Gen Re has released findings from its latest US Group Medical Evidence of Insurability (EOI) Underwriting Survey, which examined how companies staff and process EOI applications.
The survey included responses from 21 companies, all of which reported tracking EOI data for Group Term Life, Short Term Disability, and Long Term Disability products.
In 2024, participating companies received more than 2.7 million EOI applications, averaging 136,771 applications per company for those reporting this data. The survey found that, on average, 36% of EOI applications were submitted via a web-based interface, while another 36% were submitted through a web-based interface that included reflexive questions.
Companies reported that 57% of EOI applications were submitted using a long form in 2024. Among companies in the low volume segment, 25% of applications were submitted via a short form, compared to 62% for companies in the high-volume segment.
Managing volume during peak times was identified as the top challenge for group medical underwriting departments. Other significant challenges included inefficient underwriting systems, technology deficiencies, and the need to update or develop applications to improve risk selection and meet marketing requirements.
The survey also highlighted the increasing use of automated systems for approving coverage. Eighty-one percent of participating companies have an EOI system capable of automatically approving coverage without a medical underwriter’s review, a process known as straight-through processing (STP). Of the four companies without STP, three indicated plans to develop this capability within the next year.
Gen Re’s focus on automation in underwriting is also reflected in its 2024 Individual Life Accelerated Underwriting (AU) Survey, which found that 82% of life insurance carriers have either fully or partially implemented an AU workflow. Most carriers reported that these workflows have helped reduce the time to policy issuance and improve operational efficiency.
Among the 16 companies with automated underwriting systems for group medical EOI, 10 developed their systems in-house, while six purchased systems from outside vendors, with four of those subsequently modifying them internally.
For companies that provided both the number of EOI applications received and the number processed through their automated system, an average of 69% of applications were processed through STP. Low and medium volume companies processed 61% and 55% of their EOI applications through STP, respectively, while high-volume companies processed 82% through automated systems.
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