The quote “Work Smarter, Not Harder” dates back to the 1930s and was coined by an industrial engineer emphasizing work simplification. As old as this saying may be, it remains relevant, and in the life insurance industry of 2025 building efficiencies is critical to maintaining a competitive edge.

Use of electronic medical data plays a significant role in enhancing operational efficiencies, especially as the data continues to evolve and become more meaningful. Organizations that fail to use EHRs to their full potential risk falling behind in the competitive landscape.

The positive momentum in driving efficiencies that electronic data has seen in recent years is driven by many factors:

• Electronic data enhances any type of risk assessment, regardless of the workflow type – from accelerated underwriting through all variations of fully underwritten processes.
• EHR is an ideal data optimization tool when underwriters use it as a first step, and only order additional, more costly requirements once deemed necessary.
• With fewer special authorizations (6% for EHR vs double digit results for an APS), coupled with an ability to automatically pivot to an APS if an EHR is unavailable, workflows are simplified and turnaround times shortened when an EHR record is requested first.
• Whether during the point-of-sale processes, the initial formal application review or in post-issue activity such as random holdouts, post issue audits or early claims investigations – there are many workflows beyond pre-decision underwriting that benefit from the cost and cycle time savings electronic data provides.
• Industry studies and articles by the reinsurance community are showing that the content is becoming more robust. Additionally, in analyzing the type of data captured in our own records, as revealed in my blog of last June, MIB has seen a positive trajectory of growth in the return of clinical content that is needed to perform an accurate mortality or morbidity assessment.
• EHR provides an opportunity to flush out non-disclosure. Since searches are performed at the applicant (patient) level, results may be returned for ANY encounters found, regardless of whether they were disclosed. This provides an advantage over an APS which only searches for disclosed encounters. The benefits of this are significant. According to a recent study, material misrepresentation on applications is the #1 most common type of fraud reported.
• Provider coverage is expanding within data sources, making it more likely that a search leads to a record found. Further, technology improvements at both the data source and provider source level are improving interoperability, enabling access to a wider network of data. As a result, access has improved overall and many states that were at single release rates merely months ago have seen rapid growth.
• Underwriters are getting more comfortable with using electronic data, either in isolation or as a compliment to other data, and operational leaders are leveraging use of electronic data to improve application unit costs.

By supporting the ability to remain within an automated or accelerated process, solve for disclosure gaps, accurately align customers within appropriate rate or preferred classes, quickly identify uninsurable risk, reduce the need for clarification requirements between case managers, underwriters, and field partners…electronic data is demonstrating value. And the efficiency wins are endless.

MIB’s Medical Data Solutions team continues our mission of providing access to meaningful electronic health record data, at reasonable price points, as quickly as possible. In recent months, we have executed several enhancements designed to help our clients scale up and improve efficiencies:

• Expanded our partnerships and our platform capabilities to automatically pivot to an APS when an EHR is not located within our network of data sources.
• Made it easier to execute a new APS search from our platform if an EHR(s) is received yet lacks sufficient information to finalize a risk assessment.
• Enhanced our capabilities to provide underwriter-friendly data summaries with additional services performed by RiskRighter.
• Expanded our portfolio of risk assessment services to include support for quick quote or informal application reviews, formal application reviews, file assessments, audits, and more through RiskRighter.

If you are not yet taking full advantage of all that EHR has to offer, including the ability to pivot to an APS when an electronic record is not available, now is the time to act. The resulting efficiency gains and operational cost savings will undoubtably enhance your organizations competitiveness and success in 2025.

¹ Gen Re, September 11, 2021, U.S. Claims Fraud Study