Ensuring accurate mortality assessment with vendor APS summary products.
Angela Jordan recently joined the Catholic Order of Foresters (COF) as Chief Underwriter. Prior to COF, Angela built an extensive background in underwriting with stints at CNO financial for 11 years, Erie Family Life for five years and Mass Mutual for three years.
Throughout her career, Angela has used several (APS) summary services. While she has found these services to be helpful in saving staff time, she has also seen their limitations. “All of the APS summary solutions on the market use humans to make decisions, and humans just naturally make mistakes – even more so in recent years as EMR platforms have increased both the page count and the complexity.”
The other challenge she observed is that human summary services often missed key details underwriters need to evaluate risks. “The summary services don’t have access to our underwriting manuals to see all the data points underwriters need. So, too often we end up paying the summary service, and we’re paying the underwriter to re-review the entire record to find missing information or because they don’t trust the summary.”
Angela has found the underwriters at COF to be pretty similar to the other carriers she’s worked for i.e., they have a strong focus on quality and take a lot of pride in making accurate decisions. So, when she first took on her new role, she wasn’t surprised to hear concerns about their current APS summary service.
DigitalOwl’s Digital Underwriting Abstract (DUA) uses powerful AI technology to deliver a 360° view of an applicant’s entire medical record, significantly reducing the time it takes to gather and interpret important medical data in order to make an accurate underwriting decision.
Angela learned about DigitalOwl when she saw one of her former underwriting co-workers had moved there to focus on product training and design. She reviewed the DigitalOwl website and was impressed by the company's digital underwriting abstract (DUA) product. After seeing a demo of the product, she decided to move forward with a Proof of Concept. For the POC, Angela specifically sent files that had previously been summarized by other APS services so she could do a side-by-side comparison. She was pleasantly surprised to find that DigitalOwl's abstracts were much more thorough and accurate.
“The first case I looked at really stood out. Our prior company had missed a history of DCIS (Ductal Carcinoma in Situ) found via a biopsy, which would have changed the rating by two tables. Not only would we have underpriced the risk, but we also would have set up an insufficient reserve–and that’s a big deal.” DigitalOwl’s Abstract identified the history of breast cancer in the Impairment Rundown and provided a summary of all diagnostic tests completed regardless of whether they’re normal or abnormal.
Adoption & Efficiency
Angela says the training and adoption process for her underwriters has gone pretty smoothly despite some of the underwriters being nervous about making a change. “The underwriters appreciate that the DUA helps them find the information they need and ignore the noise. We still have some refinement in our best practices, but so far, it’s been a success.” Angela is looking forward to the new version coming out in January, especially with the enhanced impairment rundown tied to the RGA underwriting manual.
Angela also noted that her cost has decreased, which was a nice bonus. “Our primary driver was quality, but it was a nice bonus to have the cost decrease. I’m now sending ALL cases to DigitalOwl to summarize. Previously, we were only sending cases over 60 pages. And we’re sending the entire file, which means any of our current lab tests or RX results are merged with the APS information into the DUA”. COF is also using DigitalOwl for contestable claim reviews.
Based on her experience with DigitalOwl, Angela offered the following advice:
set clear expectations with your team
make sure you have key champions to help train and answer questions
make sure your team gets hands on experience early on; the more they use the DUA, the more comfortable they will be with this new tool
encourage the team to trust the Case Overview and Impairment Rundown; DigitalOwl provides multiple solutions to find key information, but they don’t need to review every page
And from DigitalOwl’s perspective, working with someone like Angela is a big plus. She had clear goals and a good understanding of technology and how she could utilize the Digital Underwriting Abstract to enhance her business. This created the opportunity to hit the ground running and provide immediate value to Angela and her team at COF.
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