Insurance 101 – Chapter 3 – Volume 19 – More on Post Loss Underwriting

 More on Post Loss Underwriting – 2

The beneficiary of a health plan, under Hailey, has nothing to lose and everything to gain by concealing material facts and claiming the concealment was innocent. Hailey deprives the Health Plan of the right to rely upon him who would be covered for such information as the Health Plan desires so that it can make a wise discrimination in selecting its risks. Rather, it expects the insurer to assume the falsity of the statements made by the prospective beneficiary and thoroughly investigate the risk presented to it, or take all risks presented. It turns the covenant of good faith and fair dealing on its head and makes it a one way.

The following video was adapted from my book, “Insurance Claims A Comprehensive Guide” Published by the National Underwriter Company and is available at the Zalma Insurance Claims Library

Legal Disclaimer

The author and publisher disclaim any liability, loss, or risk incurred as a consequence, directly or indirectly, of the use and application of any of the contents of this blog. The information provided is not a substitute for the advice of a competent insurance, legal, or other professional. The Information provided at this site should not be relied on as legal advice. Legal advice cannot be given without full consideration of all relevant information relating to an individual situation.

This entry was posted in Uncategorized. Bookmark the permalink.

Leave a Reply

Your email address will not be published. Required fields are marked *