Beyond the Phone Interview
Offer solutions to BGA's and agents
on rated cases: IBU MD Questionnaire
Actual Case Quoted Table 2 by carrier brought to Preferred thanks to an IBU MD Questionnaire
Case: Male, age 55, non-smoker with hx of heart murmur
An APS from Dr. XXX indicated a history of heart murmur, which didn’t square with the information provided by the proposed insured (PI) on the application. When the carrier rated the case Table 2, the broker went back to the writing agent and asked if the PI ever had his heart murmur checked out.
While the PI did not mention the condition on the application, when asked he indicated that he was diagnosed with a low grade functional heart murmur over 10 years ago, and that it had never been an issue. Five years ago, the PI had a cardiac work up by Dr. XXX at High Point Regional Hospital. These records were ordered and sent to the carrier for re-consideration.
Several tests were performed but nothing that targeted the heart murmur. Because of a lack of conclusive information, however, the carrier underwriter believed that the heart murmur was a concern. In turn, The carrier did not change their decision and quoted the case Table 2.
IBU Underwriter Charles Melgar received the file and reviewed the available information, which raised enough questions that he felt the case might not warrant a Table 2 rating. He faxed a letter to the PI’s personal physician [IBU MD Questionnaire] and persistently called the office until he received clarifying information. The doctor faxed a signed note clearly indicating that the PI has a “life-long functional murmur that does not require any medication nor does it affect his daily activities.” [fax from Dr.]
The case was then referred back to the home office underwriter with the IBU letter to the doctor as well as the doctor’s response, and the case was re-evaluated. The persistence of the IBU underwriter resulted in a new offer of “PREFERRED best class.”
Experienced IBU underwriters know exactly what to ask the physician’s office to bring clarity to a case. The next time a case is rated, declined or needs additional information, forward this newsletter to your producer. An IBU MD Questionaire is a must-have tool for every BGA or agent.