Risk Identifier is built on a transparent, rules-based architecture that enhances, rather than replaces, underwriter expertise. It operates on a foundation of clearly defined logic, applying a consistent set of rules to integrated data streams. The power of this approach comes from the fusion of high-value, longitudinal data: comprehensive prescription histories, extensive clinical and life insurance lab results, and detailed medical claims information. By structuring this information around specific medical conditions, ExamOne’s Risk Identifier provides a holistic view of an applicant’s health journey, moving beyond isolated data points to uncover a more complete picture of risk.

The result is a system that brings newfound clarity and efficiency to the underwriting process. For example, Risk Identifier synthesizes related findings across data sources—such as a diagnosis code from a claim, a corresponding prescription fill, and a recent lab value. It then applies a transparent debit/credit score based on the rules for that specific combination of findings, providing a multifaceted, quantifiable view of a condition and its severity. This allows underwriters to move with confidence and speed, secure in the knowledge that decisions are based on a consistent, logical, and well-documented framework. ExamOne’s Risk Identifier provides the velocity the market demands, without sacrificing the underwriting precision that sound portfolio management requires.

By implementing Risk Identifier into the underwriting workflow, carriers can drive a more efficient and accurate risk selection process. It creates a powerful synergy between data science and underwriting expertise, laying a foundation for sustainable growth.

To learn more about ExamOne’s Risk Identifier and how it can fit into your workflow, contact your Strategic Account Executive or request a meeting here.

The post  The New Rules for Automated Underwriting: How ExamOne’s Risk Identifier® Delivers Precision and Velocity appeared first on ExamOne Blog.

When we embark on a new year, we bring our teams together for our kickoff conference to celebrate the past year’s achievements, reflect on our goals, and look toward the future. This year, our conference theme was “Igniting Growth,” focusing not only on business innovation but also on strengthening our connections and our purpose. It’s a time for thoughtful discussion about who we are, the work we care about, and the direction we’re headed.

Nurturing our team culture

We believe that true growth extends beyond our company walls. As part of our kickoff events, we put a special focus on giving back to our home community of Lenexa, Kansas. This year, we had the privilege of partnering with Bikes for Goodness Sakes, a wonderful national non-profit that donated the bikes built in our event to Big Brothers Big Sisters of Kansas City to support local youth in need. This partnership was a perfect way to bring our “Igniting Growth” theme to life for the youngest members of our community.

When it comes to team building, we aim for activities that are both meaningful and memorable. We chose to do something with a dual purpose: giving back to our community while giving our teams positive time to connect with each other. By working together for a selfless cause, we start the new year by reinforcing a culture of care and collaboration.

We are grateful to Bikes for Goodness Sakes for their incredible mission and for their recent blog post that highlights their experience with our teams. We encourage you to read it to learn more about the positive impact they are making.

The post Igniting Growth in Our Business and Our Community appeared first on ExamOne Blog.

Medical record reviews have long been time-consuming and error-prone, especially when analyzing Electronic Health Records (EHRs) and Attending Physician Statements (APSs). On average, EHRs contain 222 pages and APSs average 152 pages, often filled with duplicate information and excessive documentation. Manually sifting through hundreds of pages to extract key medical details is inefficient, leading to delayed underwriting decisions and higher operational costs.

To address this challenge, DigitalOwl and ExamOne have formed a collaboration to provide AI-powered medical record review services, making it easier than ever for carriers to process EHRs and APSs efficiently. This blog explores how this collaboration is transforming documentation review for medical underwriting workflows.

Addressing Common Challenges

DigitalOwl and ExamOne have joined forces to streamline electronic medical record review for life insurance underwriters. This collaboration makes it easier than ever for carriers to leverage AI medical record review solutions without the hassle of IT integrations, direct contracting, or complex implementation hurdles.

“​​By integrating DigitalOwl into the ExamOne workflow, it becomes a seamless transition for our customers. There’s no need to vet, negotiate contracts, or build new infrastructure. Everything is part of the ExamOne ecosystem, providing easy access to the innovative solutions DigitalOwl is developing for our customers,” said Justin Doolittle, Director of Business Development at ExamOne.

With ExamOne handling all connectivity and data transmission, underwriters gain access to faster, more efficient, and highly accurate medical record audits, enabling them to focus on high-impact decision-making rather than administrative tasks.

Watch this video to hear what Justin Doolittle, Director of Business Development at ExamOne, has to say about this collaboration.

The Solution: AI-Powered Summaries for Seamless Underwriting

Through this partnership, ExamOne clients can now seamlessly enable DigitalOwl’s AI-powered medical record summaries without requiring a separate IT build or contract. Consider the following benefits of DigitalOwl and ExamOne’s collaboration:

• Faster turnaround times: AI reduces manual record review timelines by two or more days.
• Seamless integration: With this collaboration, there’s no need for direct IT work. Simply turn it on through ExamOne’s existing infrastructure.
• Consistent data presentation: Standardized medical record summaries provide a uniform experience, whether reviewing a large-scale EHR or a local APS.
• AI-driven accuracy: Unlike humans, AI never gets tired and is trained to detect even the smallest discrepancies across hundreds of similar-looking pages, ensuring nothing critical is overlooked.
• Effortless contracting: Pre-vetted by ExamOne, DigitalOwl can be added under an existing master contract, eliminating separate vendor agreements.
• Simplified AI governance: DigitalOwl has already met and exceeded ExamOne’s rigorous security and compliance protocols, making it easier for compliance teams to approve and implement AI medical records summary tools.

Why This Matters: A Smarter, Faster Future for Underwriting

Life insurance carriers need scalable medical record review solutions that reduce administrative burdens and improve efficiency. DigitalOwl’s AI is trained by underwriters for underwriters, ensuring that it cuts through duplication and surfaces only the most critical insights—allowing teams to focus on what truly matters: risk assessment and decision-making.

By eliminating common barriers to AI adoption in medical chronology software, this partnership allows underwriters to work smarter, not harder, saving time typically spent on reviewing tedious medical records.

Learn More

Ready to experience the benefits of AI-powered medical record summaries? Contact your ExamOne Strategic Account Executive (or have an SAE contact you!) to see how DigitalOwl and ExamOne can transform your review of EHRs and APSs.

The post Guest Blog: Simplifying Electronic Health Record Reviews with AI appeared first on ExamOne Blog.

RGA’s contributions make ExamOne Risk Identifier even more applicable to real-world underwriting challenges, helping carriers strike a balance between speed, accuracy, and alignment by incorporating the 3 major health data types—prescription, LOINC, and ICD codes—into 1 comprehensive ruleset.

Accelerating and enhancing the underwriting process

Risk Identifier, powered by ExamOne and UnderwriteMe, and now in collaboration with RGA, was built to meet the modern demands of underwriting operations by supporting automated and accelerated underwriting programs. The tool classifies risk using real-time health data. It combines the leading health data elements of LOINCs, ICD Codes, and prescription identifiers found in ScriptCheck, LabPiQture, and Medical Claims, then applies a debit/credit scoring model based on configurable rule sets.

The tool offers underwriters a unified risk signal that can be used to:

• Instantly classify risk
• Surface contributing risk factors for explainable decision-making
• Reduce the need for traditional APS reviews or full medical exams for qualified applicants
• Identify hidden high-risk (or overlooked low-risk) profiles early in the application journey

With the addition of RGA’s insights, ExamOne Risk Identifier now incorporates a manual-aligned, condition-focused approach that helps carriers:

• Detect health concerns with greater nuance
• Support accelerated decisioning
• Maintain clarity and transparency in automated outcomes

“The collaboration with RGA brings a condition-focused approach to the engine’s decision logic,” says Justin Doolittle, director of product development for ExamOne. “We’re aligning risk assessments more closely with underwriting manual philosophies and advancing the tool’s ability to support accelerated underwriting workflows.”

Strengthening decision logic through expertise

As one of the most trusted names in life and health reinsurance, RGA is renowned for its innovative thinking, risk management leadership, and cutting-edge use of artificial intelligence and new evidences.

By integrating RGA’s underwriting expertise into ExamOne Risk Identifier, the tool now:

• Prioritizes condition-level insights rather than relying solely on thresholds or broad indicators
• Supports more granular underwriting decisions, helping underwriters pinpoint critical health risks or identify low-risk applicants for fast-track offers
• Makes full use of current data science to quantify mortality impacts and identify interaction effects between and among laboratory, prescription, and diagnosis histories
• Aligns with the philosophy and logic of underwriting manuals, improving transparency and trust in automation
• Enhances underwriting performance without sacrificing accuracy or compliance

The result is a tool that not only automates faster but does so with a stronger connection to how underwriters evaluate risk.

A practical solution for today’s challenges

ExamOne Risk Identifier is designed to help you keep up with changing expectations – both from applicants and internal teams. It fits seamlessly in any workflow, is easy to integrate via API and lets underwriters or automation engines act with confidence.

More insight. Less friction. Better outcomes.

ExamOne Risk Identifier is redefining what’s possible in risk assessment. For life insurance carriers seeking to strengthen their accelerated underwriting programs and empower underwriters with smarter tools, this collaboration delivers.

Interested in seeing how Risk Identifier fits into your underwriting strategy? 

Connect with your ExamOne Strategic Account Executive or visit www.examone.com/underwriting-assessment-engine to learn more.

The post Enhancing automated underwriting: ExamOne and RGA expand Risk Identifier® appeared first on ExamOne Blog.

hr | ReFlex Select – Underwriting rules for LabPiQture

Hannover Re collaborated with ExamOne to develop a rules-based solution that enables life insurers to automate the use of LabPiQture’s comprehensive, real-time clinical laboratory records to enhance accelerated underwriting programs and overcome data interpretation challenges.  ExamOne LabPiQture returns clinical and insurance labs results typically regarded as LOINCs (Logical Observation Identifiers Names and Codes). Due to the volume and complexity of the data, underwriting outcomes are typically produced manually. hr | ReFlex Select allows for the automatic ingestion and evaluation of this data, providing a valuable automatic risk assessment tool to the life insurance underwriting industry. The data provided includes up to 7 years of lab history results in an FCRA-compliant report that can help reduce overall underwriting time and cost, serving as a possible APS alternative. hr | ReFlex Select for LabPiQture streamlines the process by automating rules for precise underwriting assessments, in line with Hannover Re’s underwriting manual hr | Ascent, and has been shown to reduce evaluation time.

Initially only available to hr | ReFlex clients, the rules are now available to carriers through hr | ReFlex Select, an API-based solution that enables carriers to use hr | ReFlex Select rules for LabPiQture irrespective of their current underwriting engine. Hit rates are approximately 70%² with an automated underwriting decision for the LabPiQture data on more than 85% of people with LabPiQture results per Hannover Re Underwriting Analytics.

Protective Value of hr | ReFlex Select

The hr | ReFlex Select product optimizes the protective value of ExamOne’s LabPiQture data compared to alternative solutions. The hr | ReFlex Select product instantaneously analyzes large sets of lab data provided by ExamOne and interprets the data to produce comprehensive underwriting recommendations that fits seamlessly into traditional underwriting structures.

Rule-building philosophy and considerations

Hannover Re’s rules for LabPiQture are firmly grounded in the hr | Ascent underwriting manual and also provide additional guidance with rules that address LabPiQture data with nuance. To develop the rules and launch the automated solution, the HLR US team collaborated extensively between underwriting, medical directors, data analytics, and hr | ReFlex team. Hannover Re’s Chief Medical Director is at the center of rule development, offering a level of expertise for each rule that is not possible with traditional manual reviews.

As a result, hr | ReFlex Select for LabPiQture has provided recommendations on over 500,000 digital applications from over 20 unique US clients. This solution offers clear, structured underwriting recommendations based on the unique dataset of laboratory results available through LabPiQture; recommendations are complete with detailed rationales and precise follow-up actions. It also expedites accurate and complex decision-making at the point of sale. By enabling real-time access to comprehensive data, this integration streamlines underwriting decisions and policy issuance.

Conclusion

hr | ReFlex Select rules for LabPiQture supports carriers’ use of the data to help make automated decisions, reduce manual case reviews and improve the efficiency and consistency of those cases requiring manual review without negatively impacting mortality. hr | ReFlex Select for LabPiQture highlights the value of the collaboration between Hannover Re and ExamOne, unlocking the potential of laboratory results for data-driven underwriting. This collaboration also includes detailed mortality studies on key lab results, many of which have not been formally studied in the US Life Insurance space.

To learn more about LabPiQture and how it can transform your underwriting processes, reach out to your ExamOne Strategic Account Executive or request a meeting.

1. (2022). “Insurance Industry Outlook.” (https://www2.deloitte.com/us/en/insights/industry/financial-services/financial-services-industry-outlooks/insurance-industry-outlook.html)
2. ExamOne, a Quest Diagnostics Company, internal data.

The post hr | ReFlex Select for LabPiQture wins “Global Development Award” for data driven underwriting automation appeared first on ExamOne Blog.

Key topics:

• Learn what this common laboratory panel can tell you and how you can use it as an
  important risk-assessment tool
• Find out how to interpret this panel for your applicants and better assess potential
  long-term health risks
• Understand the conditions this panel predict

The serum protein panel is a valuable data source for your underwriting for risk assessment, learn how to make it work for you!

[Register Now]

* National Library of Medicine (U.S). Comprehensive Metabolic Panel (CMP)
(https://medlineplus.gov/lab-tests/comprehensive-metabolic-panel-cmp/). Last updated 12/4/2023. Accessed 11/15/24

The post Serum Protein & Underwriting: Exploring the Hidden Potential of a Routine Panel appeared first on ExamOne Blog.

Physician and hospital adoption of Electronic Health Records (EHR) has skyrocketed over the last decade, with office-based adoption up to 78%, from 34%, and Non-federal acute care hospital adoptions up to 96% from 28%. Coupled with new AI-powered enhancement tools like DigitalOwl, ExamOne is helping to drive significant change with the amount of time needed to retrieve, summarize, and review electronic records.

Can this widespread adoption of EHRs be used to your advantage in underwriting? What tools are available to help gather and analyze applicant data in a way that is actionable?  

In our latest webinar, our panel of experts discussed how you can gain efficiency in your current workflow, reduce application cycle time, and improve your underwriting decision making with EHR data retrieval, now available with DigitalOwl’s AI powered summaries.

Key topics:

• The value of ExamOne’s comprehensive EHR solution
• The role of artificial intelligence tools like DigitalOwl for the insurance industry
• Connecting the dots with tools for actionable risk assessment decisions
• Traditional APS workflow vs. EHR with APS workflow
• Supporting the accelerated journey through data insights

The EHR adoption trend provides a valuable data source for your automated underwriting workflows, learn how to make it work for you.

Watch the On-Demand Video for this informative webinar.

About ExamOne’s EHR retrievals and summaries:

Utilizing applicant search and physician search, EHR retrievals and summaries offered by ExamOne, a Quest Diagnostics® company, make it easier and quicker to tap into critical information and actionable insights for superior risk assessment and decision-making.

About AI-powered DigitalOwl APS summaries

DigitalOwl’s platform helps to mitigate some of the biggest challenges with medical record reviews, primarily the time it takes to review medical records for expedited decision making. DigitalOwl helps enable data-driven decisions by streamlining underwriting with deduplicated data, in-depth filtering and reducing time it takes to review medical records from hours to minutes.

The post On-Demand: Streamlined EHR retrievals available with DigitalOwl summaries appeared first on ExamOne Blog.

Whether you are screening for undisclosed conditions, requiring additional detail on prior medical events, or need a post-issue surveillance resource, EHR retrievals and summaries offered by ExamOne, a Quest Diagnostics® company, make it easier and quicker to tap into critical information and actionable insights for superior risk assessment and decision-making.

Confident decisions

Our process provides you with actionable data for making underwriting decisions in a format designed to fit into your workflow.

Cost-effective workflow

Delivers cost savings and efficiency by reducing manual touches and associated follow-up costs.

Accurate results

Unique, automated matching process improves usability and reduces redundancies.

EHR Retrievals are innovative solution that can help accelerate your risk evaluation process and improve the consumer experience. Contact your ExamOne representative to find out more, or visit Medical records for life insurers – ExamOne.

The post EHR retrievals are a rapid and efficient tool for actionable risk assessment decisions appeared first on ExamOne Blog.

Now more than ever, it is important that we continue to help make it easier for more families to be protected with life insurance. According to LIMRA and Life Happens 2024 Insurance Barometer Study a record-high proportion of American adults (42%) — representing 102 million people — say they need (or need more) life insurance.

For more than 50 years, ExamOne has been helping insurers and individuals complete the life insurance application process with convenience and ease. As the industry continues to change, we have evolved and enhanced our product solutions while staying dedicated to improving the applicant experience.

“Our teams at ExamOne are dedicated to delivering a holistic approach of a high-quality end-to-end solution to our clients and life insurance consumers. From our professional and precise paramedical collections, and laboratory testing expertise, to innovative data insights, we are committed to helping empower our clients and life insurance applicants to make the best decisions for the carriers’ business and the consumers’ families,” said Keith Ward, ExamOne President.

The life insurance industry works together to protect more families with life insurance. At ExamOne, we are proud of the part we play in that process — one exam at a time, one data insight at a time, and ultimately one life at a time. This month, help spread awareness of the need of life insurance with us.

#LIAM24 #GetLifeInsurance

The post Protecting more people with life insurance, one life at a time. appeared first on ExamOne Blog.

About 35.5 million people in the United States are currently affected by chronic kidney disease (CKD), and the prevalence of ensuing kidney failure is rising.¹ ExamOne was asked how insurers can quickly and confidently determine if their applicant has kidney disease. In a recent case study, we show how eGFR results highlighted in LabPiQture ^TM uncover or disprove chronic kidney disease.

What is eGFR?

• According to the National Kidney Foundation, Glomerular filtration rate (GFR) is the best overall index of kidney function. ²
• Healthcare providers use estimated glomerular filtration rate (eGFR) to determine kidney disease, and if so, what stage.
• The standard way to estimate eGFR is with a simple blood test.

What value do eGFR results bring to an underwriter?

• The underwriter will look for the stability or conversely the instability of the eGFR to make a possible risk assessment decision.

How would an underwriter access this data?

• eGFR results will be highlighted in laboratory testing results provided through ExamOne’s LabPiQture.

See eGFR results in action through LabPiQture.

Learn more about how LabPiQture provides critical information regarding CKD and tremendous insights into an applicant’s health profile.

Read the case study.

About LabPiQture

Through LabPiQture insurers have access to an extensive clinical laboratory database which includes physician-ordered laboratory testing results related to preventative care, disease monitoring, and diagnostic purposes. LabPiQture has become an integral part of many underwriting decisions. In addition to clinical laboratory results, detailed information such as diagnosis codes, LOINC codes and ordering physician information has proven valuable. Reinsurers have been actively engaged in studying subsets of deidentified LabPiQture data to evaluate the effectiveness of this unique information source.

Read more studies here.

¹Centers for Disease Control and Prevention. Chronic Kidney Disease in the United States, 2023 (cdc.gov)

²Source: eGFR Calculator | National Kidney Foundation

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