Assurant on CBS news tonight

the company refused to pay based on a 3-year old-reference to an "angina episode."

Note the 3 yr lookback.

My guess is this was a STM with a 5 yr lookback.

Time writes more STM than almost anyone. The liberal underwriting & 5 yr lookback make it easy for them to be a target for this kind of journalism.

I am not a fan of Time, but this looks like a setup.
 
Being new in the business, articles/news stories like this are always an interesting read. In Michigan, BCBS has to issue a policy to an individual, regardless of pre-existing conditions. Obviously, they are subject to a 6 month waiting period before they can receive treatment for any pre-existing, but still.. .they CAN get coverage. Yes, it's expensive... but available. I guess my question is... is this not the case in all states? I read some of the articles about people not being able to find any company to insure them. How do other states work? Is there not a company who has to guarantee coverage? Like I said... I'm new, and learning more and more each day. Figured this is always the best place to ask questions! :)

Definitely not here in California. All individual coverage is underwritten and applicants can be denied coverage based on health history. The only option in that case is major risk pool or group if a job comes along.
 
Note the 3 yr lookback.

My guess is this was a STM with a 5 yr lookback.

Time writes more STM than almost anyone. The liberal underwriting & 5 yr lookback make it easy for them to be a target for this kind of journalism.

I am not a fan of Time, but this looks like a setup.

I think you are right. Most individual and family I see (not STM) have a 2 year contestability period. I have not looked closely at the STM products since I really don't sell them. STM to me is an instant setup for failure. A few simple questions and you are enrolled. Post claims underwriting seems dangerous to me, and I think this story points out just how dangerous it can be to the subscriber.
 
You're thinking like an insurance agent Salpro...no offense..but it really doesn't matter how you feel about it. How will the public perceive it?

Funny thing, I thought I was an insurance agent ;)
No offense taken! Take into consideration that we are both right. It does matter how I feel about it because I am honest with my clients and they believe what I say because I convey that I am trustworthy. In fact, if we ever do get a national health system, I will gladly change roles from a commission only position to charging clients hourly fees for my time to help them navigate the "system." Consumers Reports is what I run into a lot and I have a lot of respect for that publication.

The majority of the public is liberal. The majority of my clients are not. I had a wonderful conversation with a nice lady who wanted to hear my thoughts on Hilary Care yesterday. Makes me want to move to Virginia.
 
I think you are right. Most individual and family I see (not STM) have a 2 year contestability period. I have not looked closely at the STM products since I really don't sell them. STM to me is an instant setup for failure. A few simple questions and you are enrolled. Post claims underwriting seems dangerous to me, and I think this story points out just how dangerous it can be to the subscriber.

I am under the impression that the 2 year period is standard for all life/health products. Correct me if im wrong.
 
Isn't the 2 year look back for life insurance only?? I heard somewhere that health insurance companies can look back as far as they want for a major illness. And as we see here they can!!

I just had one of my clients diagnosed with stage 4 cancer not too long ago. She's only been on the plan for 3 months before it was diagnosed. Funny thing is I took her off an Assurant plan with a 2k per year Rx drug cap. Who know what would have happened otherwise. I put her with World and after verifying she had prior credible coverage and no prior history of cancer it is being paid. I just saw the first EOB, everything is being covered 100% minus her deductible.

I guess some companies have very strict rules and guidelines when a major claim comes in, trying to find a reason to deny the claim is messed up though.
 
I'm also a big fan of the telephone interview that some companies do. If the client leaves something off the application on purpose, and also fails to disclose it on the telephone interview it's on the client, not the agent!!

Yet another reason I require the client fill out the application as opposed to me. You really can't trust some people out there in this sue happy world!
 
I'm also a big fan of the telephone interview that some companies do. If the client leaves something off the application on purpose, and also fails to disclose it on the telephone interview it's on the client, not the agent!!

Yet another reason I require the client fill out the application as opposed to me. You really can't trust some people out there in this sue happy world!

I'm starting to think that in this day in age it doesn't really matter who fills out the application because a lawyer will find a way to win. I feel comfort in keeping meticulous notes on all applicants and storing them in a safe place.

"Ok, Mr. Agent, you did not fill out the application, but she said you told her to put this down and leave this out. "Oh yeah, prove it!"

"Ok, Mr. Agent, we know you filled out the application for my client and even though she submitted a verification link (assurant), got a phone interview from the insurance company (World, Assurant, GR, etc.) and submitted the acceptance letter (Assurant), and went past the 10 day free look period (all companies)....You are at fault! "Hmmm, there once was a man from Nantucket who told a lawyer to #$#$ IT! :D
 
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