Your feedback on how you would manage this substandard case

Posted by Jack Cotlar, M.D. on Sun, Mar 09, 2014 @ 05:32 PM

Substandard case managementCASE: 66 y/o man who had applied for life insurance; was unhappy when he got a moderate rating for life insurance, as “there is nothing significantly wrong with me. I feel fine”. After you (as a consulting underwriter) review of the medical records you find that the medial problems are increased build, coronary artery disease (s/p mi and stent placement in 2008), hypertension, LVH, diabetes mellitus – type 2 (+ neuropathy) and sleep apnea / cpap and that the medical records often cite compliance issues. Assuming you had reviewed the records and felt that the underwriting decision was appropriate and even generous, what are some things you might do to get the case issued and why this path? As a producer whose underwriting staff reviewed the records and arrived at the same conclusion, what path might you take? Feedback please on how you would manage this case …..

 
Dr. M. Jack Cotlar, President
Strategic Medical Consulting, Inc.®
Voice: 317.536.2603 (ET)
Email: jcotlar@strategicmedconsulting.com

Important Notice:

The opinions and examples contained in this article are those of Strategic Medical Consulting, Inc. (SMC). As each case is fact sensitive, it would be ill-advised to take action on any given case based on the conclusions from examples that are included in this communication. Whether or not they are appropriate for a specific medical underwriting situation must be determined by the producer who will assume all responsibility should the outcome not be favorable. The examples illustrated herein are what SMC provides on a case-by-case basis for and to its clients. In addition, the opinions are not medical advice and they do not establish any physician-patient relationship.


Topics: Life insurance medical underwriting, Dr. Jack Cotlar, case management, rating, communicate, Underwriting, substandard case, diabetes, underwriting assessment

The upside and downside of our digital society

Posted by Jack Cotlar, M.D. on Mon, Jul 09, 2012 @ 09:27 AM

With so much emphases given to social media and the like, sometimes it is helpful to step back and reassess. We may find that some of the “old fashion” methods allow us to live and work in a more healthy and successful fashion. 

Our new digitalized society enables individuals to communicate with others around the world from the comfort of his or her home. This is good. Using these same tools we may find ourselves communicating “remotely” even to our own family members who are in the same home! This is not so good. In this brief musical YouTube clip, I am reminded of the joy and benefits of real interpersonal interaction; how much each individual can add to the effort of others and how many people can benefit from what they accomplished. Enjoy this uplifting clip.


Topics: social media, communicate, music