Monday, February 02, 2009

Outrageously Stupid Carrier Tricks: AA Edition

It's difficult, really, to decide which carrier is more incompetent. I'll lay out the facts, and encourage readers to draw their own conclusion.

First up, we have the curious case of Aetna, which doesn't seem to know how to actually underwrite individual medical insurance. I only recently began writing business with them; until a short time ago, their individual policies had a "poison pill" which made them unacceptable. They did away with the offending verbiage, and I was pleased to see what appeared to be well-designed plans with reasonable rates.

Unfortunately, the "2 out of 3 rule" came into play: alas, they have no clue how to underwrite plans. Case in point: a client who completed an online application in early January, requesting a mid-month effective date. This client had some very minor health issues, but that didn't stop Aetna from dragging its feet.

They conduct "phone interviews" with prospective clients; unfortunately, they kept calling mine at his home. During business hours. When I called them to point this out, I was told he could call it in himself. So I passed along the contact number, and he did, in fact, call in. They requested additional information, which he promptly got from his physician. We actually sent this twice, since Aetna couldn't be bothered to keep track of it.

I was told by Aetna that this was all that was needed, so I presumed that all would be fine. What they neglected to inform either myself or my client was that apparently this fax, from the physician, wasn't enough - they needed to talk with him again. Again unfortunately, they neglected to communicate this to either my client or myself, with the result being that they've now closed the case.

This will become a major component of at least one future Continuing Education class.

Anthem doesn't fare much better: on another recent case, they took so long to underwrite and issue that the effective date came and went. Ordinarily, this wouldn't be a major problem, but in this case, the client had paid a semi-annual premium to his current carrier, and we couldn't get a partial refund. So, we asked to move the effective date forward one month.

No big deal, right?

Not so fast: it took well over two weeks, numerous phone calls and emails, and I finally received word that the date had been changed to February 1.

I got that information today: February 2.

We may be able to resolve this with the current carrier, but why should it take so long to make a very simple change? It isn't as if we're asking them to retroactively issue a policy so as to cover a new condition. Actually, they're off the hook by one month, which would be a reason for them to honor the request quickly. There just isn't any acceptable reason to put my client through this aggrevation and stress.

So there you have it.

UPDATE: Poll's closed, here are the results:



blog comments powered by Disqus