No. Think about it, if a carrier is using a drop box the checks arrive automatically and are cashed. If need be, the carrier refunds the money.
Your Opinion
- Thread starter SamIam
- Start date
No. Think about it, if a carrier is using a drop box the checks arrive automatically and are cashed. If need be, the carrier refunds the money.
- 728
Agreed but payment was later accepted. Not arguing just trying to get a tighter grip.
Sent from my Samsung Galaxy
I'm going to disagree here. I think the carrier must reinstate, because there was an offer, an acceptance, a binder, and an acceptance of that binder. The carrier might SAY they would not reinstate, but in court I feel that they would lose (note, I'm NOT an attorney, this is just my viewpoint).
HOWEVER... that is winning the battle and losing the war. Reinstatement isn't the only issue. Once reinstated, I think the client would not get a dime on a claim. I agree that hernias are usually pre-existing. It's kind of hard to prove that you applied for insurance, then suddenly had a hernia. Often policies like these even list things like hernias, tonsillitis, adenoiditis, etc., because of the common occurrence of these types of conditions being pre-existing. Usually the pre-ex clause even says pre-existing conditions include conditions for which you had symptoms prior to the effective date, even if you did not get a diagnosis or treatment. Sometimes it even says the condition is pre-ex if it EXISTED prior to the effective date, even if you were not aware of its existence.
HOWEVER... that is winning the battle and losing the war. Reinstatement isn't the only issue. Once reinstated, I think the client would not get a dime on a claim. I agree that hernias are usually pre-existing. It's kind of hard to prove that you applied for insurance, then suddenly had a hernia. Often policies like these even list things like hernias, tonsillitis, adenoiditis, etc., because of the common occurrence of these types of conditions being pre-existing. Usually the pre-ex clause even says pre-existing conditions include conditions for which you had symptoms prior to the effective date, even if you did not get a diagnosis or treatment. Sometimes it even says the condition is pre-ex if it EXISTED prior to the effective date, even if you were not aware of its existence.
Last edited:
- 728
Ann that was my thinking. They offered to reinstate and then accepted payment. The hernia is a completely different story. I see that denied as preexisting.
Sent from my Samsung Galaxy
Sent from my Samsung Galaxy
- Thread starter
- #16
I agree not only did they say they would re-instate the policy and cashed 6 months. They also sent a claim form to the client for the claim. They had an obligation IMO to tell the client it's not guaranteed to be reinstated instead they told her it was reinstated. We could of reapplied if we new it wasn't guaranteed.
- Thread starter
- #17
Similar threads
- Locked
- Sticky
