How do I challenge being mistakenly "RATED"?

[RLV]

What is the name of your state? California

I applied for a life insurance policy and was told I did not qualify for their preferred rates but was offered a "RATED" policy at 4 times the preferred rate. The underwriters claim that the results from a stress test taken during a routine physical in 2004 showed abnormal tracings yet my doctor has repeatedly said the test was perfectly normal. In addition now the insurance company is saying they need more information to properly evaluate the stress test but in the meantime have left the "RATED" designation on the books. I am perfectly healthy, non smoker, non drinker and my parents are healthy in their late 70's. All of my numbers are within the normal range on the medical exam the insurance company ordered with the exception of my LDL which is only 10 points higher than normal. How do I fight the "RATED" designation and get it removed from the database so that I can get a life insurance policy with a decent premium? I feel like the underwriters/insurance company has done something illegal/immoral. Thanks for any advice you can offer.

 

[Betty]

What is the name of your state? California

I applied for a life insurance policy and was told I did not qualify for their preferred rates but was offered a "RATED" policy at 4 times the preferred rate. The underwriters claim that the results from a stress test taken during a routine physical in 2004 showed abnormal tracings yet my doctor has repeatedly said the test was perfectly normal. In addition now the insurance company is saying they need more information to properly evaluate the stress test but in the meantime have left the "RATED" designation on the books. I am perfectly healthy, non smoker, non drinker and my parents are healthy in their late 70's. All of my numbers are within the normal range on the medical exam the insurance company ordered with the exception of my LDL which is only 10 points higher than normal. How do I fight the "RATED" designation and get it removed from the database so that I can get a life insurance policy with a decent premium? I feel like the underwriters/insurance company has done something illegal/immoral. Thanks for any advice you can offer.

I was a life ins. underwriter. It's possible the ins. company's dr. and/or underwriter interpreted the stress test as abnormal & requiring a rating. All cos. are different but what our co. might let you do to try for a better rating is submit a current stress test for review. It does seem your ins. co. is requesting some type of add'l. info for review to see if it makes a difference in the rating. However; until and unless they get some add'l. info that lets them remove or reduce the rating, the rating will remain.

 

[RLV]

Why is the interpretation of a stress test so subjective that a doctor can say everything is normal but an insurance company can say otherwise? It seems as though it would be of little use to have a stress test done when the interpretations can be used against you at a later time.

 

[Betty]

That's the way it is sometimes - in some cases. Have your dr. (if you haven't already) write a letter to the underwriting dept. of the ins. co. giving his interpretation that he believes the test is normal. The underwriters & probably medical director at the ins. co. will review what he has to say & it may or may not change their interpretation/decision. Sometimes one dr. can see something they believe is of concern where another dr.may not. Sometimes a more current stress test will help - the ins. co. can look & see if the same "problem" they were concerned about is still there.

 

[RLV]

Do I have the right to receive a copy of the insurance company's findings explaining their reason for the rating when I have been rated? Thanks

 

[ErinGoBragh]

Yes, write a letter saying that you want the reason for your rating to be sent to your doctor and provide doctor's information.

 

[Betty]

The info will be sent to your dr. as ErynSMA noted. The co. needs a letter signed by you requesting the reasons for the rating be sent to your doctor. (give name/address) That will be a good idea to do that. That way your dr. can see where the ins. co. is coming from - what they based their decision on.

 

[RLV]

Thanks so much for the advice. What recourse do I have if my doctor is adamant that his interpretations are correct after seeing the insurance company's reason for the rating?

 

[ErinGoBragh]

I don't really believe you would have any recourse. As Betty suggested you could have the doctor write to the insurance company, that may change the mind of the underwriters, but ultimately the insurance agency has the right to refuse insurance to, or rate someone higher, if they feel they are a greater risk then the average person. If the LDL is out of normal range though, even a bit, they have the right to assign a higher rating as it does not indicate "perfect" health. Also abnormal traces are, ironically, normal to find, but MAY be an indicator of a risk. It's a little subjective and open to interpretation. I would also suggest shopping around; company standards may vary on what are acceptable ranges.

 

[RLV]

How do you "shop around" after being rated? Will companies give a preliminary cost without adding your name to the dreaded "RATED" list? Or does it even matter anymore, once rated always rated? Is there anyway to clear it off my records?

 

[ErinGoBragh]

I have never heard of this dreaded "rated" list you speak of. Most companies really don't communicate like you're implying. You don't have to take the insurance policy until you know and accept the conditions, including what your rating is. It will not hurt you to shop around.

 

[Betty]

How do you "shop around" after being rated? Will companies give a preliminary cost without adding your name to the dreaded "RATED" list? Or does it even matter anymore, once rated always rated? Is there anyway to clear it off my records?

You can ask your agt. if he works for more than one co. & if he does, he can send your application to other cos. for review. If he only works for one co., you might look for a broker who can send applications to more than one co. for multiple reviews & quotes. Companies that are members can report significant information to the Medical Information Bureau - it will just be a code (no actual medical information/reports, etc.). Other ins. cos. that are members can access these codes. They will remain for 7 yrs. unless the info is proven incorrect.

 

[RLV]

I have not accepted the life insurance but feel like I need to clear the rated designation before I look elsewhere for insurance. I am still somewhat confused here. ErynSMA says the Insurance Companies don't communicate yet Betty says that they report the information to the MIB via codes. I've been told by the broker that all insurance applications have the question "Have you been rated?" I will now have to answer that "YES" for all additional quotes. I am assuming that will put me at a distinct disadvantage at the outset. I sure appreciate your insight on this because I am unable to talk with the insurance company and my broker seems to have never faced this situation before.

 

[Betty]

Yes, most all life ins. applications ask if you have ever been rated or declined for insurance. If you have, you need to be truthful & answer yes - they will ask for you to give details (ie reason, etc.). That co. may or may not rate you no matter what you answer on their application - they will do their own review of the application (their own underwriting) & make their own decision.

If you are still in the process of "disputing" your rating with the original co. you applied to by sending them add'l. info for review, having them write your dr., etc. you might want to wait & see how that turns out before trying other cos. It's a decision you will have to make.

Ins. cos. do share info in some cases & in various ways. One major way is through the MIB for member cos. However, through the MIB all a co. will see is a code reported by another co. - they will have to do their own underwriting to gather details.

 

[RLV]

You have given me hope that the info will be removed "if proven incorrect". That is my goal at this point. I am still waiting for the the insurance company to provide their findings to my doctor and then for my doctor to respond. I intend on waiting until that is finished as you suggested, before applying to other companies.

At what point in the application process with other companies for reviews and quotes does it remain just a review or quote and not become records that are reported to the MIB?