Quick Reference Guide. underwriting and. individual disability insurance. For Producer use only. Not for use with the general public.

Transcription

1 Quick Reference Guide underwriting and NEW BUSINESS services individual disability insurance For Producer use only. Not for use with the general public.

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3 Contents Introduction Accessing and Completing Applications and Forms Appointment and Licensing Requirements Approved Medical Vendors Attending Physician s Statements (APS) Orders Batch Billing Conditional Receipt and Prepayments Cover Letters Dating Rules Declined Cases Delivery Requirements Discount Programs DI to Life Insurance Certificate Program Agency Satisfaction Survey FIO Exercise Applications Follow-Up Procedures and Closing Pending Cases General DI Underwriting Questions Guidelines for Mapping of Occupation Classes Helpful Tools to Use Help with Financial Requirements Initial Premium Advances Initial Premium Payment Methods Jet Issue Team Lab Results Medical Information Bureau (MIB) Multiple Producers Competing for an Applicant Policy Issue Cycle Time Post-Sale Communication Prepayment Refunds continued next page

4 Contents (continued) Reinsurance Reissues Selecting a Contract State Service Center Submitting New Applications and Initial Requirements TeleMed Cases Underwriting and New Business Service Goals Underwriting Appeals Underwriting Inquiry Forms Wastage/Policy Placement

5 A t B e r k s h i r e, we are committed to providing exceptional service to all of our customers, in all aspects of our relationship with them. It is the goal of Underwriting and New Business Services to help you obtain the best coverage for your clients in the most effective manner possible. We know how difficult the application process can seem to proposed insureds, how many questions they may have, and how many details you have to remember when you submit your new business. This guide will provide you with an easy reference source for key information on common topics. If at any time you have any questions about Underwriting and New Business Services, feel free to contact us at one of our regional tollfree numbers: Region 1: Region 2: Region 3: Region 4: Thank you for choosing us for your clients. 1

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7 Service Center The Underwriting and New Business Service Center connects you with available administrators and underwriters the first time you call, so no more frustration with voic and phone tag. Taking advantage of our regional toll-free numbers shown below allows you to have better access to the individuals at Berkshire who can help with your cases. Region 1: Region 2: Region 3: Region 4: When you call, you are prompted to select the area you wish to connect with. Based on your choices our smart system finds the available individual from your region who is best suited to assist you with your particular question or request. We still provide you with the option to speak with a particular associate via option 4 in the main menu. If you do receive voic , just dial zero pound (0#) and you will be connected to another member of your Underwriting or New Business team. General DI Underwriting Questions A special box is available for when you have a question for Underwriting that is not specific to a case (e.g., How would you consider an applicant with this condition?) Your question will be responded to within 24-hours by a member of your regional underwriting team. Insert your region number to the following format: Region1DiGeneralUnderwritingQuestions@ BerkshireLife.com. 3

8 Accessing and Completing Applications and Forms All state-approved insurance applications and new business forms are available on BerkshireLifeTools.com. In addition to searching forms and creating application packages for printing, complete, preassembled fillable DI application packages are available for all states. Utilize this fillable electronic version for faster application completion and submission. You can also save information in the fillable forms such as the agent s name and number and save a customized package locally to save time. Submitting an application with typeset (rather than handwriting) provides improved clarity and efficiency when processing and underwriting the application in our office. For some states, fillable DI application packages are also available through the Laser Apps website, LaserApp.com. Answer all questions on the application and provide sufficient detail where instructed. Blank answers slow down the application process and result in an amendment to be signed by the insured upon delivery of an issued policy. If changes are made to any questions on the application, please have the applicant initial the changes. If the changes are not initialed an amendment will need to be signed by the insured upon delivery of an issued policy. Tip The annotated applications available in the New Business Tool Kit on BerkshireLifeTool.com provide helpful instruction for properly completing the DI application. 4

9 Selecting a Contract State The residence state of the applicant generally determines the contract state unless the applicant has a connection with another state. That connection could be a workplace or a secondary residence (generally defined as the state where the applicant resides for at least four months a year). The application and other new business forms should be the state forms as determined by the contracting state. For FIO, FPO and GDR options the same rules apply. However, if the insured has moved since the original policy was issued, the client can request that the contract state be either the original contract state or the new state where he or she is connected. Submitting New Applications and Initial Requirements A New Business Transmittal (AA1732) should accompany all applications. For TeleMed cases, submit your TeleMed request to the approved vendor of your choice. Fax new applications and requirements to our Pittsfield office at , or new applications to ApplicationRequirements@ BerkshireLife.com and requirements to DisabilityNewBusiness@BerkshireLife.com. Applications should not be signed and dated more than 90 days before submission. When an out-of-date application is received in the Home Office it will be forwarded to underwriting for review, but may generate a request to submit a new application with a current date. 5

10 Original documents are not required to be sent to the home office. They should be retained in your office. Note Income ProVider (Multi-Life) applications and requirements should be faxed to Tip Submit a signed Authorization for Disclosure of Protected Health Information (AA1542) with the application. This authorizes the underwriter to provide more information to the producer when requested. Cover Letters A cover letter is strongly recommended when submitting an application for insurance. It serves as a critical communication piece between the producer and underwriter. A well-prepared cover letter including significant detail may result in fewer underwriting requirements, speed up the underwriting process and better position the underwriter to provide the best offer initially. This often places the producer in a stronger competitive position in situations when insurance is applied for with multiple carriers. This also results in fewer surprises for the producer when the underwriting decision is made. Tip For examples of good information to include in the cover letter, refer to Why Send a Cover Letter? (AA838) located in the New Business Tool Kit on BerkshireLifeTools.com 6

11 TeleMed Cases The TeleMed program streamlines the underwriting process by taking the labor intensive tasks you once spent time on completing the medical questions on the application, ordering APSs, inspection reports, lab tests and paramedical exams and delegating those details to a unit that specializes in completing this work for you. TeleMed is recommended for all applications submitted and is required to participate in the Quick Issue Underwriting Program. For ExamOne TeleMed cases, complete the TeleMed Request Form (AA1484) and fax to Exam One at or it to TeleMedOrders@ExamOne.com along with a copy of the signed Authorization to Obtain and Release Information form (C-AUTH). For APPS TeleMed cases, submit the TeleMed order through the APPS website, Attach an electronic copy of the signed Authorization to Obtain and Release Information form (C-AUTH) to the website order or fax the form to APPS at For Portamedic TeleMed cases, submit the TeleMed order through the Portamedic website, Attach an electronic copy of the signed Authorization to Obtain and Release Information form (C-AUTH) to the website order or fax the form to Portamedic at Comprehensive information about the TeleMed program and vendors can be found in the TeleMed Tool Kit located in the New Business section of BerkshireLifeTools.com. 7

12 Note Refer to the Approved Medical Vendors section for additional information about the TeleMed program. Tip Take time to review the TeleMed Consumer Guide (Pub3783BL) with your client to set expectations for the underwriting process. Underwriting Appeals When you have a question on a case or question an underwriting decision, your first point of contact should be the assigned underwriter or Jet underwriter. The underwriter has a unique familiarity with the case, and in most cases is in the best position to discuss the specifics of the case. The underwriter can discuss the reasoning behind a particular decision or action. It is during these conversations where it is often discussed what, if any, additional information or documentation may allow for reconsideration of the decision or a more favorable outcome. When the Authorization for Disclosure of Protected Health Information form (AA1542) is completed and submitted with the case the underwriter has the ability to share a much more detailed explanation based on what might have otherwise been considered confidential information that cannot be shared. It is also beneficial to discuss with the underwriter the desired outcome. It is helpful to the underwriter to understand what the most important coverage features are to the applicant. If, for instance, the benefit period is the most important consideration for the sale, in some circumstances it may be possible to consider an 8

13 alternative offer with a rating that may allow the benefit period to be extended to meet the needs of the applicant. If, after discussion with the underwriter, you still have additional questions or are not satisfied with the resolution, your team coordinators and regional supervisor can further assist you. And if further discussion or review is required beyond that point, please feel free to contact any other member of the Underwriting Management team. Our goal through this process is to partner with you to make the best medical, financial and occupational offer to meet your client s needs and assist you in placing the case. Underwriting Inquiry Forms The inquiry form can provide a faster way of determining likely action for a specific medical impairment. Because it authorizes the company to obtain medical records, underwriters can access the medical information required to make an informed decision. The producer can then do a better job of setting expectations with his or her client. If the offer cannot be made, then all parties will have saved time and cost involved in a full work up (physical exam, blood tests, specimen, inspection, additional APSs, other medical requirements and processing, etc.). Refer to BerkshireLifeTools.com to obtain the Underwriting Inquiry Form. Note Underwriting cannot review confidential information without receiving the signed authorization that is part of the Underwriting Inquiry application. 9

14 Appointment and Licensing Requirements Approved state appointments are required prior to the solicitation of an application in the following states: Florida, Indiana, New Mexico, Pennsylvania, and Utah, This means that Berkshire will not be able to process applications solicited in these states by a producer not yet appointed. For all other states, the producer may submit the application with a copy of the producer s license and Berkshire will begin the underwriting process. Berkshire is unable to accept or process an application solicited by producers not licensed in the state the solicitation occurred. The producer must be licensed in the state in which the application was solicited and signed. Tip consult the Field Underwriting Guide (Pub4089BL) on BerkshireLifeTools.com for agent licensing requirements for applications solicited by mail. Approved Medical Vendors TeleMed All Services Program When submitting cases through the TeleMed All Services program, all medical requirements will be ordered for you. Approved Vendors When not using the TeleMed All Services Program, medical requirements must be ordered from the following approved vendors: 10

15 Service Paramedical exams, blood and urine collection, EKG and X-Ray APS retrieval service Inspection Reports Approved Vendors ExamOne, APPS, Parameds.com, Superior Mobile Medics ExamOne, GIS, EMSI ExamOne, GIS Attending Physician s Statements (APS) Orders When you submit a new application and have already ordered an APS, please include the information in the New Business Transmittal (AA1732). Subsequent APS Orders The underwriter may decide that a subsequent APS is needed after reviewing the file or an APS. You will receive this information via Guardian Online New Business Tracking update and the Daily Activity Report. APS retrieval service vendors are listed in the previous Approved Medical Vendors section. Note Subsequent APS ordering and follow-up for TeleMed-All Services cases will be handled for you by Berkshire. Lab Results As a courtesy, Berkshire mails a letter with lab results to the insured when the lab results are received by Berkshire. The letter encourages the client to discuss the lab results with his or her physician if they have any questions about those results. Note The letter and results are sent directly to the insured s attention marked as Personal and Confidential. 11

16 Medical Information Bureau (MIB) MIB Group, Inc. ( MIB ) is a membership corporation owned by approximately 470 member insurance companies in the U.S. and Canada. MIB s core fraud protection services protect insurers, policyholders and applicants from attempts to conceal or omit information material to the sound and equitable underwriting of life, health, disability income, critical illness and long term care insurance. If an applicant has a condition that is significant to health or longevity, then an underwriter is required to send a coded report to MIB. The underwriter will not base a decision solely on information obtained from the MIB. Rather, underwriting decisions are the result of evaluation and investigation of information from many sources. Berkshire checks with MIB to see if there is a record for each applicant when the signed Authorization to Obtain and Release Information form (C-AUTH) is received. This includes inquiry applications. Known identified conditions are reported to MIB, but the action that Berkshire takes (approval, decline, rating, etc.) is not. Tip information regarding MIB and how an applicant can obtain a copy of his or her MIB file or correct it, can be found on the MIB Consumer Web Page at Help with Financial Requirements Obtaining financial requirements can often delay underwriting an application. Use the 12

17 Authorization to Release Tax Information form (AA288) to expedite the receipt of financial information. The producer, applicant or applicant s accountant may use this form to fax financial requirements directly to New Business Services. Reinsurance Reinsurance is a transaction where Berkshire transfers some of its insurance risk to another company the reinsurer. The reinsurer agrees to reimburse Berkshire for covered losses claimed under the policies that have been reinsured according to the terms of the reinsurance agreement. Berkshire conducts most reinsurance with Munich Reinsurance Company. When insurance amounts applied for exceed certain limits the application file is also reviewed by the reinsurer to determine eligibility for coverage. The reinsurer generally responds within five days from receipt of the final underwriting requirement. Conditional Receipt and Prepayments For a prepayment to be accepted, it must be accompanied by the Conditional Receipt for Disability Insurance form, DI-CR-2007, signed and dated by the applicant. No receipt other than the regular conditional prepayment receipt should be given for any amount collected. If question 4m or 4n on the Part 1 application are answered yes, then a prepayment cannot be taken from the applicant. 13

18 The check and the Conditional Receipt must be dated the same. If they are not, the prepayment will be returned to the client with a letter indicating that the Conditional Receipt is being returned for this reason and is not valid. The applicant s prepayment check and a Suspense Ticket form, 235, should be mailed to the Initial Premium Specialists using the Initial Premiums Reporting Requirements envelope, The applicant s check must be received in the Home Office at the same time as the Conditional Receipt. This means the check should be received within a day or two after faxing or ing the Conditional Receipt to Berkshire. The Conditional Receipt is not a binding receipt. The Conditional Receipt sets the date and conditions under which the insurance applied for will go into effect. Said otherwise, coverage does not take effect unless all conditions described in the receipt are met. The dating rules set forth by the Conditional Receipt (paragraph 1) will take effect if information required by the company to determine insurability is received by the home office within 60 days of the date the receipt is signed. This includes both underwriting and administrative requirements. If the information is not received within this time frame, then the conditional receipt is void. Reissues are not allowed when the policy is issued as applied for within 60 days of the valid Conditional Receipt. 14

19 Note If the Conditional Receipt becomes invalid for any reason, normal policy dating rules apply. Refer to the Policy Dating Rules section for further details. Tip refer to the Guidelines Conditional Receipt for Disability Insurance (DI-CR-2007), AA1717 on BerkshireLifeTools.com for more information about when a prepayment will be refunded to the client. FIO Exercise Applications The Conditions of Coverage, FIO-CC-2009, must be completed when submitting a prepayment with an Application for Disability Insurance Option Exercises, FIO If this form is not received then the prepayment may be refunded directly to the client. Prepayment Refunds If all information necessary to determine insurability is not received or if the policy s benefits are modified or restricted within the 60 days the prepayment is returned directly to the applicant. However, in all situations, the refund will be sent only after the 60 days and with a 5-day advance notice to the agency. Delivery Requirements A delivery requirement is any requirement that is communicated at issue and must be received by New Business Services to place the policy in force and pay commissions. Such requirements may be an amendment, exclusion and Declaration of Insurability. These requirements must be signed, dated and should never be altered. If the applicant indicates any change in health, occupational or financial status since signing the application, or provides a positive response 15

20 to any of the questions asked in the Declaration of Insurability, the producer must not leave the policy with the applicant. The producer must return it to the home office with an explanation of the change in circumstances for further review by the underwriter. Submit delivery requirements via fax at , to berkshirelife.com or mail to the Initial Premium Specialists using the Initial Premiums Reporting Requirements envelope, Initial Premium Payment Methods Guard-O-Matic (GOM) Arrangement If the applicant requests the monthly automatic payment plan as a new service, please have the client sign the Request for Guard-0-Matic Arrangement form, R223, and submit it along with a copy of a voided check or savings deposit slip from the account to be drafted. If a GOM account already exists with Berkshire or Guardian and the new policy is to be drafted from the same bank account, simply select Add to My Existing Service on the Part I Application for Insurance. Once the policy is issued, payment of the initial premium can be authorized by the producer or agency by calling or sending an to a member of our administrative staff. The producer should inform the bank depositor (if other than the insured) to expect the draft from his or her bank account. Note Routine monthly automatic payments occur on or after the 15 th of each month. 16

21 Tip consider offering GOM on list bills without discounts. Use monthly drafts to automatically pay each premium and your client avoids receiving monthly premium notices. Also, there is no GOM modal fee for ProVider Plus forms 1400 and 1500 the GOM monthly premium is equal to one-twelfth the annual premium. Check-by-Phone This free service is a great option for getting the initial premium paid and the policy in force. If the last requirement is a payment of the initial premium, then have your client call Berkshire s Client Information Center at A Client Services Representative on a recorded line will obtain authorization and bank information, including account number, routing number and bank name. The payment will be applied the same day when received by 3:00 p.m. Eastern Time (6:00 p.m. ET on month-end closing days). Note All Berkshire and Guardian DI products and all premium modes can be processed through Check-by-Phone. Initial Premium Advances The advancing privilege provides the agency with paid-for credits and the agent with earlier commissions. New Business will advance the initial premium (with or without a copy of the check) and delivery requirements (excluding GOM forms and voided checks) for cases approved by underwriting and issued. Contact Your Initial Premiums Specialists to request that a case be advanced. 17

22 All premiums due and outstanding requirements must be submitted to Initial Premiums by the close of business on the 13 th day of the following month. All premiums due and outstanding requirements for the additional monthly benefit rider on GOM must be submitted by the 6th day of the following month. Mail advanced delivery requirements and the initial premium to the Initial Premium Specialists using the Initial Premiums Reporting Requirements envelope, Delivery requirements may also be submitted via fax at or by to Advance Reversals and Agency Suspension of the Advance Privilege All cases advanced and not cleared by the 13 th of the following month will be reversed and placed back to issued, not yet paid status or not taken (whichever is appropriate), on the 14 th of the month. The agency receives an on the 14 th of the following month with a list of reversed cases. If the reversed cases exceed 15% of the total paid premium, then the agency receives a warning. If warnings occur for two consecutive months, the agency s advancing privilege is suspended for three months. Any warning/suspension patterns will result in a revocation of the advancing privilege. Note No suspension will take affect without the agency s explicit knowledge and involvement. Contact New Business management to obtain your agency s standing at any time. 18

23 Jet Issue Team The Jet Issue team is comprised of staff with a strong background in New Business administration and processing who code, review, underwrite and issue cases that fall within certain guidelines. They are trained to handle cases in a quick, efficient manner. In other terms, they re the express lane. Cases processed by the Jet Issue Team include: New Young Professional cases for amounts up to $7,000 Underwritten & Guaranteed Conversions FIO/FPO option exercises Enhanced Quick Issue review for amounts up to $5,000 Underwriting review of Reinstatements automatic Benefit Enhancement (ABE) and Automatic Increase Rider (AIR) renewals cases submitted for exclusion rider reconsideration on an in-force policy Berkshire established the Jet Issue team with processing speed in mind. The following are the cycle time targets for the Jet Issue team: Conversions day Future Increase Options days Quick Issue days Enhanced Quick Issue days after all TeleMed requirements received ABE/AIR Removal days Reinstatements days Exclusion Reviews days 19

24 Note For additional information about the Jet Issue Team, refer to the DI Product & Information Manual on BerkshireLifeTools.com. Guidelines for Mapping of Occupation Classes Old Berkshire BLICOA/ Guardian ProVider Plus (1400/1500) OE (4100) / DBO (3100) BRT (AH55-A) Limited Issue Plus (LI+) Class 6 Class 6 or 6M Class 6 or 6M Class 5 Limited Issue (LI) Class 5 Class 5 or 5M Class 5 or 5M Class 5 Class 1 Class 4 Class 4 or 4M Class 4 or 4M Class 4 Unavailable Class 4P Class 3M Class 3M Class 4 Class 2 Class 3 Class 3 or 3M Class 3 or 3M Class 2 Class 3 Class 2 Class 2 or 2M Unavailable Class 2 Class 4 Class 1 Class 1 or 1M Unavailable Unavailable Batch Billing A batch billing is one premium notice consisting of at least three (3) individual lives. The policies will be billed to the same payor usually the business and have the same mode of payment and billing day. In situations where a batch billing will be generated at both Berkshire and Guardian for one payor we will inform the payor, by letter, that they will receive two bills: one from Berkshire and the usual bill from Guardian. All applicable discounts will continue to be applied to the policies issued by Berkshire as though the policies were included on one bill. 20

25 Multi Client Billing Discount A 10% billing discount is available with certain business products with a minimum of three lives on the bill. See the DI Product and Information Manual for further details. Follow-Up Procedures and Closing Pending Cases If an application has remained pending for 30 days without activity, messages are sent to the agency requesting the status of the outstanding requirements and if the case should remain open. If no response is received from the agency after 40 days, the case will be closed and a letter will be sent directly to the client with a refund of any prepayment submitted with the application. If the agency requests the case remain open or there has been recent activity on the case the case will remain open. Individual consideration will be given to each case and communications will occur with the agency prior to closing a new business case. For TeleMed cases, New Business will conduct a follow-up with the APS vendor at 15 days following the placement of the order. Note Jet Issue abides by a much shorter follow-up schedule, but does communicate with the agency in the same manner as described above. 21

26 Discount Programs Qualified Sick Pay Program (QSPP) QSPP is available on a unisex basis with at least two lives (three for medical occupations) when coverage is 100% employer-paid. A 10% permanent discount will apply to each policy issued. If the policy has Future Increase Option (FIO), the exercise policy will also have unisex rates. The 10% discount will apply if the applicant is still an active member of the QSPP at the time of exercise. Voluntary Insurance Program (VIP) The VIP program is available with genderdistinct rates with at least two lives (three for medical occupations). A 10% permanent discount will apply to each policy issued. To receive the discount, each application must be accompanied by the Voluntary Income Protection Program Eligibility Confirmation form (AA1670). If the policy has Future Increase Option (FIO), the exercise policy will also have gender-distinct rates. The 10% discount will apply if the applicant is still an active member of the VIP at the time of exercise. Association Program The Association program is available with the gender-distinct policy (unisex in MT). Applicants who are members of an approved association will receive a 10% permanent policy discount. The applicant must provide proof of membership through a copy of his or her membership card or dues paid or by completing the Association Membership Confirmation Form (AA1706). Local, county, state and regional associations are eligible when comprised of occupation classes 6 through 3. 22

27 The endorsed producer is the only person who can market the discount program to the association. Any other contracted producer whose client is a member can offer the discount by submitting the required forms and awarding a minimum 10% commission split to the endorsed producer. To submit a new association for consideration, submit the Disability Income Association Market Evaluation, AA980 available at BerkshireLifeTools.com. Note New Association plans have been suspended in Florida. For further information consult the Field Underwriting Guide or contact Distribution Services. Dating Rules Coverage is effective when the policy is delivered and the first premium is paid absent any change in the applicant s insurability. The policy will be dated 15 days following the date the policy is issued with exception to the following: A specific date is requested in the Part 1 application. A policy issued with a valid Conditional Receipt will be dated according to terms of the Conditional Receipt. See the Conditional Receipt section for more details. If, after adding the 15 days, the policy date falls on the 28 th of the month or later, the policy will be dated the first of the following month. 23

28 Dating to Save Age A policy can be dated to save the insured s age. ProVider Plus Overhead Expense and Disability Buy-Out policies may be dated no more than 30 days prior to the date the application was signed. The Reducing Term policy may be dated as much as six month prior to the date the application was signed. Request a date to save age in the Special Request section of the application. Reissues To change the details of a contract after it has been issued, a reissue request can be submitted via or use the New Business Request to Reissue form, AA1674. Depending upon the details of the request the case may require further underwriting. Reissues that require underwriting will be reviewed within four business days. If approved, a reissue may require a signed Declaration of Insurability from the applicant. A reissue request can be submitted up to six months after the policy is issued. Thereafter, the request must be submitted as an in-force policy change to the Policyowner Services Department. Refer to the Guidelines to Make Change to In-Force Disability Insurance Policies document on BerkshireLifeTools.com to determine if the change being requested is allowable. 24

29 Multiple Producers Competing for an Applicant Occasionally, a producer submits an application on an individual and at some point, either during underwriting or post-issue, a second unaffiliated producer becomes involved with the case creating a competitive situation. Berkshire offers no opinion or recommendation as to which producer places the case, but adheres to the following course of action: Both producers are extended the same medical and financial offer based on any additional information that may have been submitted by either producer. The first producer is made aware that another producer has developed interest in the case. Both producers are made aware the applicant must submit a signed statement to Berkshire stating which producer to work with and accept a policy form. This letter is a requirement for placing a policy in force and is not eligible for month-end advancing. To become involved in the case, the subsequent producer must submit a fully completed and currently dated new Application for Insurance listing himself or herself on the Producer s Certification. All requirements obtained from the previous application will be accepted. If any additional information or requirements obtained for the second application allow for a more favorable offer, both policies will be issued or reissued to both producers and both agencies (if applicable) will be notified that the applicant must choose which policy to accept. Internally, the two policies are treated as alternate policies, accepting only the first policy placed in force. 25

30 Declined Cases When it is determined through the underwriting process that an applicant is uninsurable, our goal is to provide as much information as possible to assist you in preparing your client for the notification that will follow. When an application is declined, the agency contact indicated on the New Business Transmittal is immediately notified. The letter to the applicant is held for five business days to allow time for the agency to notify the producer and in turn to notify the applicant. After the five-day waiting period, the decline letter along with a refund check for any prepayment submitted with the application will be mailed directly to the applicant at the residence address noted on the application. If you believe there is additional information forthcoming that may change our decision to decline, please notify your Initial Premiums Specialist immediately so the letter to the applicant can be held until such time that additional information can be reviewed and a final decision rendered. Innovative Underwriting When a case is declined, all underwriting requirements are automatically forwarded to Innovative Underwriters who packages the case and submits it to several impaired risk insurance carriers. If a carrier is in position to provide an offer for insurance, the carrier will directly contact the agency contact listed on the New Business Transmittal. Berkshire has no involvement in this process. Note Innovative Underwriters service is not available in California or New York. 26

31 DI to Life Insurance Certificate Program This program enables clients who purchase disability insurance to leverage that underwriting to purchase a life insurance policy and optional Waiver of Premium without any new/additional medical testing. Clients have up to 120 days after the disability insurance policy issue date to purchase a policy on a pre-qualified basis. Please refer to the Program Information Guide posted at for complete program details. Note This is not a direct mail program. Instead, the offer and a certificate specifying the amount of coverage the client is pre-qualified for are generated when the disability insurance policy is printed. The Financial Representative delivers it when they present the finalized disability insurance policy documents to the client. Underwriting and New Business Service Goals New Business Services is committed to adhering to strict time standards in order to expedite the processing of your applications. The following are our response time goals: An is sent to the agency confirming receipt of an application on the same day it s received. The policy number and underwriter assignment is sent to the agency within two business days of the receipt of the application. An confirming that the application is coded is sent to the agency within three business days of the receipt of the application. Underwriter s initial review is completed and updates are sent to the agency within six business days of the receipt of the application. 27

32 Responses to are sent within 24 hours of receipt. Additional requirements received subsequent to the original application are reviewed and responded to within three business days of receipt. Final requirements are reviewed within two days of receipt. Underwriting action is communicated immediately, followed with an to the agency. The policy is issued and mailed to the agency within one day of the underwriter s approval. Policy Issue Cycle Time The measure of Cycle Time is from the point an application is received in New Business Services until the policy is issued. Cycle time is inclusive of weekends, wait time, internal process time and holidays. Cycle time is a corporate quality measure. Cycle time details and rankings are sent monthly to each agency. Wastage/Policy Placement Wastage is defined as the percentage of new disability applications that do not result in issued and paid policies because the underwriting information is incomplete or the issued policy is not paid. Policy placement is a corporate quality measure. Wastage summaries and case details are sent monthly to each agency. Note If an application is reopened during the time period measured, it is not included in the count of closed applications. 28

33 Post-Sale Communication The post-sale communication survey measures our end customer s satisfaction with the sale process including satisfaction with his or her agent, product brochures and materials and more. The survey is mailed to the policy owner 45 days after the policy goes in force. Underwriting and New Business management reviews the returned information to determine if any follow-up action is needed. The agency will be informed through of steps taken. Agency specific post-sale survey summary information is available upon request. Agency Satisfaction Survey Twice each year, the Underwriting and New Business Department invites General Agents, Disability Income Specialists, Office Managers and New Business Agency Contacts to participate in a survey aimed to gauge how well we meet the needs of agency staff, producers and clients. Agency satisfaction is a corporate quality measure. The survey also solicits open feedback, which often identifies what works well and opportunities to improve our service and services. Many new programs and process enhancements have been realized as a result of this exchange. We appreciate your suggestions and welcome your feedback anytime! It is our continued goal to be your choice Disability Insurance carrier. 29

34 Helpful Tools to Use BerkshireLifeTools.com is your primary source for information on all products and services offered by Berkshire. To access helpful documents, applications and information about the Underwriting and New Business process, go to the DI section of the site and click on New Business link under Forms for Doing Business. The New Business Tool Kit and TeleMed links will bring you to many of the documents and forms referenced in this Quick Reference Guide. Additional information, including the Field Underwriting Guide, FAQs, and recent announcements can be accessed through the Underwriting and New Business Information folder within the Marketing and Training Center section on the site. Thank you for choosing Berkshire/Guardian as your choice disability insurance carrier. 30

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36 Disability income products underwritten and issued by Berkshire Life Insurance Company of America, Pittsfield, MA, a wholly owned stock subsidiary of The Guardian Life Insurance Company of America, New York, NY. The Guardian Life Insurance Company of America 7 Hanover Square New York, NY F O R P R O D U C E R U S E O N L Y. N O T F O R U S E W I T H T H E G E N E R A L P U B L I C. Pub4217BL