Last week, INTERTEL’s Nathan Hessel attended the Eastern Claims Conference in Boston, MA. ECC is an excellent conference for the Disability and Life Insurance Industry, which made it a prime event to showcase the PRE-EX Canvassing Program.
PRE-EX Canvass has been created to work with carriers on both the underwriting and claim end to secure the information necessary to make the proper determination on assessing that risk or covering the claim. More than 100 million adults in the US under the age of 65 have pre-existing conditions. Most long-term disability policies contain a clause that allows an insurance company to make a claim decision on the basis that a pre-existing condition exists. Pre-existing conditions can also be automatic disqualifiers for life insurance. As the name suggests, PRE-EX Canvass was designed to give insurance companies the best information available to aid their determination of whether or not a pre-existing condition is present. Even if it is determined that there is no pre-existing condition, the information gathered can be used to determine the validity of the claim in other ways, such as:
- Determining if the Claimant received treatment prior to the date of loss.
- Verifying the alleged injuries are not those for which the Claimant previously sought treatment.
- Helping determine whether the Claimant has a history of injury claims.
- Assessing whether the reported injuries occurred outside the course of employment.
- Discovering unknown treatment information not previously disclosed by the Claimant or Claimant’s attorney.
- Uncovering possible patterns of drug-seeking behavior.
- Substantiate Claimant statements about prior medical treatment and reveals possible material misrepresentations.
- Providing treatment information for specific time periods when conducting searches for pre-existing conditions.
Attending conferences such as ECC is a great opportunity for INTERTEL to showcase our Medical Canvassing programs and discuss more specifically how we can assist our current and potential clients. We are currently planning to be at more than 15 conferences this year, so be sure to subscribe to our blog and follow us on Twitter and LinkedIn to stay up to date on the latest INTERTEL news!
