What would raise suspicion of misrepresentation related to medical history?

• A. A patient reports all issues clearly with no gaps.
• B. No changes in medical history over time.
• C. Reported medical history exactly matches exam outcomes.
• D. Inconsistencies between reported medical history and medical exam results or MIB records, or hidden health conditions.

Answer: (D)

Misrepresentation is suspected when what a patient reports about their medical history doesn’t line up with objective findings from a medical exam, with records checked by the MIB, or with known but undisclosed health conditions. Underwriters rely on truthful disclosures to accurately assess risk, so inconsistencies between reported history and exam results or MIB data suggest that information may be incomplete or hidden. If the medical history provided matches exam results and there are no discrepancies or concealed conditions, that would not raise suspicion. Therefore, inconsistencies between what is reported and what is found in exams, MIB records, or hidden health conditions are the main signal that misrepresentation could be at play.