Monday, August 24, 2015

Dumb Carrier Trick: Redeemed

So, 20+ years ago, I had the privilege of writing my first single-pay Long Term Care policy. What was so special about it was that the client, the prototypical little old lady with the most beautiful smile, called me a few months later to buy another one.

Fast forward a couple of decades, and she passes away. A sad time for her family, to be sure, but the best time of all for any life insurance carrier to shine.

Or screw up mightily.

Unfortunately, "Ajax Life" chose the latter.

[ed: I've redacted the carrier's real name because they've demonstrated a willingness to resolve the issues.]

When Emily (not her real name) passed away, her son originally called the home office instead of me; his brother, with whom I had met alongside Emily in those early days, had since died. Eventually, the surviving son (we'll call him Les) called me for help. He had never received the forms that Home Office had promised to send him.

To further complicate things, there were multiple beneficiaries on multiple plans, so I had to coordinate them. So, I called Home Office and requested the proper forms and instructions on how to put this together. To their credit, Ajax promptly emailed me the forms and instructions.

I eventually received all the completed forms and appropriate documentation, packaged everything up (sans pink ribbon, natch) and sent them to Ajax.

And waited.

And waited.

Finally, I called to ask where the checks were, and was told any number of different stories: first, they'd never received the package. Then, they'd received it, but it was still being processed.

No one could (or would?) tell me exactly what needed "processing;" these were 20 year old policies, the insured had died of natural causes, this was not rocket surgery. I was finally able to get them to commit to having their claims "processor" call me.

Which he did. And then told me that the reason it took so long was that they had to get an exception because I'd sent in the wrong forms.

Excuse me?!

I got those forms from you!

Well, you see, he'd also (allegedly) sent the correct ones to Les in May and again in July, but never heard back. Which was news to Les when I told him about it: he'd never received any such forms. But even supposing he had, how is it relevant? Ajax sent me the claim form, which I in good faith passed along to the beneficiaries. The only clock that counts here is the one that started when I sent in the completed forms and documentation.

The "good" news is that (supposedly) the claim has been approved and the checks will go out shortly.


This was my very first death claim with this company, and there are very few things they could have screwed up worse. Topping the list is the complete stupidity of sending me the wrong form in the first place: how does that happen, exactly?

And no one thought it’d be appropriate to reach out to me to indicate that there'd be a delay, and why?

Until now, I'd had no reason to doubt the capabilities of this carrier, and felt good about recommending them to my clients.

What to do?

So, I reached out to the Vice President of Claims & Operations, expressing my frustration, explaining its source, and offering a path to redemption. Several days later, I received a very satisfactory reply, including an unqualified apology and a detailed explanation of the steps being undertaken to ensure that this kind of thing doesn't happen again (or at least, will minimize the chances).

I was particularly impressed that this executive admitted that he "was embarrassed to see the timeline and claim form confusion associated with this claim. The claims management team will be discussing the coaching and additional processes we need to implement to prevent future experiences such as this." That was just one of several steps he mentioned towards remediation.

Although I was quite disappointed that this whole situation occurred, I am quite satisfied with the outcome. People do make mistakes, and this company's willingness to unequivocally acknowledge (and correct) theirs is a very positive sign.
blog comments powered by Disqus