The Insurance Commission has required life insurance companies to create and share the medical information data base of policy holders to prevent fraud in the industry.
Insurance Commissioner Emmanuel Dooc issued a circular directing all life insurance companies to share the medical facts of policy holders as part of their due diligence in risk assessment and prevention of fraud, misrepresentation and concealment.
The IC said the shared information would be compiled in a medical information database for all insured policyholders.
It said the circular would be disclosed to applicants and policyholders within one year of its effectivity.
The commission ordered the Philippine Life Insurance Association to administer the MID and issue the guidelines within 30 days from the effectivity of the directive.
The PLIA will also ensure the security and privacy standard of the data base to guarantee the protection of sensitive information on the policy holders.
While all life insurance companies would have access to the data base, the IC said they must limit it to employees directly involved in the risk assessment function.
The IC earlier required all insurance companies to submit an anti-fraud plan to monitor and detect closely an insurance deceit in the industry.
The order required all life and non-life insurance companies to formulate and maintain procedures for monitoring and early detection of insurance fraud.
“The concept of mandating the submission of an insurer anti-fraud plan was developed to encourage insurers to proactively fight insurance fraud. It is necessary that all insurance companies are ready to combat insurance fraud for its own protection and for the welfare of its stakeholders,” Dooc said.
“To adequately protect itself from the risks posed by insurance fraud, every insurance company should have an appropriate framework in place to prevent, monitor and investigate its occurrence,” he said.
He added each plan should include measures to protect the company from policyholder and claims fraud, and other deceits perpetuated by an ordinary insurance agent, general agent, insurance brokers and management company of a consortium and adjusters.
Insurers are required to observe the minimum standards set in the guidelines concerning their anti-fraud efforts, including prevention detection and investigation and reporting.
