Services -
Insurance Rescue

When a life or living benefits insurance application or claim is denied, rated, modified or postponed, then RCM's medical advisors can come to the rescue.

RCM's objective is to generate hard evidence of insurability and to communicate this to the medical underwriters.

Step one

Step one begins with the insurance applicant/claimant retaining RCM.

RCM will review the documentation that was provided to the insurer.

RCM will complete a medical review by phone to identify the health risks that led to the decline, rating, modification or postponement of coverage.

RCM's medical adivsors will attempt to communicate with the medical underwriters at the insurer and/or the reinsurer to determine what actions must be taken to clarify whether the applicant is insurable or the claim payable.

The cost for RCM's advisory and advocacy work for step one is $495 + HST.

Step two

RCM will (if requested) provide our client with an action plan and budget to address the reasons for the decline, rating, modification, or postponement.

RCM provides a 27/7/365 call centre with translation capabailities.

RCM's experienced doctors and nurse case managers lead teams of medical specialists with deep knowledge of the issues to advocate for our clients.

RESCUE clients have access to RCM's network of over 1,500 medical experts from leading centres of excellence for opinions and advice.

RCM arranges, coordinates and directs RESCUE clients' access to RCM's national network of over 2,000 specialty vendors of MRIs, CTs, PET scans, songrams and outpatient surgery and access to RCM's secure online image archive allowing for expert interpretation of the imaging studies as appropriate.

Case Study

A national retailer recruited a new senior manager of logistics. The paramedical examiner took his EKG and it was reported as abnormal indicating a heart attack. He was declined insurance.

RCM completed a medical review and recommended a cardiac MRI test. This test, funded by the employer, proved conclusively that the manager had never had a heart attack.

RCM presented the client's case to the insurer and reinsurer. The insurer issued the policy on a standard basis.

Insurance applicants/claimants should call RCM if:

• the applicant has a complex medical history and a problem with medical underwriting is anticipated
• the applicant's coverage had been rated, postponed, declined or modified due to a medical issue needing clarification before the application is acceptable to the insurer
• the medical underwriters have not provided a clear reason for the rating, modification or decline or have asked for more information or testing
• the insurance is an urgent risk management strategy for the applicant and there are complicating health issues
• a valid claim has been declined for lack of medical evidence

Ebook Highlight:
Chapter 21 - Dealing with insurance companies

Enroll now