MIB and coding

Posted by Jack Cotlar on Mon, Feb 27, 2012 @ 04:55 AM

MIB is as important to the insurance underwriting process as it is misunderstood. What MIB is, what it does and what it does not do was the?topic of my most recent blog, “What you need to know about MIB and how it functions It generated several emails from life insurance agents.

Their main concern was that if a test is "coded" because of being abnormal, an adverse underwriting decision will necessarily?happen. This is not the case. Often the abnormal test result does not have underwriting significance and because, by MIB rules an adverse underwriting decision is not to be based solely?upon an MIB code. In addition, a subsequent test that was coded normal might negate the significance of the earlier abnormally coded test. Case in point ... as the Medical Director of?an insurance company I was asked to interpret an EKG done in February 2012, which was normal. We are aware that there is an abnormal MIB EKG?code from January 2011. The underwriter will "code" the current EKG as being normal so that another underwriter seeing the case in the future?will have a more complete and accurate picture of the EKG information.

Topics: Strategic Medical Consulting, MIB, Life insurance medical underwriting, Insurance medical underwriting, Dr. Jack Cotlar, Underwriting

What you need to know about MIB and how it functions | Underwriting for life insurance

Posted by Jack Cotlar on Mon, Feb 20, 2012 @ 09:34 AM

Who reports information to MIB? Any life insurance application sent to a MIB Member Company that includes a signed authorization obligates the company's underwriting department to report to MIB, as a code, certain underwriting information disclosed in the medical records and application and insurance exam. This is done regardless of whether the case is issued, not issued or withdrawn. What are not coded are adverse underwriting decisions such as declinations and ratings. Another misunderstanding is that attending physicians report information to MIB; they do not. MIB currently purges the MIB records after seven years.

MIB Group, Inc. is a membership corporation owned by about 470 member insurance companies in the US and Canada. MIB's services "protect insurers, policyholders and applicants from attempts to conceal or omit information material to the sound and equitable underwriting of life, health, disability income, critical illness and long-term care insurance ... 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."

A consumer may request free disclosure of his or her consumer report once annually. Only he or she can request an MIB file on his or her behalf. A U.S. resident can call MIB's toll-free telephone number 866-692-6901 to request disclosure of the file. Specifics about how to do so can be found HERE.

For more information go to MIB's Consumer Guide.

Topics: Dr. Cotlar, Strategic Medical Consulting, MIB, Life insurance medical underwriting, medical underwriting guidelines, medical undewriting, underwriting for life insurance