We fought for the client — and wonBlog added by Andrea Caruso on August 1, 2013
Andrea Caruso

Andrea Caruso

Harrisburg, PA

Joined: April 18, 2012

In 2011, we received an informal inquiry on an elderly female with a complex medical history. The client needed coverage and we were determined to obtain it for her.

Our first challenge started with medical records that revealed a significant history of depression. Depression in the elderly is a major risk factor for functional decline and death. Given this information, we received rejections from multiple carriers.

Our underwriter reached out to the producer and client for more details, and this led to a better understanding of the history. We discovered that her depression was prompted by her daughter’s passing from cancer. From there we reached out to her psychologist for his opinion and feedback. He was able to provide a very detailed letter that corroborated the story. More importantly, the psychologist was able to advise that the depression had improved and remained stable. The client was doing better and was actively involved with her family and her community on a regular basis. This helped us secure coverage for the insured at standard, resulting in the placement of an insurance policy with a $28,000 premium. However, the client was interested in more coverage and the process continued.

A few of the carriers who had originally declined the file advised they could possibly reconsider in six months if the client continued to do well. After six months went by, we obtained updated medical records which continued to show that the client remained stable. Although no other opinions were as good as the first standard offer, we moved forward with coverage at Table 3 with another carrier. During the insurance examination for this policy, we encountered another challenge — the client’s performance on the cognitive section of the senior supplement portion of her insurance exam was not as expected. In addition, she reported a fall. Due to these signs of frailty, the carrier declined to offer.

Hoping for a reasonable explanation, we turned to the producer and client for help. It turned out her fall was the result of her tripping over her luggage while she was traveling abroad with her family. To address the cognitive concerns, she went for a neurological evaluation that resulted in a very good exam score of 29 out of 30. The neurologist’s opinion was that she was simply experiencing normal mild age-related memory difficulty.

Unfortunately, after all this, the carrier still preferred not to make an offer. We were not deterred. We shopped these new details to other carriers and were able to get an offer of Table 2, resulting in the placement of an additional policy with a $56,000 premium. In the end, it took over a year to place all of the coverage. The producer and client were both very grateful to our underwriting team for working so diligently and not giving up.
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