CARD T062
Attending Physician Statement (APS)
A report from an applicant’s treating medical professional used in underwriting. It may clarify a disclosed medical condition.
How it works
An attending physician statement supplies information from the applicant’s treating medical professional, such as diagnosis, treatment, and progress. It differs from a new examination arranged for underwriting and from MIB’s coded information exchange. Appropriate authorization and privacy requirements apply. [2]
An underwriter needs details about a disclosed cardiac condition. A report from the treating physician helps explain the diagnosis and follow-up history.
APS = treating clinician’s report. It does not by itself approve or reject coverage.
CARD T063
Consumer Report
A report supplied by a consumer reporting agency about a person, potentially including credit history or other information relevant to permitted insurance underwriting. It is not necessarily just a credit score.
How it works
A consumer reporting agency supplies information for legally permitted uses, including insurance underwriting. The Fair Credit Reporting Act gives consumers notice and dispute rights. If a consumer report contributes to an adverse insurance decision, the insurer must provide an adverse-action notice identifying the agency and relevant rights. The consumer generally has 60 days to request a free report after that notice. The reporting agency did not make the insurer’s decision. [16]
An insurer charges a higher rate partly because of information in a consumer report. An adverse-action notice is required even if that report was not the only reason.
Consumer report is broader than credit score. Medical-related specialty reporting can also fall within the FCRA.
CARD T064
MIB (Formerly Medical Information Bureau)
An insurance information exchange used by member insurers to help identify discrepancies in applications. Its information does not replace the insurer’s own underwriting.
How it works
MIB helps participating insurers identify possible discrepancies or omissions in application information. Its Code Solutions database contains coded information, not a complete set of medical records. Member insurers must investigate rather than base an adverse underwriting decision solely on MIB information. Consumers can request their file and dispute inaccuracies. [17]
An application reports no relevant condition, but an MIB entry suggests information needing clarification. The insurer seeks supporting information rather than treating the code as an automatic denial.
MIB is an information source—not the underwriter, a complete medical chart, or a guarantee of eligibility.
Practice MIB (Formerly Medical Information Bureau) · 3 questions
CARD T065
Statement of Good Health
A statement about the proposed insured’s health, sometimes required before coverage takes effect. It may address changes since the application.
How it works
A required good-health statement can identify health changes between application and completion of policy delivery requirements. The applicant must accurately disclose what the statement asks. It is not a new blanket guarantee of perfect health, nor does it automatically undo valid coverage already provided under a receipt. [2] [13]
After applying but before satisfying final delivery conditions, an applicant is hospitalized. The required health statement should accurately disclose the change for the insurer’s review.
Health confirmation, premium payment, and acceptance of terms are separate delivery requirements.
CARD T066
Field Underwriting
The producer’s initial gathering and reporting of application information. Final underwriting decisions remain with the insurer.
How it works
The producer collects complete answers, observes and reports relevant facts honestly, obtains required signatures and authorizations, and submits the application. The producer should not coach applicants to conceal facts or promise a preferred rate before approval. Field underwriting supports but does not replace the insurer’s underwriting. [2]
A producer notices that an application question was left blank and asks the applicant to complete it rather than inventing the answer.
Field underwriting gathers and reports evidence. Final risk acceptance belongs to the insurer.
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Practice questions
Select an answer, then check it to see why each option is right or wrong.
T062 · Attending Physician Statement (APS)
0 of 3 answered
T063 · Consumer Report
0 of 3 answered
T064 · MIB (Formerly Medical Information Bureau)
0 of 3 answered
T065 · Statement of Good Health
0 of 3 answered
T066 · Field Underwriting
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Sources & further reading
Original explanations and practice scenarios informed by the following regulatory, legal, and product resources. State examples are not presented as nationwide deadlines or requirements.