Thursday, January 28, 2010

Robo-underwriting

There is a change you can believe in when it comes to underwriting health insurance plans and it is not what you had hoped for. More people who apply for health insurance in Georgia are being declined for coverage. More are having coverage denied for certain pre-existing medical conditions. More are getting offers from health insurance companies at much higher premiums than originally quoted.

The reason?

The biggest reason is, most people do not know how to properly fill out a health insurance application. They give too much information, or not enough.

Even if you do all the right things the next obstacle is the application itself. All health insurance companies now offer online, electronic applications. Some companies will ONLY accept electronic applications.

This may seem like a good thing but in fact it can be a hornet's nest.

The electronic applications are designed to have almost no human intervention. Give the wrong answer to any one question and you will find your application rejected. Many health insurance companies are routinely rejecting 40 - 50% of applications due to medical reasons.

These automated, or as I like to call them, robo-underwriters, are creating havoc. I can't tell you how often I hear from people who have applied to 2 or 3 health insurance companies only to be denied coverage. Once I hear the details the only thing that is apparent is that they did not know how to fill out an application that would satisfy robo-underwriter.

Most of the time I am able to find a health insurance company that WILL issue coverage. Sometimes I can even get a policy issued by a company that has previously rejected them (although this is becoming increasingly difficult and time consuming).

My best advice is to avoid the robo-underwriter if at all possible by allowing an experienced agent to review and advise the best way to construct and submit an application. A knowledgeable agent will also review possible outcomes from each health insurance company based on your health history and will provide a detailed, written evaluation of offers that may be forthcoming.

So you can take your chances with robo-underwriter and risk getting rejected or rated up for a condition that another health insurance company will consider standard, or you can use an agent to assist.
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