Consumer Resource Guide
Check Your Medical Information
Make sure the information insurance companies may use to evaluate your application is accurate.
Most of us know we should occasionally check our credit report. What many people don't realize is that similar consumer reporting services exist for medical and insurance underwriting information. Depending on the type of insurance you are applying for, an insurance company may use prescription histories, medical claims, information from prior insurance applications, and other data as part of its underwriting process.
That makes the accuracy of this information important.
Why Should You Check Your Information?
Mistakes happen. Technology errors happen. And unfortunately, fraud happens.
A prescription could be associated with the wrong person. A medical billing code could incorrectly suggest a condition you do not have. Information could be outdated, incomplete, or simply inaccurate.
Most of the time, you may never know there is a problem. But if you apply for an insurance policy that requires medical underwriting, inaccurate information could potentially affect the insurance company's decision.
If you have recently been declined for insurance or approved at a higher-than-expected rate, reviewing these reports is especially important.
The Two Reports to Know About
Both are free to request and both can contain information that affects your insurance application.
Milliman IntelliScript
Prescription & medical claims history
Gathers electronic health information — including prescription history and medical claims — from pharmacies, health insurance companies, and pharmacy benefit managers, when you authorize its release during an insurance application.
If you have recently been declined for insurance, this is one of the first reports to consider checking.
What You'll Need to Request
- · Full name, mailing address, date of birth
- · Daytime phone number
- · Last four digits of your Social Security number
- · The insurance company that processed your application
- · Email address (optional, to receive report by email)
MIB Consumer File
Insurance underwriting database
MIB maintains a contributory database of underwriting information used by member insurance companies. Your file may contain underwriting information reported in connection with previous insurance applications. MIB is a nationwide specialty consumer reporting agency under the federal Fair Credit Reporting Act (FCRA).
You can request one free copy of your MIB Consumer File each year. An additional free copy is provided if you received an adverse underwriting decision.
What Should I Do If I Find an Error?
If you find information you believe is incorrect, do not ignore it. Even a simple error could potentially affect a future insurance application.
Look for things such as:
- · A prescription you have never taken
- · Incorrect dates or other details
- · A medical condition you do not have
- · Information belonging to someone else
- · A claim or procedure you do not recognize
- 1
Dispute the Information With the Reporting Company
Both Milliman IntelliScript and MIB have dispute procedures. Follow the instructions provided with your consumer report and be as specific as possible about what you believe is incorrect. Keep a copy of your report and everything you submit.
- 2
Look for the Original Source of the Error
The reporting company may be passing along information it received from a pharmacy, doctor, health insurer, or previous insurance application. If you can identify the origin, contact that organization directly — correcting the source prevents the error from reappearing.
- 3
Ask for Documentation When the Error Is Corrected
Keep copies of letters, emails, corrected reports, and medical records showing the information was disputed and corrected. This documentation may be helpful during future underwriting.
- 4
If You Were Declined, Ask for Reconsideration
Your medical provider can help determine where incorrect information originated, correct the medical record, and provide supporting documentation. Your insurance agent can help determine what documentation the insurer needs to reconsider its decision. There is no guarantee the company will change its decision — but corrected information may give the underwriter an opportunity to review your application again.
Were You Recently Declined for Insurance?
If you have recently been declined for life insurance, Medicare Supplement insurance, long-term care insurance, or another policy that uses medical underwriting, do not automatically assume the information used to make that decision was correct.
Start by reading the letter from the insurance company explaining its decision. Then consider requesting your Milliman IntelliScript Consumer Report and your MIB Consumer File. Review them carefully for prescriptions, medical conditions, claims, dates, or other information that does not look right.
Think of these reports like your credit report: you may not need to check them constantly, but when you are applying for medically underwritten insurance — or you have received an unexpected decline — it is worth knowing what is in your file.
Need Help Navigating a Decline or Underwriting Decision?
Jason works with clients through exactly these situations — understanding what happened, correcting the record, and exploring the best path forward.
Schedule a Free Call with JasonOr call directly: 317-505-1705