Underwriting Suzy Saxon Second Vice-President TMK1536 0510 Agents are Field Underwriters • Agent's responsibility to collect accurate and complete information from the applicant • This helps the Agent: Get policies issued quicker Get paid quicker Reduce follow-up work Reduce declines, cancels, and not-takens Increase bonus and renewals Make more money! TMK1536 0510 Product Suitability • You should determine in each case that any policy sold is suitable to the needs of the applicant • You should consider such issues as: Proposed insured's financial condition Need for insurance Values, benefits, and surrender charges in relation to any existing coverage Whether in the totality of each applicant's circumstances, the sale is suitable TMK1536 0510 Instructions to Agents for all Applications • Read health questions as they appear • Ask applicant for explanations to 'Yes' answers • Complete 'Explanations' section for every 'Yes' answer • If additional explanation required, attach Cover Letter to the application • The more information you can provide regarding 'Yes' answers to health questions, the more successful you will be in effectively submitting the application TMK1536 0510 Instructions to Agents (Continued) • Life Insurance policies go through an underwriting process • Underwriters may request additional information, so let applicant know they may receive call • Underwriters ultimately determine insurability • Process determines amount of rated premium • Agents should not make promises to applicants TMK1536 0510 Underwriting Requirements • • • • • • • • • • • • • • • • Info Agent Oral Specimen HIV Consent Form MVR Rip Call (QAC) IBU Inspection-SBSI Criminal Records Check APS Thru AI Records Paramed Blood Profile Urine Specimen Electrocardiogram Treadmill EKG Fingerstick Test HO Handling TMK1536 0510 Agents Instruction Guide TMK1536 0510 Agents Instruction Guide TMK1536 0510 Underwriting Requirements Underwriting requirements may be requested on any proposed insured on the app. If the app contains a spouse rider, the requirement will indicate whether the requirement is on the insured or the spouse. TMK1536 0510 Info Agent Can be any message from Underwriting, such as a request for the proposed insured’s doctor’s name, address, and telephone number or a message indicating that the case requirements are under another file number when more than one case is submitted on the same proposed insured at the same time. TMK1536 0510 Oral Specimen Indicates that Underwriting is pending for the oral specimen lab results that the Agent took at app time, provided the barcode number on the app, and mailed immediately to the lab Note: if the app does not provide the barcode number, the following message will be sent to the Branch with the oral specimen requirement: TMK1536 0510 Oral Specimen Please advise barcode number of oral and date it was completed. We will pend 7 days. If the barcode number or the oral specimen results are not received within 7 days, Underwriting will order an exam with blood profile and urine specimen. Underwriting will still accept the oral instead of the exam if the oral specimen is obtained and the barcode number provided to Underwriting before the exam is completed. TMK1536 0510 Underwriting Requirements TMK1536 0510 HIV Consent Form The form that must be completed and signed in states that require this form. If this requirement is received along with the oral specimen requirement, it is for the Agent to obtain. If this requirement is received along with exam requirements, it is for the examiner to obtain. TMK1536 0510 HIV Consent Form TMK1536 0510 MVR Motor vehicle report Underwriting requests this from an outside vendor. TMK1536 0510 Rip Call (QAC) Indicates that Underwriting has requested a telephone interview to be completed through our QAC department. If the interview has not been completed within 7 days, the following message will be sent out to the Branch: Attempts to contact applicant at given number have been unsuccessful. Please have applicant call 1-800288-4265 to complete the phone inspection. TMK1536 0510 IBU (Interview by Underwriter) Indicates that Underwriting has requested a telephone interview to be completed through an outside vendor. Not all cases are sent to the same IBU Underwriter for handling, so initially the requirement will only indicate “IBU.” TMK1536 0510 IBU (Interview by Underwriter) If the interview has not been completed within 7 days, the following message will be sent out to the Branch: Please have the PI call 1-XXX-XXX-XXXX to complete the IBU. We will pend 7 days. The toll-free number will be specific to each case according to which IBU underwriter is to be contacted. TMK1536 0510 Inspection – SBSI Indicates that Underwriting has requested a telephone inspection interview through an outside vendor. If the interview has not been completed within 7 days, the following message will be sent to the Branch: Attempts to contact applicant at given number have been unsuccessful. Please have applicant call 1-800444-7274 ext. 1 to complete the phone inspection with SBSI. TMK1536 0510 Criminal Records Check Indicates that Underwriting has ordered a criminal records check through an outside vendor. TMK1536 0510 APS Through AI Records Indicates that Underwriting has requested an attending physician’s statement on the proposed insured through AI Records. It will also indicate the name of the doctor or facility from which the records were requested. TMK1536 0510 APS Through AI Records AI Records contact information: Website: https://prodwebapps.ailife.com/apsweb/login.aspx Username: liberty Password: national1 Phone #: 866-922-6453 Email address: airecords@ailife.com TMK1536 0510 Underwriting Paramed Blood Profile Urine Specimen Electrocardiogram Treadmill EKG Fingerstick Test HIV Consent Form TMK1536 0510 Paramed Indicates that Underwriting has requested an exam in combination with the other requirements such as blood profile, urine specimen, electrocardiogram, etc. through one of three outside exam companies TMK1536 0510 Paramed Portamedic’s contact information: Phone #: 866-335-5575 Website: www.portamedic.com EMSI’s contact information: Phone #: 800-872-3674 Website: www.emsinet.com ExamOne’s contact information: Phone #: 877-93-exam1 or 877-933-9261 Website: www.myexamone.com TMK1536 0510 Paramed Note: If the exam company has been unsuccessful in scheduling the exam within 14 days, the Branch will receive the following message: Please assist in getting the exam scheduled and completed. We will pend 7 days. (We will pend longer only if the exam has been completed or at least scheduled) TMK1536 0510 SAM E-mails Daily TMK1536 0510 Field Underwriting Applicants with the following conditions will be automatically declined. Terminal Illness Lou Gehrig’s Disease or Amyotrophic Lateral Sclerosis (ALS) HIV / AIDS or Positive Test to Antibodies for AIDS virus Alzheimer’s Disease or Senile Dementia Confined to a hospital or nursing facility Use of illegal drugs within a two-year period Confined to jail TMK1536 0510 Field Underwriting Do not submit an application for standard issue for the following conditions. An ALX will be considered if the underwriters determine the proposed insured is eligible for coverage. TMK1536 0510 Field Underwriting Heart / Circulatory / Blood Disorders: Congestive Heart Failure within 1 year Defibrillator Implant Angioplasty, Coronary Bypass, Heart Attack or Diagnosis of Angina within last 6 months Coronary Artery Disease and Heart Valve Replacement More than 2 Heart Attacks Heart Attack, Bypass or Stroke and still smokes More than 1 stroke Sickle Cell Anemia TMK1536 0510 Field Underwriting Diabetes and Related Disorders: Diabetes and Kidney Disease (App may be submitted if the proposed insured has diabetes without a related condition) Insulin-dependent Diabetes and No Doctor consulted within last two years TMK1536 0510 Field Underwriting Cancers: Cancer, other than skin, last treatment within 12 months Metastatic Cancer (spread to other sites) within 10 years Hodgkin’s Disease, last treatment within 2 years Leukemia Diagnosed prior to age 50 TMK1536 0510 Field Underwriting Misc. Medical Disorders: Cirrhosis Cystic Fibrosis Depression - hospitalized within 6 months - or unable to work Suicide Attempt within 5 years Emphysema or Chronic Lung Disease using Home Oxygen Kidney Dialysis Transplant Recipient of any major organ (except Kidney Transplant) TMK1536 0510 Policy Issue • • • • Issued as Applied For Issued COD – Additional Signature Required Issued – Insured is Rated Issued COD – Applicant Qualifies for ALX Only. TMK1536 0510 Issued COD – Additional Signature Required • COD Letter of Transmittal - amount of premium to be collected $0. • Policy Amendment - advises proper signature required on Policy Delivery Acknowledgement. • Policy Transmittal Letter - instructs Agent to refer to Policy Amendment. TMK1536 0510 Issued COD – Additional Signature Required • COD Letter of Transmittal - amount of premium to be Policy Delivery Acknowledgement - Agent has 30 days to place policy and return the signed Policy Delivery Acknowledgement and COD Letter of Transmittal to Home Office. TMK1536 0510 Issued COD – Insured is Rated • Policy amendment - explains reason for rating – policy issued at reduced face amount to match submitted premium. • Policy Transmittal Letter - shows original face amount and rated premium. If customer wants original face amount applied for rather than the reduced amount, the Agent should collect the additional premium at delivery or have the customer sign the COD Letter of Transmittal to draft the additional amount of premium due. If reduced face amount is placed, no signature is required on the COD Letter of Transmittal. TMK1536 0510 Issued COD – Insured is Rated • COD Letter of Transmittal – amount of premium to be collected $0. • Policy Delivery Acknowledgement - Agent has 30 days to place policy and return the signed Policy Delivery Acknowledgement and COD Letter of Transmittal to Home Office. If reduced face amount is placed, no signature is required on COD Letter of Transmittal. TMK1536 0510 Issued COD – Applicant Qualifies for ALX Only • Policy Transmittal Letter – if the premium submitted with the application will purchase less than a $15,000 ALX, we will produce an ALX policy to match the submitted premium and include an alternate premium quote for an ALX policy equal to the original amount applied for up to a maximum of $15,000. TMK1536 0510 Issued COD – Applicant Qualifies for ALX Only • If the customer wants the alternate amount, the Agent should collect the additional premium at delivery, or have the customer sign the COD Letter of Transmittal to draft the additional amount of premium due. TMK1536 0510 Issued COD – Applicant Qualifies for ALX Only • Policy amendment – plan amended to ALX due to medical history. ALX policy issued at reduced face amount to match submitted premium up to a maximum of $15,000. • COD Letter of Transmittal – amount of premium to be collected $0. TMK1536 0510 Issued COD – Applicant Qualifies for ALX Only • Policy Delivery Acknowledgement – Agent has 30 days to place policy and return signed Policy Delivery Acknowledgement and COD Letter of Transmittal to Home Office. • If reduced face amount is placed, no signature is required on COD Letter of Transmittal. TMK1536 0510 OI525002 (OI525003) Pending COD Policies by Days Pending Weekly TMK1536 0510 FA215001 (FA215003) Premium Notice/Combined Billing Clients Weekly TMK1536 0510 LNL New Business Status Report • • • • • • • APS – Attending Physician Statement MVR – Motor Vehicle Report PARAMED – Medical tests required ADDIT EXAM ORAL SWAB COD REMITTANCE INFO AGENT TMK1536 0510 Pending Messages • • • • • • • NAR/AR – No Action Required / Action Required RIP — recorded interview by phone QAC — quality assurance call SBSI — call requesting financial info for large life cases IBU — interview by underwriter MEDICARE LETTER INFO AGENT TMK1536 0510 BI925003 (BI925011) Batch Pending Worksite Report Agents Weekly TMK1536 0510 BI025004 (BI925013) Batch Pending Report Agents Weekly TMK1536 0510