AfroPope
Expert
MS. I'm assuming it was the MIB report, I'm just going on what Apptical said needed "further review." I can still write her with some other companies and get her approved but Foresters had by far the best price for what she wanted and she could still get preferred level with them minus this fluke.What is the medical condition? Maybe you can use a carrier that doesn't mess with MIB?
Interesting stuff.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.
So, assuming someone has NOT been treated for drug or alcohol abuse (i.e. assuming she's telling the truth) why would such a thing get pinged during a phone interview?
I had her whole script history there and the person doing the phone interview said that wasn't the problem and that her prescriptions were fine, it was just a record of treatment for drug or alcohol addiction. Person at Apptical also said something to the effect of "I dunno, it looks kind of weird. I'm not sure what's going on here."
I rarely write Foresters, both because they're usually the most expensive option and because of crap like this. I don't think I've EVER had an app easily go through with them.