The Medical/HMO Insurance Application
After discussing the issues of importance to you, you will be shown an application for the coverage.
- In answering the questions on this application, remember that the company will rely on your responses in issuing the policy.
- Read and answer all the questions yourself. Do not just have the agent read them to you.
- Answer each question fully, honestly and literally. As previously mentioned, if a company later learns that any key answer in the application was inaccurate or incomplete, it may be able to rescind or void your policy and deny an otherwise valid claim. This can be so even if the misstatement was unintentional.
- If you are unsure about the meaning of any question, ask the insurance company representative about it and write the person’s response on the application. If possible, have the representative initial it.
- Application questions about prior medical histories can be especially tricky. For example you may be asked: “Have you or any applying family member ever had any signs or symptoms, been consulted for, received advice, sought treatment, had treatment recommended, received treatment or been hospitalized for the following conditions?” It is necessary to answer these types of questions thoroughly and completely. If you don’t remember everything, write “I am not able to remember every symptom I have ever had or complained about but the following list is to the best of my recollection…”
Never sign an application – or any insurance paperwork – without reading and understanding what you are signing. If you do not understand anything, ask for an explanation and take down notes. Save these in your file. Again, these notes can make a big difference in benefits paid in the future.
There are some very basic rights that you must have as an insurance consumer, and that should be expected of any insurance company you deal with. See our Insurance Consumers’ Policyholder Bill of Rights for guidance.