Transcript 11 Underwriting - United American Insurance Company

Underwriting
Suzy Saxon
Second Vice-President
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Agents are Field Underwriters
• Agent's responsibility to collect accurate and
complete information from the applicant
• This helps the Agent:
 Get policies issued quicker
 Get paid quicker
 Reduce follow-up work
 Reduce declines, cancels, and not-takens
 Increase bonus and renewals
 Make more money!
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Product Suitability
• You should determine in each case that any
policy sold is suitable to the needs of the applicant
• You should consider such issues as:
 Proposed insured's financial condition
 Need for insurance
 Values, benefits, and surrender charges in
relation to any existing coverage
 Whether in the totality of each applicant's
circumstances, the sale is suitable
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Instructions to Agents for all Applications
• Read health questions as they appear
• Ask applicant for explanations to 'Yes' answers
• Complete 'Explanations' section for every 'Yes'
answer
• If additional explanation required, attach Cover
Letter to the application
• The more information you can provide regarding
'Yes' answers to health questions, the more
successful you will be in effectively submitting the
application
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Instructions to Agents (Continued)
• Life Insurance policies go through an underwriting
process
• Underwriters may request additional information, so
let applicant know they may receive call
• Underwriters ultimately determine insurability
• Process determines amount of rated premium
• Agents should not make promises to applicants
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Underwriting Requirements
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Info Agent
Oral Specimen
HIV Consent Form
MVR
Rip Call (QAC)
IBU
Inspection-SBSI
Criminal Records Check
APS Thru AI Records
Paramed
Blood Profile
Urine Specimen
Electrocardiogram
Treadmill EKG
Fingerstick Test
HO Handling
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Agents Instruction Guide
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Agents Instruction Guide
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Underwriting Requirements
Underwriting requirements may be requested on any
proposed insured on the app. If the app contains a
spouse rider, the requirement will indicate whether the
requirement is on the insured or the spouse.
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Info Agent
Can be any message from Underwriting, such as a
request for the proposed insured’s doctor’s name,
address, and telephone number or a message
indicating that the case requirements are under
another file number when more than one case is
submitted on the same proposed insured at the same
time.
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Oral Specimen
Indicates that Underwriting is pending for the oral
specimen lab results that the Agent took at app time,
provided the barcode number on the app, and mailed
immediately to the lab
Note: if the app does not provide the barcode number,
the following message will be sent to the Branch with
the oral specimen requirement:
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Oral Specimen
Please advise barcode number of oral and date it was
completed. We will pend 7 days.
If the barcode number or the oral specimen results are
not received within 7 days, Underwriting will order an
exam with blood profile and urine specimen.
Underwriting will still accept the oral instead of the
exam if the oral specimen is obtained and the barcode
number provided to Underwriting before the exam is
completed.
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Underwriting Requirements
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HIV Consent Form
The form that must be completed and signed in states
that require this form.
If this requirement is received along with the oral
specimen requirement, it is for the Agent to obtain.
If this requirement is received along with exam
requirements, it is for the examiner to obtain.
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HIV Consent Form
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MVR
Motor vehicle report
Underwriting requests this from an outside vendor.
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Rip Call (QAC)
Indicates that Underwriting has requested a telephone
interview to be completed through our QAC
department.
If the interview has not been completed within 7 days,
the following message will be sent out to the Branch:
Attempts to contact applicant at given number have
been unsuccessful. Please have applicant call 1-800288-4265 to complete the phone inspection.
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IBU (Interview by Underwriter)
Indicates that Underwriting has requested a telephone
interview to be completed through an outside vendor.
Not all cases are sent to the same IBU Underwriter for
handling, so initially the requirement will only indicate
“IBU.”
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IBU (Interview by Underwriter)
If the interview has not been completed within 7 days,
the following message will be sent out to the Branch:
Please have the PI call 1-XXX-XXX-XXXX to complete
the IBU. We will pend 7 days.
The toll-free number will be specific to each case
according to which IBU underwriter is to be contacted.
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Inspection – SBSI
Indicates that Underwriting has requested a telephone
inspection interview through an outside vendor.
If the interview has not been completed within 7 days,
the following message will be sent to the Branch:
Attempts to contact applicant at given number have
been unsuccessful. Please have applicant call 1-800444-7274 ext. 1 to complete the phone inspection with
SBSI.
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Criminal Records Check
Indicates that Underwriting has ordered a criminal
records check through an outside vendor.
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APS Through AI Records
Indicates that Underwriting has requested an attending
physician’s statement on the proposed insured through
AI Records. It will also indicate the name of the doctor
or facility from which the records were requested.
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APS Through AI Records
AI Records contact information:
Website:
https://prodwebapps.ailife.com/apsweb/login.aspx
Username: liberty
Password: national1
Phone #: 866-922-6453
Email address: [email protected]
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Underwriting
Paramed
Blood Profile
Urine Specimen
Electrocardiogram
Treadmill EKG
Fingerstick Test
HIV Consent Form
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Paramed
Indicates that Underwriting has requested an exam in
combination with the other requirements such as blood
profile, urine specimen, electrocardiogram, etc.
through one of three outside exam companies
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Paramed
Portamedic’s contact information:
Phone #: 866-335-5575
Website: www.portamedic.com
EMSI’s contact information:
Phone #: 800-872-3674
Website: www.emsinet.com
ExamOne’s contact information:
Phone #: 877-93-exam1 or 877-933-9261
Website: www.myexamone.com
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Paramed
Note: If the exam company has been unsuccessful in
scheduling the exam within 14 days, the Branch will
receive the following message:
Please assist in getting the exam scheduled and
completed. We will pend 7 days.
(We will pend longer only if the exam has been
completed or at least scheduled)
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SAM E-mails
Daily
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Field Underwriting
Applicants with the following conditions will be
automatically declined.
Terminal Illness
Lou Gehrig’s Disease or Amyotrophic Lateral Sclerosis (ALS)
HIV / AIDS or Positive Test to Antibodies for AIDS virus
Alzheimer’s Disease or Senile Dementia
Confined to a hospital or nursing facility
Use of illegal drugs within a two-year period
Confined to jail
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Field Underwriting
Do not submit an application for standard issue for the
following conditions.
An ALX will be considered if the underwriters determine
the proposed insured is eligible for coverage.
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Field Underwriting
Heart / Circulatory / Blood Disorders:
Congestive Heart Failure within 1 year
Defibrillator Implant
Angioplasty, Coronary Bypass, Heart Attack or Diagnosis
of Angina within last 6 months
Coronary Artery Disease and Heart Valve Replacement
More than 2 Heart Attacks
Heart Attack, Bypass or Stroke and still smokes
More than 1 stroke
Sickle Cell Anemia
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Field Underwriting
Diabetes and Related Disorders:
Diabetes and Kidney Disease (App may be submitted
if the proposed insured has diabetes without a related
condition)
Insulin-dependent Diabetes and No Doctor consulted
within last two years
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Field Underwriting
Cancers:
Cancer, other than skin, last treatment within 12
months
Metastatic Cancer (spread to other sites) within 10
years
Hodgkin’s Disease, last treatment within 2 years
Leukemia Diagnosed prior to age 50
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Field Underwriting
Misc. Medical Disorders:
Cirrhosis
Cystic Fibrosis
Depression - hospitalized within 6 months - or unable to work
Suicide Attempt within 5 years
Emphysema or Chronic Lung Disease using Home Oxygen
Kidney Dialysis
Transplant Recipient of any major organ (except Kidney
Transplant)
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Policy Issue
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Issued as Applied For
Issued COD – Additional Signature Required
Issued – Insured is Rated
Issued COD – Applicant Qualifies for ALX Only.
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Issued COD – Additional
Signature Required
• COD Letter of Transmittal - amount of premium to be
collected $0.
• Policy Amendment - advises proper signature
required on Policy Delivery Acknowledgement.
• Policy Transmittal Letter - instructs Agent to refer to
Policy Amendment.
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Issued COD – Additional
Signature Required
• COD Letter of Transmittal - amount of premium to
be Policy Delivery Acknowledgement - Agent has
30 days to place policy and return the signed
Policy Delivery Acknowledgement and COD Letter
of Transmittal to Home Office.
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Issued COD – Insured is Rated
• Policy amendment - explains reason for rating – policy
issued at reduced face amount to match submitted
premium.
• Policy Transmittal Letter - shows original face amount
and rated premium. If customer wants original face
amount applied for rather than the reduced amount, the
Agent should collect the additional premium at delivery or
have the customer sign the COD Letter of Transmittal to
draft the additional amount of premium due. If reduced
face amount is placed, no signature is required on the
COD Letter of Transmittal.
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Issued COD – Insured is Rated
• COD Letter of Transmittal – amount of premium to be
collected $0.
• Policy Delivery Acknowledgement - Agent has 30 days
to place policy and return the signed Policy Delivery
Acknowledgement and COD Letter of Transmittal to
Home Office. If reduced face amount is placed, no
signature is required on COD Letter of Transmittal.
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Issued COD – Applicant Qualifies for
ALX Only
• Policy Transmittal Letter – if the premium submitted with
the application will purchase less than a $15,000 ALX,
we will produce an ALX policy to match the submitted
premium and include an alternate premium quote for
an ALX policy equal to the original amount applied
for up to a maximum of $15,000.
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Issued COD – Applicant Qualifies for
ALX Only
• If the customer wants the alternate amount, the Agent
should collect the additional premium at delivery, or have
the customer sign the COD Letter of Transmittal to draft
the additional amount of premium due.
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Issued COD – Applicant Qualifies for
ALX Only
• Policy amendment – plan amended to ALX due to
medical history. ALX policy issued at reduced face
amount to match submitted premium up to a maximum of
$15,000.
• COD Letter of Transmittal – amount of premium to be
collected $0.
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Issued COD – Applicant Qualifies for
ALX Only
• Policy Delivery Acknowledgement – Agent has 30 days
to place policy and return signed Policy Delivery
Acknowledgement and COD Letter of Transmittal to
Home Office.
• If reduced face amount is placed, no signature is
required on COD Letter of Transmittal.
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OI525002 (OI525003)
Pending COD Policies by Days Pending
Weekly
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FA215001 (FA215003)
Premium Notice/Combined Billing Clients
Weekly
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LNL New Business Status Report
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APS – Attending Physician Statement
MVR – Motor Vehicle Report
PARAMED – Medical tests required
ADDIT EXAM
ORAL SWAB
COD REMITTANCE
INFO AGENT
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Pending Messages
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NAR/AR – No Action Required / Action Required
RIP — recorded interview by phone
QAC — quality assurance call
SBSI — call requesting financial info for large life cases
IBU — interview by underwriter
MEDICARE LETTER
INFO AGENT
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BI925003 (BI925011)
Batch Pending Worksite Report Agents
Weekly
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BI025004 (BI925013)
Batch Pending Report Agents
Weekly
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