The Producer’s Participation in Medical Underwriting

Posted by Jack Cotlar on Tue, Jan 17, 2012 @ 04:57 AM

istockphoto 6131779 the main part of mechanismSuccessful entrepreneurs know that what separates them from the competition is doing a few things of value really well. Often, one of these is a task that others ignore. In the life insurance industry, some producers either ignore the field underwriting piece of the case development, i.e. they simply don’t do it, or they delegate this task to staff that are not trained in this area. Life insurance company carriers have well trained professionals, underwriters, who make a risk assessment based upon the financial and medical data they see and this determines how much your client will be asked to pay for the product you sell. This simple concept should provide incentive to apply some of the sales energy into case management. What do I mean “case management”? This in part means to gather the necessary financial and medical data, ask the questions and record the answers on the insurance application (to gain first-hand knowledge and to cement the producer-client relationship), anticipate what the underwriting issues are or might be and take necessary steps to preempt underwriting problems. Any underwriter would say, “the devil is in the details”. This characteristic as it relates to medical underwriting is often outside the producer’s comfort zone. Because it is, any producer has an opportunity do standout from the others and to provide the kind of expertise your clients expect.

Jack Cotlar, M.D.
Strategic Medical Consulting, Inc.
Phone: 317-536-2603

Topics: Dr. Cotlar, Life insurance medical underwriting, medical underwriting, Straegic Medical Consulting, case management

How to manage an error in the medical records

Posted by Jack Cotlar, M.D. on Wed, Jan 04, 2012 @ 06:50 AM

dreamstimefree 164477 resized 600Problem: You or your underwriting adviser discovers an error in the medical records that will probably adversely impact the carrier’s underwriting assessment (rating). What might you do, prior to case submission or after the carrier informs you there is a problem? Example: The records state that your client has a permanent pacemaker and you do not think he or she does.

Example solution:

1. Verify with your client whether or not he or she currently has a pacemaker. If not, then ...

2. Find the page in the medical records that makes the statement that there is a permanent pacemaker in place.

3. Circle the statement that you believe is in error or ambiguous.

4. Have your client provide his physician a copy of this page (#3 above) along with a cover letter that addresses this issue.

5. If there is an error or a significant ambiguous statement in the medical record then your client can discuss with his or her physician the appropriate way to correct it or to clarify it.

6. Obtain a copy of the “corrected” statement and provide it to your carrier when the case is submitted.

In my opinion, explaining a potential underwriting issue and working with the client in order to solve the problem pays dividends, especially if problems are solved before the case is initially submitted. Addressing medical underwriting problems in this fashion may not only resolve the underwriting problem, but the client will appreciate your expertise that separates you from others. To see similar case examples, GO?HERE.

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

Effective communication between underwriter and applicant

Posted by Jack Cotlar, M.D. on Tue, Sep 20, 2011 @ 11:18 AM

describe the imageEffective client communication is one of the most overlooked ways to compete in today’s life insurance marketplace. Producers are not only interested in compensation and product, but they are also looking for a “home” where they can comfortably function. The differentiating factor among life insurance underwriting shops is communication. A carrier underwriter’s traditional approach to communication is vastly different compared to a more direct and informative method to which a carrier’s concierge team’s “hands-on” approach. A carrier who is looking for an underused solution to an old problem (case wastage) or a high-end producer who wants to know the questions to ask when he or she is being courted by insurance carriers, then take a look at the complete article: “Bridging the Underwriter and the Applicant

Topics: life insurance marketplace

A Proactive Way to Avoid a Possible Medical Underwriting Glitch

Posted by Jack Cotlar, M.D. on Mon, Sep 05, 2011 @ 10:19 AM

dreamstimefree 168394 resized 600Question: You have a client who is applying for a large amount of life insurance coverage and he sees a therapist for anxiety. The “APS” or attending physician’s statement you receive from the therapist is a one-page document that cites a diagnostic code for “anxiety” or only a diagnosis and no other useful descriptive information. You are concerned that the carrier’s underwriter will want more information given the size of the case, and you cannot afford a time delay. How would you manage this situation?

The most simple and direct way is to go to the client explaining the underwriting dilemma and to do so before the case is submitted. Providing the carrier up front what he or she will need to do their work properly is likely to greatly expedite the case being issued. There will be occasions when providing answers to key questions in a cover letter will allow the underwriter to make a decision about this issue without needing another APS. To see a brief case example, go HERE.

Topics: Dr. Cotlar, Strategic Medical Consulting, Life insurance medical underwriting, medical underwriting, medical records, attending physician statement, underwriting glitch, underwriting dilemma