apply again a few months down the road.
 
Typically after a MI (heart attack) there's a 3 month postpone even for a small one with minimal damage. Since there will be a statement to be signed upon delivery that his health hasn't changed since the initial application, he cannot sign that without lying.

Subject to the cardiac testing, in a best case scenerio for a fully underwritten product, you may want to look at what a T-2 rate looks at now whe he can apply again a few months down the road.

Just an FYI, many clean policies come back with no more than a delivery receipt. There are a couple that do not even have a receipt.

At first blush I was thinking yes you need to say something. However, he answered the questions on the application and exam truthfully on the dates signed (assuming) so I am not so sure if the proposed insured had an obligation to disclose the MI .
 
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Gotcha. I only mentioned it because just this morning I had 2 delivery reciepts with "amendment to application with health statement" that were altered due to a change in health. I accepted one, I pulled the other for continued underwriting.
 
Gotcha. I only mentioned it because just this morning I had 2 delivery reciepts with "amendment to application with health statement" that were altered due to a change in health. I accepted one, I pulled the other for continued underwriting.

Yeah, I have seen many health statements especially if the policy was amended.

I am glad I do not have to be the one making the decision to disclose something after the app and exam. Since there was TIA if he had died there would have been no coverage.
 
Yeah, I have seen many health statements especially if the policy was amended.

I am glad I do not have to be the one making the decision to disclose something after the app and exam. Since there was TIA if he had died there would have been no coverage.

I can't recall ever seeing a policy that was COD without a statement of health as part of the delivery requirements. This is why it is so important to get premium with app if at all possible.

Of course, this guy might not have been eligible due to age.
 
Yes, everything was truthful.
I guess if when he recovers, he would be insurable hopefully.
Death benefit wasn't that great , but if the company will insure him anyone know how long some companies would make him wait ?

And if I could help the client in the future, it would be a win---win. Even if the commission would be greater as I am sure that premium will be greater.

I should have got in touch with him sooner.
 
What insurance company did he apply to?

When did the company request the aps? Have your client call doctor to see if the records were sent yet.

From underwriting standpoint....he's probably going to be low table rating after postpone period of aprox. 3-6 months.
 
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Just an FYI, many clean policies come back with no more than a delivery receipt. There are a couple that do not even have a receipt.

At first blush I was thinking yes you need to say something. However, he answered the questions on the application and exam truthfully on the dates signed (assuming) so I am not so sure if the proposed insured had an obligation to disclose the MI .

We as appointed agents to our carriers have a fiduciary responsibility to the Carrier and not the client. As this is a disclosure to you by the client, it is in essence a disclosure to the insurance company.

If not disclosed, the 2 year incontestable clause may not apply as it would be a willful act of fraud by the agent to the company and would be subject to the Fraud Statutes in the State of the insured (if a claim is presented) and it could be 5-7 years for the Statute of limitations to expire if such an act is done.

Since the policy should never have been issued, the insurance company is in its rights to rescind the policy and the insured's estate would have an E&O claim against the Agent. Unfortunately for the agent E&O insurance usually won't cover a felonious act perpetrated by the Agent.

The Big Lesson is....ALWAYS get a binder Check on Application. If the APS is in and all Medicals were completed before the heart attack and the insured dies, The company could be on the hook if they would have issued the policy prior to the heart attack, and issued it on the date of the application.

Wow....Did I pass the BAR EXAM YET.......
.
:GEEK::GEEK::GEEK:
 
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