Everything You Need to Know About the MIB Group and Life Insurance

You’re probably familiar with the health forms and possible medical exam that are part of a life insurance application. You may feel less sure about what happens once your application is out of your hands. Insurance underwriters want to confirm that your health details are as complete and accurate as possible, and they use several resources to check this. One important tool is a database operated by a corporation called MIB Group.

MIB Group helps protect insurance companies against potential fraud. If you have applied for a life insurance policy, certain information about your health or medical records may be available through the MIB database. Learn how insurance providers use records from MIB, and how you can access or update information MIB has about your health.

What Is MIB Group?

MIB Group, or MIB, is a corporation collectively owned by over 400 insurance companies. You can think of it as the health version of a credit bureau like Experian.

MIB Group is the new name for the Medical Insurance Bureau. Nearly all companies offering individual life insurance policies are member companies of MIB. Insurance companies update the database by reporting codes that would lead a future underwriter to investigate a person’s history, and they in turn can look up applicants to view codes other companies may have shared. This helps insurance companies catch inaccuracies or omissions and set the fairest rate for an applicant’s profile.

What Does MIB Do?

MIB’s main mission is to provide accurate records to help support insurance underwriters and lower the chances of insurance fraud.

Your life insurance application typically asks detailed questions about your health, including your history of any diagnoses, treatment and prescriptions. Underwriters consult MIB records to see if a current application is in line with any previous applications on file. This helps them catch potential omissions or inaccuracies and set your premium rates.

MIB holds information in your file for seven years, so it’s an important resource for life insurance companies to cross-check information in your insurance application history.

How Insurance Companies Use MIB Files

First, it’s important to note that insurance companies don’t exchange information with MIB without your permission. When you read through your life insurance application paperwork, you should see a document called “MIB Pre-Notice” or something similar. This notice explains that the insurance company may report information about your medical conditions to MIB, and that MIB might share this with other companies you apply to. You’ll sign an authorization to permit MIB to share information in this way.

Your MIB file isn’t the only source underwriters rely on to check your health. They compare your application, medical exam, MIB file, lab reports, prescription history and possibly other sources to get a full picture. The MIB file is one way to check for any information that might have been missed on the application.

If someone applies as a nonsmoker but their MIB records show they used tobacco in the past, for example, that could make a difference in ratings. Or if there’s an omission of a diagnosis or surgery on the application that shows up in the MIB file, that can slow down the application process while underwriters make sure all their information is complete and accurate.

How Does MIB Get My Medical Records?

MIB doesn’t actually have your medical records. Your doctor doesn’t submit medical records to the MIB database. Instead, MIB receives codes from participating companies based on the application materials. What’s the difference? Rather than having a medical file with all your exact health details, the underwriter receives reports with high-level codes that can encompass multiple impairments and severities. They can reference those codes within MIB’s manual to figure out what if any additional underwriting may be needed.

They’re likely to have the following information:

• Dates of any life insurance applications you’ve completed in the last seven years.

• A general sense of timing for a given medical condition, either when symptoms last

  occurred or were last under treatment (this can vary). The time frames underwriters can

  see are high level, such as “three to five years ago.”

• Whether a given medical condition is currently under treatment or was under treatment

  in the past, but not specific details on what that entails.

• Any known health conditions you’ve disclosed.

• Treatment plan (e.g., prescriptions).

The information in the MIB file doesn’t contain X-ray files, lab reports, physician statements or other real records. They keep records of your applications but not the outcome, meaning they don’t show if you were approved or declined for a policy in the past. Instead, life insurance underwriters use proprietary codes to indicate information about your health that could matter for underwriting (e.g., heart condition in health history). The information is coded and encrypted for security and does not contain sensitive personal health details like your health plan member ID. Because the records don’t include this information, your MIB file is unlikely to pose a risk for medical identity theft.

The MIB file codes may also show where particular information comes from. For example, if a prior insurance company asked you to submit an attending physician statement, the MIB file would note what information was obtained from that statement versus a medical exam or other health records.

Will My MIB File Hurt My Chances of Getting Insurance?

Having an existing profile on MIB Group doesn’t affect your insurability. Your MIB records don’t reveal whether you were approved or denied at another company. MIB Group rules also prohibit insurance companies from basing decisions solely on an MIB file code. The codes are typically too broad for an underwriter to make a specific decision, so a code is simply a sign for underwriters to investigate for answers—not an answer in itself.

Admittedly, underwriters don’t submit a code that means “perfectly healthy.” Codes are generally for some type of medical, driving record or lifestyle marker that could make you a riskier (and therefore pricier) person to insure. But the existence of an MIB file doesn’t affect your rates—the risk factor does.

The medical questionnaire on your application should already give underwriters a strong sense of your current health and medical history. If the information on your application is correct and complete, the MIB file check won’t turn up anything underwriters don’t already know about you. Take your time to answer all application questions thoroughly, and your MIB file should be a good match.

Can Any Insurance Company View My Records Through MIB?

Because MIB gets their information from member insurance companies, they only open a file on you once you apply for life, health, disability or other participating insurance in the last seven years. If you haven’t applied for insurance in the last seven years, you wouldn’t have any information with the MIB Group for companies to pull.

If someone does have a file with MIB, insurance companies still can’t go in and browse through just anyone’s records. MIB has to follow various regulations, including HIPAA, to protect people’s sensitive information. That’s why you sign an authorization with your application to allow that specific insurance company to check your records.

How to Check Your MIB Report

You have a right to access and help manage your sensitive information. You’re entitled to a free copy of your MIB report under the Fair Credit Reporting Act, just like you’re entitled to free credit checks from major credit bureaus.

Here’s how to get your free MIB report:

• You can request a report via the MIB website or their phone line.

• If an insurance company declines your application or offers a lower-than-standard rating

  that’s influenced by a code they found in your MIB file, you’re entitled to a free copy in

  addition to the annual copy of your MIB report.

After you make a request, you’ll either receive the file or a notification that MIB Group doesn’t have a file open on you. If you have a file open, your report will translate the codes so you can read what they mean in more normal English. MIB codes are generally much more broad than the highly specific codes the medical community uses, so your code may not match your precise condition. The idea is that codes will give a reasonable indication of your medical condition and signal underwriters to look further, not provide all the information they need to make a decision.

If you spot an inaccuracy in your file, you can take action to dispute the incorrect information. Disputing your MIB file is free, and it can take about 45 days to correct the report. If you’ve applied for insurance in the past and are looking into a policy now, it can be worth checking your MIB report to make sure everything looks correct and to make your application process as smooth as possible.

MIB Group reports won’t affect everyone applying for life insurance, but they are an important resource to help insurance companies keep ratings as accurate as possible. Knowing your rights and how your information is protected can make you feel on top of the information in your file.

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