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The simplified underwriting is not a colander !


Alain Thériault

3 October, 2018 07:00

Some bad tongues will say that the insurance issue simplified is a strainer to never refuse person. But the reality is different, say the insurers.

The latter can take precautions to avoid unpleasant surprises, said Alain Plante, regional vice president sales, Quebec Center, Canada protection Plan (CPP). “A person has answered no to a question about diseases ? We check with the MIB to learn that it has been refused in another insurer, due to a myocardial infarction. We will make a verification call to find out that she had this disease 5 years ago. His response was just because the questionnaire exemption to report a malaise that goes back more than three years for insured persons under the age of 55 years, and more than two years for insureds age 55 and over, ” he explains.

This approach saves time during the claim. “We will not need to make a check for this stroke, since it is already recorded in the record of the insured. The purpose of the audit in the MIB is to speed up the process. We are here to pay. Most risk management is done well, the more the prices of insurance products should be affordable, ” said Mr Plant.

There are also clients who do not tell the whole story, without necessarily acting in bad faith. It invites counsellors to assist their clients to ensure that they respond well to questions.

“A person has contracted hepatitis C. she says She has had it for a number of years. A check at the MIB, however, reveals that she was rejected for life insurance due to cirrhosis of the liver, a common consequence of hepatitis C. She said be cured ? Impossible, the liver does not hold back. The person feels healed, but suffers from a chronic disease; its life expectancy is therefore reduced. It must answer yes to the question. “

Mr. Plant added that it is very important in these situations to contact her underwriter and the latter to provide written responses. The regional vice-president of the PPC says that his company has accumulated over the years a ratio of payment of claims of 98 %.

For his part, Pierre Vincent, senior vice-president, individual insurance and sales ofiA financial Group, has reported that this rate is roughly in the average of the industry. He argues, however, that this rate does not take into account false statements or fraud discovered at the time of the claim, or the death caused by suicide within a period of 24 months. “When people pass on true information, it is very rare that the benefits are not paid “, he said.

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