Individual Underwriting by the Insurer/Information Sources and Regulation
- University of Massachusetts, Amherst
- Astronomy 100
- Individual Underwriting by the Insurer/Information Sources and Regulation
Last Modified: 2011-07-04
No insurer, representative or support organization may request an investigative consumer report in connection with an insurance application, policy renewal, reinstatement or a change in benefits – unless the affected individual is informed
- That each individual may request to be interviewed in connection with the report; and
- That, upon request, this individual is entitled to receive a copy of the report.
If an investigative consumer report is prepared by a support organization, the responsible entity must inform the organization of any request for a personal interview.
No investigative consumer report is permitted to contain any information related to the affected individual’s sexual orientation. Furthermore, these reports cannot divulge information related to counseling for AIDS.
In addition to a paramedical report and an attending physician's report, the underwriter will usually request a Medical Information Bureau (MIB) report.The MIB is a membership corporation owned by hundreds of member insurance companies. In other words, insurers are members of the MIB. It is a nonprofit trade organization which receives adverse medical information from insurance companies and maintains confidential medical impairment information on individuals.
- The insurer must reveal the use of testing to the applicant and obtain written consent from the applicant;
- The test must be administered in a manner that meets the protocol of the U.S. Department of Health and Human Services;
- The insurer must disclose the test results as authorized by the applicant in writing;
- If the applicant has not identified a physician to receive test results, the positive test results and the identity of the applicant must be sent to the state Department of Health;
- The reporting of test results must include the name and address of the reporting company.
Applicants who are rejected are considered declined risks. Risks that the underwriters assess as not insurable are declined. For example, a risk might be as follows:
- Where there is no insurable interest.
- Where the potential for loss is so great it does not meet the definition of insurance.
- Where insurance is prohibited by public policy or is illegal.
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