Will They Really Pay?

by jeffreywilkins » Thu Jul 30, 2009 08:46 am

Hello all,

I was going through the phone interview about past health with the insurance company for a 500k policy, and there were so many questions I was unsure of. Didn't remember dates of medical incidents, which medication I had taken, etc.

My medical history is pretty extensive, seen a couple psychiatrists, take 2 medications, have had about 5 surgeries. None of this stuff has been life threatening. But I'm really worried that I will pay these premiums for 10 years or whatever and if I die the insurance company will deny payment based on some small inconsistency in my history.

My beneficiaries live in a foreign country and are not very savvy, so they would have an impossible time dealing with the company. Can you really trust these companies? Which are the best ones (I live in the US)? What steps should I take to ensure they pay? Please advise. Thanks.

Total Comments: 8

Posted: Thu Jul 30, 2009 11:53 am Post Subject:

What company is this with? Were the health questions not answered already on the paramedical exam? Usually, the company will ask for the attending physician statement (APS) when someone has an extensive medical history.

If the policy is approved, there is a two year contestability period for the company to investigate your death claim.

Posted: Thu Jul 30, 2009 08:12 pm Post Subject:

Thanks for the answer.

The company was USAA. What is a paramedical exam? After I picked out the kind of policy, they had me do a phone interview on my health history, then I was supposed to get a physical exam. Although I have quite a bit of medical history most of the stuff has not been serious and I don't have an ongoing condition or regular doctor.

You mean after I've been paying the premium for 2 years they cannot refuse payment based on my medical history even if stuff was omitted or incorrect?

Posted: Thu Jul 30, 2009 08:16 pm Post Subject:

A paramedical exam is the same as a physical exam....a nurse will usually come to your house to measure your height/weight, check your blood pressure, ask you some medical questions, and draw your blood.

If you have some health conditions, USAA can be tight on their underwriting. They have competitive rates for people in perfect health, but if you do not qualify for their best rates, you may be able to find less expensive coverage elsewhere.

After the policy has been in force for 2 years, assuming USAA is the same as every other life insurance company, they cannot contest the medical history unless (in some states) there was intentional fraud or misrepresentation involved.....such as if you had 3 heart attacks but told them you're in great health and somehow got approved. What state are you located in?

Posted: Thu Jul 30, 2009 10:45 pm Post Subject:

Yeah, come to think of it, the sales rep did mention something about the 2 years. I'm in Washington state. What companies do you recommend?

Posted: Thu Jul 30, 2009 11:16 pm Post Subject:

It's hard to say without knowing the background information as that is what will determine your risk class (which helps determine your premium). If you want to send me an e-mail, we're licensed in Washington and could at least give you some numbers to compare. dgold[at]goldfinancialgrp.com

E-mail id deactivated for your safety

Posted: Fri Jul 31, 2009 06:26 am Post Subject:

You mean after I've been paying the premium for 2 years they cannot refuse payment based on my medical history even if stuff was omitted or incorrect?



Yeah, kind of!

Even if you intentionally omit certain information in the application and the insurance company fails to locate it withing the two years period, the chances are there that they may end up paying the benefits. But, they would contest it anyway.

However, if it occurs within the two years look out time, you would only get the premium back that you have paid.

Posted: Fri Jul 31, 2009 07:08 am Post Subject:

But, they would contest it anyway.



Any idea of their success rate under such circumstances?
I've heard that most of the carriers would choose to pay-off such claims in order to safeguard their reputation. Is that correct? JBerty

Posted: Fri Jul 31, 2009 11:25 am Post Subject:

froglike, they can't contest it. They have no choice. It doesn't matter that the insured had 12 kinds of cancer when they applied for coverage and was HIV+ and knew, but didn't disclose, this information. If they live for 2 years, the claim will be paid.

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