Previously Declined

[UW Guy]

Why is decoding codes a no no? Most here are licensed agents by their states or in my and many others cases multiple states...we deal with phi, access to financials, ss numbers, and a fiduciary, yet we are treated as though we should not have access to codes and reasons for denial. Its the same thing as a finance manager being blocked access to credit reports... How well would they do their job or how well could they serve their clients without all the information? Mib in my opinion is just a big ole scam and a good ole boy club for the insurers, it should be banned and abolished if agents are not allowed access.

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Ill add one more comment. At least tell the agent the reason for a decline or a rate up. This would help, we already know everything about the pi, more than even the underwriter, not revealing uw decisions is completely asinine...especially on simple issue.

It might be a confidential history- unadmitted psych, hepatitis, drugs/alcohol are usually the most prevalent. If the client comes to you and wants their MIB report ordered then that's their business but you're still in a gray area if they (or you) are asking someone to tell you what the codes themselves mean. In our own documentation on files they're picky on how we denote matching codes.

MIB isn't the ideal detente with the field and carriers but it is important to prevent antiselection. Some carriers lean too heavily on it from what I read here but it's cheaper on the whole than a $10 Rx scan and rolling the dice on discretionary records.

And on the final point- unless the issue is confidential I make it a point to tell agents the reason(s) for the rating.

 

[PaperHanger]

It's something I've been discussing... MIB is our way of telling each other things like say someone comes in on my company and is an undiagnosed Type II diabetic. Does labs and has a HgA1c of 13% of a glucose of 200. That person should get those labs to their doctor and start treatment, right? Well, some of these people stock up on life insurance that doesn't require blood specimens before they make that appointment.

MIB helps us let each other know (without telling each other what we specifically did-because that might give away our mortality and rating data) so fewer of us end up with toxic or improperly priced risks on the books.

I've been thinking about doing a piece on MIB (I know it can be the bane of your existence when it trips up an app), some have supported a section on it here but I hesitate to open it up too wide because decoding codes out in the open is a no-no for us.

I've been told by uw, after discussing clients past aarp, moo, etc policies and cancelations, and uw response was "no she lying, she's got more and declines too"...

 

[UW Guy]

I've been told by uw, after discussing clients past aarp, moo, etc policies and cancelations, and uw response was "no she lying, she's got more and declines too"...

Unless they can look at those specific applications and files and see they're declines or any misrepresentations were that's a fairly bold and dangerous statement to make on both fronts. You can say based on the code(s)-more accurately the third party information- that the insured isn't likely to get coverage or a favorable offer but unless you spoke to the other carriers on their other files it's hard to outright state they declined.

 

[John Galt]

It might be a confidential history- unadmitted psych, hepatitis, drugs/alcohol are usually the most prevalent. If the client comes to you and wants their MIB report ordered then that's their business but you're still in a gray area if they (or you) are asking someone to tell you what the codes themselves mean. In our own documentation on files they're picky on how we denote matching codes.

MIB isn't the ideal detente with the field and carriers but it is important to prevent antiselection. Some carriers lean too heavily on it from what I read here but it's cheaper on the whole than a $10 Rx scan and rolling the dice on discretionary records.

And on the final point- unless the issue is confidential I make it a point to tell agents the reason(s) for the rating.

Im not arguing the MIB database does not hold validity on adverse selection or being more risk adverse for the insurer..what I am arguing is the fact that we as agents are not allowed to be told:

1. What the reason for the rate up or decline is
2. No access to the MIB database itself
3. Not being told specifically the reason within an application question what area is being considered an MIB hit.

Think about it..we are the very ones who engage with the PI to get them to sign off on a HIPPA form allowing you the underwriter or PHI firm to conduct an MIB and RX check...my question is, is it really even technically legal or moral to allow a $15hr phone interview clerk with no state license access to MIB and RX history when I cant even access it? Does not pass the smell test and never will.

And for the record on the last point, you would be absolutely the very very first UW to give me a reason for a decline or rate up at the end of a PHI or uw review...you should be in Ripleys believe it or not book, because that doesnt hold water from my experience. Only one carrier out of dozens I deal with have ever ever even revealed to me what the reasons where and that was done by only telling me which question didnt jive, and remember a question on a app can ask about multiple scenarios, diagnosis and meds so in the end they dont help worth a poop either.

 

[WinoBlues]

I've been told by uw, after discussing clients past aarp, moo, etc policies and cancelations, and uw response was "no she lying, she's got more and declines too"...

While it is much rarer today than in the past. I try to build a relationship with my underwriters so that we have a mutual trust. I get more information from some and zip from others. Another reason I like smaller companies over the ivory towers.

 

[UW Guy]

Im not arguing the MIB database does not hold validity on adverse selection or being more risk adverse for the insurer..what I am arguing is the fact that we as agents are not allowed to be told:

1. What the reason for the rate up or decline is
2. No access to the MIB database itself
3. Not being told specifically the reason within an application question what area is being considered an MIB hit.

Think about it..we are the very ones who engage with the PI to get them to sign off on a HIPPA form allowing you the underwriter or PHI firm to conduct an MIB and RX check...my question is, is it really even technically legal or moral to allow a $15hr phone interview clerk with no state license access to MIB and RX history when I cant even access it? Does not pass the smell test and never will.

And for the record on the last point, you would be absolutely the very very first UW to give me a reason for a decline or rate up at the end of a PHI or uw review...you should be in Ripleys believe it or not book, because that doesnt hold water from my experience. Only one carrier out of dozens I deal with have ever ever even revealed to me what the reasons where and that was done by only telling me which question didnt jive, and remember a question on a app can ask about multiple scenarios, diagnosis and meds so in the end they dont help worth a poop either.

That does suck that you don't get final action calls or emails for declines and rates. I know I'd be standing tall before the man if I wasn't doing that on my files. Some carriers have all the luck

It is tough to have Home Office have access to the Rx Check and MIB info and not to the agent I'll grant you but for various reasons it exists.

I feel for with FE UW's... I have to wash people through four reinsurers and tell my reps about our brokerage house before declining a file. I read about the FE guys thinking that someone takes two BP meds and jump to them having CHF and toss the app.

 

[John Galt]

That does suck that you don't get final action calls or emails for declines and rates. I know I'd be standing tall before the man if I wasn't doing that on my files. Some carriers have all the luck

It is tough to have Home Office have access to the Rx Check and MIB info and not to the agent I'll grant you but for various reasons it exists.

I feel for with FE UW's... I have to wash people through four reinsurers and tell my reps about our brokerage house before declining a file. I read about the FE guys thinking that someone takes two BP meds and jump to them having CHF and toss the app.

If an fe agent does that he is not an agent, he or she is a moron.

 

[jdeasy]

If an fe agent does that he is not an agent, he or she is a moron.

Yeah, I don't know where he's getting that crap. I certainly haven't seen that.

 

[John Galt]

Yeah, I don't know where he's getting that crap. I certainly haven't seen that.

Makes me kinda wonder if the user is actually an underwriter

 

[pcbinsurance]

We had another underwriter who used to post here...named Insurance Monkey. I haven't seen him around in a long time but he was a great poster.