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Elder abuse or neglect and how to report it.

Any agent who’s been working as long as I have with Medicare beneficiaries has stories to tell. Some are heartwarming, some are humorous, some perhaps are disturbing and others are just heartwrenching. I could spend all day telling you all about the experiences I’ve had, but let’s get serious for a minute.  The story I have for today is about elder abuse or neglect, and highlights why it’s important for independent senior insurance agents. I encourage all agents to take a moment to read up on their state’s Department of Economic Security/Adult Protective Services (DES/APS) resources, and here’s why.

As an employee agent with a large national carrier some years ago, I was blessed to work with an in-house social worker team. We had great training on what to watch for and which situations we should report to the team. I was lucky to make a few reports of what I considered shocking situations regarding the physical welfare or emotional state of a Medicare beneficiary to the team. They knew who to contact among government and assistance agencies.

Well, for about the last 15 years I have worked as an independent agent without having recourse to that wonderful team. Just last year a “new to Medicare” client who was also eligible for a Dual Special Needs Plan was referred to me. She was obviously in distress.

This client had recently been granted permanent resident alien status and full Medicare-Medicaid eligibility through her American husband’s U.S. citizenship (He was born in the United States but had moved back to India, where they later met and got married). Shortly after the couple relocated to America in 2013, the husband passed away. There were no other family members my client could turn to — they were all back in India.

She was barely literate and had never acclimated to American life, living in a condo she had owned with her late husband. It was falling into neglect, and the power and water had been shut off. My client only had natural gas service to her unit, and she was gathering water from the common area hose. You get the picture — she needed some help.

I reported the situation to Arizona Adult Protective Services (APS). I made the referral online on an anonymous basis because there was no second party abuse or exploitation. I will add that all reports are confidential in my state.

The next time I visited with my client her condo was spic and span, hooked up to full utilities. She was now connected to a number of other services as well. Most importantly, she had been assigned a social worker that spoke fluent Hindi, her native language.

Help is out there for vulnerable seniors, and we Medicare agents can do our part in facilitating the connection. Self-neglect becomes a major issue as people who live alone or do not have close family members age and deal with health issues like dementia. Seniors also face the risks of exploitation and abuse — be it financial, physical, emotional or sexual. A nursing home does not protect them from these risks, either. APS works with law enforcement, courts, non-profits and other groups to protect seniors.

Take a minute and check out your state’s APS website because you never know if you will encounter elder abuse or neglect in the field.

RBI takes the welfare of the members we help very seriously. If you encounter elder abuse or neglect, and don’t know what to do about it, please call our office at 1-800-997-3107 and ask for advice! 

Dementia can affect how you sell senior insurance

Most of us know AARP alerts seniors about scams, fraud and identity theft that can impact their financial well-being and cause them intense stress. Some of the risks our aging population faces could affect agents and their livelihood, too, though in a different way.

Many agents have probably heard about Glenn Neasham and how just one annuity sale almost permanently damaged his career as a sales professional and put him in jail. He was convicted of felony theft under California’s Elder Abuse Law in 2011 after selling an indexed annuity to 83-year-old Fran Shuber three years prior.

The case’s main questions were whether the financial product was truly suitable to be sold to seniors up to age 85, as the state department of Insurance had previously determined, and whether the client had sufficient cognitive ability to understand its risks and benefits and not otherwise be vulnerable to manipulation. After appealing, the conviction was reversed against Neasham in 2013.

Being attentive to how well older adults grasp things and sensitively responding is the greatest respect you can show them, but it can be tricky for agents because there are no industry standards or training available to help them do so in the appointment. Contact RB Insurance for helpful tips that can help you be proactive.

I won’t go too far into California v. Nesham’s legal workings (You can read more about its complexity and drama here), but will instead focus on how agents can learn to make good judgments about clients’ cognitive health in light of the case. Being attentive to how well older adults grasp things and sensitively responding is the greatest respect you can show them, but it can be tricky for agents because there are no industry standards or training available to help them do so in the appointment. Even if it sometimes means agents may not be able to make a sale, it can protect them from getting into serious legal trouble.

Neasham argued his client showed no signs of cognitive impairment when he sold her the indexed annuity in 2008. According to the Society of Certified Senior’s coverage of the case on their blog, it did not become apparent to Shuber’s family that she may have showed signs of Alzheimer’s disease, a specific kind of dementia, until 2011. This is when her family obtained conservatorship.

Because there were no industry standards to help agents determine how well a prospect understands the risks and benefits of a product, who was to say when the client actually lost her cognitive abilities? The jury’s verdict was eventually reversed by a state appellate court, but the damage had already been done — Neasham lost his license, his house and he had to declare bankruptcy. His license has been reinstated since, but he has to completely rebuild his book of business and deal with going through six years of litigation.

This case teaches agents a valuable lesson despite the fact it was decertified or disallowed from becoming a precedent for future cases. The Society of Certified Senior Advisors and other interest groups came out with several suggestions to be proactive about client cognitive ability. Many of them are common sense and are easy to implement, such as asking your potential client to invite a family member or neighbor to the appointment to help. You can also ask simple questions like “Who is the current president?” or something similar. Consider asking your client permission to record your appointment conversation, and offer him or her a copy. One of the best ways to confirm understanding is to simply ask a client explain the product back to you. Always take copious notes, and include them in your client file or on your client’s profile within the Medicare Sales Engine. As a licensed agent, your notes are admissible in court.

The number of people who will be diagnosed with a form of dementia is expected to triple by 2050, so the issue of cognitive ability is only going to become more relevant to senior insurance agents. Elder abuse is real, and unfortunately, it’s as prevalent as Medicare fraud, waste and abuse, which agents do receive guidance and training on. Start protecting yourself now to avoid the legal hazard of signing someone up for something they may not totally comprehend or want.

Call RB Insurance at (800) 997 3107 or email me for more advice about selling to the senior market and to discover how the Medicare Sales Engine can organize all of your clients’ information for quick, simple reference.