Your Health Insurance Company Can Actually Kill You!

Many health insurance companies, including Illinois Health insurance companies are now selling direct to the consumer, bypassing the health insurance agent. The cost of health insurance is the same, there is no discount whether you are buying it from the agent, or directly from the insurance company. The advantage for the insurance company is simply more profit, by not paying the agent, they make more money.

One large Midwest Health Insurance comments that they have a goal of selling 10% of their sales volume in house, but despite that they realize the importance of having agents in the field becuase there is no way they could service their cutomer base without the aid of independent agents. Still that 10% adds a lot to the bottomline, so they go after it while still supporting affiliated agents.

For the consumer there is no advantage to buying directly from the health insurance company. What the consumer gets is a reduced, to non existant level of policy service. That's right, dealing directly with the company means you are going to be dealing with entry level customer service people on the phone, and more often, or not that customer service is being outsourced to foreign countries.

The level of service you expect won't be there. The same health insurance companies that want you to buy direct, and cut out the agent to increase their profits is also cutting back on the level of customer service it provides. Do you really think they will act in your best interest rather than the insurance companies? Does this really surprise you? In a profit driven health care system that is becoming more centralized in power it should be no surprise.

Your health insurance company can actually kill you!

Let me give you a prime example of how having a health insurance agent can save you, or a family members life. The following is a recent scenario that I was involved in that became a life and death situation for the insured.

I sold a health policy to a Chicago family in 2002, sometime along the way the primary applicant developed cancer, he went through various treatments, got better, but had a relapse this Spring. He also had a problem with his checking account where he was over drawn a small amount. His bankdraft for his insurance premium was returned, so his policy lapsed, and he lost his coverage, which in his case is a death sentence.

In Illinois, and most states you have a 30 day grace period when it comes to paying your health insurance premiums. Once you are past thirty days with no payment, you lose your policy. You can apply for reinstatement, but if you have cancer like my client did, they won't take you back after a lapse of more than 30 days. My client never learned in writing that his policy has lapsed till May 24th, which was too late to reinstate by payment, and in his case no exception could be made due to his prior health history.

If you do not have an agent in a situation like this, and you are dealing with entry level customer service at your health insurance company, you are as good as dead, honestly you have been handed a death sentence because hospitals are not going to treat you, that's right no chemo, no radiation, until you show up with cash, or make other financial arrangements. In the end a public health hospital will make you comfortable.....that's it, that is the reality, and the coldness of the current health care system in America.

You have nobody on your side, no advice, you are completely alone if you do not have an experienced health insurance agent by your side in a situation like this.

Well in my clients case he called the insurance company first a number of times directly to try to rectify the situation before he contacted me, which wasting valuable time. He had no idea that the clock was ticking on all his available options because nobody on the phone he talked to at the insurance company was trained well enough to tell him what they were.

He owned a small business, had a few employee's, but never offered group coverage in the past, so he could have formed a small group if there was time, and he could have gotten credit for continuous coverage credits for Hippa (63 days), but by the time he was able to react to the letter he received, that option was gone too!

He asked me for help, his case had to go through an elaborate appeal process which by law can take up to six months. This guy didn't have six months, or six weeks, if he didn't get treated the cancer was going to spread, and quickly become untreatable. He would of course leverage everything he owned to prevent that, his house, his cars, his two pizza restaurants, they would all have to be sold to give him a chance to live. All because of a delayed correspondence, and being less than $100 shy in has bank account for the first time in ages.

I had one option, and that was to write the most important letter of my life, and that was his appeal letter. I had to completely state his case, his contacts, and his lack of correspondence. Everything involved had to be documented including copies of his bank statements, copies of the correspondence he received, and the postmarks on the envelopes they were delivered in.

I sent the appeal in, and didn't hear anything for a few weeks even though I contacted the company each day. On June 17th my client received a letter from the company. It was dated April 20th, but postmarked June 14th. The letter informed him that if he didnt get his premium in by the end of the April his policy would lapse. Well obviously he never had time to react, the letter had been misplaced in the company mailroom.

When I forwarded the insurance company a copy of that letter, they reinstated the policy for back premium within 48 hours, and my client had another shot at life. I spent maybe 30 hours working on this situation from May 24th till today, June 22nd, when this was resolved in my clients favor.

I ask you, would you receive that type of service dealing directly with your health insurance company?

What would have happened if he didn't have an experienced agent?

He would never have heard about the reinstatement process, he would never have known in time about the appeal process, he would not have been able to expedite his appeal because by law they can take up to six months. In other words he would have lost everything he owned, everything his family had worked for, and most importantly he would have lost his life.

Perhaps he could have called an attorney, he could have called the state insurance commisioners office. All good ideas, but that would have guaranteed the six month appeal process, by law the insurance company can take six months to decide an appeal. It is a common unwritten practice that if the company is threatened by an outside authority, (Attorney, Insurance Commisioner) they sit on the appeal for the six month period allotted by the law. To my client, and anyone else in this situation, it would have been a death sentence.

Long after he passed away, perhaps two to three years from now his family would have recourse in the court's, and there is a very good chance they would win.

Insurance companies have yearly budgets for litigation, and they know that most people won't sue, they will end up beaten down by the circumstances and just give up. Insurance is a calculated risk business, and yes litigation is part of the calculated risk formula. On average they know they will come out ahead regardless of the outcome.

In life sometimes you can't wait six months, or two years, so that why it is important to have a health insurance expert on your side.


Here are a couple of guidelines for picking an Illinois health insurance agent, or a health insurance agent in any state for that matter.


1. Only work with a licensed independent insurance agent who gives you at least five companies to choose from. There is something wrong if the agent only gives you one choice, that means he represents the company, not you. A good agent will always offer plenty of choice.

2. Only work with an agent who has five or more years of experience and is a succesful producer for the companies he represents. Succesful producers can get problems solved with a phone call, in fact they can go to the very top of the company to get a problem solved. A top agent can circumvent the red tape.

3. Never buy your health insurance directly from the insurance company. If you do, you won't have anyone who is independent that can represent you when problems arise, or simply when you have basic policy questions.

4. Shopping on the internet is a great way to buy health insurance, but who are the people behind the website? Make sure you are buying from an experienced health insurance agent who will be there when you need him, not a telemarketer reading a script. Don't buy from a phone room, buy from an agent.

5. When buying on the internet call before you apply. Get to know the agent you are dealing with, make sure he is around to service you. A good way to figure that out is if he presses you to buy, if he does that it is a sign that he may not have your best interest at heart. We all of course want you to buy a policy from us, but our agency www.medequote.com want's you to make sure you understand everything before you buy. We want you take your time. A good agent gives you the information to make your own best decision. A good agent lets you take your time.

In conclusion the internet has made comparing policies, getting information and applying for health insurance a lot easier for the consumer, but the most important decision you make is always picking the right agent, or agency.

At Medequote we are that type of agency, and if you want service after the sale, and you aren't getting it from your existing agency give us a call at 800-301-7469, or visit us online at www.medequote.com , www.medequote.net , or if you are a young single stop by www.unicaresoundplans.com .

I have over 18 years of experience as a life, and health agent. I am known by the companies I represent in words, and deed. I personally service every client who calls, and we are always available. We make a commitment to always be there for you and your family, and we take that commitment seriously.

Whomever you choose, make sure they compare to the standards set by www.medequote.com, if you are in a state we are not licensed in, we currently serve Illinois, Texas, and Michigan, if you need a referal for a quality agent in a state we do not directly serve, just give us a call!