Medical Underwriting Preparation. Avoid the hurdles. Get straight to the finish line!

Transcription

1 Medical Underwriting Preparation Avoid the hurdles. Get straight to the finish line!

2 Accredited by The Institute for 1.0 CE credits as Successfully Avoiding the Pitfalls of Paramedicals (#IAS )

3 CONGRATULATIONS! YOU VE MADE A SALE. NOW WHAT?

4 pre pare /priˈpe(ə)r/ Verb Make (something) ready for use or consideration. Synonyms make - get ready - make ready From dictionary.com

5 Prepare yourself Prepare your clients You will get paid sooner! Prepare the Underwriter 5

6 Prepare yourself

7 Work smarter, not harder What are your issues around training for paramedical services? Completing application medical information How to order paramedical exams and services Managing client expectations through the paramedical process Client service experience with the QUS Health Professional

8 Uberrimae Fides Insurance Contracts Each party required to make FULL disclosure Advisors and paramedical companies act as the eyes and ears of the Insurance companies

9 Fill in the blanks It all starts with the application Missing information may result in an amendment, a delay or even a decline!

10 Avoid the unknown Take your time Read the entire question Don t rephrase or skip questions Be accurate in your response Obtain additional details Ask the 5 Ws Applicants have information on their own condition(s) Don t be shy!

11 Just the facts Confirm medical and other requirements Company, face amount Applicant s name, address, phone #s and address Which telephone # should we try? May we leave a message? Where and when do they want to be seen? Home? Office? Special language or cultural considerations

12 Ask your client to: Quality s Top Paperwork Prep Tips Have government ID (with picture) at the start of the appointment for verification Prepare a list of all doctors consulted past 5 years Who has complete medical records? Why were they seen? What was the result? Have a list of all medications (prescriptions & homeopathic), including dosages

13 Place the order with QUS

14 Your client wants and needs the coverage, so make sure they get it! KEEP TRACK!

15 Prepare your clients

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17 Clients FAQ How long will it take? Paramedical services required determine length of appointment. Leave approximately 45 minutes. What is involved? HP will visit your home to collect specimens and ask health history questions. What tests will be performed? Who is doing the examination / testing? Is disrobing is required? Determined by the insurance company. Usually, health history questionnaire, blood and/or urine tests. Quality Paramedical Services is contracted by the insurance company to perform the medical tests. An insurance medical lab does the testing, and results are disclosed only to the insurance company. You will be required to remove your shirt only if an ECG test will be performed.

18 Preparation is Key Quality Underwriting can help! Your client needs to know what to expect Client brochures in 16 languages Convenient locations with customized health professionals - cultural and language diversity The Paramedical Examination

19 R.N.s Top 10 Tips 1. No strenuous exercise for at least 24 hours prior to exam 2. Be well rested 3. If applicant has a cold or flu reschedule! 4. Limit alcohol for 24 to 48 hours prior to exam 5. Limit caffeine 6. Reduce smoking 7. Ideally, fast for 12 hours before the exam Water is OK. Drink a large glass 1 hour before exam 8. Avoid vitamins and supplements for 24 hours 9. Continue all prescribed medications 10. RELAX!

20 Why limit exercise? Vigorous Exercise Before the exam: High-impact aerobics, contact sports, weightlifting, distance running, etc.) causes red blood cell platelets to leech into the urine stream. After the exam: exercise may cause bruising at the blood draw site Lab test shows blood in the urine Underwriter worries it may be indicative of: Kidney Disease Infection Cancer Result: Repeat Testing APS requirement

21 Why rest? Applicant not well rested Possible increase in blood pressure Possible irregular heartbeat A single night of inadequate sleep in people with existing hypertension can cause elevated blood pressure throughout the following day * *Source AMA

22 Why reschedule? If applicant is sick (cold, flu, etc ) or if female client has menses Underwriter sees: elevated temperature irregular heartbeat blood / protein in urine etc Reschedule

23 Smoking Let s talk: Spousal secrets Cigars and the golf game Betel nut comes from Areca Palm tree Chewing tobacco, nicotine gum or patch Marijuana Used to smoke in high school What is the next question to ask? When did you last smoke? Be honest Underwriter wants to see fully disclosed smoking habit. State when they last smoked. Meet individually to maintain privacy and honesty when answering questions.

24 Why reduce alcohol? ALCOHOL Even one drink causes the heart rate to increase and small blood vessels to dilate Excess consumption increases blood pressure and causes dehydration Carbohydrate rich drinks impact blood sugar levels Result: Applicant won t receive best decision Re-testing may be required

25 Why limit caffeine? Caffeine Increases Blood Pressure Increased heart rate Irregular heart rate Sources of caffeine: Coffee Chocolate Sports drinks Result Adverse decision Re-testing may be required

26 Why fast? Blood Test Eating prior to a blood test will affect the results, including cholesterol and glucose Do not drink Milk before test; it includes both sugar and fat Avoid vitamins and other supplements Avoid chewing gum even sugarfree versions can affect test results Result: Retesting may be required

27 Managing the Applicant s Expectations

28 Your client needs to know what to expect in their paramedical examination PREPARATION IS KEY

29 Before ANY Specimens are collected the applicant MUST sign a release form that authorizes the examiner to draw the samples and permits the lab to test & forward the results to the insurance company Informed consent

30 Urinalysis Reagent Strips aka common DIPSTICK Tests test for: Blood Ketones Glucose Protein ph level Timing: about 5 minutes

31 Blood Profile Exam Complete Blood Profile 2 or 3 test tubes filled Mini Blood Profile Urine Specimen Two attempts only May require fasting Other Specimen Collection TIMING: about 15 Minutes

32 Electrocardiograms Resting Taken on a mobile basis in home Spot to lay down required Stress Doctor s office or clinic Other Tests Ultrasound TIMING: Minutes

33 Prepare the Underwriter

34 A reasonable and prudent Underwriter will want to know: a. the amount and purpose of the proposed coverage; b. the Financial Status of the life insured; c. the amount of coverage in existence and pending. Armstrong v. North West Life Ins. Co. (1987) 28 C.C.L.I.(B.C.S.C.); and on appeal (1990) 46 C.C.L.I. 18 (B.C.S.C.)

35 The Underwriter s Perspective They never meet your client They only see: Health History on application and paramedical form Lab Test Results APS, Financial Statements, MVRs or other reports

36 Underwriters are skeptical They are trained to look for the inconsistencies What s missing? Different answers from application to paramedical form Incomplete information Gaps in the details

37 Dear Underwriter Cover Letter How long have you known the applicant? Purpose of Insurance Business Personal / family How was the Face Amount determined?

38 Full disclosure Disclosure Complete disclosure of all medical and financial details, along with avocations and other information are vital. The Underwriter relies on the declarations made by the applicant both on the application as well as the medical to make a decision. Result Coverage may be denied or rescinded Policy declined Claim denied at time of death

39 Prepare yourself for the extras just in case!

40 Additional Factors Attending Physician s Statements (APS) Which Doctors have complete records? Inspection Reports Advise client Financial Statements and Financial Reports may be requested (business insurance) Motor Vehicle Report (MVR)

41 Be thorough Even some harmless activities, such as flying away on frequent vacations, using small aircraft, or scuba diving can alter the Underwriting risk assessment!

42 Over the last hundred years in paramedicals, things haven t changed much..

43 In 1848

44 Today

45 The future is now at QUS

46 Electronic Paramedical Advantages to Advisor 100% in good order paramedicals means underwriting proceeds faster Applicant is contacted by one Health Professional to complete an interview and subsequent specimen collection Faster turnaround as there is no delay in getting documents to the underwriters

47 Perfect Output

48 is for Quality Underwriting Passionate About Paramedicals

49 Passionate Entrepreneurs Delivering 24/7 Local Expertise Western Canada Ontario Quebec Atlantic Canada Vancouver Barrie Victoria Calgary Edmonton Hamilton Kitchener London Toronto Montreal Nova Scotia New Brunswick Newfoundland Saskatoon Oshawa Quebec PEI Winnipeg Ottawa

50 Q is for Quality Underwriting Quality Integrity Quality Underwriting Privacy Passion

51 Questions?