Life Insurance and Medical Information Bureau (MIB)

This was a rather interesting week for me.  For the first time ever, I had a life insurance agent cursed at me with an F word.  The story started last summer when I tried to purchase a term life insurance policy from this agent.  He helped my parents stop the monthly payments on their whole life policies from New York Life, and let the policies pay for themselves using the existing cash value plus the dividends.  Naturally, I consulted with him about my own life insurance.

He walked me through a few options and gave me several term life insurance quotes from New York Life.  I didn’t think they were affordable and didn’t pull the trigger.  Later he came back saying that he is actually an independent agent and could work with many different insurance companies.  He then offered to get me a few more quotes, which I accepted.   In the mean time, I started to look online through sites like InsureMe, so that I can get an idea of the ballpark figure.

A few days later he came back with an attractive rate from Prudential, so we started the application process.  But the insurance company had a few questions and they requested for my medical record.  Unfortunately, I just switched doctor at that time so the new one didn’t have enough information about me, and my other lousy doctors that I left for various reasons weren’t too cooperative with getting my record over to Prudential.  To keep a long story short, I ended up go through a few hoops, including getting a few tests done.   The result from these tests concluded that I was not going to die any time soon — I was healthy.

Once Prudential received the results, they completed the application and made me an offer.  The agent called with the offer; however, the annual premium was three times higher than what he originally quoted. When I asked why, he said that the insurance company found elevated liver enzymes from their independent blood test — hmm…a completely different problem all the sudden.  As a result, I declined the policy saying that I have blood test done annually and none of doctors ever mention anything about my liver before.

This is when he started to tell me all kind of things about the Medical Information Bureau (MIB) and how my record is now red flagged and I’ll never be able to get another life insurance policy from any company again.  When I called his bluff, he lost his temper and start saying that he wasted a lot of time on me and eventually resorted to swearing.

What Is Medical Insurance Bureau (MIB)?

This agent tried to scare me more than once using the MIB as a scarecrow, so I want to talk a bit about this entity.

Medical Information Bureau, or MIB, is a non-profit trade association that enables its member companies to share information in the form of medical codes.  There are approximately 230 codes the MIB uses to signify different medical conditions.  Member companies use it as a clearinghouse for all life, health, and disability insurance applications, primarily to protect themselves from fraud by cross checking medical information, and identify individuals who might be stacking coverage with multiple carriers.

The Truth About MIB

Here are a few facts about MIB that you should be aware of if someone ever try to pull a fast one on you.

  • Only about 20% of applicants have an MIB record.  These are individuals who have applied for individually underwritten life, health, or disability insurance coverage within the last seven years and been found to have a medical issue.
  • A code can only be entered by an underwriter of a member company.
  • A code stays active in the MIB system for seven years.
  • Any information in the MIB cannot be used directly to deny someone insurance.  In other words, an insurance underwriter cannot just decline your application because you have a record in the MIB.
  • The Fair Credit Reporting Act requires insurance companies to notify you if they intend to contact the MIB and give your information to them.
  • You have the right to see your MIB file, if there is one.  To see your record, contact the MIB at www.mib.com.

When my ex-insurance agent told me that I will have an MIB record and will never be insured by anyone again — that is a lie.  The MIB is analogous to credit bureau (i.e., Experian, Equifax, and TransUnion), and your MIB record is similar to your credit report.  In the same way that your credit history and credit score are designed to help lenders make informed decisions pertaining to you, the MIB is designed to help insurers.

43 thoughts on “Life Insurance and Medical Information Bureau (MIB)”

  1. Talk about harsh. I’ve heard of all sorts of pressure tactics from insurance salesman, but this is bad.

    Strange that your physician didn’t inform you that your AST/ALT levels were abnormal but your insurance agent all of a sudden knows what is best. I would be a pain and ask for documentation from the independent lab and compare those to your physician’s lab. Maybe try to catch him in a lie with a paperwork trail.

  2. I would certainly ask. If he gives you static, maybe you can play the concerned patient angle saying if you have a red flag from a diagnostic test, both you and your physician wants to see it. I’m sure you have a right from a legality standpoint as well. If a confirmatory test negates their test, I would probably be emailing the folks at The Consumerist.

    Stuff like this really ticks me off b/c its one thing to sell you a Snuggie or ShamWow, but to screw with your health is taking it to a higher level.

  3. @Matt – That’s my thought exactly and that’s why I declined the offer until I can get another test done. He said previously that I could request the result, but I doubt he will help me at this point.

    @Manshu – Thank you. Yeah, he’s crappy. He even said he doesn’t make any commission on this sales and why a few dollars should make any difference. I told him $25 x 12 months x 30 years = $4,320 not including interest.

  4. Pinyo, thanks for educating us! I don’t want to invoke an old stereotype, but are you sure he is not a used car salesman moonlighting as an insurance agent? 😉

  5. Are you freakin serious? Report that guy. That’s absolutely absurd and almost criminal.

    And to say he doesn’t make any money? Of course he’ll make something. Might not be the big payday that he’s looking for, but he’ll get paid. I’m surprised he didn’t try to tell you that whole life is much better than term and that’s they way to go.

  6. @Matt – I wrote to the company he was working with and they willing to help. I just have to send in a request in writing.

    @Steve – No problem. May be he got fired from the used car lot.

    @Jeff – He did try to sell me whole life the entire time. He said I should at least take out a small $50,000 so that I would have something permanent.

  7. Man, I can’t believe that guy did that. How unprofessional! Glad you found a new insurance agent and I’m glad you did your homework. He probably was ticked off because he is not used to people doing their own research and not challenging him. Way to go Pinyo!

  8. I’ll back you up on your MIB research. I work with our underwriting department and we are not allowed to make decisions based solely on MIB codes. It does bring attention to the code in question and we will make sure to verify, but we will do all of our own underwriting and testing. No insurance company is going to pass up a possible sale based solely on something they see reported on MIB.

    I’d also like to disagree with your agent. There are plenty of agents that make a lot of money selling a lot of term insurance. In the long run an agent will make the most money selling you a policy that makes the most sense for you. Good luck on your continued life insurance quest.

  9. @SGM – Thank you. Yeah I think he’s just pissed that he’s not getting his commission as fast and as much as he wants.

    @Michael – Thank you for chiming in and back me up on my research. It’s refreshing to see people that recognize the importance of putting customers first and tie that to his/her success.

  10. Glad to see you didn’t fall for that guy’s ruse. I would consider reporting him as well, but I’m sure he can just deny everything took place. It would be difficult to get concrete evidence. Still, it would be good to lodge a complaint if it makes other people think twice about visiting him.

  11. I am an insurance agent and I would never use the F word with a prospective client nor would I ever play the MIB card with anyone. You give good advice in regard to people finding out what information MIB has on them. We have had several situations in which MIB had erroneous information about prospective clients and it created a lot of work for us and the clients. You can find out what information they have and you do have recourse in getting erroneous information removed (just like the credit bureaus).

  12. And just to follow up, my independent blood test shows my liver function at midrange(about 50% below max) and my lab test from Liberty Mutual shows I am perfectly healthy — I even got preferred rate from Liberty.

    So that lying bastard of a sorry agent could go to hell. 🙂

  13. I am an insurance agent at a small bank and I HATE it when I hear stories like that. In my opinion, you might want to try going to a rep in a local small bank, the reason why I say that is most of the time the banks dont payout as much commision as an independent broker, so the chances that the agent will be motivated by the amount of money he/she stands to make is less. Also, if you are young and can afford it, look into whole life with limited term pay. Its always more per month but you only have to pay the premiums for a limited amout of time (usually 20 years) as opposed to paying until you are 85 yrs old, and you always have the cash value to dip into if you really need it years down the road.

  14. I’ve been in the insurance industry for about 12 years now. Problem is, A LOT of agents like to quote overly aggressive premiums. For example, most companies have what they call risk classes: Super preferred nonsmoker, preferred nonsmoker, standard nonsmoker. Generally, super preferred will result in the lowest premiums, and the lesser the class, the higher the premium. Unfortunately, like I mentioned, agents like to “wet your appetite” with a premium based on Super Preferred, then if you get a standard, or substandard rate, it’s all your fault because your health sucks, and YOU are the one wasting their time, they aren’t to blame because you said you were healthy. However, by this time, as you mentioned, you’ve been entangled in the “sales process”. Like any sales process, the more you get sucked into it, the harder it is to get out, and that’s the whole idea. So, if you ever come across an agent giving you a quote, be sure to ask what health rating was assumed.

  15. I’m currently in a fight with the MIB, They erroneously stated that I have cholestrol above 320, High blood pressure 170/110, elevated sugar at 160 and an abnormality on my EKG, complements of a new life insurance application. 2 weeks after the initial test I went to my physican and had my test run once again, cholestrol 185, BP 110/55, Sugar 60, and normal EKG and backed that up with a ultrasound. I since have had my medical insurance increase 4X, had to drop that insurance due to a monthly cost of over $1400.00, denied health insurance from 2 different companies, and currently have no health insurance nor life insurance. I cannot get the mistaken information removed and my doctor cannot get the correct information added because it was not submitted through an Insurance company. Sad case of Guilty until proven innocent. I was further told this can and will hinder my chances of landing a new position on the executive level with a larger firm. Most attorney’s laugh when I explain this situation and do not want to get involved. What exactly do you do?

    • @Rayc – I am sorry about your unfortunate incident. Unfortunately, I don’t have experience fighting something like this. I was fortunate enough to get in touch with a reputable insurance company (Liberty Mutual) who took the time to review medical information from my doctor and perform their own lab tests. The results were counter to what my former agent put in, so I was able to get preferred insurance rate.

      You may want to get in touch with a reputable insurance company and show them your medical record and ask them for another test. If their test confirms that you’re healthy, it should be easier to correct the MIB record.

  16. A few things to consider when shopping for life insurance:

    1. Only simplified issue will allow an applicant not to take a paramed. They usually come with coverage limits and are often standard-rated. If you’re healthy and not afraid of the needle, go for the paramed and possibly the preferred rating.

    2. “Elevated liver enzyme” – A piece of fruit on an empty stomach in the morning before the paramed visit will throw your lab result into abyss. The best way to prepare for paramed is to “fast”. Eat nothing for at least 12 hours. The longer the better.

    3. Always request re-exam if something like above happens. That way the correct numbers will also show up on the MIB.

    4. When it comes to term life, the cheapest is NOT always the best. Ask about conversion and renewal options.

    5. When it comes to permanent life, always ask to see the guaranteed column (if the agent flinches when you ask, consider another product).

    Finally, try not to worry about the commissions. You pay the same premium for the same product no matter where you go. Worry about the features and options and don’t be afraid to ask questions. Cheers.

  17. Thanks a lot for all the info… I am having a similar issue with Prudential Life with Elevated Liver Enzymes…. Rates are jacked up 2x.
    I may go with another company.. Never Trust These insurance agents – They only want to know how much will they make out of you… As for insurance companies – They are here to make a profit out of you. This is way they will always win. Our politician are bought by them on an hourly basis.

    Can’t trust anyone these day. Good luck man… any I hope that i will find something good too.


  18. I applied for life insurance last year and was unaware of MIB. I was declined life insurance due entirely to what is in my MIB file. I am in my early 50’s and in great health. In fact the technician who tested me could not get my heart rate high enough for my age group, even though he had me run on the treadmill for 20 minutes. He finally gave up and said I was in great health.

    Why was I rejected? Solely on the contents of my MIB file. I finally received my MIB report, after numerous failed attempts to get their automated phone system to understand my country as the “United States”. And now, thanks to MIB, I have “two code symbols which translate as follows: 1) Drugs. Marijuana or hashish. and 2) Test for drugs other than cocaine, positive…” I am a legal medical marijuana patient. So I could be either a legal medical marijuana patient or a heroin addict, at least from MIB’s information.

    So what is my recourse? Wait 7 years and reapply when I am 60? Or reapply and DON’T allow the insurer to search MIB or put any results into MIB.

    This is a clear violation of HIPAA and my civil rights. I am not breaking any laws as medical marijuana is legal in California. This reminds me of the early days of Equifax when it was impossible to get information about your file or get incorrect information out of your file.

    • Anonymous, I just found your comment in my email and wanted to reply. Frankly I’m a little confused. In order for you to have any MIB record, you had to have applied for life insurance sometime in the past. So did the company from the past offer you a coverage?

      With regard to marijuana use, I personally don’t know of any one company that would decline a healthy applicant solely based on that. There HAS TO BE other reasons apart from marijuana use. What did the new company specifically tell you their decision was based on? “Drugs other than cocaine” refer to other less risky drugs (typically marijuana) because use of cocaine is considered a high risk and that’s what the companies look for.

      The insurance company didn’t violate any HIPAA or civil rights because you signed both HIPAA Authorization and Medical Information Disclosure form when you applied that allowed them to look up your MIB records.

      My guess is that the decline was probably based on one of the following:

      1. your current medical condition that requires prescribed medical use of marijuana (e.g. mental anxiety is considered a very high risk) and/or

      2. you did not disclose the above condition on the app and/or

      3. you did not disclose that you were declined for life insurance in the past.

      It’s one thing to hide that you smoke occasional pot but quite another thing to hide that you have a condition that requires physician’s prescription of medical marijuana. Hope this helps.

    • Anonymous, you did not get declined because of what is your MIB file. In your application, it would have asked you about drug use. Did you admit to the drug use? Did you admit to the medical problem that forces you to be a drug user.

      What the MIB did was get the insurance company to look into your situation. Some insurance companies will turn down people who get stoned on occasion. An every day smoker is going to get turned down in most cases. The fact that this is medical marijuana is even worse because we know that there is also a medical problem.

  19. I am curious about the claims that folks were denied coverage due to info in the MIB database. I was told that anything in the MIB had to be verified independently and that insurance companies had to justify any decisions with other supporting information. I have no doubt that insurance companies do everything they can to circumvent this and hate the fact that the MIB exists. However, I figured the companies would at least try to keep up appearances and at least say they validated thing independently.

  20. I’m in a sticky situation. I recently got the results from my insurance application that my monthly premium would be 3x what was originally quoted. My agent to told me that even all my health exams indicated good health, I was labelled as a smoker! I took my inquiry all the way to the underwritter and they said that my primary physician made a note on my file that I smoked a couple of cigarattes per day. This is NOT true at all! In fact, I don’t smoke. I did try a couple when I was younger. I believe the physician mis interpretted this when I told him and wrote the note incorrectly on my file. I’m trying to rectify this with my physician, but I’m not sure how he can convince the insurance company. As a result of this situation, the insurance company has now labeled me a smoker even though all my med exams came out good. I’m not sure what to do at this point since their giving me a 3x premium hike. I could shop around but I know the it’s probably in my MIB records. Any advice?

  21. First, as an ex-life insurance agent, let me assure everyone that they WANT to sell you insurance. The MIB has a legitimate purpose: to protect companies against fraudulent claims. Let say you have liver cancer and apply to company A. The deny you. Then you apply to company B and don’t disclose that information.
    The problem is twofold: the garbage in/garbage out thing, and the ability of the MIB to get information indirectly with no responsibility for the accuracy of that information. When you sign the waiver, you allow the insurance company to use whatever they find from any of your medical records anywhere and store it on the MIB. In today’s internet based insurance market and the resultant low profit margins, most companies don’t care about the accuracy of what they put in there and won’t make the effort to confirm anything. If one of your ex-doctors takes your urine sample in his Styrofoam coffee cup and you show sugar in you urine, that result goes in there and good luck getting it out.

    Since the MIB is resistant to virtually all litigation (like the credit bureaus), all you can count on is their self-imposed integrity… and we know how that usually turns out.

  22. I am 40 years old and have experimented with cocaine use when I was 35. I applied for life insurance in 2006 and was denied due to having cocaine in my system. I have not been able to get life insurance since (two attempts) being denied. I was at a different time in my life and have not touched it since being denied. I am perfectly healthy and have this one regrettable instance keeping me from getting LI. It was reported to the MIB so I have always been honest about my past use. Is there a certain amount of time before an insurance company would consider me for insurance after my prior drug use? Am I banned from obtaining life insurance due to having cocaine in my system 5 years ago? Thank you for your reply.

  23. I am trying to figure out if we apply for Life Ins. if they will notice a prescription my husband was taking last year to get off an opiud drug a friend of his got him on. Last year I had group ins. in FL and he did use this ins to pay for the medication and the doc that presribed it. He used a different doc than his regular physician. He was on it for less than a year. We now live in a different state. We now have individual health ins. We would like to apply for Life insurance, but I am wondering if he should wait 7 years.

  24. @dukee – You can try another insurance company. Some are more reasonable than others.

    @MB – It was a while since I applied, but I believe you do have to disclose this to your insurer and it will likely inflate your rate.

  25. This agent should be removed from the field, however underwriters are a different breed they base there decisions on a set criteria. So what your doctor thinks is usually very different then an underwriter.

    • @UnKnown – Sorry I misread your question. After further research, you’re not covered by HIPAA, but you’re protected by GLB. According to this artilce https://www.privacyrights.org/fs/fs8-med.htm:

      “The federal Gramm-Leach-Bliley Act (GLB) allows financial companies such as banks, brokerage houses, and insurance companies to operate as a single entity. GLB gives you the right to be notified about the information-sharing practices of financial institutions. And you must be given an opportunity to opt-out of third-party information sharing. But GLB does not keep information from being shared among affiliated companies.”

      Also, if you are referring specifically to your MIB record, here’s what the article has to say:

      “The MIB is not subject to HIPAA. MIB files do not include the totality of one’s medical records as held by your health care provider. Rather it consists of codes signifying certain health conditions.”

      In any case, you may have signed a Privacy Policy when you applied for your insurance. You have to read that because it will say specifically what the insurance company can and cannot do with your information.

  26. so if I have never signed something saying he could tell people about that… he could be in trouble if I wanted to purse something legally

  27. We just turned down life insurance because of a sketchy privacy policy relating to MIB, which we’d never heard of before today. The bummer is we really like our insurance agent.

    The language in the Authorization for Use or Disclosure of Protected Health Information states that information will be released to MIB, and that after the information is received by “the person or entitiy” (MIB), that our medical information “may be redisclosed and no longer protected by these regulations.”

    There is no information about the limitations of storing, sharing, selling, trading, or otherwise making our medical information available. By signing this form we in effect give MIB and every MIB member permission to do whatever they want with our information.

    This makes a joke of HIPAA, and we just can’t give this sort of unlimited access to our private medical information without any assurances. The bummer is we’d like life insurance.

  28. I put in applications with 3 different ins. companies to get whole life ins. One ins. co. sent me an email stating that they are now showing that I submitted a life insurance application to another carrier in March and they are needing to know the specifics of this to approve & finalize my policy. The need to know the carrier name, type of life policy (term or whole), how much I am applying for, and the status (in force, pending or cancelled, etc..) to clear and issue at the rate quoted.

    Can this ins. co. require me to share this information with them about the other ins. co.? I am trying to get the best premium quote. I don’t understand why they would ask for this information. If I were shopping for a car and went to 3 dealers, one dealer couldn’t ask me to share information from the other dealer. I’ll look forward to your response.

    • @Jackie: The insurance industry is very over-regulated. The insurance commissioner (state governed) requires all replacement information, including applications applied for (whether accepted, declined or not-taken), be disclosed and acknowledged by the insured. This is an effort to protect the insured from churning, or replacing existing policies for no reason other than generating commission.

      The intention is to protect you, but it is inconvenient. A lot of the process of applying for life insurance is inconvenient and unfortunately a lot of the agents are not very professional or knowledgeable.

      The key is to find a great agent that is qualified and trust-worthy.

      I work in the industry. I’m happy to help with any questions.

    • Yes Jackie, this is legal. There is a maximum amount of coverage that will be issued on your life and each carrier you apply to will need to know where you are accepting coverage to make sure you are not over-insured and to make sure they are not taking on too much risk. If you apply for credit cards and loans, all that activity shows up on your credit report and affects your credit score. Just like credit bureaus, MIB information is used as a monitoring system for insurance carriers to manage risk. Your bank does similar things. Most insurance procedures are in place to keep the best interests of the insureds in mind, they are not in place to provide advantages to the insurance company as a way to cheat the end consumer. Various procedures may seem confusing but a qualified agent can explain procedures and processes so that you can understand them and feel comfortable with the process.

      MIB information is not normally going to hinder your ability to obtain life insurance. If there are discrepancies, there are steps you can take to correct them (if they are in fact, incorrect codes). Most people are not affected by MIB codes.

      Please keep in mind, with the strict HIPAA laws and privacy policies that are in place, MIB and insurance companies take great care to protect your information and do not share inappropriately.

      Underwriters are looking at files and determining long term risk, financially and medically. They attend meetings and receive training from their company to learn more about medical risks. Some companies have MD’s that work for them and provide feedback and training to underwriters. Underwriter’s often have more up to date information and studies available to them than practicing MD’s do. Or maybe the underwriter’s just take more time to keep their knowledge current. Often MD’s will write letters to companies advising that their clients are in perfect health, when it is clear that the client has symptoms that they should be addressing already, often times with simple diet and lifestyle improvements. For example, it’s common for insurance companies to see that a client is pre-diabetic, however the client’s MD has told the client they are in perfect health, nothing to worry about when the test results are clearly pointing in another direction. Most insureds are upset when an insurance company finds something of concern and instead of going right to their MD, who will most likely tell them that they are fine (without researching thoroughly enough), I believe (given the state of our broken medical system) the insured should obtain their records and lab results and do a bit of research themselves.

      It’s up to each of us to find a trustworthy financial rep. That Rep/agent will be able to help us with any questions, concerns, problems we run up against. If they can not help you, they are not doing their job so find a better one. Most of the problems and concerns I see listed above, could be answered and resolved by working with a qualified agent who has their client’s best interests in mind. Even if the agent does not have all the answers immediately, they will know who to contact to get the situation resolved. Although please keep in mind that this may not be resolved overnight. Some of these issues take time to resolve due to the systems and laws that are in place. Look at The Evil Insurance Salesman’s responses. That person obviously knows their stuff. Find your own The Evil Insurance Salesman!

  29. Yes, report that agent to the Department of Insurance in your state!. That was a display of dishonest and unethical behavior. He can be fined or have his licensed suspended.

  30. Was wondering about the MIB and health insurance coverage in Texas. I know that my husband and I applied for Life Insurance in 2000 (got it). We have always been on employer-sponsored Health Insurance. We will be applying for our OWN coverage now (within the 63 -day continuance period, as my COBRA ended 8/31/12). Would we be in the MIB? If so, would it help or hinder us to get our reports?

    I also just read that if we get coverage within that 63-day period, an insurer can’t invoke a pre-existing condition limitation on us??

    Is this correct??

    Thanks for your help!!!

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