What the MIB, prescription databases and driving records reveal

When you apply for a fully underwritten life insurance policy, the insurer does not rely only on what you wrote. With your signed authorization, it can consult several outside sources and compare them with your answers. The three that come up most often are the MIB file, a prescription history report and a motor vehicle record. Each holds a different slice of information, each has limits, and each can contain an error that you would rather find before the underwriter does.

This article explains what each source is, what it does and does not show, how the pieces fit together, and how to see and fix your own records. It is an explainer rather than a how-to checklist; for the step-by-step version of requesting reports, see How to request your own MIB and prescription reports step by step.

Why insurers check at all

Life insurance prices risk by pooling people who look alike and charging each pool for its expected claims. That works only if applicants describe themselves accurately. If someone with an undisclosed heart condition could buy at the same price as a person without one, the cost would be pushed onto everyone else in the pool, a problem insurers call adverse selection. Outside records are a cross-check that keeps the pool honest.

The checks also protect applicants in one way that is easy to overlook. A record that confirms your answers can speed a decision, and in some accelerated programs a clean set of reports can replace an exam entirely. The same records that can reveal a surprise can also let you skip a needle.

The authorization you sign on the application is what lets the insurer run these checks. It is worth reading that form once, a point the post what you are signing in a life insurance medical authorization covers in detail.

The MIB file

The MIB (originally the Medical Information Bureau) is a database that member insurers use to check an application against earlier ones. It does not hold your medical records. It holds coded entries that a member insurer reported after underwriting someone, when the information had underwriting significance, such as a particular test result or condition. According to MIB's description of the consumer file, the file may also show which member companies received a copy of the information, other carriers that checked your file, and disability insurance information if there is any.

Three limits matter:

• It is a file only if you applied. If you have never applied for individually underwritten life, health or disability coverage with a member company, or only had group coverage, there is probably nothing to see.
• It does not record decisions. MIB says its file does not show how an applicant was rated or whether an application was accepted or declined. A member cannot make an adverse decision based solely on MIB data without further investigation.
• It forgets. MIB says it retains information for seven years from the application date.

What the file is good for, from the insurer's side, is a consistency test. Say you told one insurer about elevated blood pressure three years ago, and it was coded. If you leave it off the next application, the second insurer sees a code that does not match your answer. That does not end the application. It prompts a question or a request for records. The The MIB report: what insurers know about your history guide has a worked example of exactly that.

The prescription history report

A prescription history report is built from pharmacy and pharmacy benefit manager records. It generally lists the drugs dispensed to you over several years, with fill dates, quantities, doses and the prescribing doctor. Some vendors add a computed risk score or clinical flags. The CFPB's published list of consumer reporting companies includes prescription history services, such as Milliman IntelliScript, which the list describes as collecting prescription purchase history to help quantify mortality risk for life insurance underwriting. According to that list, the company provides a free copy of your report on request.

What the report does not contain is the diagnosis. The underwriter infers it from the drug, and that inference can be wrong. A medicine used for several conditions can suggest the wrong one. A prescription filled once and never taken can look like an ongoing condition. A report can even mix up two people with similar names. It also misses cash purchases outside the data network, samples and many over-the-counter products.

The prescription database check glossary entry gives the short definition, and how insurers check your prescription history has the longer treatment. The point for this article is how the report interacts with the others: it is the quickest way for an underwriter to spot a condition you did not mention, and the quickest way for a harmless drug to start a conversation that your application had already answered.

The motor vehicle record

Many insurers order your motor vehicle record, or MVR, from your state's motor vehicle agency, often through a vendor. It typically lists license status, moving violations and their dates, convictions such as DUI and reckless driving, and in some states points and certain at-fault accidents. Not every policy uses it. Insurers tend to order it more often on larger amounts and fully underwritten applications, and some skip it on small or automated ones.

The insurer's interest is partly the accident risk itself and partly what the record suggests. A DUI conviction raises questions about alcohol use, which is also a health question. A clean record or an occasional minor ticket usually has little effect; serious violations, several in a short period, or a suspension can affect the rate class or delay an offer. Each insurer sets its own lookback period, so the same record can be treated differently at different companies. how your driving record affects life insurance covers how violations are handled.

Other sources that sit beside them

The three databases are not the whole file. Depending on the insurer, the product and the amount, the underwriter may also look at:

• The exam and labs. The blood and urine results and the measurements from a paramedical exam are compared with your answers and with the other reports.
• A phone interview. A trained interviewer goes over the application again, which gives a chance to clarify a mismatch.
• An attending physician statement. When something in the file needs context, the underwriter can request your doctor's records through an attending physician statement.
• Financial information. For very large policies, the insurer asks whether the amount fits your income and purpose. That concerns the size of the policy, not your health.
• Newer data sources. Some insurers use credit-related mortality scores or other data in accelerated programs. Rules on this differ and are still debated; your state insurance department can say what is allowed.

None of these decide the outcome alone. The underwriter combines them into a picture and compares it with the application.

What each source tells the underwriter

The common thread is that all four are secondary evidence. An entry is a clue, and the underwriter is trained to ask what it means rather than assume.

Your rights over these reports

Reports from nationwide specialty consumer reporting agencies fall under the federal Fair Credit Reporting Act (FCRA). In summary:

• An insurer needs a permissible purpose to obtain one, and your authorization on the application supplies it.
• If the insurer takes an adverse action, such as declining you or charging more, partly because of a report, it must tell you and name the reporting agency.
• You can ask the agency for a copy and, if you find an error, dispute it. The agency must investigate and correct or delete what it cannot verify.
• MIB gives you one free disclosure every 12 months, and an additional copy if an adverse decision was influenced by an MIB record.

State insurance privacy laws add rules on how health information is used and shared, and they vary. Your state insurance department can tell you what applies where you live. The post your rights when an insurer takes an adverse underwriting action covers what to do when a decision goes against you.

How to see your own records

1. MIB. Request your consumer file from MIB through the methods listed on its website, at mib.com. Use the official site, not third-party services that may charge fees. If you have not applied for coverage in the past seven years, you may find nothing.
2. Prescription history. Ask the insurer or agent which service it uses, or look at the adverse action notice if you received one. Then request your report from that company. The CFPB list gives the contact for Milliman IntelliScript.
3. Driving record. Most state motor vehicle agencies sell copies of your record, usually for a modest fee that varies by state. Check the state agency's website for how to order.
4. Medical records. Ask your doctors' offices for copies of recent records, since the underwriter may request them. Patients generally have a right to their own records, with procedures and fees that depend on the provider and state.

Do this several weeks before you apply, because corrections take time.

How to dispute a mistake

1. Identify exactly what is wrong. Is it a drug you do not take, a violation that was dismissed, a coded condition you never had, or someone else's record?
2. Dispute with the source in writing. For MIB, use its dispute process; for a prescription report, write to the reporting company; for a driving record, contact the motor vehicle agency. Keep copies and dates.
3. Ask for a doctor's letter if the issue is why a drug was prescribed. For example, a drug used for migraine prevention can look like a heart medication. A short note from the prescriber, or the relevant record, resolves it.
4. Tell the insurer. Ask your agent to have the underwriter reconsider with the corrected report or the doctor's context.
5. Add a statement if you disagree with the outcome. Under the FCRA, you may add a short statement of dispute to a file when the agency's investigation does not resolve it.

The post questions about disputing a wrong entry in your underwriting file takes the dispute process through a series of common questions.

A hypothetical example of the sources lining up

This is an invented illustration. Say Elena, 36, applies for a 20-year term policy. On her application she lists a daily thyroid medication and a past episode of high blood pressure during pregnancy that resolved. Her prescription report shows regular fills of the thyroid medication and nothing else unusual. Her MIB file contains no entries, since she has never applied before. Her motor vehicle record shows one speeding ticket several years ago.

The underwriter sees consistent answers across the board. The thyroid drug matches her disclosure; the pregnancy-related blood pressure episode does not show up as an ongoing prescription, which matches her statement that it resolved; the ticket is minor. The file moves ahead to exam results and a decision without a request for doctors' records.

Now change one fact. Say the prescription report also showed a beta-blocker that Elena takes for migraine prevention, and she had not mentioned migraines or the drug. The underwriter might infer high blood pressure and ask questions, or order a doctor's statement. Her answer is still easy to explain, but now she is explaining after the fact, and the file is delayed. Listing the migraines and the medication at the start would have avoided that.

Common misunderstandings

• "These databases hold my full medical history." They do not. MIB holds coded entries, the prescription report holds fills, and the MVR holds driving events. Your full records stay with your providers unless the insurer requests them with your authorization.
• "If it is not in the databases, I do not need to mention it." The application asks what it asks, and your answers must be accurate. A condition that never reached a pharmacy or an earlier insurer still counts. A material misstatement can allow the insurer to contest a claim, particularly in the first two years; see the two-year contestability period.
• "I can opt out of the check." Not for a standard fully underwritten policy, since the insurer needs the information to price the risk. Applicants who dislike the checks can look at simplified or guaranteed-issue products, which use fewer sources but usually cost more or cap the amount.
• "An entry means I will be declined." An entry is a clue. Context decides, including how long ago, how it was treated and what the tests show.
• "Errors are rare, so I can skip the check." Mix-ups of identity, outdated entries and misread prescriptions do happen. If you have a reason to expect an error, or you applied in the last seven years, checking costs little.

What to do next

If you are about to apply, request your MIB file if you have applied before, review your prescription history if you have recent fills that could be misread, and order your driving record if you have had violations. Build a short medical history list so your answers agree with the records, using the worksheet in build a medical history worksheet before you apply for life insurance. If the file has already come back with a surprise, ask the agent which item drove the decision and go from there.

Key takeaways

• The MIB file, prescription history and motor vehicle record are cross-checks. Each holds a narrow slice of information, and none holds your full medical history or the insurer's decision.
• A prescription report shows drugs, not diagnoses, so a drug can suggest the wrong condition; a short doctor's explanation usually resolves it.
• Many of these reports fall under the Fair Credit Reporting Act, which gives you the right to a copy, to dispute errors and to be told when a report contributed to an adverse decision.
• Request your own records several weeks before applying and make sure your application answers agree with them.
• Disclose fully even when a condition would not show in a database; a material misstatement can put a later claim at risk.