How Far Back Do Insurance Companies Check Medical Records?

How Far Back Do Insurance Companies Check Medical Records?

Insurance companies check medical records for a variety of reasons, including determining eligibility for coverage, assessing risk, and determining payment amounts. But how far back do insurance companies typically check?

Insurance companies typically check medical records back five to ten years, depending on the type of coverage and the insurer. This means that any medical history, including diagnoses, treatments, and medications, that occurred within that time frame can be used to determine coverage and payment amounts.

There are some disadvantages to insurance companies checking medical records. For one, it can be difficult to access records that are more than a few years old. Additionally, insurance companies may use the information to deny coverage or limit the amount of coverage offered. Finally, medical records are often incomplete, leaving out important information that could be used to determine coverage.

The practice of insurance companies checking medical records dates back to the late 19th century. In 1892, a group of physicians and businessmen created the American Association of Life Insurance Companies (AALIC). The AALIC began collecting medical records from its members in order to assess the risk associated with offering life insurance policies. This practice eventually spread to other types of insurance, such as health and disability.

Today, insurance companies continue to use medical records to determine eligibility for coverage, assess risk, and determine payment amounts. While this practice can be beneficial in some cases, it can also be a source of frustration for those who are denied coverage or limited in the amount of coverage they receive.