Turning No into Yes

I had a referral a few weeks ago. A really nice guy. Sixty years old and in reasonably good health.

He takes something for high blood pressure, acid reflux and cholesterol.

And he is deaf in one ear as a result of a benign cyst from a few years ago.

He has coverage now, if you can call it that. The plan covers almost nothing and will leave him financially ruined if he ever has a major claim.

Every carrier refused to make an offer due to the cyst.

Every carrier but one.

They agreed to consider his application before making a final determination. We didn't have a problem with that and thought it was only fair.

We sent the application in, and waited.

A week later we got a letter declining coverage.

That would probably stop most people dead in their tracks, but I am not most people.

I have over 30 years in this industry, and know what works and what doesn't. I also know that "no" sometimes means "yes" . . . IF you know how to properly appeal your case.

So I made a call to "my people" inside the carriers home office and presented my case. I showed them earlier correspondence from underwriting indicating the cyst was not a problem, and then we reviewed their declination which was a complete reversal.

My contact agreed I had done a thorough job of laying out the situation in the pre-screen process, prior to the application. There were no surprises. The condition was exactly as first revealed.

So the appeal started.

It took a bit longer than anticipated and I did get feedback while waiting. It seems the initial review wasn't as thorough as it should have been, but the "final" underwriting was also a bit sloppy.

Today they called and said an offer would be coming in the mail. The policy will be issued standard, with exclusionary riders for acid reflux and the hearing loss.

Sounds like a fantastic offer to me.

My client is pleased.

This is what makes my business so rewarding.