MIB does not collect, maintain or store any medical records in its database such as examination reports, attending physician statements, lab test results, x-rays, underwriting files or reasons for denial of insurance. Instead, MIB's members furnish "codes" to MIB, which represent medical and avocational information that is significant to the underwriting process. These codes can be thought of as a simple form of encryption.
Members report information to MIB using these proprietary and highly confidential codes to signify different medical conditions (typically hazardous avocations and adverse driving records) affecting the insurability of the applicant (in most cases, the person applying for the insurance policy [the applicant] is the same person who would be insured under the policy). These are conditions that have a significant impact on an applicant's health or life expectancy and are reported under broad categories.
If a member company wishes to search MIB's database or report information back to MIB (or both), then it must first provide the applicant with the MIB Pre-Notice, which describes MIB's role in the application and underwriting process. The MIB Pre-Notice notifies the applicant that a report concerning his or her medical conditions and avocations may be made to MIB and further, that if he or she later applies for life or health insurance (or files a claim for benefits) with an MIB member company, then MIB may supply that company with an MIB report. The Pre-Notice also provides the address for consumers to contact MIB to request a copy of their MIB Consumer File and to seek correction or amendment of an MIB Consumer File, if one exists.
After receiving the MIB Pre-Notice, the applicant is asked to sign an authorization in which MIB is identified as an information source along with others that might have records about the applicant, such as personal physicians. This signed authorization allows the member company to exchange information with MIB. Therefore, a member company cannot search MIB or report information to MIB without the applicant’s knowledge and authorization.
Once the member completes the underwriting process, any conditions that have a material impact on mortality or morbidity are reported to MIB using highly proprietary and confidential codes.
In order to have an MIB Consumer File, a consumer must have applied for individually underwritten life, health, disability income, long-term care or critical illness insurance within the past 7 years (or earlier depending on applicable law) and the insurance company to which he or she applied (or its reinsurer) must have been an MIB member company that submitted an MIB inquiry with the consumer’s authorization. Therefore, a consumer may not have an MIB Consumer File if: (i) he/she applied for insurance more than 7 years ago; or (ii) he/she applied for insurance that was not individually underwritten; (for example, group insurance or guaranteed issue life, or ACA-based health insurance); or (iii) he/she applied to an insurance company that was not an MIB member.
As a practical matter, MIB codes are not typically reported on individuals who are in good health, meaning that their life and health insurance applications are approved by the insurer as standard or preferred risks.
With your authorization, MIB shares individually identifiable information about you only with its member life and health insurance companies (or their service providers who are acting on the member’s behalf), or with you directly, unless otherwise required or allowed by law. MIB does not sell any individually identifiable information to any non-member third parties.
Further, the federal Fair Credit Reporting Act and the Privacy Rule under the Health Insurance Portability and Accountability Act ("HIPAA") severely restrict the use and dissemination of individually identifiable information, and MIB complies with both the letter and spirit of these laws.
MIB is firmly committed to the principle that every person is entitled to know the contents of their MIB Consumer File, if one exists. There is no charge to request a free copy of your MIB Consumer File once per year directly from MIB using our toll free line (866-692-6901) or our online process.
While MIB plays a critical role in an insurer's underwriting and risk classification process by ensuring the information on an application for coverage is accurate and complete, the decision to insure and set premium rates is borne solely by the MIB member company. Insurance companies make every reasonable effort to offer coverage to as many people as possible, while making sure they adequately classify individuals according to the degree of risk they present. Charging appropriate premiums for insured risks allows insurers to remain financially strong so they can meet their long and short-term policy obligations to each and every policyholder.
Additionally, having an MIB code does not make a person uninsurable. These MIB codes do not provide enough detail for an underwriter to make a decision on whether to approve, deny or rate an application for insurance because they typically depict broad, general categories of medical histories or conditions. In fact, underwriters from MIB member companies are prohibited under the MIB General Rules from making adverse underwriting decisions on the sole basis of a reported code. Instead, members are required to conduct a further investigation to obtain more information about the reported medical histories or conditions before making an adverse underwriting decision. If an applicant answers every question on his or her application fully and frankly, then the MIB report should have little or no bearing on the underwriting of the application because the underwriter would already be aware of the conditions disclosed by the applicant.
MIB's database consists of highly confidential and proprietary codes that signify different medical conditions and other conditions affecting the insurability of the applicant, as verified by members during the underwriting process. These codes do not indicate what action a member company took with respect to an application for insurance (i.e., approval, denial, approved with a substandard rating).
As part of the underwriting process, with your authorization, a member insurance company may obtain your medical records from your health care provider along with other underwriting requirements. Once it has reviewed your medical records, the member company may then make a brief report to MIB of conditions that are significant to underwriting. However, MIB does not obtain any information directly from your physician. Only those life or health insurance companies that are members of MIB can contribute coded information to MIB's database.
The accuracy of information in MIB Consumer Files is of paramount importance to MIB. MIB and its member companies are fully committed to ensuring that only accurate, timely, verified and complete information is reported to MIB. MIB has long provided consumers with the right to obtain their MIB Consumer File (if one exists) in order to ensure its accuracy and completeness. In fact, out of all the free disclosures that we provide to consumers, we find that only 1-2% of these Consumer Files have to be amended due to inaccurate or incomplete information.
In addition to making this commitment to accuracy, MIB also offers an effective reinvestigation process in accordance with the federal Fair Credit Reporting Act. If you have received a copy of your MIB Consumer File and you feel that the information in your MIB Consumer File is inaccurate or incomplete, then you may request a "reinvestigation." To learn more about how to request a reinvestigation, visit How to Dispute Your MIB Consumer File.
If an identity thief stole an individual's MIB Consumer File, it would not yield the precious data from which to steal the individual's medical identity. That is because your MIB Consumer File (if you have one) does not contain personal identifiers that make individuals vulnerable to identity theft such as unencrypted Social Security numbers (SSN) (or a SIN in Canada), driver's license numbers or financial account numbers or PINs. In addition, MIB Consumer Files do not contain health plan member identification numbers—the precious piece of data that would be needed by a medical identity thief to use your health plan coverage.
MIB's actual records contain "coded" information about a consumer's medical or other conditions that are of underwriting significance and the codes are both highly confidential and proprietary to MIB. Therefore, this information, even if it were decoded, could not lead to identity theft or financial fraud. For more information, see Can Medical Identity Theft Impact Your MIB Consumer File?
MIB is subject to a myriad of laws governing the use of consumer reports and addressing the privacy of individually identifiable information. These laws either regulate MIB directly or they regulate and impact MIB's members in such a way that MIB must likewise comply in order to allow members to continue using MIB’s services.
Classified as a "nationwide specialty consumer reporting agency," MIB is directly regulated under the federal Fair Credit Reporting Act ("FCRA"), which was enacted in 1970 to promote accuracy, fairness, and the privacy of personal information assembled by "consumer reporting agencies." MIB complies with FCRA on an enterprise wide basis just as it protects sensitive and confidential information through an Enterprise Security Program. Through MIB, Inc., its subsidiary operating company, MIB maintains a secure and confidential consumer database for the sole benefit of its member companies, issues consumer reports containing coded information to its members, provides free annual disclosure to consumers of their MIB Consumer Files, and extends FCRA rights and privileges to consumers. To view a comprehensive list of other consumer reporting agencies (as identified by the Consumer Financial Protection Bureau), visit: CFPB List of Consumer Reporting Agencies.
Since 1974, MIB has required all members to comply with its General Rules as they relate to the FCRA, irrespective of whether the member is a United States or Canadian domiciled insurance company. Because MIB's operations are regulated as a consumer reporting agency under FCRA, it provides US consumers with the rights, protections and privileges available under FCRA. In addition, MIB also provides substantially equivalent rights to Canadian consumers. In short, MIB conducts its operations throughout North America with a consistently high degree of confidentiality and security.
In addition, because MIB member companies are governed by the Gramm-Leach-Bliley Act ("GLBA"), Health Insurance Portability and Accountability Act ("HIPAA") and numerous state privacy laws, including the NAIC Model Insurance Information and Privacy Act, and Canadian members are governed by the Personal Information Protection and Electronic Documents Act ("PIPEDA"), MIB conducts its business in a manner that allows its members to comply with such laws.