Insurance Underwriting
The Application Process
When you purchase
a health insurance policy, you are
required to give information about
your health. This process is know
as underwriting.
The insurance company then uses the
information to predict what's the
likelihood that you'll need health
services and will file benefit claims
against the policy. The underwriting
standards vary for each insurance
company, which means even though one
company might reject your coverage
application, another provider could
accept it.
Insurance companies get
most underwriting information of their
applicants from the following:
Underwriting
Decisions
After applying for coverage,
a insurance company will either accept
your application or do any one of
the following:
-
Issue you the full coverage policy
but with a higher premium
which may happen if you have a pre-existing
condition.
-
Modify some of the benefits,
such as increasing the deductible.
-
Exclude a pre-existing
health condition from coverage by
the addition of an exclusion rider
in the policy.
-
Or just simply decline
your application.
If
your application is denied:
Find out why they refused
to issue you coverage. The insurance
company is legally required to provide
you a written statement stating the
reasons. If the reason was because of
your medical history, then be sure your
medical record was stated correctly.
Sometimes the underwriting information
can be incorrect.
Then apply for coverage
from other companies. Remember, each
insurance company has their own underwriting
standards. Another provider could just
as easily grant you coverage.
Yet another health coverage
possibility for some high risk individuals
is by obtaining coverage through an
insurance purchasing pool or risk pool
(also known as high-risk pool). Many
states provide established risk pools
for those medically uninsurable individuals
(people with pre-existing health conditions)
so they can buy health insurance coverage
at an affordable price. (Usually the
insurance premiums for individuals in
these risk pools are much higher than
for comparable plans from health insurers.
Yet expensive health coverage is better
than none at all. )
Medical
Information Bureau
Whenever you apply for
health insurance, you authorize the
company to review your medical information
retrieved from the Medical Information
Bureau (MIB). The MIB is a privately-held
company that insurers use to help share
information about applicants.
If you are refused insurance
coverage because of medical history,
then you could review your MIB file
if you have one, and see if its correct.
If the information in your file is incorrect,
then you have the legal right to request
the MIB to make proper corrections.
A copy of your MIB report can be obtained
by calling or writing:
MIB, Inc.
160 University Avenue
Westwood, MA 02090-2307
(718) 329-4500
http://www.mib.com/
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