Transcript 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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Agent Statement
• Make sure they understand the difference between
the Applicant and Proposed Insured
• Did you see the Proposed Insured?
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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
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Underwriting Requirements Continued
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APS Thru AI Records
Paramed
Blood Profile
Urine Specimen
Electrocardiogram
Treadmill EKG
Fingerstick Test
HO Handling
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SAM E-mails
Daily
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OI125001 (OI125002)
New Business Status Report
Weekly
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LNL New Business Status Report
• APS – Attending Physician Statement
• MVR – Motor Vehicle Report
• PARAMED – Medical tests required
• ADDIT EXAM
• ORAL SWAB
• COD REMITTANCE
• INFO AGENT
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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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Underwriting Requirements
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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 has two options:
1.Will cancel if the face amount is less than $100,000.
2.Will order an exam with blood profile and urine specimen
if the face amount is $100,000+. 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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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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Agents Instruction Guide
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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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Additional Field Underwriting
Do not submit an application for standard issue if the
medical condition is disabling:
Example: Disabled due to …
•High Blood Pressure
•Diabetes
•Cancer History
•Stroke
Exception:
Not all disability due to back disorder requires an ALX
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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 – Proposed Insured 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
• Policy Delivery Acknowledgement - Agent has 30
days to place policy and return a copy of the
signed Policy Delivery Acknowledgement and
original signed COD Letter of Transmittal to Home
Office.
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Issued COD – Insured is Rated
• COD Letter of Transmittal – amount of premium to be
collected $0.
• 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.
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Issued COD – Insured is Rated
• Policy Delivery Acknowledgement - Agent has 30 days
to place policy and return the signed COD Letter of
Transmittal to Home Office. The original signed Policy
Delivery Acknowledgement should be filed in the Branch
office.
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Issued COD – Applicant Qualifies for
ALX Only
• COD Letter of Transmittal – amount of premium to be
collected $0.
• Policy Amendment – plan amended to ALX due to
medical history and/or Underwriting rules. ALX policy
issued at reduced face amount to match submitted
premium up to a maximum of $15,000.
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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, an ALX policy to match the
submitted premium will be produced 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 Delivery Acknowledgement – Agent has 30 days
to place policy and return signed COD Letter of
Transmittal to Home Office. The original signed Policy
Delivery Acknowledgement should be filed in the
Branch Office.
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OI525002 (OI525003)
Pending COD Policies by Days Pending
Weekly
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What questions can you ask an
applicant to determine if you
should present ALX?
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•How’s your driving record?
•Are you receiving disability income?
•What medications are you taking?
•Do you have: cancer, diabetes, heart
problems, high blood pressure?
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When should you submit a
trial application?
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Let’s look at some
common scenarios.
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What should you tell an applicant
for $50,000 whole life who has
diabetes and high blood pressure?
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On payroll deduction, if an
applicant is declined for Group
Term and ALX, are there any other
options to get a policy issued?
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What happens if an applicant
answers ‘Yes’ to any Question 2-8
on the Group Term application?
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What have you put on your
To Do List?
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