Life Insurance Underwritting

[alcala]

most insurance companies require applicants to provide medical records or history of their previous health. This is to ensure that all qualified policyholders dont have pre-existing conditions or any serious ailments

[AngelinaCat]

The spammers can't even speak English nowadays. Gotta love it...not.

I know...

[keepsmiling]

The spammers can't even speak English nowadays. Gotta love it...not.

[bluehue79]

The reports should be the same. I think your best bet would be to request one and see what's on it. I suppose it's possible that you have a pharmacy that doesn't report to any of them, but I can't really give you any guarantees on that. Also, there's something called a contestable period on policies, usually a year or two period starting from the sign date of the application, where if a claim is filed during that period, the company is allowed to verify the validity of your answers to the underwriting questions at the time of the application.

[lorrieduke]

Do you think it's possible that a pharmacy isn't tied into either of them? I'm just wondering because I was nervous about information the MIB may have on me before I leaned they had nothing. Also, if I call for my free report will it be the exact same report (identical) to the one an underwritter will get?

Regards

[bluehue79]

I don't believe that all pharmacies are tied into both of them. It looks like this is covered under federal law and not at the state level. I remember that the company I worked with would use both of them so that if they didn't get a hit on one of them, they'd use the other one. Intelliscript seemed to be the most inclusive. I also believe that they can only report your prescriptions if you use your insurance card when you buy them. I could be wrong on that part, though.

Funny story, we had a woman who had a prescription for her dog for insulin and it came up on her Ingenix(Medpoint) report and made it look like she had diabetes. She sent in medical records for her dog to prove it.

[lorrieduke]

Thank you bluehue79. I went on the web and found some info about what you are referring to. Apparently (from what I can tell) regarding prescriptions previously filled, there are two companies, intelliscript and medpoint databases. Guess if you've applied for individual life or health insurance and regardless if you've been denied or not, once a year you are entitled to one free copy. My questions are these... are all pharmacys automatically tied into the intelliscript and medpoint database or not and is this legal in all states?
This has really been educational since I had no idea there was the MIB or the prescription database. Any information anyone can provide will be greatly appreciated.
Regards, Lorrie

[bluehue79]

They do have the ability to access prescriptions filled previously. There are companies that insurance companies use specifically for this purpose. For example, you say no to all of the underwriting questions but have, say, insulin dependent diabetes and they run your prescription report and find numerous prescriptions filled for insulin, they're going to know that you have diabetes and either want further information from you about it, decline you outright, or rate up your premium.

[lorrieduke]

Well I found out the MIB has nothing on me afterall! That is good news but I wonder something else... Since the MIB has nothing on me, how else would a life insurance underwritter find out about any medical conditions I may or may not have if I did not disclose them on the application? I'm wondering if other than the MIB, do they solely rely on information I provide to them on the application?

[lorrieduke]

Thank You! That was a great response. I was just wondering if after an application has been made for life insurance if the life insurance company underwritters will contact your health insurance provider? I mean if they will say for instance go on a fishing expedition and contact your health insurance provider to find out if you've had any claims and what they consisted of? I know they have to get consent from me first and say I have signed the consent for them to collect and disclose first. But is that something I mean contacting the health insurance provider something they normally do. Do they even ask if you have health insurance? Do they even care? LOL

[ValleYum]

Thank you Valle Yum!

So you are saying they collect information from application information when applying for insurance? For instance, I apply for life insurance.. Any information on the application I provided will be reported to MIB. ?? If that's correct then I already feel better. :-) I thought claims and etc were reported.
Also, in regard to the insurance company calling a hospital and asking if you had ever been there.. I understand HIPPA is suppose to protect our privacy but when filling out a life insurance application that may state by signing you are giving them the right to access your medical history give them the right to call a hospital and ask if you had ever been there? That's the part I really don't understand. Don't know if they even do that but I dont know.

You know the medical questions that are asked on insurance applications:

Do you or have you used tobacco products?
Have you been treated for or consulted a physician about... high blood pressure, high cholesterol, heart disease, cancer, blah blah blah

The answers you give to THAT type of question are what is stored in the MIB along with the results of any lab tests, etc. that you have done for the policy physical exam. Then if you apply for another policy 6 years after that and the answer to the same question is different, the info in MIB will flag it and you may have to provide more info in order for the policy to be issued or if it is a big enough problem, you may be declined or rated up (pay more) for the policy.

Again, no one will tell someone if you have been admitted to a hospital based on a telephone inquiry. You have to sign a specific release for each entity that will release your medical records that are requested by the insurer or underwriter. Don't ever sign a release that is not fully completed.

If your insurance company is going to use info from MIB in determining your ability to get a policy, I am pretty sure they must disclose this fact to you.

Call MIB tomorrow and see if you even have a file. If you haven't applied for any type of insurance in the past 7 years, you may not have one and you will have been stressing about nothing! If you do have one, ask for your allowed personal copy of the info they have about you so you know what data is stored.

Hope this helped!!

[lorrieduke]

Thank you Valle Yum!

So you are saying they collect information from application information when applying for insurance? For instance, I apply for life insurance.. Any information on the application I provided will be reported to MIB. ?? If that's correct then I already feel better. :-) I thought claims and etc were reported.
Also, in regard to the insurance company calling a hospital and asking if you had ever been there.. I understand HIPPA is suppose to protect our privacy but when filling out a life insurance application that may state by signing you are giving them the right to access your medical history give them the right to call a hospital and ask if you had ever been there? That's the part I really don't understand. Don't know if they even do that but I dont know.

[ValleYum]

I worked for a company whose job it was to provide underwriters with medical records for people that applied for life and disability policies. We had signed releases that allowed the release of this information under HIPAA. The information on which providers to contact for medical records came directly from the insurance application(s) that the prospective client filled out NOT from MIB.

MIB's website also offers a bit of info on how their information is shared as well as what information is shared. This info reads as if only items you listed when you made application for health, life, disability insurance, etc. is listed. It does not sound like every diagnosis from every office visit is listed. It does read as though if, for example, you had an EKG when applying for life insurance that the results of that test would be listed.

MIB is basically a comparison tool for underwriters to prevent them from issuing policies based on applications that contain purposefully excluded information.

Local underwriters will not randomly call hospitals since the medical records release forms are for specific entities and HIPAA protects you from this type of privacy violation.

Who are Members of MIB?

Members are insurers that write individually underwritten life, disability income, health, long-term care or critical illness insurance.

What do these companies do with this information?

Authorized underwriting personnel of the Member company review the application information provided by the person applying for insurance and compare it to what is in the person's MIB file. The information in the person's MIB file is used only as an alert. No underwriting decision can be made solely on the basis of a coded report, such as issuing a policy with an extra premium or declining to offer coverage.

How does information get into my MIB file?

When an application is made to an MIB Member company, any information that is of significance to health or longevity (whether admitted on the application or discovered during the underwriting process) is sent to MIB by the Member company in a coded, encrypted format. Use of these codes ensures that this confidential information is protected.

How do I know if MIB will be checked at the time of my insurance application?

If a Member Company wishes to check with MIB to see if you have an MIB record, then it must provide you with the MIB Pre-Notice and it must obtain your signature on an authorization in which MIB is identified as an information source along with other sources that might have records, such as your personal physician.

Who else can get my MIB file?

Unless otherwise required by law, only Member companies will have access to information in the MIB database and only when you are applying for individually underwritten insurance. Employers, vendors, and non-Members do not have access to MIB files.

What does an MIB file say about me?

Coded information identifies medical conditions or medical tests that are reported by MIB Members to MIB under broad categories. There are also a few codes that are non-medical. Those codes report potentially hazardous avocations or hobbies, or results of a motor vehicle report showing a poor driving history. MIB has no actual “reports” or “medical records” on file, only the coded “resume” provided by the Member.

Where does this information that goes into an MIB file come from?

As part of the underwriting process, an applicant provides information to the Member company and in addition, the insurance company may obtain your medical records along with other underwriting requirements. Any information that has significance in the underwriting process may be reported to MIB.

How long do MIB codes stay on my file?

Based on today's environment, MIB has elected to automatically and uniformly purge MIB records from our database after seven years.

Does everyone have an MIB file?

You may have an MIB record if you have applied for individual insurance in the last seven years with an MIB Member company, and have a condition or avocation that is considered significant to your health or longevity.

How can I find out if I have an MIB file?

The federal Fair Credit Reporting Act, as amended by the Fair and Accurate Credit Transactions Act (FACTA) of 2003, allows a consumer to request free disclosure of his or her consumer report once annually. Only you can request an MIB file on yourself. If you are a US resident, call MIB's toll-free telephone number 866-692-6901 (TTY 866-346-3642 for hearing impaired) to request disclosure of your file. You will be asked for some personal identifying information so that your record can be located, if one exists. During this recorded call, you will need to certify, under penalty of law, that the information you are providing is accurate, and that you are the person requesting disclosure. The personal identifying information that we collect is used only to locate your MIB record, if any, and for no other purpose. We safeguard this information and keep it confidential. Residents of Canada must download the Request for Disclosure Information form and mail it to our Canadian office.

What else would I see in my MIB file?

When disclosure is requested, MIB provides you with a list of Member companies that have made an inquiry on you in the prior twenty-four months. Also provided is a list of any Member companies that received your MIB record in the prior twelve months. Even if you have an MIB record, it will not contain any information regarding the underwriting decision made on your application.

How long will free disclosure take?

A response will be mailed within 15 days of receipt of adequate identifying information to locate your record, should one exist. If we cannot determine if a record exists from information provided, MIB will contact you with instructions as to any additional identification information and/or steps needed to complete your request for disclosure.

What if I have a letter of adverse action from the insurance company?

If your insurance company advised you by letter that it has taken an unfavorable action on your application and the letter specifies that MIB was an informational source, US residents may call the toll free number–866-692-6901 (TTY 866-346-3642 for hearing impaired) and Canadian residents may call our Canadian office at (416-597-0590). Alternatively, you may request free disclosure in writing by sending us a request for disclosure along with a copy of the adverse action letter. We will send you an identification form and your request will be processed within 30 days of having received adequate identifying information to locate your record. If you wish, you can email us at [email protected] to request the form or send a letter to:

For U.S. Residents:
MIB, Inc.
50 Braintree Hill Park
Suite 400
Braintree, MA 02184-8734

For Canadian Residents:
MIB Information Office
330 University Ave, Suite 501
Toronto, Ontario, Canada M5G 1R7

http://www.mib.com/html/consumer_guide.html

[lorrieduke]

I appreciate your response but it did not answer my specific questions.

Can anyone lend me some answers? I would very much appreciate it. :-)

Thanks

[bluehue79]

MIB is used by insurance companies to report only medical information and not any type of credit information. They only report medical information when they've declined or issued a policy but with a higher premium due to medical history. It's used to prevent fraud on the part of the applicant so that a company can run a report to see if the applicant is on the up and up when they apply for life insurance, disability or even critical illness policies. Also, a life insurance company can't just call hospitals since it's against HIPAA.