The extent of medical record review by insurance companies is a critical aspect of underwriting and claims processing. The timeframe for these checks can vary depending on the type of insurance, the specific policy, and the jurisdiction governing the insurer’s activities. Generally, insurers aim to verify the accuracy of information provided by applicants or claimants and to assess risk based on past medical history. This assessment ensures appropriate coverage levels and helps prevent fraudulent claims.
Accessing historical medical data provides insurers with a more complete picture of an individual’s health status. This broader perspective assists in accurately calculating risk, particularly in life and health insurance policies. The ability to review past records helps to determine pre-existing conditions and potentially identify patterns of healthcare utilization. This practice also ensures fairness across the insured population by mitigating the risk of adverse selection, where individuals with higher risks disproportionately seek insurance coverage.
