Munich Re found that the decisions underwriters made on the basis of EHR data were rarely changed when reappraised with the benefit of additional APS data.
Munich Re had a team of underwriters review 301 cases using application data, MIB check, prescription histories and/or medical claims data, insurance exams and labs, and electronic health records (EHR). Then, all cases were reassessed with the addition of attending physician statements (APS).
In 73% of cases, the foundational data plus EHR gave underwriters all the information they needed to make a decision. Furthermore, in 87% of cases, the decisions made on the basis of the foundational data plus EHR were the same as those made with the benefit of an added APS.
As a result, the reinsurer concludes that EHRs are good candidates to replace APSs when applicants have a limited number of impairments.
Additional findings and conclusions:
- 301 APSs yielded only one additional case of tobacco misrepresentation.
- EHRs provided more up-to-date information than APSs in several cases.
- EHRs are an effective tool in lieu of APSs for the purposes of meeting age/amount requirements or as a follow-up on MIB or Rx/Dx findings.
Munich RE also notes that EHRs are faster and more affordable than APSs and may as a result open up opportunities for carriers to improve their customer experience.
“As EHR adoption has grown, the assumption has typically been that the best use case was as an APS replacement. I think the most surprising finding coming from all of these studies is the multitude of ways that EHRs can be used to improve underwriting efficiency.”
James Swinton
2nd VP, Underwriting Risk Management
Munich Re Life US
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