By Vikas Somani
In Insurance Verification

What is Video MER?

A medical examination done by a doctor over video is called Video MER. To fully understand medical examination, we will need to dive a little deeper in understanding what is medical examination and why is it needed then we can delve deeper into the aspect of video based medical examination.

What is Medical Examination and what type of insurances need it?

FMR or full medical report is required by the insurance companies to help with calculating premium and for correctly medical underwriting a policy. A person applying for an insurance policy is called a proposer. Once the application form is filled by the proposer along with the desired sum assured for life cover in case of life insurance or term insurance. The insurance company, then, depending on the sum assured or the age of the proposer and/or insured, can decide if they can issue the policy without medical tests. A term insurance plan is where there is no return of premium paid by the insured. Medical test for term insurance is required if the sum assured is high and the insurance company wants to make sure that their risk is not high, before issuing a policy.

The insurance company assigns this proposal to an agency who will help complete the MER test for insurance by filling out the MER through Tele MER or Video MER. They do this by setting up a time with the proposer and/or insured, sending a phlebotomist over to their house for collecting blood samples, urine samples, take height, take weight and measure blood pressure. The blood and urine collected is used to perform a battery of tests and procedures. Blood tests usually give information on complete blood count, differential count, bio, fasting plasma glucose and hemoglobin. All the other information taken is then filled up in an MER form. This part takes care of the first part for the medical examination.

Next part is where the doctor speaks or takes a medical examination with the proposer and/or insured. This includes asking questions on a variety of topics including mental health, physical health, history of any medical issues etc.

Why is Medical Examination so important?

Medical Examination is important as the insurance company can then validate the results against a benchmark that they have set for a policy holders’ health. While taking a medical examination, the doctor seeks answers to any pre-existing medical condition or illness.

Why Video based Medical Examination?

A video based medical examination helps the doctor to speak with the proposer face to face, thereby eliminating any confusion or communication issues. The doctor can see in person if the proposer has understood the question and if not can explain again. Also, Video MER recording is evidence of any pre-existing medical conditions that the proposer may have hidden. Video MER is better than Tele MER as we know that the person on the other side is actually the proposer and not someone else.

Why did my insurance company do videography instead of Video MER?

Videography ensures all medical procedures are visibly verified and recorded, which enhances the integrity and accuracy of health data used in underwriting. This leads to more reliable risk assessment, benefiting both insurance providers and policyholders. It merges digital efficiency with human expertise, transforming insurance health assessments.

Why did my Insurance company ask me to do a PIVC, before my Video MER?

Before your Video MER, your insurance company sent you a Pre-Issuance Verification Call (PIVC) link as part of their enhanced verification process, which now includes face comparison and face match technologies. This step ensures that the person undergoing the Video MER is indeed the proposer, enhancing the accuracy of identity verification and significantly reducing the risk of impersonation fraud. This process is crucial for maintaining the integrity and trustworthiness of the insurance procedure.

Is there an MER check after the completion of my Video MER?

After completing your Video MER, the examination report is thoroughly checked through a process called mer check and analyzed by advanced AI-driven tools. This process ensures that all necessary medical information has been accurately captured and assessed, maintaining high standards for medical examination quality and consistency.

How do I read my test results as I don’t understand the pathology report format?

If you’re struggling to understand your test results due to complex pathology report formats, discussing them with your healthcare provider can be very beneficial. They can clarify and translate the medical terms into simpler language. Additionally, some laboratories are now adopting more patient-friendly pathology report formats, which are designed to be easily understood by laypersons. This new approach aims to make health data more accessible and understandable to patients, enhancing communication and understanding regarding health conditions.

Does the proposer have to pay for these tests?

No, the tests are done by the insurance company to protect their own interests and as a result they don’t charge the proposer and/or insured for the tests. They only expect cooperation.

Does the proposer get a copy of the test results?

Yes, IRDA has mandated that insurance companies share not only the MER but also pathology reports, ECG, TMT Test results, and other relevant medical test outcomes with the proposer. This ensures transparency and allows individuals to have a comprehensive view of their health as assessed during the insurance application process.

What next, when does the policy get issued?

Once the medical tests are done, the medical tests along with the MER (Medical Examination Report) is sent to an underwriter nominated by the insurance company. This information along with certain financial information, is then assessed by the underwriter. Some service providers help prepare a case, called ‘Case Preparation’ which includes the points that are needed by an underwriter to comfortably and with confidence underwrite the policy.
To cut the long story short, once this process is completed, the insurance company either accepts the initial proposal and issues the policy. If there are concerns, it could do one of the following

Permanent Exclusions

In this case, the company could issue the policy in harmony with the original proposal, but add some permanent exclusions. So, for example if the person is found to have a history of cardiovascular issues, they could exclude any and all claims arising from cardiac issues.

Higher Premium

In this case, the company is aware of either a pre-existing ailment, or a borderline illness and is ready to cover the illness at a higher premium. So, for example the person could be suffering from hypertension and the company could accommodate the condition, but increase the premium to help cover the cost of the expenses due to the condition. The premium could also be higher if the condition is severe and age is a factor.

Rejection

The insurance company could reject the proposal on grounds where the condition or illness may require frequent hospitalization and the premium would not be able to justify the treatment of expenses.

Takeway

Video MER has proven to be an effective tool for insurance companies to not only help reduce the risk but also offer policies with higher sum assured and lower premium. Thereby helping the proposer with higher sum assured at lower premiums and insurance companies at gaining a better market share. Given these advantages, the industry has now taken another bold step in VideoGraphy.

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