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Evidence of Insurability FAQs

 

What is Evidence of Insurability (EOI)?

Why is EOI used?

When is EOI required, and why must I answer health questions?

What does the online EOI application consist of?

What about privacy when using online EOI submission

What about employees without Internet access? Will you still accept an EOI application in paper form?

What are the advantages of online EOI submission?

What information do I need to know before beginning the online application process?

What is the underwriting process?

What information is required to process my EOI application?

If an exam or medical records is required, how long does it take Dearborn National to receive the requested information?

What is the time frame for processing my EOI application?

Who should I contact for underwriting questions or the status of my EOI application?

What is the appeal process if I am denied coverage through EOI?

 



What is Evidence of Insurability?

Evidence of Insurability (EOI) is an application process in which you provide information on the condition of your health or your dependent’s health in order to be considered for certain types of insurance coverage. The completed EOI application requires review and approval by Dearborn National before coverage becomes effective.



Why is EOI used?

EOI is utilized to protect an employer’s group insurance program from adverse risks and reduce the likelihood of disproportionate claims risks. This helps the employer’s utilization and controls the cost of their insurance program.



When is EOI required, and why must I answer health questions?

Most group life policies offer a certain amount of guaranteed coverage. EOI may be required if you apply for an amount of coverage higher than the guaranteed issue amount; you are currently enrolled and want to increase your insurance amount; or you decline coverage during your initial eligibility period and then want coverage at a later date.



What does the online EOI application consist of?

Online EOI allows employees to submit their EOI application electronically and employers to access medical underwriting activity reports, which include the status of EOI submissions.



What about privacy when using online EOI submission?

Privacy and security features have been built into our Web site to assure protection of personal information. Your answers to all health questions are kept strictly confidential and are not shared with your employer. For more information, read our Online Privacy Statement.



What about employees without Internet access? Will you still accept an EOI application in paper form?

Yes. Printable EOI applications are available to download and print in our Group Benefits Forms section. Your Human Resources (HR) representative should also be able to provide you with a paper EOI application that can be mailed or faxed.



What are the advantages of online EOI submission?

Online EOI submission eliminates or reduces the processing of paper applications for coverage requests, increases accuracy and confidentiality, and speeds application processing. Step by step instructions lead you through the application process, which usually takes about 15-30 minutes. The site includes many interactive features ensuring complete and more accurate submissions. Following completion of the application, our system will provide confirmation your application has been received. Your application will be further processed by Dearborn National’s Medical Underwriting team and subsequent correspondence to you will be by mail. An online EOI application can be submitted 24 hours a day, seven days a week.



What information do I need to know before beginning the online application process?

You will need:

  • the Group number;
  • the Employer or Sponsor name and address;
  • Who will be submitting EOI;
  • the Reason EOI is required;
  • Type and total amount of insurance being requested;
  • Type and total amount of current insurance with Dearborn National if requesting an increase;
  • Name, date of birth and Social Security Number of all applicants requiring EOI;
  • Current height and weight of all applicants requiring EOI; treatment history and medication(s) for any health condition(s); name and address of any physician, hospital or other practitioner that provided medical care, consultation or treatment.


What is the underwriting process?

When your EOI reaches Dearborn National’s office, we create a record for you. An underwriter then reviews your EOI. Factors such as current physical condition, medical history, height and weight are used to determine if you meet the Company’s acceptance standards for the type of insurance requested.



What information is required to process my EOI application?

Most EOI applications are processed using only the information you provide. However, in some cases, a physical examination is needed. The basic physical examination includes height, weight, pulse, blood pressure and a medical history questionnaire. The examination may include special testing such as a blood test, urinalysis and an EKG.

If an examination by a qualified medical professional is required, we will notify the exam center of any required testing, and you will receive notification which will include a brochure to help you prepare for the examination. The exam service will contact you to schedule an appointment. Most exams can be done in the convenience of your own home and take less than 30 minutes. There is no charge for the examination unless you are enrolling for coverage as a late entrant.

Dearborn National may also call or send a letter to you to clarify information during the evaluation process. A review of your past medical records may be necessary to evaluate your EOI. If so, a medical records retrieval service is used to obtain the requested information from your doctor or other health care provider. We will also send a letter notifying you that your medical records have been requested. Your medical records are considered confidential, and information is not released to anyone else without your consent or a court order. There is no charge for the medical records unless you are enrolling for coverage as a late entrant.



If an exam or medical records is required, how long does it take Dearborn National to receive the requested information?

When you complete the physical examination, a report of the examination is sent to Dearborn National’s Medical Underwriting Department. We usually receive the reports in our office within a week to 10 days of the examination. If blood tests or a urinalysis are needed, they are handled by an independent laboratory. We usually receive these results within a week of the examination. If we need to write to your doctor for medical records, it may take 2 to 4 weeks depending on the physician’s office procedures. Sometimes it helps if you call your doctor’s office and ask for a prompt response.



What is the time frame for processing my EOI application?

Your EOI application will be active in the review process for 60 days. Once we receive all the information requested, we will review it promptly. The majority of decisions are made within 15 days of receipt of all requested information. Occassionally, additional information might be needed. If further information is needed to evaluate your EOI, we will notify you by mail within a few days.

If Dearborn National does not receive requested application information, medical records and/or exam/lab tests within 45 days from the date of the initial request, your file will be closed and you must reapply for the coverage you want.



Who should I contact for underwriting questions or the status of my EOI application?

For underwriting questions or the status of your EOI application, please contact our Medical Underwriting Department via e-mail or at (800) 451-0271. Hours of operation are Monday – Friday, 8:00 a.m. to 4:30 p.m. CST.



What is the appeal process if I am denied coverage through EOI?

If you are denied coverage through medical underwriting, you can appeal the decision in writing. You can request an explanation and reason for denial. You may also furnish to Dearborn National further medical documentation for re-evaluation and review.