Medical Information Bureau (MIB) Explained

Whether you apply to a fully underwritten or no-exam life insurance policy, the carrier’s underwriter will request access to your MIB file, provided you have one.

The Medical Information Bureau provides consumer reports (not credit reports) for the exclusive use of insurance companies which are members of MIB Group, Inc.

In a nutshell, the MIB helps insurers in charging and classifying applicants based adequately on mortality risk and therefore keep rates affordable.

In this post, I’ll go over the questions we get from potential clients about the MIB’s role in the life insurance underwriting process.

What Is MIB?

MIB Group, Inc. has been around since 1902 and has operated on a not-for-profit basis in the United States and Canada. It acts as “nationwide specialty consumer reporting agency” under the federal Fair Credit Reporting Act (“FCRA”) because it provides consumer reports to its members (insurance companies) during the underwriting process and consequently assisting them in the risk and eligibility assessment.

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What Does MIB Do?

In essence, the MIB maintains a database of confidential information, safeguarded in a coded format, about underwriting risks such as medical conditions, hazardous hobbies, and unfavorable driving records which can have an adverse effect on one’s insurability.

These records, which are collected with your permission, alert insurance underwriters to potential errors, omissions, or misrepresentations that were collected during a phone interview, the medical exam, or answers on the application.

By maintaining that information and alerting companies for potential red flags, they assist insurers to avoid insuring individuals who pose an increased risk and to charge at the proper risk class for those who aren’t in good health but are insurable.

By mitigating unwanted risks, insurers can keep prices affordable and reward those who are eligible for preferred rates.

Let’s review a few of the questions about the MIB.

Does MIB Collect and Store My Actual Medical Records?

Absolutely not!

MIB doesn’t collect or store any information from your medical exams, lab test results, or reasons for denial of insurance. Instead, codes are provided by its members about significant risks to the underwriting process.

Think of these codes like encryption and their sole purpose is to signify different medical conditions that affect one’s insurability.

For instance, if you had a stroke and reported it on the application, a carrier may report it the MIB, and it will be coded as a stroke but without the actual doctor’s records or any other test results.

Does Everyone Have an MIB Record?

No. Only if you applied in the last seven years with an MIB member company for underwritten health (prior to the ACA), life, disability income, long-term care, or critical illness insurance and if you have an adverse condition that can impact your mortality or morbidity.

After seven years, MIB removes information reported about you to comply with the prohibition in the FCRA against reporting obsolete information. Furthermore, if you applied and got preferred or standard health class ratings, you will not have a file with the MIB because your health doesn’t affect your insurability.

What Is in My MIB Record?

As mentioned above, the MIB does not store any medical records, test results, or attending physician statements (APS). Instead, after your underwriting process, a member (insurer) may report significant health conditions using codes in broad general categories.

The codes do not reveal the amount of insurance applied for or any action the insure took concerning your application, such as a rate up, approval, or denial.

Lastly, underwriters are prohibited from making the final ascertainment about your application solely from the data they have gathered from the MIB because the information is neither complete nor in-depth. Simply put, carriers are just alerted about your health condition to investigate further.

Who Can Obtain a Copy of My MIB Record?

MIB will only release information to its members after they have your signed authorization. Keep in mind that, when you apply for an underwritten life insurance policy, there is a section that called “Authorization to release information”, which gives the carrier the right to order medical records and obtain information from third-party sources to determine your eligibility for insurance. The request to access your MIB file is also included in that section.

Can I Get a Copy of My MIB Record?

Absolutely! Provided you have one, you may do so by calling MIB at 866-692-6901, or you may complete your request online. You will need to provide some personally identifying information, and to certify that your provided information is accurate.

You can request this file free of charge once a year, and you should get it within 15 days. The MIB will translate all the codes to something you can understand along with the names of companies that made an inquiry in the last 24 months and lists of the members that received your MIB file in the prior 36 months.

MIB Functions in a Highly Regulated Environment

The MIB is directly regulated under the federal Fair Credit Reporting Act (“FCRA”) which promotes accuracy, privacy, and fairness among consumer reporting agencies.

MIB is also subject to many other laws they must comply with in order to allow its members to use the service they provide. Hence, they must maintain a secure and confidential database for the sole use of the members.

If, for some reason, you believe your file contains inaccurate information, you can dispute it using this link.

Case Studies: Utilizing Medical Information Bureau (MIB) in Insurance

Case Studies: Leveraging Medical Information Bureau (MIB) for Enhanced Risk Assessment

Case Study 1: Life Insurance Underwriting

A 45-year-old individual applies for a life insurance policy. During the application process, the applicant discloses a previous history of heart disease and a recent heart surgery. Being a member of the Medical Information Bureau (MIB), accesses the MIB database and discovers that the applicant had not disclosed these medical conditions in previous applications with other companies.

The MIB report helps identify the undisclosed information and assess the applicant’s risk accurately. Based on this information, Company X adjusts the premium and offers coverage that is appropriate for the applicant’s medical history.

Case Study 2: Health Insurance Underwriting

A 30-year-old individual applies for health insurance. During the underwriting process, the applicant reveals a pre-existing condition, such as asthma, but fails to disclose a recent hospitalization for a severe allergic reaction. Being an MIB member, accesses the MIB database and finds a record of the hospitalization that the applicant had not mentioned.

This additional information allows to make an informed decision regarding coverage and premium rates. By utilizing the MIB report, the company ensures that the applicant’s health risks are adequately assessed, and the policy terms are adjusted accordingly.

Case Study 3: Disability Insurance Underwriting

A 35-year-old self-employed individual applies for disability insurance. The applicant discloses a previous back injury that required surgery, but fails to mention ongoing physical therapy sessions. As an MIB member, accesses the MIB database and discovers the additional information about the ongoing therapy.

This knowledge allows to accurately assess the applicant’s risk and determine appropriate coverage and premium rates for disability insurance. By leveraging the MIB report, the company ensures that the applicant’s health history is thoroughly evaluated, leading to fair and appropriate underwriting decisions.

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Bottom Line

You should know by now that insurers must use everything in their arsenal to make sure they don’t go under by insuring the uninsurable but also being able to keep prices at bay if a person deserves so.

The MIB assists insurance companies in figuring out an additional piece to the underwriting puzzle by operating as an “information exchange database” and allowing its members to report adverse risks which could affect one’s insurability.

In other words, if you applied to one company and disclosed that you have cancer, or it was discovered through the exam or medical records and, therefore, were denied coverage, even if you apply to another company and never disclosed it, they will be able to find the condition through the MIB report and will ask you to provide more information.

It goes without saying but is worth repeating: be honest when you apply for life insurance, and if you are, there is nothing to worry about.

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