What about diabetes in the life-insured population? Data from ExamOne points to a notable percentage of applicants with diabetes or prediabetes seeking to obtain life insurance (Figure 2).² As expected, the prevalence is much higher in the mature age group. 

However, one can’t help but notice a significant percentage of people with diabetes within the acceptable age range for many accelerated underwriting programs as well. What does their application journey look like? 

People with diabetes often find themselves with limited options when seeking to obtain an accelerated offer, let alone an instant decision. This is due to underwriters’ reliance on lab work to make an accurate decision when assessing diabetic risk. Most accelerated underwriting programs do not ingest lab data, only prescription and/or medical claims data. 

While these are incredibly helpful data sources when trying to evaluate conditions and treatments, gauging control of chronic conditions like diabetes with these data points alone can be challenging. In many instances, the prescription and diagnosis codes can inform an underwriter or rules engine that the applicant is a diabetic, but the most important question regarding their diabetes is often left unanswered: How are the applicant’s treatments and personal decisions impacting their diabetic control?  

This question is primarily answered through laboratory testing – specifically, the hemoglobin A1C test. According to the National Institutes of Health, the hemoglobin A1C test is considered the gold standard for assessing glucose control in patients with diabetes.³ In addition to A1C, microvascular complications can also present themselves in laboratory testing. alitheia’s screening logic pertaining to serum creatinine, urine albumin and urine protein ensures people with diabetes presenting complications are referred to an underwriter for review.

Given the wide variety of underwriting outcomes based on A1C, it comes as no surprise to the underwriter community that people with diabetes are often referred out of automated rules engines. For example, a well-controlled diabetic in their forties could receive a mild substandard rating. On the other hand, that same applicant could receive additional debits should their A1C results show a climbing trend. Even worse, they could be declined altogether if the A1C demonstrates uncontrolled diabetes.

The situation presents a challenge for carriers as they focus on underwriting automation and a frictionless customer experience. The diabetic population is growing, yet the accelerated environment is generally not a viable option for those applicants due to the types of data obtained in most programs.

A path forward with alitheia

Enter alitheia, Munich Re’s rapid risk assessment and decisioning platform. alitheia recently integrated with ExamOne’s laboratory data product, LabPiQture. As part of the integration, Munich Re’s alitheia underwriting and data teams have developed new rule sets based on Munich Re’s EDGE underwriting manual.

These rules are designed to assess lab values within the context of the disease presented. As an example, an A1C of 7.6 has different risk implications in the event the applicant is a type 1 or type 2 diabetic or not diabetic at all. alitheia’s rule set can process these lab values and provide nuanced handling for more accurate decisioning.

In addition to this rule set, Munich Re has created a patented framework within alitheia that optimizes requirement ordering. As a result, automated LabPiQture orders can be placed should certain risk factors present themselves.

These developments are bolstering the industry’s ability to offer a personalized digital underwriting experience. They also exemplify Munich Re’s commitment to expanding insurability to customers who typically do not have an accelerated decision path at an affordable price. Munich Re created this solution with flexibility in mind. Outside of requirement optimization techniques within alitheia, our laboratory rules can be used in combination with a carrier's existing accelerated program as well.

In either case, Munich Re’s integration with ExamOne’s LabPiQture allows for carriers to decision with greater confidence when final assessments are dependent on laboratory results.