If a life or health insurer rated you up or turned you down and you cannot figure out why, the answer may be a consumer report you have never seen, from a company most applicants have never heard of. Milliman IntelliScript collects prescription drug purchase history and turns it into risk scores that insurers use in underwriting. It is a consumer reporting agency, its report about you is governed by the Fair Credit Reporting Act, and when that report is wrong, you have the same federal rights you would have against a credit bureau.
What Milliman IntelliScript is and who keeps it
The CFPB’s consumer reporting company list places IntelliScript in its medical category: it collects prescription drug purchase history to quantify the relative mortality risk of life insurance applicants and provides risk scores for underwriting decisions. It is part of Milliman, Inc. In a 2007 settlement, the Federal Trade Commission treated Milliman as a consumer reporting agency and its applicant profiles as consumer reports; the FTC noted that the settlement was not an admission of a law violation.
The company’s own consumer page says it plainly: its consumer reports and related services are regulated by the Fair Credit Reporting Act, it gathers your information when a HIPAA authorization is in place (the one you sign inside an insurance application), and reports exist only for people who have recently applied for individual coverage. The CFPB’s listing agrees: if you have not applied for individual life or health insurance, there is no report to request.
IntelliScript is one of several insurance-underwriting files. MIB, also in the CFPB’s medical category, holds medical-condition information that life and health insurers use in underwriting, and the MIB Consumer File fails in the same ways. The CLUE report and the rest are in the property and insurance reports directory.
What is on the report and how insurers use it
When you apply, the insurer sends your authorization to IntelliScript, which returns your medication purchase history and scoring. In general terms, the report is a history of the prescriptions purchased in your name, with the scoring built from it. The FTC and Milliman’s own FAQ both name pharmacy benefit managers as a source.
The CFPB and the FTC both describe life and health insurers using these reports; Milliman’s own consumer page also lists disability, long-term care and Medicare Supplement underwriting.
IntelliScript itself does not grant or deny coverage; as its own site states, the insurance company makes the decision. But the report is an input, and an error in the input can become an error in your premium or your denial.
A consumer reporting agency may not furnish a report containing medical information for an insurance transaction unless you affirmatively consent (15 U.S.C. § 1681b(g)(1)(A)), and the FTC tells insurers to get the applicant’s permission before the report issues.
Where IntelliScript reports go wrong
These are the problems to check for:
- A report you never authorized. Milliman says it gathers no information without a HIPAA-compliant authorization in place, and the FCRA requires your affirmative consent before medical information is furnished for insurance. A report sent to an insurer you never authorized is a problem in its own right.
- A correction that never reached the insurer. A fix does not help if the insurer still has the old report. You can ask that the correction go to anyone who received the report in the past six months.
Each is a problem the FCRA addresses directly.
How to get your IntelliScript report for free
Per the CFPB’s listing, IntelliScript will provide a free copy of your report if one exists and you request it: by phone at 877-211-4816, through rxhistories.com, or by mail at Milliman IntelliScript, P.O. Box 2223, Brookfield, WI 53008. Milliman’s own consumer page lists the same phone number and post office box. Companies required to provide free annual reports must do so within fifteen days of the request.
An adverse action notice gives you a separate 60-day right to a free copy (below). Read every entry exactly as it appears.
How to dispute an IntelliScript entry
If anything is inaccurate or incomplete, dispute it in writing. Milliman’s FAQ says it requires a written statement that identifies the disputed items, then reinvestigates and sends an updated copy to you and to the company that requested the report.
Under 15 U.S.C. § 1681i, IntelliScript must conduct a reasonable reinvestigation free of charge and finish it within 30 days. Within five business days of receiving your dispute, it must notify whoever provided the disputed information. Any entry found inaccurate or incomplete, or that cannot be verified, must be deleted or corrected.
The source of the data has its own duty. The CFPB’s listing says the company that provided the incorrect information must correct the error, and under § 1681s-2(b), a company that furnished information and receives a dispute from the reporting agency must investigate it and modify, delete or block an item it cannot verify. If the entry stays, you can add a brief statement of dispute to the file. Keep a copy of everything you send and receive; if the case comes to litigation, those documents are the record. The credit dispute letter guide applies to specialty bureaus like this one.
The adverse action notice your insurer owes you
If an insurer denied you, rated you up, or otherwise changed your coverage for the worse based in whole or in part on the IntelliScript report, it owes you an adverse action notice (15 U.S.C. § 1681m(a)). For insurance, adverse action includes a denial or cancellation, an increase in any charge, and a reduction or other unfavorable change in coverage (§ 1681a(k)(1)(B)(i)). The FTC’s guidance for insurers says the notice is required even if the report played only a small part in the decision.
The notice must name the reporting agency with its address and phone number, state that the agency did not make the decision and cannot give the reasons, and tell you that you can get a free copy within 60 days and dispute anything inaccurate. If you received one, that window is the time to order the report.
When an IntelliScript error becomes a legal claim
If you were denied or rated up over prescription history that was not yours or not accurate, and a proper dispute did not fix it, the FCRA may give you a claim:
- Accuracy (15 U.S.C. § 1681e(b)). IntelliScript must follow reasonable procedures to assure maximum possible accuracy of the report.
- Reinvestigation (15 U.S.C. § 1681i). IntelliScript must actually reinvestigate a dispute, not simply repeat what it already has.
- The source’s investigation (15 U.S.C. § 1681s-2(b)). The company that furnished the data must investigate a dispute forwarded to it.
- Consent (15 U.S.C. § 1681b(g)). Medical information may be furnished for insurance only with your affirmative consent.
For a negligent violation, the FCRA provides actual damages, such as the premium difference, plus attorney’s fees (§ 1681o). For a willful violation, it provides actual damages or statutory damages of $100 to $1,000, punitive damages as the court allows, and attorney’s fees (§ 1681n). Suit must be filed by the earlier of two years after you discover the violation or five years after it occurs (§ 1681p).
I handle these cases on contingency. Specialty bureaus outside the big three are still consumer reporting agencies, from LexisNexis to SageStream to this one, and the law reaches all of them.
Have your IntelliScript report reviewed
Send me the IntelliScript report, any adverse action notice your insurer sent, and whatever Milliman sent back after your dispute, and I will tell you whether I see a claim. The FCRA attorney page covers how these cases work. Contact the firm to have your report reviewed.
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This page is about consumer report accuracy. The Kim Law Firm is not affiliated with Milliman, Inc., Milliman IntelliScript or MIB, and this page is not a complaint about any of them. It describes how prescription-history entries can appear on an insurance-underwriting report and the rights consumers have when an entry is wrong.