When there's no options

[Crabcake Johnny]

But Paul, is the "X factor" that she's held her plan much longer than 2 years and not subject to review?

 

[moonlightandmargaritas]

But Paul, is the "X factor" that she's held her plan much longer than 2 years and not subject to review?

If she had it 50 years she'd be subject to review.

When there's a BIG claim involved, they check it out. Only prudent...

A material misrepresentation or fraud...doesn't matter how long they've had it!

I don't know if you could call it fraud, but representing that you're a PA resident when you live in MD and therefore NOT eligible...I'm no attorney (I don't even play one on TV) but whether that's material or not looks like an easy one to me...

 

[Crabcake Johnny]

That's true - but can a claims review even be triggered absent of evidence of funny business after 2 years?

I would hate to think that every one of my clients who has been on the books for longer than 2 years, upon having a major event, will go into review.

 

[NewHealthStrategies]

That's true - but can a claims review even be triggered absent of evidence of funny business after 2 years?

I would hate to think that every one of my clients who has been on the books for longer than 2 years, upon having a major event, will go into review.

I'm curious on this question as well... but was told by an attorney that this was a common myth that carried over from the suicide provision of life insurance carriers.

Anyone actually have some legal standing on this? It certainly mades sense that fraud/misrepresentation would not be subject to some time limit... so I get that part.

 

[Crabcake Johnny]

Interesting question. Claims review is indeed 2 years with the exception of fraud.

I would think the carrier would need some type of probable cause that fraud occurred before launching a claims review after the 2 year period.

If not, then all claims are open to review basically forever. And if that's the case the 2 year clause is meaningless.