Life insurers continue to look for ways to improve underwriting efficiency without sacrificing risk discipline. This challenge has become more pronounced as accelerated underwriting grows, changing how and when medical requirements are used to balance speed, cost, and risk protection.
Recent research from Munich Re Life US helps quantify this dynamic, showing that when Electronic Health Records (EHRs) are used as the first source of underwriting evidence—with additional requirements ordered only when needed—decision rates increase, mortality outcomes improve, and overall underwriting costs decline.
Key findings from research
- Net increase in the number of final decisions that can be made without additional evidence.
- 52% of total study cases could be decisioned based on EHR alone, without ordering additional data.
- Increased decision rates by 20% (from 66% to 86%) compared with a traditional AUW approach where EHR is not used.
- Improved mortality slippage due to more accurate, but potentially more adverse, risk
class assessments.- Decision changes resulting from Leading with EHRs yielded 25% higher mortality vs
Traditional AUW, offsetting mortality slippage. - This translates into a mortality savings of $752 for an average policy.
- Net savings of $702 per policy, when factoring in the cost of EHR.
- Mortality savings were seen across all age and face amount bands, most significantly for older age bands and higher face amounts.
- Savings achieved in evidence and underwriting expense reductions in addition to
mortality.- The net increase in decisions has the potential to substantially decrease knockouts
and refer-to-underwriter decisions in accelerated underwriting. - Estimated $29 in evidence and underwriter time savings per application.
- This figure may be understated, as the study assumes 1.4 EHR data sources
compared with a single APS data source; equivalent data volume would more
closely align with a 1:1 assumption.
- When mortality, evidence costs, and underwriting time were considered together, the
EHR‑first approach has the potential to deliver $781 in total savings per application, with mortality protection as the dominant driver of value.
What this means for carriers
Published studies across reinsurers have consistently shown that accelerating underwriting decisions without adequate clinical context increases the risk of misclassification and mortality slippage. Munich Re's findings suggest that Leading with EHRs, paired with reflexive evidence strategies, provides a practical way for carriers to balance acceleration with protection to make more accurate risk decisions, reduce unnecessary follow‑up requirements, and focus underwriting effort where it is most needed.
Additionally, while these findings are grounded in accelerated underwriting, the underlying principles of evidence sequencing and early clinical insight can also be applied to other underwriting models as carriers modernize their workflows.
Why MIB EHR supports an EHR‑first strategy
While the Munich Re study focuses on accelerated underwriting, MIB's experience supports using EHRs first more broadly across underwriting models. When ordered early, EHRs frequently provide enough clinical data to support a decision without additional requirements—allowing carriers to avoid unnecessary cost and reserve follow‑up evidence for cases where it is truly needed. This is supported by an earlier Munich Re EHR Retro Study on Traditional APS replacement, which found that for 73% of cases, EHR provided sufficient information for decision making. While Munich Re demonstrates that leading with EHRs early in underwriting improves decisioning, RGA research (The 'Moneyball' Link to Digital Underwriting Evidence in Insurance | RGA) confirms that optimizing the sequencing of evidence—of which EHR is a core component—can reduce costs and maintain mortality outcomes. MIB's own data‑quality reviews also reinforce this point. Ongoing USCDI analyses show continued improvement in the presence of key underwriting elements such as medications, problems, encounters, vitals, and lab information—supporting decisions in a significant share of cases.
When EHRs are sufficient, carriers avoid unnecessary requirement expense. And even when they are not, the early clinical insights they provide helps underwriters target exactly what evidence is needed next, rather than defaulting to broad, higher‑cost requirements.
In this way, EHR‑first workflows empower carriers to make faster, confident underwriting decisions, balancing risk and efficiency while unlocking substantial savings.
