Health Net Redux

[Crabcake Johnny]

True - just an example.

How about a separate form all clients have to sign if they used an agent. The form would need to be signed stating that all health information that was relayed to the agent is on the application.

It would have a warning in bold that if any health history information is omitted from the app the policy could be rescinded and give a toll free hotline number to report any agent who is advising that any information be left off the app.

 

[TXINSURANCE]

Remember $#! flows down hill.

H N is going to attack the low man in the food chain, which is the agent. This agent from what I read did nothing wrong or out of the ordinary - he simply was at the wrong place at the wrong time, with the wrong client. Don't think for a second this couldn't have been ANYONE of us , because it could.

H N is the one that rescinded and did not underwrite properly from the beginning. The fact that H N dropped this agent and mentioned "possible criminal acts..." shows how bad corporate america will chew you up and spit you out.

I believe this whole case as BS, I hope H N appeals and wins - not only is this decision wrong, the award is completely excessive and should be illegal.

How much is cut to the Attorneys in this matter?

Sorry but our legal system is completely out of control.

 

[Crabcake Johnny]

"Forget" to tell your auto insurance company that you got a DUI last week and see if you get a claim paid if they catch it later.

 

[moonlightandmargaritas]

Here's what I don't understand. Both parties have to sign the application and date it + the client has a 10 free look period.
So how the hell should the agent be held responsible?

A lawyer friend of mine explained to me one time that because it's what's called a "unilateral" contract, which means it is prepared by one party who does not change it (the insurance company) , it is "more strictly construed" against them.

Also, as has been mentioned, ANY of these insurance companies will "throw the agent under the bus" in a hot minute!

 

[JMO Fan]

As a reward for lying on the app, the lady is a millionaire (as well as the attorneys), courtesy of the other policyholders, whose rates will probably rise to cover the cost.

 

[somarco]

This agent from what I read did nothing wrong or out of the ordinary -

The agent altered the app without getting the clients initials on the change.

The agent is unsure if he asked all the questions or not.

The agent is a dufus.

The agent no longer represents Health Nut.

H N is the one that rescinded and did not underwrite properly

No doubt, Health Nut dropped the ball.

The time frame on this was clearly within the contestable period. They had every right to challenge the application as fraudulent.

(Coverage was approved with an August 2003 effective date. Breast cancer diagnosed September 2003. Policy rescinded January 2004).

Maybe "have you ever used (or been to, or gone to) the the ER?"

Wait. Is this this the "fight" thread?

Have you ever used falls under the marijuana section.

Been to, or gone to would apply to rock concerts . . . such as Woodstock.

Oh wait. This is CA. I suppose they can't ask those questions, huh?

 

[Dave020]

Interesting, the agent has not been licensed in CA since 2005.

 

[djs]

"Forget" to tell your auto insurance company that you got a DUI last week and see if you get a claim paid if they catch it later.

From experience, I can assure you they will pay your claim.

For HealthNet, the problem they have is they rescinded the policy based on information that wasn't the cause of the claim, unless I misunderstand something. They recinded based on weight and heart condition, because she filed for cancer. Yes, weight can be an issue with cancer, but it's not direct.

If they recinded because she filed for a heart attack, and she had left off her weight or heart condition, it would make more sense to the average person. Using something somewhat unrelated makes it sound like they just didn't want to pay the claim.

Dan

 

[somarco]

the agent has not been licensed in CA since 2005

Probably in the agent protection program . . .

 

[arnguy]

A few years ago, I wrote American Republic health policies. They required the applicant to personally fill out the app and to initial each entry. At the end of the app the agent had to attest that it was completed by the applicant in his/her presence. I don't know if it is still that way.