Is there a big databank of ur medical records that health ins companies can look at?

Question

Otherwise how would they know if you had a pre-existing condition? You could just lie and say u never had anything and act like it just now got diagnosed. I mean, unless u tell them who ur doctor was before this, they would have to search every doctor's records in the state/country. Or is there just a database where they can type in your name and find out your medical history??

Answer 1

There is no database of medical records. Instead, the Medical Information Bureau (MIB) receives VERY limited information from life and health insurers regarding medical conditions reported on applications for insurance; health insurers do not report health conditions arising during the time a person is covered. In other words, if a person has coverage through XYZ Insurance Company and has a heart attack after the coverage is issued, XYZ does NOT report this to the MIB.

Only member companies may report and request information from the MIB. While most life insurers are members, not very many health insurers are.

Many people do lie when they apply for insurance. That's why the MIB is so important for life insurers; health insurers, on the other hand, issue coverage then wait for claims. Once a claim is filed, they investigate the person's health history. If they find any material misrepresentations in the past medical history, whether it pertains to the cause of the present illness or not, the insurer is legally able to rescind the contract. This is a legal term that means the policy is canceled from its inception; thus, it's as if the policy was never issued.

Answer 2

There is no database like you describe.

When a claim is submitted into your insurance carrier certain diagnosis codes can and will trigger the carrier to do a pre-exsisting investigation. They generally already know who your physicians are and they will simply request your medical records from them and or any other physician that has treated you during a certain time period. (physicians put their names on the claims that are submitted to your carrier so they can get paid and as stated before, your carrier keeps track of this information)

If they do not know who your doctors are, they will ask you to provide that information, if you refuse or lie, they will deny your claims and you will be responsible for the balances.

Answer 3

Yes

MIB Medical Information Beaurea (sp?)

Its based on what youve put on previous apps
declinations and claims
NOT info directly from care providers

there is probably less on there than you think


Lie on an app and a claim can be denied first 2 years of policy


you can get a copy for minimal $ or free

they are in Mass. Just google

Answer 4

Your medical records are NOT databased - but the claim payments ARE. So, they can see you've had $25,000 in paid medical bills in the past 3 years, and the year before that, it was $100,000.

Well, something happened!! That's how they know something is up. Healthy people have maybe $300 a year in medical bills - one doctor visit, and the usual testing.

Answer 5

If a judge gives them permission, they can. Or if YOU give them permission. Of course, if you don't give them permission, you aren't cooperating, and they won't settle. And if you DO sue, and go to court, then the judge will allow them this information. It's relevant. You're not going to see a dime until/unless they've had full access to your medical records, one way or another. And it's not limited to claims made through Aetna, it's ANY medical treatment. They can pull reports from the Medical Information Bureau, once the judge signs off on it.

Answer 6

As mentioned above they can get your records through the MIB. They usually wait until you have a large claim and then begin their detective work.