What is medical underwriting?
Your medical records can be obtained by the insurance company from your current physician, past physicians, medical facilities and pharmacies. In most cases, there is a disclaimer on the insurance application that authorizes the insurance company to obtain this information through your approval and authority. Another source for the insurance companies to obtain your medical history is from the Medical Information Bureau, which is kind of like the credit reporting agency for your health. The ability of the insurance company to access your private medical records and information is their safeguard that you are not falsifying the application in an attempt to obtain coverage for which you would otherwise be denied. In some cases, the type of health insurance you are applying for may be guaranteed issue. This means that the insurance company may not decline your application based on medical reasons, if you meet other guidelines. In the case of guaranteed issue coverage, the insurance companies may still practice medical underwriting, but for reasons other than determining your acceptance. They may wish to know of your health history so they can impose any pre-existing exclusionary periods, or calculate the rate adjustment that will be charged to a company applying for small business health insurance. A few states prohibit medical underwriting for individual health insurance by the insurance companies, strictly for the purpose of determining eligibility and acceptance. These states are referred to as “guarantee issue” states, in which the insurance companies must accept all new qualified applicants, regardless of their health status. For those insurance companies that lawfully use medical underwriting, their guidelines may vary substantially from the medical underwriting guidelines of another insurance company. If you are declined coverage from one insurance company for medical reasons, do not always assume that you will be denied by all insurance companies. Before completing the process all over again with another company, talk to an agent or representative for that company and be open with them about the reason you were declined by another company. They should be honest with you about your chances of obtaining coverage with them, and will probably review their underwriting guidelines with you over the phone before they encourage you to complete an application. Since medical underwriting will often require the insurance company to obtain medical records from your doctor, the process can take several weeks. You should be aware of this, and if possible, facilitate the request from your insurance company by contacting your doctor and asking him for his immediate compliance with the request from the insurance company. Any insurance company should gladly tell you from which of your health care professionals they need medical records. 1 CommentLeave a comment |
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What is medical underwriting?
Many health and life insurance companies use medical underwriting to determine which applications they want to accept, which they want to decline, and which they want to provide a counter-offer. Any insurance company that asks health related questions is “medically underwriting” your application. How you answer these questions can determine the decision made by the insurance company to provide you with the medical coverage you wish to purchase. With any application for insurance that uses medical underwriting, it is crucial to answer the health questions as completely and as accurately as possible. Failure to do so may result in a future dispute over a medical claim that could cause the insurance company to rescind your policy and hold you responsible for any accrued medical expenses. By signing and submitting your application, you are giving the insurance company the right to obtain and review your medical records; both prior to and after you become an accepted health plan member.
Hi, I am in a bind here, do I have to show the insurance company my medical records if I want to get private health insurance? I really don’t want them or anyone else for that matter to see my medical records. It is really quite embarrassing, but when I was 17 and just a teenager (I am 26 now), I was at a party where someone was smoking marijuana and they were passing around a joint and I was stupid enough to participate. I got very sick from it and had to go to the hospital to get my stomach pumped and be there for observation. I really don’t want them finding out about this. I am applying with Cigna by the way.
Comment by Nate — June 24, 2009 @ 1:31 am