Part of our Underwriter-to-Underwriter blog series
April 21, 2025For EMD (Electronic Medical Data), you will find me in the role of cheerleader
When it comes to industry headlines in online publications, I am easy bait. Most of the time, the information provided in these publications is fact based, accurate and useful. However, lately, I am reading commentary that feels negatively slanted and over generalized which may, unknowingly, perpetuate misinformation about electronic medical data. To correct for this, I am offering rebuttals for a few recent statements that I have read.
Note: The original statements have been slightly modified or condensed for clarity within this blog.
1) “Electronic Records offer an overview of the applicant’s medical history which is less detailed than other sources of data.”
Rebuttal: While it is true that some pieces of electronic medical data may hold lighter content, we are seeing a significant amount of information regarding smoking status, height and weight, tobacco use, and medication use in most records, and our review of clinical content is showing an overall increase in useful information year-over-year.
2) “Over the next two to five years, EHRs will become an essential data source for carriers’ medical underwriting decisions.”
Rebuttal #1: EHRs are already an essential data source for underwriting decisions with a steady increase in the number of carriers adopting them, and a corresponding increase in search activity over the past five years. Their use has proven to be particularly vital for carriers that are focused on driving down the unit cost of application review and/or the cycle time from application receipt to policy issue.
Rebuttal #2: With response times serving up data in real and near-real time, the fast TAT for electronic data not only improves cycle time metrics but also presents opportunities to use the data in more creative ways. Beyond traditional underwriting requirements, electronic data is a strong fit for post-issue activity and contestable claim review, among other use cases.
3) “An EHR might indicate that a client saw a specialist, but it may not include associated procedures such as an EKG or the results of a stress test.”
Rebuttal #1: This statement is equally likely to apply to an APS record from a personal physician.
Rebuttal #2: This is a broad-brush statement assuming that all electronic medical records lack granularity. However, the information within electronic medical records is often as robust as an APS. Minimally, it includes the most critical information for underwriting related to a patient’s encounter, overall health history, family history, medications, laboratory results, procedures, and often includes clinical notes.
4) “For individuals with significant or complicated medical histories, attending physician statements provide a more complete view of a diagnosis as well as medical management and treatment plans.”
Rebuttal #1: One could argue that a quick and less expensive EHR will give insights into whether or not an applicant is even insurable. Why pursue more extensive requirements and the cost associated with fully underwriting the risk if that is not the case? With fewer special authorizations required compared to an APS, as well as quicker TAT and a lower cost, starting with electronic medical data as the initial requirement just makes sense. With the critical information needed for preliminary assessment included, underwriters will know where to focus their efforts in collecting additional requirements, saving time and money.
Rebuttal #2: There is an assumption in this statement that electronic data is inferior. However, as I noted previously, our analysis of the clinical content within the data indicates that the information provided by an EHR is both strong and consistently improving.
5) “Digital medical records are unorganized and often incomplete, leading to challenges in understanding an applicant’s complete medical history which delays the underwriting process.”
Rebuttal #1: APS records are also often disorganized and/or incomplete, and experience similar delays.
Rebuttal #2: There are a myriad of tools to support the organization, de-duplication, and ease of use of electronic medical data. And the price of these summary services, even when combined with the retrieval cost of the electronic medical record, is still more favorable than the expense associated with a standalone APS record.
6) “An APS is still the ‘gold standard’ requirement for medical underwriting.”
Rebuttal: I hear this over and over again, and in 2025, I think we need to retire this tired saying. Obtaining an APS can be a costly and time-consuming process that often results in the need for a special authorization from the client. In an age of access to real and near real-time data, with electronic records offering an equal amount of content to an APS, we need to rethink what constitutes a “gold standard”! I find this saying often reflects a change-resistant mindset.
While I love to see, hear, and read about efforts to educate our industry regarding the challenges of using new tools and solutions, I also want to give a voice to the underwriting efficiencies and cost savings they provide. With their ability to improve turnaround time at a lower cost than other options, use of electronic records enables faster decision making while retaining accuracy. They are a critical tool to enable carriers to gain efficiencies, process more applications, and insure more consumers. As such, embracing the use of electronic data in this digital age just makes sense. I hope that my rebuttals are taken simply as an opposing opinion in the spirit of continuous education.
Please reach out to me directly if you would like to continue the conversation!
About Carolyn McAvinn
Carolyn McAvinn is the Director of Underwriting Innovations for MIB. Prior to joining MIB in late 2018, she held various underwriting roles supporting multiple companies, product lines and distribution platforms. These included underwriting management, direct line production underwriting in the life, disability and long-term care markets and assisting with the development of underwriting engine automation and accelerated underwriting programs. Carolyn is a graduate of the University of Massachusetts - Amherst and currently serves as a board member of the MUD (Metropolitan Underwriting Discussion) Group in NYC.
