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 Posted: Fri Jan 09, 2009 7:19 am Post subject: |
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| Quote: | | ANYONE has a right to have Medical or Life Insurance |
Then why do we come across queries referring to"Pre-existing conditions" while applying for a policy? Why do our premiums vary when pre-exisiting conditions are mentioned? Why do our applications get rejected so often? I'd rather ask SD to reply to my queries now.
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anonymous00
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| Posted: Fri Jan 09, 2009 10:39 am Post subject: |
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Where's Paul Harvey when you need him?
"...and now page 5..."
SD' for the 5th time now....please link us up to verifiable and credible information that supports your understanding of HIPAA.
You refuse to do that because their isn't any such credible site.
Below is a collection from this thread of what you have submitted as credible information:
| Quote: | | A friend of mine has a 'pre-existing' Medical condition, that is 'covered' under the HIPAA Law. 'His' Insurance company refused to sell him Life Insurance if he did not sign a similar form ('not responsible for...). His Mother was POA. When my friend passed away, his mother sued the Insurance company and won. |
Please provide the county and state this occured and the case number. Court records and proceedings are Public Records. I want to research this court case for myself because I do not believe your story.
| Quote: | | The HIPAA Law......my friend was HIV..AIDS. He din't have to divuldge any of that information to any sort of Insurance. |
The above statement is FALSE.
| Quote: | | In the field that I work in, I deal with HIPAA everyday. No.........my friend did NOT have to reveal anything to anyone. Maybe that's why his mother WON a lawsuit with an Insurance company. |
The above statement is FALSE.
| Quote: | | ...I DO want to add, if other 'clients' are not given the CORRECT information on how HIPAA can completely 'cover' them, then the 'client' will be misinformed, and THAT would be very sad. |
The above statement is FALSE if relating that to any type of medically underwritten life insurance.
Then for verifiable and credible information SD' writes:
| Quote: | There is nothing to "cover" in this case. Everyone has their opionions on different issues that people have. In this 'case', it 'is what it is'.
People don't HAVE to AGREE on how 'cases', like this one, are handled. They just need to accept it.
I do want to make a comment: I'm glad I'm NOT an Insurance Agent/Expert......most of them worry too much about getting their quotas each month, signing some stupid form, or quoting a bunch of 'mumbo jumbo' that means absolutely nothing. What happened to the CLIENTS' needs? That's where ALOT of my job 'comes in to play'. I'm there to 'PROTECT' the 'client'. ...to 'protect' her rights and make sure Insurance companies, Doctors, Clinics, etc. give her the respect she deserves.
I KNOW what I said. My friend, who was ONLY 36 when he died, had HIV. He passed away in December of 2005. He was a VERY DEAR friend..I knew him 17 years. I went to his 'Viewing' and his Funeral. When he passed away, his mother took in ALL of the 'evidence' she had, to a lawyer. She started 'proceedings' after my friends death. When she WON the Lawsuit, she gave ALOT of the money to the Aids Reasearch ( that kind of thing).
As I said, SEVERAL times, it 'is what it is'.
Thre ARE Health questions on applications, concerning Life Insurance...........there was ALOT of Health/Medical questions on mine, anyway. The Life Insurance I have in the Military asks ALOT of Health questions..............I have a $400,000.00 policy through the Military. I'm "wrong" telling my 'client' this infomation? Well...................then you better let the 'client's caseworker know this.............the caseworker gets her nformation from the county/state of PA. So.........as I said, I don't think an ENTIRE state is wrong.
I don't know what to tell ya'll........Laws and Guidelines can't be changed because someone doesn't approve of them.
As I said, people have their OWN opionion: You agree or you don't. My making posts ( on how the HIPAA laws protect my 'Client' and what I'm allowed to do for her/him) will continue on this forum...that's how it is. I said, from the beginning, I'm NOT an Insurance Agent
I make posts ANYWHERE on the forum. I give advice on what I know: I don't give advice on Insurance ( in general)..just on what the Insurance Companies, that my 'Client' deals with, are obligated to give her/him. And...what can (possibly?) happen if the Insurance Companies don't 'live up' to those obligations.
It amazes me that Insurance Agents/Companies get very defensive when they are 'challanged' by others. My 'Client' deserves ALOT better 'treatment' than what her/his Insurance Companies are giving her. It's very upsetting to see. |
SD' you were asked to provide us with credible and verfiable information that supports your understanding of HIPAA.
Why do you refuse?
P L E A S E.... take us to the woodshed. Beat us down. Show the whole World Wide Web how these stupid insurance agents have no clue what HIPAA actually means.
Go for it girl!
You may want to start by reading and comprehending THIS LINK from the United States Department of Health and Human Services.
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GarySpicuzza
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| Posted: Fri Jan 09, 2009 12:14 pm Post subject: |
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| Why do people's applications get denied??That could be for SEVERAL reasons: depends on the situation of the 'Client/Consumer'. I would have to see the situation on the 'Consumer/Client.' Paul Harvey?: never heard of him. |
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sdchargersfan
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| Posted: Fri Jan 09, 2009 12:58 pm Post subject: |
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SD' thank you for your non-responsive reply.
The issue on the table we're waiting for you to answer is:
Please link us up to verifiable and credible information that supports your understanding of HIPAA.
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GarySpicuzza
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| Posted: Fri Jan 09, 2009 2:04 pm Post subject: |
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Watch Out Gary, sdchargersfan is calling me a bully on other post now on the forum. You will be next. LOL.
I think that anyone that reads this post will see everything they need to know about sdchargersfan.
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lifeagent911
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| Posted: Fri Jan 09, 2009 5:54 pm Post subject: |
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...and now...the rest of the story...
Where's that dead horse?
Ahh there it is...
Hopelessly
and
Incessantly
Parsing
of
Actual
Accomodations
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GarySpicuzza
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| Posted: Fri Jan 09, 2009 7:48 pm Post subject: insurance |
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| I won't give you the PRIVILEDGE to know everything about me. It really sickens me how certain Insurance Agents ( that's what they call themselves, anyway) treat people like my 'Client'. |
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sdchargersfan
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| Posted: Fri Jan 09, 2009 10:59 pm Post subject: |
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Horse Incontinence Problem Adverse Action
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| Posted: Sat Jan 10, 2009 4:25 pm Post subject: |
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Ok, first off let me say, I don't know squat about hippa...just that everywhere you go they shove the darn things at you i sign them and go on....
Let me pose a question to you all, (slightly off topic, but 'maybe' not)....Let's say, Joe John Doe, applies for health and life insurance he is issued both policys, he is at this time, in good/excellent health...and answers the same....then let say, that a few years out he finds himself with HIV and subsequently dies of the same...now am I correct that if he kept up his premiums both policys must pay?
Same situation, only Joe John after finding out he has HIV wants to increase his coverages, IS there or ARE there any policys that MUST allow Joe John to 'up' his coverage without 'further' medical questions....such as some kind of 'guaranteed' increase or acceptance policy (I honestly don't know I'm asking)
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Lori
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| Posted: Sun Jan 11, 2009 12:03 am Post subject: |
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| Quote: | | Let's say, Joe John Doe, applies for health and life insurance he is issued both policys, he is at this time, in good/excellent health...and answers the same....then let say, that a few years out he finds himself with HIV and subsequently dies of the same...now am I correct that if he kept up his premiums both policys must pay? |
Yes, you are correct.
| Quote: | | Same situation, only Joe John after finding out he has HIV wants to increase his coverages, IS there or ARE there any policys that MUST allow Joe John to 'up' his coverage without 'further' medical questions....such as some kind of 'guaranteed' increase or acceptance policy. |
Yes and No.
There are GUARANTEED PURCHASE options but you pay a higher premium up front for the right to buy more coverage later without evidence of insurability.
The more accurate answer is NO.
Once you've been diagnosed with HIV/AIDS you will not be able to buy any type of medically underwritten life insurance or increase your existing coverage. HIV/AIDS would be an automatic decline. No different than if a person recently had a stroke, cancer, heart attack, COPD or any other chronic disease.
Now anyone can buy guaranteed acceptance life insurance but the premiums on those policies already have adverse selection built into the rates and they limit the death benefit for the first two years.
See http://www.colonialpenn.com/Web/GuaranteedAcceptance/Description.aspx
| Quote: | You Can't Be Turned Down!
If you're between the ages of 50 and 85 (in most states), you are guaranteed acceptance for this life insurance. There are no health questions to answer...no physical exam to take. We can guarantee your acceptance because of a two-year limited benefit period. |
HIPAA has to do with medical insurance.
That's why its called the Health Insurance Portability and Accountability Act (HIPAA)
The Health Insurance Portability and Accountability Act (HIPAA) was enacted by the U.S. Congress in 1996. HIPAA protects health insurance coverage for workers and their families when they change or lose their jobs.
HIPAA limits restrictions that a group health plan can place on benefits for preexisting conditions.
Group health plans may refuse to provide benefits relating to preexisting conditions for a period of 12 months after enrollment in the plan or 18 months in the case of late enrollment.
Link deactivated by moderators
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GarySpicuzza
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| Posted: Sun Jan 11, 2009 2:50 pm Post subject: |
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 I'm laughing at myself, as I said I don't know squat about HIPAA including (obviously) how to spell it!  
Thanks Gary for dumbing it down for me... so Hipaa has zero to do with life ins...(or any other ins) and only has to do with health/medical ins...and 'only' with group ins? is that right? you said | Quote: | | Group health plans may refuse to provide benefits relating to preexisting conditions for a period of 12 months after enrollment in the plan or 18 months in the case of late enrollment. |
Is this a state, or company thing in addition to hipaa? I ask because I'm relatively sure that as an employee (not a dependent) that my present and past employer's plan had to take me 'warts and all' from day one, UNLESS i enrolled late...
So let me ask you this Gary....If Joe John worked and had coverage with his employer and developed (and subsequently died) of HIV let's say ten years after beginning his employment (and health coverage) then that health carrier could not deny those expenses right?
Now if Joe John (same situation)...only this time his employer switched plans (and companys) mid HIV treatment, they could still not deny him based on the hipaa protection is that right?
And Hipaa has nothing to do with any life insurance even if it too is a group policy thru the employer is that right?
If you lost your coverage due to your employer going belly up or whatever that's when the cobra thing becomes an option...is that right? and that would have nothing to do with hipaa right? or wrong?
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Lori
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| Posted: Sun Jan 11, 2009 7:04 pm Post subject: |
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Wow, seems like we have several conversations going on at once here, so I want to get back to the "form".
I agree with someone, I think Gary, who said they would not sign the form if it was presented to him. I would neither sign it nor use it in my business.
Since it has not been approved for use by any state insurance department, I just don't think it would hold up in a court of law, if that became necessary. If you actually have the applicant sign the insurance application, why would you personally require the additional form.
As far as E&O, an insurance agent who does not carry Professional Liability insurance is just playing Russian (You know what the word should be, the spam filter in this community views it as a "bad" word. ???????)
Someone asked a question about a perfectly healthy person buying life insurance and later finding out that he/she had some disease. This situation would obviously fall into the "contestible" period of the life insurance policy (normally 2 years). After the 2 year contestible period, the person would be fully insured.
Keep in mind here, some insurance companies issue a life insurance policy with little or no medical underwriting up front, but when the insured dies, the underwriting process begins. If the insurance company finds any medical condition that would have prevented the policy being issued, there will be a return of all premiums paid and that's the end of it.
Just because a person has never gone to the doctor for an illness, does not mean that he/she shouldn't have. Most "pre-existing" clauses in insurance policies state, and I am paraphrasing here, "a condition for which a reasonable person should have sought medical treatment".
| Quote: | | So let me ask you this Gary....If Joe John worked and had coverage with his employer and developed (and subsequently died) of HIV let's say ten years after beginning his employment (and health coverage) then that health carrier could not deny those expenses right? |
Maybe. Why and how did this person contract the HIV virus? Was he a drug user? Did his mother or father carry the HIV virus? This question is just not that simple.
| Quote: | | If you lost your coverage due to your employer going belly up or whatever that's when the cobra thing becomes an option...is that right? and that would have nothing to do with hipaa right? or wrong? |
Both could possibly apply in this situation. The COBRA coverage might be available for the entire cost of the insurance, including the premium the employer was paying.
If the employee had "credible coverage", under HIPPA, he could possibly purchase an individual health insurance policy without any pre-existing condition exclusion.
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| Posted: Sun Jan 11, 2009 7:06 pm Post subject: |
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| OK, I'm out of here - twice in one day is just too much! |
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InsuranceMaze
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| Posted: Sun Jan 11, 2009 7:14 pm Post subject: |
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| Quote: | | twice in one day is just too much! |
ah dude...forget to log in again? I hate when I do that! 
| Quote: | | Why and how did this person contract the HIV virus? Was he a drug user? Did his mother or father carry the HIV virus? This question is just not that simple. |
What on earth would the way they contracted aids/hiv have to do with acceptance or denial of a claim?  seriously I don't understand that maze...is there some policy language that excludes illnesses that resulted from unprotected sex? or illegal drug use? what about hep.c (or a,b,d either) ? or the clap? (i'm not playin' when i say i don't know much at all about heath/life ins ) | Quote: | | If the employee had "credible coverage", under HIPPA, he could possibly purchase an individual health insurance policy without any pre-existing condition exclusion |
THAT is really good to know given the economy....(as i said I don't know nuttin' about health ins. really)....
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Lori
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| Posted: Sun Jan 11, 2009 7:38 pm Post subject: |
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First of all, I am very proud to say - I LOGGED IN!!
Now to the question . . .
| Quote: | | What on earth would the way they contracted aids/hiv have to do with acceptance or denial of a claim? seriously I don't understand that maze...is there some policy language that excludes illnesses that resulted from unprotected sex? or illegal drug use? what about hep.c (or a,b,d either) ? or the clap? |
Let's suppose you apply for a life insurance policy and on the application you state that you "do not now" or "never have used" illegal drugs. The life insurance policy is issued and everything is just fine.
One, two years from now, you contract the HIV virus as a result of your earlier experimentation with drugs of some kind. You actually provided false information on the application and the claim would more than likely be denied.
That's just one example, there could be others. |
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InsuranceMaze
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