How do I challenge being mistakenly "RATED"?

[Betty]

Normally info (codes) are reported to the MIB after final action is taken on an application - after it is approved (with or without a rating & sent to policy issue), retired or declined.

Info (codes) will be corrected or deleted if already reported & it can be proven to the ins. co. that reported the codes that the info is incorrect.

 

[RLV]

Great news! I received a phone call from my broker today saying that the Insurance Company has reconsidered their evaluation and offered me a standard policy. I now can shop around without having to say I have been rated.

Interestingly enough on 4/21/08 I contacted the Ca Dept of Insurance and filled out an online request for assistance. Is this coincidental that the Insurance company changed their mind and removed the rating within a week of my online request to the Ca Dept of Insurance?

The only disadvantage to the lengthy process(nearly 6 months) of getting the insurance company to remove the rating is that now my premiums are based on being 1 year older. Is their anything I can do about having the insurance company honor a premium based on the younger age because of their drawn out unjustified process?

 

[Betty]

That is great news. I'm glad things worked out for you.

Re your contacting the Ca Dept. of Ins. - I don't know if that had anything to do with removing the rating -- possibly. However, it might have very well gotten them to take action on your case faster.

Re your last question about charging you a premium for one year younger than you currently are - you will have to ask the agt./ins. co. to see if they will do this. They would probably have to make the effective date of the policy (date the policy back) to coincide with the younger age (& they will usually only date back so far) & you would then have to pay a prem. for that time already elapsed. They normally can't date a policy current (where you pay a current prem. only - no prem. for time past) without using your current age. This is probably all confusing to you. Talk to your agent or ins. co. Also, the ins. co. did apparently believe you should have been rated originally or they wouldn't have & sometimes it takes a while to do a reconsideration - obtain all info they need.

 

[RLV]

RE: Your comment, "Also, the ins. co. did apparently believe you should have been rated originally or they wouldn't have & sometimes it takes a while to do a reconsideration - obtain all info they need."

As a consumer your logic seems quite illogical to me. Why wouldn't they first obtain all the information they need to make an informed decision rather than have partial information and offer to reconsider, only after I questioned the rating. Their rash decision to rate me kept me from being able to look elsewhere for insurance until this was cleared up.

Thanks very much

 

[Betty]

As a prior underwriter, we make a decision on the information we have if we have no reason to believe it is incorrect. If we get a request to reconsider, we will have to wait until we get info furnished to us that will allow us to change our original decision. Sometimes it takes a while to get what we need to change our decision - sometimes what we get will not allow us to change our decision. Underwriters work for the co. (as does the medical director) & we have to make decisions that protect the co. from anti-selection. I'm sure this is hard for you to understand & it is kind of hard to explain. They did originally have all the info they needed to make a decision on your case but it happened to be a rated one. Unless the proposed insured/agt. furnishes the co. something add'l. to review to see if a reduction in rate could be made, the rating would stay.

 

[RLV]

Yes you are correct, it is difficult to understand the insurance company's logic on this one.

What does "anti-selection" mean in the insurance industry?

 

[Betty]

More or less ..... it means we have to underwrite to protect the ins. co. from claims. If someone should be rated (or declined) for example, we can't offer them std. coverage if the info we have will not allow us. We have to screen applicants so that each one is rated correctly (ie pref. std., rated, declined) based on the info we have. If someone should be rated & we issued std., it would be anti-selection/adverse selection against the co.

I'm just glad things worked out in the end for you, sir.

 

[RLV]

Thanks very much for all your time in replying to my posts and educating me on the Life Insurance Industry Protocol.

I too am glad everything worked out the way it did. Now I have to work on my reducing my LDL count before applying elsewhere since that seems to be the only thing that is keeping me from receiving the preferred rates.

I think that is all the questions I have on this subject. Thanks again.

 

[Betty]

You're very welcome.