Munich RE says electronic health records ‘underutilized,’ but hopes to change that

Electronic health records (EHR) are “underutilized” in the insurance industry, but have the potential to facilitate faster, more accurate underwriting if leveraged in a strategic way, according to June Quah, VP, Integrated Analytics, Munich Re.

Just this year, in April 2024, the global reinsurer launched a new product that aims to do just that. Munich Re’s Automated EHR Summarizer was designed to streamline EHR data and make it more accessible both for underwriters and AI models.

“I think, in today’s world, EHRs are underutilized,” Quah said. “So, I think one of the biggest challenges for Summarizer is gaining adoption to help make the case for more extensive use of EHRs in the insurance industry, and then opening up the use cases across the insurance value chain.”

Quah, who is also the product’s developer, said EHRs are “a very rich source of medical history,” but also “extremely complex to use.”

“Manual review of EHRs can be time-consuming, and then they are also very challenging to integrate into underwriting decisioning workflows,” she said. “Automated EHR Summarizer is a solution that solves these two problems for the insurance industry.”

Digesting EHR data

Munich Re’s Summarizer uses AI and natural language processing techniques to extract native EHR data. It then structures, standardizes, normalizes and codifies that data to make it accessible. At the same time, Quah said the data is enriched with risk assessment expertise, identifying potential risk factors and flagging material conditions.

“We can use the tool to organize and summarize the information that is essential for an underwriter by presenting just the relevant details…like someone’s build, their BMI, impairments, lab results, medications and tobacco history,” she said.

This data is presented in a clear, concise and user-friendly report tailored to help underwriters “quickly assess a case instead of sifting through many pages of raw data.”

Additionally, it’s made available in a second format that is machine-readable, digital and structured. This allows it to be readily fed into rules engines and models, which insurance carriers can then use in automated or accelerated processing, or for analytical purposes.

Summarizer sources data exclusively from Clareto, a major health data network in the United States that was acquired by Munich Re in April 2022.

“We’re combining the capabilities of Clareto to access data and Automated EHR Summarizer to extract and process the data, as well as to provide triage guidance so that underwriters can underwrite more effectively,” Quah said.

Industry impact

Quah said using EHR data in a more effective way makes the underwriting process faster and more accurate, improving the experience for customers, underwriters and carriers.

For instance, applicants no longer have to deal with invasive or time-consuming steps such as taking a paramedical exam or requesting an attending physician statement.

“Automated EHR Summarizer improves the customer experience by making it frictionless for the customer,” she said. “It also makes it faster for the insurance company to obtain the medical evidence that they need to decision on a case. Overall, this can speed up the time to decision from weeks to days.”

It can help underwriters spend less time on straightforward cases and more time on complex cases that need their attention, enabling them to assess risk quickly without going through a bulk of raw records, she noted.

“Then, as underwriting programs integrate and use the structured data from Summarizer into their engines, more applicants can be processed without manual review,” Quah said.

From a carrier and risk assessment perspective, the EHR Summarizer aims to help mitigate applicant misrepresentation risk and mortality slippage, which Quah said is even more meaningful in accelerated underwriting programs.

“In today’s accelerated underwriting programs, there is applicant misrepresentation, whereby the applicant may not be fully truthful when they are answering the self-disclosed questions. So, having EHR data, which is verifiable medical information, will help improve mortality slippage,” she said.

Changing approach to risk

Quah suggested that the ability to use historical information to better understand an applicant’s health trajectory, rather than a snapshot of health at a single point in time, can change the way the insurance industry both thinks about and evaluates risk.

“The average acceleration rate for AUW programs without human review is only at about 20%, according to Munich Re’s last accelerated underwriting survey. Summarizer can really propel the shift to automated decisioning for carriers who are able to use the digital data in their engines,” she said.

EHR Summarizer has already gone to market and, according to Quah, feedback from carriers has been positive thus far.

“Everyone’s been extremely excited because of the potential and how this will help EHRs, which is currently an underutilized data source in insurance, and how this will improve and increase the usage of EHRs,” she said.

Munich Re operates in all lines of the insurance business. Founded in 1880, Munich Re provides reinsurance, primary insurance and insurance-related risk solutions around the world.

Rayne Morgan is a content marketing manager with PolicyAdvisor.com and a freelance journalist and copywriter.

© Entire contents copyright 2024 by InsuranceNewsNet.com Inc. All rights reserved. No part of this article may be reprinted without the expressed written consent from InsuranceNewsNet.com.

Rayne Morgan is a journalist, copywriter, and editor with over 10 years' combined experience in digital content and print media. You can reach her at [email protected].