Over Medicated

January 17, 2007 by bob.

Q. I have applied for coverage for my wife & myself with several different companies. It takes over a month for the companies to respond and they keep losing the files that are sent from my doctor. In addition, my wife has a minor medical problem that is causing her to be rejected. Why can’t I find coverage for her?

A. There are several issues here that are creating your problems. The primary cause of the rejection is over medication. More on that later.

While you have used the services of an agent, in fact, more than one agent, your attempt to control the process is compounding the problems.

When you submit multiple applications simultaneously, as you did with 2 different agents, you have needlessly created a backlog. When carriers see a condition that warrants additional information they make a request from the attending physician for more details. In this case, it was the MVP (mitral valve prolapse) that is present in your wife.

Carriers do not solicit the APS (attending physicians statement) direct, but rather will go through a third party. In your case, the request was made through EMSI by two different carriers approximately 2 weeks apart. Your wife’s doctor responded to the initial request from EMSI for carrier #1. A few weeks later when carrier #2 made a similar request, also through EMSI, your doctor did not honor the request since they thought it was a duplicate from the same carrier.

This further delayed the process by almost 3 weeks.

The first carrier declined your wife for coverage, as did carrier #2.

MVP is a benign condition in most people that does not require medication. In your case, after reviewing your medical history as well as that of your wife, it would appear you have a doctor who is more than willing to provide a medication even when it is unnecessary. I am not a doctor, and am making assumptions based on a review of your records and conversation with you & your wife. You have had a very generous (albeit expensive) plan with low copays. As such, you have used the plan to the point of making your situation unacceptable to a carrier.

My guess is, if you were to ask your doctor(s) if some of the meds could be discontinued they would agree. Once you have been off meds (without ill effects) for at least 12 months you might find a carrier who will accept you.

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