Introduction

Medirisk was founded in 1999 with the goal to provide medical and life insurance companies with an independent third party rating methodology for underwriting life and health insurance policies.

 

MediRisk Automated Underwriting System.

The MediRisk Underwriting System evaluates the information submitted with conventional medical questionnaires for individuals applying for life, medical or disability insurance policies. The applications are automatically assigned a point total predicated upon the potential claim exposure of the applicant. The point system is highly sophisticated. It was developed by team of doctors in different medical specialties. Many areas are extensively cross referenced including all prior or existing medical conditions, medications, family history occupational exposures, life styles, etc. Research has revealed that scientific cross-referencing of related conditions produces far more accurate assessment of potential exposure than evaluation on an individual condition by condition basis. The final point total determines whether the applicant is insurable, should be surcharged and/or have certain exposures excluded at policy issuance.

Although a seemingly simple and straightforward concept on the surface, MediRisk offers the following efficiencies and profit generating capabilities:

Uniform Application of Underwriting Criteria.

Underwriters and physicians often vary dramatically in their interpretation and application of underwriting guidelines. MediRisk completely eliminates these subjective factors. Thus the Insurer can no longer be hurt by a maverick underwriter/physician. Traditionally, applications are referred to a physician for underwriting evaluation when the situation exceeds the capability of the underwriter. One physician will have only a fraction of the board array of specialized medical expertise contained in the MediRisk software. The traditional approach could not possibly allow for the proper level of expertise for all conditions contained in applications that were referred to him.

Increased Sales.

The MediRisk system is easily accessed over the Internet throughout the world. If desired, sales agents in the field may offer form quotations and bind coverage via their laptop with no loss of underwriting control. Sales may be consummated immediately when the prospect is ready to buy.

Increased Home Office Control.

Underwriting activity at any office is entirely monitored by Home Office, thereby achieving centralization without the customary delays and problems. Adherence to desired underwriting criteria is guaranteed.

<Reduction of Legal Fees.

Medirisk intends to finish developing a claims handling module that will allow insurers to allow or deny a claim for those policies that have been underwritten using the Medirisk evaluation system. With MediRisk, the information that should have been provided with the original application can be reentered, yielding a definitive answer as to whether the applicant would have been accepted. The claim department can instantly access the original application for the insured.

Vastly improved data for modification of underwriting guidelines and corrective rate action.

The point system can be reviewed to determine if points assigned for conditions have proven inadequate or excessive. For the first time, insurers can review results versus the definitive underwriting criteria that was applied to generate those results, similar to the practice long ago adopted for personal lines auto and homeowners which have an objective underwriting point system.

 


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