A competent paramedical examiner is a key component for good underwriting

Posted by Jack Cotlar on Thu, Feb 09, 2012 @ 04:45 AM

Amie Hobbs, a paramedical examiner posted an interesting question in the Linkedin group, “Life Insurance Underwriters”.

“Hello all:) I am a Paramedical Examiner for over 9 years now and have been following this conversation. …. More often then not there is little or no feedback from Paramedical Companies … I would have to say it's definitely not adequate, especially missing information, what information? I need details so it does not happen again. What I would like to see is some sort of yearly evaluation, a made up scenario from a underwriter that a examiner must answer and then underwriter could critique examiners work.

EXAMPLE of scenario examiner would be given:
Applicant had Urgent care visit dx with blood clot.”

Amie’s answer:
“Applicant dx rt lower leg blood clot aprox 6/2011 admitted to hospital for 1day and given meds to thin blood. Tests done, MRI of rt leg, blood work showed non genetic per applicant. Tx now coumadin 4mg x 1 a day-ongoing, last INR 2/2012 2.5. Per applicant goes for routine checkups every 6 months last visit 1/2012, doctors orders continue coumadin and recheck in 6 months, dr's info to follow.

Dr. Cotlar’s response?to Amie:

Amie, I applaud your interest in becoming more proficient in your work and in the manner in which you seek to do so, by trying to determine what type of information is best for the end user(s), the underwriter, agent and client. By way of example look at my posted article, “Making the life insurance application work for your client”.

The short answer to your question is that the information the examiner records on to the exam should provide the underwriter with as much information about the “impairment” (medical condition or event) that he or she needs to determine the next action he or she needs to take.

Some of these actions might include: 1. Getting an APS (medical records), or not. 2. Declining the case based on these facts. 3. Rating this impairment, or not and if so, how much of a rating. 4. Asking the agent/producer to get more details about the impairment. 5. Noting the entry about this condition and not taking an adverse underwriting decision. These proposed insured could really help himself or herself by providing as much relevant detail as possible. This is because the underwriter looking an incomplete answer may assume that the condition is worse than it really is. The example you gave and the “answer” you outlined would have done a great service. It was complete in that it adequately described the condition, date of occurrence, tests done (and results), and the absence of an underlying genetic cause of the blood clot. It also mentioned the treatment and plans for follow-up. The details in your example may have allowed the underwriter to justify not needing to secure medical records from this facility, the applicant may have gotten a more favorable underwriting decision and a the agent may have gotten the underwriting response much quicker all because of a thorough and thoughtful description on the exam. You might consider becoming part of groups for agents as they, too, are end users of your service and they have their own set of expectations and needs. In addition, I suggest your talking to underwriters one-on-one and attend some of their educational conferences. You live in a city where there is a large re-insurer carrier. If cleared by management, you would be well served by asking to spend time in its underwriting department looking over someone’s shoulder and asking questions. Alternately, you could use as an information source, Risk Tutor (I have no vested interest in this and its views are not necessarily my own). In summary, if the paramedical examiner knew what the details are about any given medical condition from which an underwriting decision is determined, then the examiner would know what to ask the proposed insured. In other words, working backwards is the key.

Jack Cotlar, M.D.

Strategic Medical Consulting, Inc.?

Linkedin: http://www.linkedin.com/in/jcotlar

Phone: 317-536-2603

Topics: Dr. Cotlar, Strategic Medical Consulting, Life insurance medical underwriting, medical undewriting