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