The following are a list of new tools life insurance companies are using to shorten the underwriting process. Within the last year or two many Arizona term life insurance products have been introduced that offer coverage without the applicant having to submit blood work or have a physical exam before a policy is issued… and this is how the insurance companies do it.
One relatively new tool Arizona life insurance companies have at their disposal is the Clinical Laboratory Database (CLD.) This database allows insurers to view blood and urine test results run by the applicants’ doctor in the past. In addition, many doctors run tests that insurance companies typically do not require during the application phase such as CBC’s and thyroid panels, and these test results are available to the insurer as well through the CLD.
Similar to the CLD is the Prescription Database Search (PDS.) This search tool pulls prescriptions filled from thousands of pharmacies around the country. The PDS report is very thorough! Names of medications, dates filled, how often, doctors name, it’s all in the report. The life insurance underwriter can paint a fairly complete picture of an applicant’s health history by simply pulling the CLD and PDS reports, hopefully avoiding the need to request medical records from the applicant. As an example, the applicant’s CLD shows elevated glucose and the PDS shows regular refills for Metformin to control glucose levels. From these reports the underwriter likely does not need medical records.
Arizona life insurance companies now have access to Claims Data. Each time an individual sees a doctor a billing code is generated. From these codes an underwriter for life insurance can get a better picture of the overall health of an applicant. One downside to Claims Data is that the underwriter does not know the doctor’s treatment plan or how well the applicant followed the course of treatment.
The newest tool life insurance underwriters are using is Electronic Medical Records (EMR.) Obtaining medical records has always been the slowest part of any underwriting process, sometimes taking months. COVID made the situation worse as physician’s offices closed and cut back on staff. Now, thanks to EMR’s an insurer can pull medical records electronically without having to wait for a human being to process the request. This technology is still in its infancy and is experiencing fits and starts, but all in all is very promising. The downside today is that not every medical provider has the technology in place yet on their end.
EMR’s typically are not the same as a patient’s medical chart. The medical information you see through your patient portal is not the same information included in EMR’s… EMR’s are much more detailed.
This leads us to the old saying “Garbage In, Garbage Out.” Sometimes inaccurate medical information is entered into the system, thus spread to other medical providers and insurance companies. Determinations may be made on this inaccurate information resulting in a policy receiving a rate-up or denial. This is where a seasoned broker will be most helpful. The broker can facilitate getting copies of records and create a plan of action to overcome any issues preventing the applicant from being issued coverage, and at the best price.