Monday, September 1, 2008

How does Health Insurance Application Process work


How does Health Insurance Application Process work?
I applied for health insurance and forgot to mention an out of state doctor's visit a few years back.
Do the health insurance companies have access to all medical records even if you did not list the doctor or doctor's office on the application? Is it a big deal that I forgot to list the visit. A brief explanation of how the application review process works would be greatly appreciated. Thanks!
Insurance - 5 Answers
Random Answers, Critics, Comments, Opinions :
1 :
In the UK, they normally don't bother contacting your Doctor UNTIL YOU CLAIM ... THEN they try to avoid paying out by finding some mistake or 'error' in your application so they can say the Insurance is invalid. I've no idea what happens in the USA, but I bet Insurance companies there are just as reluctant to pay out as they are over here ...
2 :
This is a question you need to ask of your agent because "forgetting" to mention a doctor visit may come back to bite you. Insurance companies do not have access to all medical records if they don't know those records exist. Sometimes, depending on your answers to the health questions, they do not even check the records. However, in the future should you put in a claim which raises a red flag the insurance company will investigate and if they find out you "neglected" to tell them about the doctor visit they could cancel the policy and not pay the claim.
3 :
Don't worry about it... nobody has access to your medical records and there is no database that keeps it all together. If you don't list that Dr.'s visit then nobody is the wiser.
4 :
It is a very big deal, but not during the application process. What they do in the application process is to see whether you would qualify if the application was true. If they decide that you would, then they tell you that you are approved, and start charging you money. If you do not need to use the insurance much (and you are paying them more than the benefits are costing them), they let you keep the insurance, so that they can keep making money. If you need to use the insurance enough that they will lose money if they pay (for example, if you have to go to the hospital), then they conveniently discover the inaccurate information at that time, call it a lie, and use it as an excuse to rescind your policy, so that you have to pay for the treatment, hospital, etc., yourself.
5 :
It depends on what your doctor visit was for. Generally speaking, they can get all your records when you apply. You give them the permission to go through your medical history when you sign. Also the signature says everything is true as far as you know. If it was for something you disclosed other places, you should be fine. If it was for something routine, it shouldn't matter. If it was for something you are taking medicine for, you should have disclosed the medicine. Usually they'll call and do a telephone interview. If it was a visit where you were diagnosed or prescribed drugs, just call the agent and tell him/her if the issue wasn't disclosed other parts of the application. You won't be in trouble for forgetting. They'll probably catch it anyway. If it is a big deal and you file a claim on it, they'll check it and deny the claim. I hope this helps. I don't think it's a big deal, but I don't know what the visit was for. And I don't know what you disclosed on the application.


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Posted by Health Insurance at 11:03 PM