The healthcare debate and the legislation that recently passed put a bright spotlight on the insurance industrythe insurance companies as well as agents and advisors. Much of what was said and portrayed in the press and on Capitol Hill was not favorable. But as often is the case, the larger picture being drawn is most often not the reality that people face in their day-to-day lives.
Let me share the stories of two of my clients that I think serve as real-life examples of how governmentor mandatedbenefits work vs. how insurance company benefits work.
Client A, age 48, was diagnosed with muscular dystrophy a few years ago. During this time, in the middle of the economic downturn, his job was outsourced. When he lost his job, he also lost his group disability insurance coverage and his only paycheck benefits. As the disease progressed, he was unable to work any longer.
In late 2008, he filed for Social Security disability benefits and was denied. You may not know it, but this is a common occurrence for first time filers of Social Security benefits. In fact, the industry statistics indicate that 65% of all Social Security claims are initially denied.
With my help, my client engaged an attorney who specializes in Social Security disability claims. A year and a half after filing and paying attorneys fees, he was approved for benefits.
Contrast this experience with Client B. He had a substantial life insurance policy with me that was scheduled to expire for lack of payment. When I spoke with the client’s wife, I learned her husband had been declared totally disabled four years ago, due to the effects of exposure to Agent Orange when he served in Vietnam. The family had never shared this information with me.
I informed them that his insurance policy had a waiver of premium benefit, which meant that if he were to become disabled and unable to work, his life insurance premiums would be paid by the company for the rest of his life.
Once the client sent me the documentation I needed, the insurance company sent the client a refund check for those four years worth of premiums that they had paid. And now the policy is now paid for life! The whole process took just over a month, and there were no attorney fees and no hassle.
I leave it to you to decide: Which system worked better? The governments or the insurance industrys? We all want reform, but we need to understand what that truly needs to be.