How do life insurance companies obtain your medical information?

17 July 2018

There are few things more personal to you than your health, so it’s understandable that many people want to know how life insurance companies obtain your medical information. To help put your mind at rest, we’ll explain how insurers do this and your rights as a consumer during the process.

Why would life insurance companies request medical reports?

All insurance is based on risk, and insurers set their premiums based on the risks associated with offering cover for each individual. An insurer may wish to obtain a medical report during the application process in order to determine the level of risk in offering you cover. But your medical history is not the only factor that an insurer will consider, as they will also consider the risks associated with your age, occupation, lifestyle and smoker status, for example.

Do insurers need permission to obtain a medical report?

Yes, insurance companies need to obtain your consent before they can obtain a medical report. This consent is requested under the following Acts:

  • The Access to Medical Records Act 1988
  • The Access to Health Records Act 1990 (as applicable)
  • The Access to Personal Files and Medical Reports (Northern Ireland) Order 1991 (as applicable)
  • The Isle of Man Access to Health Records and Reports Act 1993 (as applicable) which gives consent for the insurer to apply for a medical report for insurance purposes.

When you apply for insurance you will be asked to give your consent for Legal & General to request a medical report. Part of this consent allows you to tell us that you would like to see a copy of the report before it is sent from your doctor to Legal & General. If a medical report is requested, you will be notified, and you will then have 21 days to arrange to see the report with your doctor.

Moreover, insurers should only request medical information that is relevant to your application. You are within your rights to refuse consent to obtain a medical report but bear in mind that this may affect your ability to get life cover

What information may be requested within a medical report?

The medical report may request information on the following:

  • Blood pressure readings
  • Cholesterol readings
  • Height and weight measurements including waist size
  • Medications you’ve been prescribed
  • Treatments you’ve received
  • Referrals to specialists
  • Allergies
  • Lifestyle information such as smoking habits or alcohol use
  • Test and scan results
  • Hospital discharge summaries
  • Correspondence between your GP and other medical professionals
  • Dates relating to your medical history.

Remember that your insurer won’t necessarily request information on all the above as they can only use relevant medical information when assessing your application.

How far back can insurers check medical records?

An insurer can access any relevant medical information as far back as the records allow, but in practice, may be more interested in medical issues that have arisen in the last five years,  requesting information on the customer’s current health situation including if a full recovery has been made and the length of time you’ve been clear of a condition.

How will your doctor use your medical records?

So once you’ve given permission, how do life insurance companies obtain your medical information? In short, they request a medical report from your General Practitioner. The medical report could include details of consultations with any doctor or healthcare professional.

When you give consent for a medical report to be obtained, you have the option to tell the insurer whether you wish or do not wish to see, the report before your doctor returns it. If you don’t wish to read it, your doctor can forward this straight to the insurance company.

Alternatively, you can view the report at your GP’s surgery within 21 days of the request. At this stage, you can ask your doctor to make amendments, deny them permission to send it, or agree to the report being sent without any changes. Your doctor can refuse to make amendments, in which case you’re allowed to include your own personal statements in the report. Under the Access to Medical Records Act, your doctor doesn’t have to tell you any information they believe will cause harm to you or someone else’s physical or mental health.

You also have the option to request to see a copy of the medical report sent, at any time within 6 months of the date the doctor sends it to Legal & General.

Do life insurance companies always check your medical information with your doctor?

No, when you apply for insurance, you’ll be asked medical questions within the application form and  your insurer can assess if the insurance can be offered, what the premium rates will be and whether any restrictions will apply based on that alone. However sometimes to make a full assessment it may mean a medical report is required. A medical report may also be necessary due to the amount of cover requested. But remember, they will need your written permission first.

Do life insurance companies check medical records after death?

In terms of whether life insurance companies check medical records after death, Legal & General will consider a variety of evidence, including the cause and timing of death, documentation left by the deceased and any medical history that can be reasonably obtained.