Cigar smoking and Life Insurance premiums.

[BigCat]

Originally Posted by brigey57

You do know that I understand that and my response was said sarcastically or why else would I look to buy Life insurance in the first place? Thank you for clarifying your point...

It wasn't clear to me that you were being sarcastic. It's one of the weaknesses of the written word at times. I was merely trying to shed light on an apparently overlooked point.

[JohnE1000]

If you lie, they will refuse your claims, then what is the insurance good for?

[Blueface]

Originally Posted by JohnE1000

If you lie, they will refuse your claims, then what is the insurance good for?

Well, applications are contracts. You agree to certain terms as does the company. Misrepresenting information not only yields a claim possibly not being paid but also may yield what they call void ab initio. This means your policy is void and never existed.

Now, back to the cigar thing, what if you are not a cigar smoker but later become one and the company doesn't f/u with you as the years pass to see if factors have changed? How on Earth will they be able to prove you intended to defraud on the application by proving you were actually a smoker at that time? Just hope they too are not on CA. (hint.................things that make you go hmmmm).

However, I won't advocate that. I am the guy that approves those voids when people lie on applications. Not a nice thing when that happens.

[Ahbroody]

This is a very valid point. Insurance companies dont follow up. More I have been able to find nothing regarding if you start smoking cigars later in life. They will not deny based on that and it is not on you to tell them you have begun smoking. The policy is based on the terms at time of signing. Given how bad insurance companies have and continue to screw people sorry if I lack compassion for them. That said I will likely disclose casual cigar use. I worked as an insurance adjuster for over 2 years. The primary focus on all claims was tryimg to see if coverage could be denied. Insurance companies love to take money and make profits, but sure dont like giving you any of your money back.

Tomorrow will make 1 week no cigars. Looks like I will make 2 weeks before the physical. That will make for an interesting dilemma.

[jkim05]

Originally Posted by Ahbroody

This is a very valid point. Insurance companies dont follow up. More I have been able to find nothing regarding if you start smoking cigars later in life. They will not deny based on that and it is not on you to tell them you have begun smoking. The policy is based on the terms at time of signing. Given how bad insurance companies have and continue to screw people sorry if I lack compassion for them. That said I will likely disclose casual cigar use. I worked as an insurance adjuster for over 2 years. The primary focus on all claims was tryimg to see if coverage could be denied. Insurance companies love to take money and make profits, but sure dont like giving you any of your money back.

Tomorrow will make 1 week no cigars. Looks like I will make 2 weeks before the physical. That will make for an interesting dilemma.

For all life insurance claims, the insurance company has 2 years from the date of the contract to make any adjustments or amendments to the policy, and that is only for information that was discovered later relevant at the time the policy was underwritten. For instance, if a criminal history was discovered subsequent to the original issue of the policy or some relevant medical information was not disclosed originally, but found out later by the insurance company, they could raise your rates or cancel the policy outright depending on the issue. However, any changes that happen subsequent to underwriting is not subject to disclosure. You could have a had any number of health conditions, but if it was not preexisting or did not come up in underwriting, the life insurance company cannot deny a claim on that basis. Once the policy is issued, you can do whatever you want, but you don't want to lie prior to the policy being issued also.

[Ahbroody]

Originally Posted by jkim05

For all life insurance claims, the insurance company has 2 years from the date of the contract to make any adjustments or amendments to the policy, and that is only for information that was discovered later relevant at the time the policy was underwritten. For instance, if a criminal history was discovered subsequent to the original issue of the policy or some relevant medical information was not disclosed originally, but found out later by the insurance company, they could raise your rates or cancel the policy outright depending on the issue. However, any changes that happen subsequent to underwriting is not subject to disclosure. You could have a had any number of health conditions, but if it was not preexisting or did not come up in underwriting, the life insurance company cannot deny a claim on that basis. Once the policy is issued, you can do whatever you want, but you don't want to lie prior to the policy being issued also.

I read all this online. Like I said earlier. I will disclose the occasional cigar. That said being healthy, young, a runner, non drinker, I dont see any health issues arrising from cigars in the next 2 years. It has almost been a week since I had a cigar though and will likely be another week apparently before this dude gets off his arse and gets out here. I am sure I will test negative.

I tell you what the Cohiba Esplendido I got in the MAW will meet its end after this physical.

[Blueface]

Originally Posted by Ahbroody

Given how bad insurance companies have and continue to screw people sorry if I lack compassion for them. That said I will likely disclose casual cigar use. I worked as an insurance adjuster for over 2 years. The primary focus on all claims was tryimg to see if coverage could be denied. Insurance companies love to take money and make profits, but sure dont like giving you any of your money back.

Wow.
I have been in the claims business for 28 years, for the largest publicly traded carrier in the country.
24 of the last 28 years as a manager.
I have dealt with Personal Lines, PIP, Auto Adjusting, Home Owner Adjusting, Bodily Injury adjusting, Catastrophe adjusting and now, for the last 12 years or so, Special Investigation Unit, addressing potential fraud.

All that said, not once have I ever, ever been told to handle claims as you state.
Not once have I been told that as a leader, I had to tell someone to handle claims as you have mentioned.
All we have ever been taught and all I have ever taught my employees is that we are here to service the customer, who pays the premiums that pays our salary. However, that doesn't mean what the customer thinks is a fair adjustment and what we perceive as a fair adjustment will always match. Remember, many states can have you lose your license and perhaps even be prosecuted for violation of ethical standards for doing what you mention. In Florida as an example, violation of the state law of Code of Ethics for insurance adjusters can result in my termination, loss of license so I can never work in the industry again and millions in fines to my company.

Not sure what carrier you worked for, but I assure you mine doesn't function with that mindset. Must be why we are so large after all.

[Ahbroody]

Well allstates pretty big and they lost a 16 million dollar bad faith claim around two years ago. I am pretty sure with minimal effort I can find articles about what ever company you work for settling lawsuits or getting judgements against them.

I will say the following. When the person first calls the first thing done is to see if the policy is enforce or has lapsed for some reason. After this the claim is triaged and the adjuster gets it, amoung determining what happened is asking a series of questions based on the policy and facts to determine exposure and if another person is liable for claim. If not then it needs to be determined if insureds policy will cover and if there was anything done that would exclude coverage. It was not a small insurance company its serves the whole country. Coverage is always checked and the company is always trying to determine if they are not responsible for paying.

Insurance companies are businesses with shareholders. The goal of any business is to make profits. Paying claims and making as much profit as possible are in direct conflict.

You said your piece I have now said my piece . We are definitely not going to agree. I quit because I hated it you love it.

As to ontopic wife was called by her screener today. She is set for next monday. I am still waiting to hear from mine. Hopefully tomorrow. Looks like next week for me also.

[Blueface]

Originally Posted by Ahbroody

Well allstates pretty big and they lost a 16 million dollar bad faith claim around two years ago. I am pretty sure with minimal effort I can find articles about what ever company you work for settling lawsuits or getting judgements against them.

I never inferred perfection in our industry. Sometimes bad faith suits are as result of being set up. Sometimes they come from mistakes. More times than not, they come from mistakes, not intentional acts. Adjusters are human an din some states, you miss one word on a letter and that constitues bad faith. In Florida, attorneys ask for the dumbest of things in letters of representation, buried in an evident way hoping you miss one and hence are in bad faith. It is unjust to paint all insurance companies and adjusters with the same brush.

I will say the following. When the person first calls the first thing done is to see if the policy is enforce or has lapsed for some reason.

It is a business. Of course this should be the first thing they do. If coverage is not in force, would you want to pay for something you did not owe? When you go to the dealer for service, don't they check to see if your car is still under warranty?

After this the claim is triaged and the adjuster gets it, amoung determining what happened is asking a series of questions based on the policy and facts to determine exposure and if another person is liable for claim.

That is called "Subrogation". If someone else is responsible, from whom you can collect from, from which you can reimburse deductibles to insureds or lower overall premium by reducing exposure, wouldn't you do it?

If not then it needs to be determined if insureds policy will cover and if there was anything done that would exclude coverage.

Policies are contracts. They contain coverages, conditions and exclusions. Again, what is so wrong with adhering to the contract and if an exclusion exists, it applies? The good thing is after many years at it, you don't need to look for the exclusions. You know them the minute you see a claim and likewise, you know there is coverage afforded the minute you see a valid claim.

It was not a small insurance company its serves the whole country. Coverage is always checked and the company is always trying to determine if they are not responsible for paying.

And if coverage exists? Which is likely the majority of the times? Again, it is a business. Don't understand why this is a bad thing.

Insurance companies are businesses with shareholders. The goal of any business is to make profits. Paying claims and making as much profit as possible are in direct conflict.

First part correct. The rest not. To correct it, containment of costs is the way to make money, with increased revenue from writing new business, but more importantly, keeping older customers happy. The money is made as result of profitable long term renewals and the profits from investments, not from the claims savings.

You said your piece I have now said my piece . We are definitely not going to agree. I quit because I hated it you love it.

True. Apparently you were asked to act in a way I have never been in 28 years.

As to ontopic wife was called by her screener today. She is set for next monday. I am still waiting to hear from mine. Hopefully tomorrow. Looks like next week for me also.

See in bold.

For those of you who live in Ga, I know an agent/financial planner (who's a fellow BOTL)that sells a smokers policy that's rated/treated as non smokers insurance.

I'm probably not explaining this right, but you're not penalized for
being a smoker and you don't lose any benefits. I can send you
his contact info if you like.