Class Action Claims IntelliScript Fails to Ensure Accuracy of Medical Info in Reports Sold to Insurance Cos.

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IntelliScript faces a proposed class action that alleges the specialty consumer reporting agency has unlawfully failed to ensure the maximum possible accuracy of the medical reports it sells to insurance agencies.

More specifically, the 16-page case out of Washington alleges Milliman, Inc., which does business as IntelliScript, compiles “mixed files” that contain information from individuals other than the subject of a report, places the burden of investigating the inaccurate information on the report’s subject, and fails to disclose the source of the medical and prescription information in a consumer’s files.

In all, IntelliScript has deprived consumers of their rights under the federal Fair Credit Reporting Act (FCRA), the case claims.

According to the suit, IntelliScript prepares from “multiple data sources” reports that detail consumers’ medical histories—including prescribed medications, dosages, fill dates, pharmacy and physician information, diagnoses, hospital and physician procedures, inpatient and clinic-administered medications and medical equipment information. The defendant then sells the consumer medical reports to insurance companies in connection with applications for insurance, the suit says.

The lawsuit alleges, however, that the defendant has overstepped the FCRA by failing to follow reasonable procedures to ensure the maximum possible accuracy of the information it sells. In particular, the case claims IntelliScript frequently sells what’s known as a “mixed file,” i.e. a file in which some or all of the information pertains to an individual who is not the subject of the report.

According to the complaint, the prevalence of mixed files among the defendant’s consumer reports stems from the agency’s failure to use “full identifying information” to match records to the personal identifying information of the report’s subject.

“Defendant employs policies and procedures that do not include the use of a reasonable number of identifiers, and that frequently allow the information belonging to one consumer to appear in the consumer file of another,” the complaint states.

Per the suit, IntelliScript employs these “loose matching procedures” in order to maximize the likelihood of a match between an inquiry and information in its database, deliberately “prioritizing quantity of matches over accuracy of matches.”

Moreover, the lawsuit claims IntelliScript, in violation of the FCRA, places the burden of investigating a dispute on the consumer. Though federal law mandates that consumer reporting agencies conduct a “substantive investigation” when an individual disputes the completeness or accuracy of information contained in their report, IntelliScript allegedly responds to disputes by requiring the submission of underlying documentation regarding the disputed information.

“If the consumer does not provide the requested records, Defendant takes no further action on the dispute, and will not remove inaccurate information, even when a basic investigation by Defendant would reveal the inaccuracy,” the complaint avers.

Further, the case claims IntelliScript has failed to forward consumer disputes to other reporting agencies, such as Medical Information Bureau (MIB), from whom it obtained the disputed information in the first place, thereby preventing consumers from correcting the inaccuracies.

The suit goes on to allege the defendant also conceals the true source of the information reported about consumers, further hindering individuals from being able to correct inaccurate information. Although IntelliScript purports to comply with the FCRA by sending consumers the information in their report upon request, the company fails to disclose whether the data was obtained from a pharmacy, pharmacy benefit manager, another consumer reporting agency, or a vendor, the case claims.

The source of the inaccurate information is “essential,” the lawsuit states, “so that consumers always know who is furnishing important information about them” and can separately contact each party to stop the further spread of errors.

The plaintiff in the case says he applied for life insurance in April 2020 with Americo Financial Life and Annuity Insurance Company, who in turn requested a consumer report from the defendant. Per the complaint, IntelliScript failed to use the plaintiff’s name, address, Social Security number and date of birth when matching information to his file. The result, according to the suit, was a “grossly inaccurate” report that contained 13 medications the plaintiff has never taken and 176 entries for medical care he never received “for conditions he never had, including osteoarthritis, diabetes, liver disease, chest pains, and sleep apnea.”

The lawsuit goes on to detail the plaintiff’s attempts to dispute the inaccurate information, after which the defendant allegedly failed to conduct “any reinvestigation” of his dispute, remove the inaccurate information or forward the dispute to any consumer reporting agency from which it obtained the data.

“Defendant’s handling of Plaintiff’s dispute was not the result of error or mistake, but was consistent with its intentionally-adopted policies and procedures for handling consumer disputes,” the lawsuit scathes.

The plaintiff says he suffered damages in the form of loss of an insurance opportunity, harm to his reputation, emotional distress and denial of statutorily mandated information.

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