State RegulationsOH specificDifficulty 3/5
An Ohio underwriter receives a reporting-organization record suggesting a cardiac impairment that the applicant did not disclose on the application. The proper next step is to:
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Answer & full 3-part explanation (select an option above, or peek)
Why C is correct
A coded reporting-organization entry is an alert, not evidence of a condition. Proper underwriting treats it as a lead to be verified through authorized channels, such as an attending physician statement obtained with the applicant's authorization, all handled within the information-privacy framework of ORC 3904. Acting on the code without verification, or ignoring it, are both errors.
Why the other options are wrong
- A) Denying on an unverified coded entry substitutes a data alert for an investigation and may rest on wrong or outdated information.
- B) Ignoring the flag abandons prudent underwriting; the whole value of the record is to prompt verification of a possible omission.
- D) The guaranty association protects policyholders against insurer insolvency; it has no role in underwriting decisions.
Memory hook
MIB rings the bell; the underwriter opens the door.