Where Does the MIB Information Come From?

So if the insurance company is reporting information about a client. Where does the insurance company get their information? I would assume it would be from Drs.?

Joe blow the patient goes to Dr X and Dr X tells him he has AFIB. The Dr makes notes of this in his patient records. Joe blow decides he wants life insurance so he goes to AAA. AAA orders medical records from DR X. AAA finds out the client is a bad risk and turns him down and then report their findings to the MIB.

So in a round about way the information is in fact coming from Drs? It is just being reported by the insurance companies. So is it safe to assume that companies that write SIWL policies would never report anything, because anything they gather they get from the MIB. So there is no need to report it again?

Yes, the insurer indicates in medical records the insured has a history of AFib (usually) under treatment and the timeframe since diagnosis. If he went to another carrier that does underwriting they would report it but SIWL wouldn't.
 
Hate to bump such an old thread, but does anyone have experience with the MIB's comments on drug/alcohol abuse? Had Forester's suspend an app this week because of question B1(a): "In the past two years, have you been diagnosed with, received or been advised to receive treatment for alcohol or drug abuse, or have you used illegal drugs?"

Client says no, Foresters says it needs further review. I have no reason to believe she would lie about this - but I'm wondering how the MIB would even get such a piece of information, especially if faulty.

Perhaps she was prescribed something for some health issue that could also be prescribed for drug abuse?? I don't have ANY idea...

obligatory: "why did you go with Foresters" answer - she has a medical condition that Foresters doesn't care about and I could get her preferred/level minus this hiccup.
 
Hate to bump such an old thread, but does anyone have experience with the MIB's comments on drug/alcohol abuse? Had Forester's suspend an app this week because of question B1(a): "In the past two years, have you been diagnosed with, received or been advised to receive treatment for alcohol or drug abuse, or have you used illegal drugs?"

Client says no, Foresters says it needs further review. I have no reason to believe she would lie about this - but I'm wondering how the MIB would even get such a piece of information, especially if faulty.

Perhaps she was prescribed something for some health issue that could also be prescribed for drug abuse?? I don't have ANY idea...

obligatory: "why did you go with Foresters" answer - she has a medical condition that Foresters doesn't care about and I could get her preferred/level minus this hiccup.

First of all, MIB has no way of knowing if a client took a medication. All MIB has are reports from particpating insurance companies. Participating companies send brief reports about an applicant when they apply for insurance with them. These reports contain basic data like:
  • height and weight (not always reported)
  • the name of the insurer that made the report
  • a description of the health conditions that may pertain to the applicant
  • the date the report was submitted

These codes themselves are invisible on an actual MIB report if a person were to order a copy of it. The codes are merely tools used by MIB and participating insurers to quickly analyze an applicants MIB file for any potentially relevant information.

These codes very often refer to a set of health ailments. Each code is usually broad in nature, and each individual code could refer to a variety of health conditions.

In the case of your client, some MIB participating insurer submitted a report about her within the last 2 years that indicated she disclosed she had or may have had a condition related the conditions that foresters flagged. For her, some carrier sent a report about her indicating she has had or has been treated for alcohol or drug abuse or used illegal drugs within the last two years (because that is the look back period with Foresters for these conditions).


Here is the part most people don't get about MIB. Insurance companies can only report what applicants voluntarily disclose (unless there is a mistake or fraud by an agent or something). Insurance companies cannot report information that is gathered from other resources like a milliman script check for example. In essence an MIB report is just a coded transcript of what applicants reveal about themselves. In the event a client had no health related data to reveal (like when a person says no to all health questions), the report itself is rather barren. In that circumstance, the report would merely have data indicating who the the reporting insurer was and the date it was submitted and potentially height and weight.

In the case of Foresters, you could explore getting a doctor letter to override this decision. I have done this successfully many times. However, this does not always work. Although I have no way of knowing this, I strongly believe that a doctors note will not refute an MIB report when the clients script history suggests the report is true.

In either event, if you have access to a non MIB participating insurer, you should be golden as long as her prescription history is actually devoid of treatment for the condition flagged from her MIB file.
 
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