Waivers from GR, what to do?

[Crabcake Johnny]

I at least would like to present the client with the rider as soon as it comes out. That's not the way GR chooses to do business. The client must wait for the policy to come in the mail. Not the way I like to conduct business.

We also now have a situation where the client has paid money down and has to wait to recieve a refund. That can hold up going to "company B." I really don't see where GR fits in unless you have spotlessly healthy clients. They are not set up for pre-ex conditions - hence the low-ball rates.

 

[somarco]

At the least you will get to see the rider wording when the policy is sent to you for delivery. You should have that in a few days. Make a copy of it for current & future reference.

 

[Crabcake Johnny]

Would their be any logical reason behind GR not making the rider available for clients before they receive their policy? I can't think of one.

There are also states where riders don't have to be signed. This is a very dangerous situation. Assurant won't mark any policy as "active" until the rider or CSD is signed. GR will mark it as active before it's signed.

Makes it easy for an unethical agent to not explain that they even received a rider and just mail out the policy. Hope the client doesn't read it and once they find out they don't have coverage everyone says "gee....you really should have read your policy."

 

[jacodaro]

In AZ BCBS considers HPB and HC together a co-morbid situation and it is a decline.

 

[trvlnut]

Jacodaro:
I know, but she doesn't have a cholesterol problem which is why I don't understand why there's a rider. I'm waiting to speak to the u/w at gr to find out why they put that rider on the policy.

 

[bluemarlin08]

If she is on Cholesterol meds she has a Cholesterol problem. When I get a rider on a GR policy , my underwriter explains and sends me a copy. With this case, it appears that the rider is just for outpatient expenses, such as visits to the cardiologist to monitor the meds. I personally think this might be ok compared to what I have seen other carriers do. The office visits aren't more than twice a year at probably 200 a pop. The increase in PDC deductible is directly related to the cost of her meds, probably on a non generic med.
The 14 day waiver is a positive, not a negative. I would put the policy in force and then shop. This client should pay very close attention to what they do because it is a good chance that she will have a hard time getting anything if she has any other events. If the patient has a weight problem and if their blood sugars are borderline normal, they are on the path to Metabolic Syndrome then to Diabetes. Get her covered immediately.

 

[trvlnut]

Thanks Blue Marlin. She isn't on Cholesterol meds, she's on high blood pressure meds. This is the reason why I'm so confused. I am very anxious to speak with the u/w. BTW, she's not even close to obese. Well within weight limits. In fact, small. I doubt Diabetes would pop up on her.

She doesn't see a cardiologist, just her GP.

 

[bluemarlin08]

I go through this almost daily, unexpected medical information. Guess what, in every case this came up the docs had submitted records that support their UW, right or wrong.

 

[newmindfashion]

Trvlnut,
Golden Rule will not rider cholesterol and other minor conditions if the customer selects a deductible of at least $2500 for an individual or $5000 for a family with no upfront Rx feature. If you're trying to use GR as a carrier for people that want immediate coverage for their existing conditions, that won't work with them. They're underwriting is set up to be more liberal on those that accept higher risk (deductible) before the coverage begins. Blue Cross/Blue Shield plans in most states will pay you less commission but will tend to accept people who want immediate coverage on things they already use.

However, according to jacodaro, the AZ Blue Cross may not be as liberal as the Blues I work with.

 

[somarco]

Golden Rule will not rider cholesterol and other minor conditions if the customer selects a deductible of at least $2500 for an individual or $5000 for a family with no upfront Rx feature

Except in Georgia . . .