Life Insurance

Fully underwritten products and Long Term Care and Disability Income products drive medical evidence in the Life space.  While many companies have moved away from the evidence models as much as they can, underwriting is still needed for certain products.

For applicants over the age of 50, or for large face amount policies, it generally takes 5 or more weeks to issue a fully underwritten life policy. Of course issues such as integrated eApp or UW delays, can impact that policy time.

Alternative underwriting models often complement records retrieval such as:

“Mortality Score” based on existing data (predictive analytics without needing medical exam or records)

Pharma Access (prescription drug access)

Attending physician statements and paramedical examinations are mostly needed in underwriting.

For Long Term Care and Disability Income, they follow similar paths to that of Worker’s Compensation and substantial fraud can occur in the adjudication of these claims. 

As in other personal injury claims, medical record review is an important part of long term care and disability income litigation. The injury must be well-documented in the claimant’s medical records.

Once the treatment for the injury is completed, an independent medical examiner (IME) will examine the claimant to determine whether there is any permanent partial disability due to the injury. The medical examiner examines and interviews the claimant and reviews the relevant medical records.