Question about applying for health insurance?

Applying for individual health insurance - mentioning borderline items?

  • I'm applying for individual health insurance (non employee sponsored). On the application questions, a 'catch-all' question says something like, 'has the applicant had any other item not mentioned previously?'. What's the rule of thumb for listing items that are borderline. For example, went to doctor, was looked at, but didn't need medical treatment. Is that worth recording or better left out? Two examples are 1) got minor whiplash, had soreness in shoulders, neck and back, went to doctor and only needed to rest, use hot water packs and ice an do exercises for a few weeks. 2) had soreness around knees, went do doctor, no medicial treatment required. Found out soreness from not having bike seat adjusted properly. Are those two example worth listing? One one hand, I did go to the doctor for them, on the otherhand, I required no medical treatment. On my application, I want to be truthful, yet I don't want to make my health look more serious than needed.

  • Answer:

    Whether applying for health insurance or not, it is my opinion that everyone should have a copy of their medical records for their records. Having a copy of the records on hand, answer all questions fully. If the underwriter wants more information once you have submitted the application you will have it at the ready. It's best to let the underwriter decide what is important and what is not. You can lessen the chances of the insuror requesting medical records by giving as much information as possible on the application. Getting the medical records is usually the slowest part of obtaining new coverage, so having them beforehand is beneficial.

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Other answers

The insurance company wants to know any condition that would cause a prudent person to seek medical treatment or advise. If you went to the doctor you were seeking advise and it should be noted. You can explain the results of that advise so the insurance company can decide whether or not to get more information. The problem you may run into is if you have problems with your shoulders, neck and back in the future the insurance company may find out that you saw a doctor in the past. If you did not mention the problem the company can rescind the policy. They will then make you pay back the money they've paid out for you or at worse charge you with fraud.

Zarnev

Honesty is not the issue. If you get something that is expensive to treat (such as cancer), insurance companies will use the slightest omission on your application as an excuse to cancel your coverage so that they do not have to pay. There was a story about this on last night's CBS news. Include everything, whether important or not, or there is no point to having insurance in the first place.

StephenWeinstein

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