EHR Retro Studies Series: Cost-benefit study confirms EHR value across life insurance underwriting use cases

Munich Re Life US underwriters have been working extensively with electronic health records (EHRs) for several years. Our ability to leverage EHRs for risk assessment has grown significantly with this experience. This led us to think anew about the efficacy of EHRs across multiple underwriting use cases: Does the original and widely held industry belief that EHRs’ primary and best use would be to replace the attending physician statements (APS) stand up to scrutiny? Is the focus on APS replacement even the best use case for EHR adoption?

These questions prompted us to take a step back and look at EHRs as we would any new data source and ask where they can most easily and effectively be employed in life underwriting. To answer this, we needed to quantify the incremental value of an EHR as new evidence in various underwriting environments. As a result, we conducted a series of rigorous and extensive EHR studies – in aggregate, likely the industry’s largest review to date. Our aim was to arrive at the real answers and not simply validate our original beliefs about the benefits of EHRs in life underwriting.  While the series confirmed the effectiveness of EHRs as a core underwriting tool, other use cases were revealed where the immediate positive impact, value, and ease of EHR implementation may outweigh APS replacement. We also found specific situations, particularly those with EHRs from a less relevant physician or those with low-data EHRs, where APS still delivers value on top of EHRs. 

For this series, we focused on a subset of over 800 lives using underwriting files provided by multiple carriers representing a cross-section of markets.¹ The goal was to determine the impact of incorporating EHRs in multiple use cases:

• Non-fluid underwriting/accelerated underwriting: This is the first in a series of papers covering findings from the studies around the protective and operational value of EHRs in underwriting workflows. 
• Fluid underwriting: This second paper presents findings from the studies on using EHRs to replace fluids for fully underwritten business without APS.
• APS underwriting: This third and final paper shares findings from the studies on using EHRs as a replacement for traditional Attending Physician Statements (APS) in fully underwritten cases.