Do Insurance Companies Share Information About Claims?

Yes. Specialty consumer reporting firms collect information regarding insurance claims you’ve made on your property and casualty policies, such as your homeowners and vehicle policies. They may also obtain a copy of your driving record.

What data do insurance companies share?

These include actuarial and statistical data derived from their own insurance books’ claims experience, data tables based on pooled high-level data from various insurance firms and combined risk and cost calculations, and market rates.

Are insurance claims public knowledge?

Home insurance claims are, in fact, public information. Under the F.A.C.T. Act, both parties’ right to obtain insurance information is safeguarded by law. If someone is interested in seeing the record, they can request a copy of the policy.

Do insurance companies check for previous claims?

The Claims & Underwriting Exchange allows insurance companies to look up previous claims (CUE). This is a central database of car, home, personal injury, and industrial disease occurrences reported to insurance companies, regardless of whether or not claims are filed.

How do insurance companies track claims?

The Comprehensive Loss Underwriting Exchange, or CLUE, and the less frequently used Automated Property Loss Underwriting System, or A-PLUS, are two databases that insurers use to track and transmit information about their customers. Insurers use your previous claims to determine how much to charge for a coverage.

What information do insurance companies have access to?

The types of information collected by life insurance companies are usually determined by the amount of coverage you want, the policy type, and the underwriting procedure they utilize. Your age and health may also play a role.

The most information is received from sources such as those listed below for fully underwritten policies. Many of these same sources are used in accelerated underwriting, with the exception of the medical exam. In addition, the simplified issue underwriting procedure may rely on limited third-party data.

Information From You

Prepare your coffee. According to the Society of Actuaries, a life insurance application might have up to 60 questions. You’ll be quizzed on your age, personal medical history and mental health, family medical history, and whether or not you use tobacco. There will also be inquiries into your driving record, harmful hobbies, and any prospective trip plans to dangerous regions.

To verify your identification, insurance providers will ask for personal information such as your Social Security number and birth date. They may also want to know your annual wage because it may limit the amount of insurance you may acquire based on it.

It’s critical to be truthful while answering questions. Keep in mind that insurers will double-check a lot of the information you provide with other sources. Incorrect responses may void your insurance policy in the future.

Electronic Health Records

Life insurance businesses have benefited from the availability of electronic health records. They can get rid of the outdated procedure of requesting an Attending Physician Statement (APS) on an applicant through phone or fax by accessing digital medical records. Firms that help insurers obtain medical records are known as records-request companies.

Your life insurance application will include a HIPAA-compliant consent form for you to sign if an insurer requests your medical records.

Since 2014, health-care providers have been obligated by federal law to keep electronic health records. Life insurers can use electronic health information to speed up the application process and, in some situations, eliminate the need for a medical exam.

Previous Life Insurance Applications

Individual health and life insurance applications are gathered by MIB Group. If you’ve ever applied for insurance with one of MIB’s member businesses, it’s likely that they have a record of you. Insurers can check to see whether your previous responses contradict what you’ve indicated on a new application. You can acquire a free copy of your MIB file.

MIB does not have information about your workplace’s group life or health insurance.

From Pharmaceutical Databases

Life insurance firms will find out if you’re taking medication for high blood pressure, diabetes, depression, or anything else. They check your prescription drug history using third-party companies like Milliman Intelliscript.

From a Life Insurance Medical Exam

A medical exam, also known as a paramedical exam, is usually required for a fully underwritten life insurance policy to identify if you have any medical issues that could affect the amount you pay.

Carriers like ExamOne and APPS are used by insurance companies to send a nurse or paramedical professional to your home or business. They’ll probably measure your height, weight, and blood pressure, as well as take blood and urine samples (which can detect nicotine and drug use, among other things).

Depending on your age or health, some insurers may require an EKG and/or cognitive assessment.

From Your Motor Vehicle Report

You’re submitting a life insurance application, not a car insurance application. So, why would an insurance company want to look into your driving history? You may be a higher risk as a policyholder if you have received speeding tickets or other offences such as DUIs.

From Your Credit

For life insurance firms, your credit may also appear to be an odd source of information. According to the Society of Actuaries, they may examine your credit. Credit scores can help determine your “mortality,” or life expectancy. LexisNexis, an analytics firm, sells its Risk Classifier score to life insurance, for example. Your credit, driving history, and other public records-based criteria are all factored into your score.

From Public Records

Insurers can look up your personal information in public records, find out what property you own, see whether you have a criminal past, and look for other information that might indicate you’re a riskier applicant.

From Financial Statements

Insurance companies may need more information to verify your financial condition if you apply for life insurance beyond a particular sum. Ameritas, for example, will demand to see tax returns or income statements, as well as a list of assets certified by an accountant, for applicants who seek a life insurance policy worth more than $5 million.

From Your Social Media Accounts

Anything you share on social media has the potential to backfire. Even when applying for life insurance, this is true. According to a poll conducted by Lewis & Ellis Actuaries and Consultants, most insurance firms scan social media sites as part of their underwriting process. The majority of people use Google, although some also use LinkedIn, Facebook, Instagram, or Twitter.

How do insurance companies get their data?

More than two-thirds of insurers credit predictive analytics with decreasing concerns and underwriting charges, according to Willis Towers Watson, and 60% say the resulting data has helped enhance sales and profitability.

This number is projected to rise dramatically in the coming year, as the inherent benefit of predictive analytics in insurance is demonstrated in a variety of ways.

Predictive analytics solutions may now collect data from a number of internal and external sources to better understand and forecast insureds’ behavior. To better understand and manage their relationships, claims, and underwriting, property and casualty insurance firms are collecting data from telematics, agent interactions, client interactions, smart homes, and even social media.

Predictive modeling in insurance, for example, is a closely similar technology “Insurers can use “what-if” modeling to prepare for underwriting workloads, provide data for filings, and assess the impact of a change on their book of business. The COVID-19 issue has showed insurers how important it is to be able to foresee change, and “What-if” modeling is an excellent tool for carriers that know they need to make changes but want to be sure they do so correctly. Insurance software with the correct predictive modeling may help define and deliver rate changes and new products more quickly.

Here are 11 ways predictive analytics in P&C insurance will change the game in 2021, based on the wealth of data presently available.

How long does an insurance company have to investigate a claim?

The insurance company has roughly 30 days to investigate your claim in most cases. The statutes of limitations in your state will also impact how long you have to file and settle a lawsuit.

Are insurance adjusters honest?

NO is the common answer to this question. This is not to say that all insurance adjusters are untrustworthy. It’s crucial to keep in mind, though, that all insurance adjusters have a certain amount of allegiance to their company. Because of this devotion, the adjustor may attempt to offer you the lowest feasible settlement so that the corporation does not lose money on your claim.

Many individuals have never heard of an insurance adjuster. If you make the mistake of believing that an insurance company is looking out for your best interests, you will almost certainly receive a lower payout than you deserve.

What is the clue report?

C.L.U.E. (Comprehensive Loss Underwriting Exchange) is a claims history database developed by consumer reporting firm LexisNexis that allows insurance companies to access customer claims data while underwriting or rating a policy.

Insurance companies who contribute loss data to C.L.U.E. have the ability to withdraw data from the exchange. Furthermore, certain insurance agents have the authority to withdraw data on behalf of the company they represent.

Almost solely, C.L.U.E. reports are used to underwrite and grade new policies. Most insurers do not consult C.L.U.E. reports when renewing existing policies, owing to the fact that they already have loss history for these properties in their own database.

It contains policy information such as the policyholder’s name, date of birth, and policy number, as well as claim information such as the date of loss, kind of loss, and amounts paid, as well as a description of the property covered. The report provides the property address for homeowner’s policy and specific vehicle information for auto coverage.

In the database, only policy information, including loss history, is kept. C.L.U.E. reports do not include information from other sources, such as credit reports, criminal histories, civil lawsuits, or legal judgments.

Only insurance companies that have signed up for C.L.U.E. have access to the system and can input loss data. C.L.U.E. reports on consumers and their own properties are available. Some businesses choose not to participate in C.L.U.E. Nonparticipating companies’ losses will not appear on a C.L.U.E. report.

LexisNexis is permitted to issue a C.L.U.E. report for the following insurance-related purposes under the federal Fair Credit Reporting Act:

  • When a consumer reporting agency has cause to think that the information will be used in connection with the underwriting of a consumer’s insurance policy. This includes circumstances in which a customer requests an insurance quote or submits an application for coverage.
  • When the insurance company or agent requests the C.L.U.E. report, the request is started by and at the request of the insurance company or agent.

C.L.U.E. records can only be viewed by the property owner, insurer, or lender, according to the federal Fair Credit Reporting Act. You can, however, ask the present owner of the property to order a C.L.U.E. report for you.

You can contact LexisNexis directly if you uncover an issue on your C.L.U.E. report, such as an invalid claim report or an improper loss payment. After that, LexisNexis will contact the insurance provider on your behalf, request clarification, and advise you of the outcomes within 30 days. If you believe an item in the C.L.U.E. report requires further explanation, you can send a personal statement, which LexisNexis will include in all subsequent C.L.U.E. reports.

Consumers are the only ones who can make notes on their C.L.U.E. reports. For example, if a dog bite claim occurs and the homeowner disposes of the dog, the consumer can note this on the property’s C.L.U.E report. The addition of notations to the database is not permitted by insurance companies.

It’s crucial to understand the difference between an investigation and a claim. An inquiry is a call made by a customer to a company representative or agent to review policy terms, such as the amount of coverage for a specific loss. Losses by kind are reported in C.L.U.E. reports. Even if the firm does not make a claim payment, consumers who contact their company or their agent to discuss an actual loss may be deemed registering a claim. Because the policy compels the organization to take specific actions within specified time frames in the event of a loss, this is the case. Consumers should specify whether they are submitting a claim or just looking for information. For example, a consumer may contact his or her agent to report an event such as a burst water pipe and determine the scope of coverage before deciding whether or not to proceed with the company’s claims process. A consumer describing this circumstance in general might be making an inquiry, but if they’re talking about a specific loss, they might be filing a claim. For a variety of reasons, the insurer may refuse to compensate the consumer for this loss: the amount of damage may be less than the deductible, the client may elect to pay for the damage, or there may be no coverage for such a loss under the policy’s terms. This information would be recorded by the company and might show on a C.L.U.E. report if the customer filed an actual claim and the insurer made no loss payment on the claim. Many insurers are working on ways to explain the difference between a claim and an inquiry to their policyholders.

Is it possible for an insurance provider to utilize the loss history of a previous owner of a home to determine my eligibility for home insurance?

If a corporation can demonstrate a link between the previous owner’s loss and the likelihood of a future loss to the house, they may be able to exploit the data. There are no restrictions that prohibit the use of the previous owner’s loss history in evaluating your coverage eligibility.

Is it possible for the insurance company to report unpaid claims to the C.L.U.E database?

If such assertions were reported to the corporation as a claim (rather than an inquiry about probable coverage) and were later denied, reporting the claim to C.L.U.E. would not be considered illegal under existing legislation. C.L.U.E. has asked insurers not to record inquiries regarding potential coverage.

Contact the Connecticut Insurance Department for assistance with all of your insurance questions:

Do insurance companies check your details?

Non-disclosure is when you don’t admit to something when applying for insurance. Because insurers base premiums on the information you provide, concealing certain details may result in a lower premium. It may appear to be worth the risk, but this is rarely the case. If you file a claim and the insurance discovers that you concealed information or flatly lied, your claim is likely to be denied. Worse yet, you could be charged with fraud.

Don’t believe that just because you have insurance means you’re safe. When a claim is filed, insurers are more likely to double-check the information they’ve been given than when insurance is purchased. In this post, my colleague Jane Baker shares a warning lesson regarding not revealing unspent convictions to your insurer.