by tab5579363 » Wed Apr 28, 2010 08:02 pm
My insurance is terminating my policy because of misrepresintations. I live in Texas and I'm with Blue Cross Blue Shield. The insurance guy who sold me my policy filled out my form and put I was a non smoker and I smoke and also checked no on headaches and I had been to a Dr about headaches and perscribed Lortab. After I got my policy I had test run and found out I have arthritis in my neck causing my headaches.So I've had shots in my neck twice. and seen many doctors to discover this plus MRI,colonoscopy etc... The ins co got records from 8 months ago and saw I had been seen for headaches and that I smoked. Now they are cancelling me. i did'nt even put all that down. I would not have lied about my headaches or smoking all I can figure is he ask me if I had migranes and i said no and said I was quitting on smoking. Can I do anything? I don't have money to pay full balance on all these bills!!!!!
Posted: Fri May 21, 2010 12:44 am Post Subject:
It's entirely possible, that BOTH the OP and his agent co-conspired to commit misrep on this app. It's also possible that the agent was instrumental in the mis-rep, sadly have seen this myself as well. Further (highly) possible the OP just flat lied, the agent asked the questions the OP gave false information, the agent recorded this false information unbeknownest to him. The OP minimally ALLOWED lies to be submitted on the application, KNOWING they were lies...
The insurance guy who sold me my policy filled out my form and put I was a non smoker and I smoke
andalso checked no on headaches and I had been to a Dr about headaches and perscribed Lortab.
To me this clearly shows that the OP KNEW that he/she was providing false information to obtain this policy, to then file claims against said policy, and in fact (I believe) had a plan to get into the doc the second it was bound..After I got my policy I had test run
Wonder how quickly after this was issued the OP saw the doc? My bet, not very long..and seen many doctors to discover this plus MRI,colonoscopy etc
To me this sounds like the ink was barely dry, when the OP went hog wild at the 'medical store'The ins co got records from 8 months ago and saw I had been seen for headaches and that I smoked.
Read the above quote again, ONLY eight months prior to him taking out this policy he had been to the doc for the headaches..within 8 months! not eight years where a person "could" have forgotten about an isolated event 8months! NO WAY the OP didn't know he was lying on this app, NO dag-gum way!i did'nt even put all that down
again, you signed it, I've NEVER seen nor signed an application for ANY type of insurance that didn't say just prior to the signature, (paraphrasing here :wink: ) "you'd better not be lying we're not kidding! If you lied we'll void this policy and you just might get into some legal trouble too!" But after reading this, the OP signed this application that had misinformation on it.I would not have lied about my headaches or smoking
all I can figure is he ask me if I had migranes and i said no
OK now wait a second....just before this the OP says that he (meaning the agent) said 'no on headaches' also an honest person if asked by the agent 'do you suffer from migranes?' would've said, 'well they haven't called them migranes but I have been to the doc for headaches, and got me some pain pills for them too!' AND what doc prescribes opiates for plain old everyday headaches? I don't know any....and said I was quitting on smoking
What on earth does this statement even mean? I 'was' quitting on smoking? Does that mean you've cut down?One more time
he ask me if I had migranes and i said no and said I was quitting on smoking.
hmmmmmmmmMax and Mack, boys lets play nice...Mack the fact of the matter is there are slimmy agents out there, I've dealt with too many of them, got two fired. It's unfortunate, it sucks for all the great agents out there, but there is scum in every pond. The longer you're in this industry the more of this you will see. Agents that just want to make a buck...period......there are even more (IMO) slimmy 'insured's' out there that lie, they lie to get a policy, they lie when they submit a claim, they lie to their wife, mother, kids, husband and boss..it's what the world is now. You'll have to decide what kind of agent (and human being) you will be. The high road is steep, but worth the climb, and for what it's worth I think you're on the right track, but I also think you're a little green and niave'.
How about we come to some type of agreement, that it's entirely possible that both parties lied. For sure atleast one of them did. The OP is going to pay the price for this. The agent? Well if he/she was party to this mis-rep, he will fall eventually.
Posted: Fri May 21, 2010 01:34 am Post Subject:
Lori . . .
No disagreement at all with what you've posted! If you look at all of my posts, I acknowledge that the OP did indeed misrepresent by (a) signing the app (b) and acknowledging that they do indeed have some prior medical issues.
It's the "other guy" who refuses to acknowledge that agents are in any way connected to misrepresenting information. I've seen my share of it, too. In health apps, life apps, LTC apps. We (those of us who have been at this for a while and have the gray hairs to show for it) have all seen more than enough examples of it. I tend to blame it on commissions, but there are other reasons, too.
Is it possible that the OP and agent colluded/conspired to submit answers known to be wrong? Sure, anything is possible, but we have no way of knowing. What we do know is that the OP failed to correct/add/delete any wrong answers on the application and now bears the responsibility for it. If (my point) the agent is the source of the problem, the agent needs to be "horsewhipped" for inviting the problem by not filling out the app correctly or not following the possibly better method of giving the health app to the client to fill out -- then we all know who's at fault for any "errors" in the app leading to a recission.
California law, however, is quite clear: an insurer is required to complete all necessary underwriting (such as seeking prior medical records) before it issues coverage. This year, for the first time, CA law now also makes all health insurance policies incontestable after 24 months of coverage (like life insurance). So definitely no "do-overs" for the insurer after 2 years except for fraud.
Posted: Sat May 22, 2010 11:58 am Post Subject:
What we do know is that the OP failed to correct/add/delete any wrong answers on the application and now bears the responsibility for it. If (my point) the agent is the source of the problem, the agent needs to be "horsewhipped" for inviting the problem by not filling out the app correctly or not following the possibly better method of giving the health app to the client to fill out -- then we all know who's at fault for any "errors" in the app leading to a recission.
Couldn't agree more Max, I remember the very first time I was involved in a claim that involved a 'bad agent'...(i worked for a captive agent company at that time)...it was very very disturbing to me...unfortunately that, like most things in life regarding greed have got worse.Posted: Sat May 22, 2010 12:22 pm Post Subject:
What we do know is that the OP failed to correct/add/delete any wrong answers on the application and now bears the responsibility for it.
The OP is responsible for whatever has happened. He was supposed to view it one last time before submitting the form. He didn't do it, so now he's living with it!
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