Health insurance PIVC and medical disclosure
In health insurance, what you say on the proposal and on the verification call decides whether a claim is paid years later. A pre-issuance verification call (PIVC) is designed to make sure that the customer understood the questions and answered honestly.
Why disclosure matters
Insurers accept and price health policies based on what they are told. If an illness, surgery or medicine is left out, a claim that relates to it can be reduced or rejected even if the premium was paid for years. A clear conversation at the start prevents that pain.
What the call usually covers
- Identity and consent: the person confirms who they are and that they bought the policy.
- Members covered: names, ages and relationships.
- Pre-existing conditions: diabetes, blood pressure, heart conditions, thyroid, past surgeries and ongoing treatment.
- Medicines and tests: regular medicines and recent investigations.
- Habits: smoking and alcohol.
- Family history where asked.
- Understanding of terms: waiting periods, co-pay, room rent limits and exclusions.
- Premium and renewal.
Tips for customers
- Keep prescriptions and reports handy before the call
- Answer for every member covered, not only yourself
- Ask the caller to repeat or explain anything unclear
- Do not rely on an agent's assurance if it differs from the form
Tips for insurers
- Ask one question at a time, in the customer's language
- Do not lead the customer to say 'no'
- Record the answers and check them against the proposal
- Flag unclear answers for follow-up before issuing
After the call
Keep a copy of what you declared and the policy wording. If your health changes or you add members later, update the insurer in writing so that the record always matches the facts.
How Praman helps
Praman by SatyaSakshi runs the PIVC as a recorded WhatsApp video call in the customer's language, with ID, face match and liveness. The questions follow the insurer's script, and answers are saved with time and location. Other checks, such as hospital or bank-account details, can be added where enabled, and a reviewer approves or flags the case.
Frequently asked questions
Why does the call ask about health?
Because insurers price and accept a policy based on health, and wrong answers can lead to a rejected claim later.
What are pre-existing conditions?
Illnesses or treatments you had before the policy. They usually must be disclosed and may have a waiting period.
What if I do not remember a detail?
Say so honestly and check your records. It is better to correct information now than to face a dispute at claim time.
Related: how Praman handles this for businesses · all instant checks
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