Formal Process

a formal application is received in our office it is referred to our Licensing Department for processing. The Licensing Department checks to make sure that all parties involved are appointed with the carrier in the appropriate state. The turn around time for the file to be processed by the Licensing Department is generally the same day unless there is some type of hold up with the agent’s appointment.

the Licensing piece is completed the file is then assigned to a Case Manager for processing. The Case Manager reviews the file and the formal paperwork to make sure that all of the information provided is complete and that all of the appropriate forms are present. The paperwork is then packaged up to go out to the carrier, complete with a cover letter from the Case Manager to the Underwriter. The cover letter gives an overview of the case, as well as the formal decision we are pursuing. All applications and correspondence to the carriers go out via Federal Express.

the case is formal, the Case Manager takes care of ordering APS updates, as well as any new APS(s) from physician(s) who may have shown up on the formal paperwork or the exam(s). All records are ordered through our in house Medical Records Department. The Case Manager is responsible for following up with our Records Department to insure that the records are received in a timely manner.

Case Manager also takes care of ordering Inspection Reports, PHI’s and MVR’s. The inspection service we have used for years is Profile Services, due to their level of service and professionalism. Typically, the availability and responsiveness of the proposed insured(s) will determine how quickly the report(s) can be completed.

Home Office is responsible for accessing MIB and lab results and that is done once they have a formal application in house.

is a list of items that are contributory to delaying the formal process: Agent's licensing is incomplete or paperwork is outstanding Incomplete or missing information on the formal paperwork Missing or incorrect forms for the state in which the case is being written APS updates or records from new physician(s) that show up on the formal paperwork Inspection Service having trouble reaching client(s) due to lack of availability or responsiveness.

the case is to the formal stage it is very important to make sure that the Case Manager is made aware of any special time frames on the case. It is always a good idea to submit a cover letter outlining any special issues. This will assist the Case Manager in identifying any possible obstacles and help the case to go along more smoothly.