Medical history is an essential component of the insurance industry. Insurers need to know your medical history to determine your eligibility for the coverage you are applying for.
The information you provide an insurer as a part of your medical history can influence whether you are approved for coverage or not. However, sometimes insurers ask for rechecks of medical history. Here are the top five common reasons why they may do so.
1. Unclear or Incomplete Information
One of the most common reasons that insurers request rechecks of medical history is incomplete or unclear information. Insurers are cautious about issuing coverage to policyholders who have undisclosed health conditions.
Suppose the policyholder fails to provide accurate information. In that case, it results in a high risk for the insurance company. Insurers may request rechecks of medical history if the medical records are unclear, incomplete, or inconsistent, to avoid providing coverage to a policyholder who poses a high risk.
2. Pre-Existing Medical Conditions
Pre-existing medical conditions are another common reason for rechecks of medical history. Insurers consider pre-existing conditions when determining your eligibility for coverage.
Pre-existing conditions refer to medical issues that a policyholder had before applying for coverage. Insurers often request rechecks of medical records for policyholders with pre-existing conditions to confirm the severity or ensure their policy covers any related medical expenses.
3. Change in Health Condition
Another reason why insurers request rechecks of medical history is a change in a policyholder’s health condition. Some policyholders may experience changes in their health that require additional medical attention or result in an increased risk.
Insurers may request rechecks of medical records for policyholders who experience such changes to ensure that their records reflect the current health condition, and coverage is still appropriate.
4. Medication Use
The use of some medications may lead to adverse health events for some people. For example, suppose a policyholder has a disease or condition and is taking medications for it.
In that case, the insurer may request rechecks of medical records to ensure the medications prescribed help manage the condition with no known adverse effects on the policyholder’s health. Insurers also need to know if you have ever had an adverse effect to any medication so they can determine coverage eligibility.
5. Invalid Claims
The last common reason why insurers may request rechecks of medical history is invalid claims. Insurance fraud is a significant issue in the industry, and insurers may suspect that their policyholders could be fraudulent when filing hefty claims.
Thus, they may request rechecks of medical records to validate the claims and ensure they are not paying for treatment that is not necessary.
