Breaking News: DigitalOwl Moves Beyond Summaries, Delivering Actionable Insights from Medical Records Learn More

Strategies for Effective Post-Issue Monitoring

Published On
July 28, 2023
Share this post
https://digitalowl.com/strategies-for-effective-post-issue-monitoring

Post-issue audits are a popular way to monitor mortality for underwriters. Discover how DigitalOwl is revolutionizing the underwriting and audits process with innovative AI-powered solutions.

Post-issue audits (PIAs) are a popular way to monitor mortality, but they can be time-consuming for underwriters to complete keeping them from focusing on other critical tasks. With advancements in AI technology, you can reduce this effort by 70-80%

If you are just getting started with post-issue auditing or simply want to make your existing post-issues more effective, look no further than DigitalOwl’s AI-powered solution that helps empower the underwriter.

Here at DigitalOwl, I recently had the pleasure of hosting an insightful webinar along with Jennifer Richards, titled A Better Way to PIA: Strategies for Effective Post-Issue Audit, which focused on the challenges faced by chief underwriters and introduced innovative solutions for conducting effective post-issue audits. In this blog post, I will cover the key points discussed in our webinar and highlight the advantages of utilizing AI in your post-issue monitoring.

Safeguarding Mortality Rates

The job of a chief underwriter is demanding! While your primary responsibility is keeping an eye on mortality, if it is the only thing you are focused on, you probably aren’t going to be successful.

Juggling multiple responsibilities, chief underwriters strive to strike a delicate balance between keeping the agents happy and driving sales, all while safeguarding mortality rates and ensuring company profitability.

Forensic Underwriting

One of the prominent topics we discussed was Forensic Underwriting, which involves evaluating policies after they have been issued. “You’re digging deeper into a mortality or morbidity concern,” explains Jennifer Richards. “This could be an agent you have a concern with or maybe a particular market you need to research further, but most commonly today, we’ve seen an increase in the need for Forensic Underwriting because of major underwriting changes like accelerated underwriting, simplified issue or new markets such as Direct to Consumer (DTC).”  

Random Holdouts and Monitoring Mortality Slippage

In order to explain Post-Issue Audits, we touched on the subject of Random Holdouts. To monitor mortality slippage in accelerated underwriting or simplified issue programs, Random Holdouts are employed. Random Holdouts entail selecting a random sample of customers who would have qualified for the Accelerated Underwriting program and requiring them to undergo additional blood profile tests. While Random Holdouts provide a useful monitoring mechanism, they can be met with some resistance from field agents and consumers due to the additional blood profile requirements.

An Alternative Monitoring Strategy

Another approach gaining popularity is using various data sources to evaluate mortality slippage after policy issues. With a Post-Issue Audit, carriers obtain data, including physician statements and EMRs, to examine if there is any misrepresentation of information from the initial application. “Another tool that’s become more common, and for lots of good reasons, is doing Post-Issue Audits of some kind,” Jennifer Richards instructed. “Post-Issue Audits can be done behind the scenes, thus there is minimal impact on clients and agents.”

Key Trends and Changes

In the webinar, we highlighted some key trends and changes in the industry. There is a push to increase the percentage of Accelerated Underwriting or Simplified Issue Program offers to customers. However, on the backend, there is also a growing reliance on Post-Issue APS to monitor mortality slippage effectively.

Alongside the push to increase Accelerated Underwriting and Simplified Issue Program offers, we also addressed the importance of balancing automation with meticulous post-issue monitoring. As the industry embraces more streamlined underwriting processes, it becomes crucial to incorporate comprehensive Post-Issue Audits to ensure accuracy and compliance.

Streamlining Underwriting and Audits with AI

In the world of underwriting, advancements in technology have paved the way for innovative solutions that streamline and optimize the process. One such groundbreaking solution is artificial intelligence (AI). AI brings a new level of efficiency and accuracy to underwriting by leveraging algorithms and machine learning to analyze vast amounts of data quickly and extract valuable insights. With AI, underwriters can automate manual tasks, improve risk assessment, and make data-driven decisions with greater speed and precision.

DigitalOwl's Post-Issue Audit product was showcased as a game-changer for claims triage in the webinar. This product leverages artificial intelligence to extract crucial data from medical records, and then use that data to identify common misrepresentations such as tobacco use, Body Mass Index, and significant medical conditions. With the PIA report from DigitalOwl, underwriting auditors can use simple rules to identify cases that are squeaky clean from those with red flags for misrepresentation. And then with our comprehensive medical records summary, the auditor can quickly research each potential issue in the original medical record to determine if further action is warranted.

One of the key advantages of DigitalOwl's tool is the significant time and effort saved audits. Hallie Hodgins, the Director of Quality Assurance for Life Underwriting at Equitable, had this to say about the audit tool; “I really like the spreadsheet feature, especially for post-issue auditing. The summary and navigation are also impressive. It was very easy to use and intuitive. You can clearly tell that it was developed by someone with underwriting experience and who has been in production before. The platform is well-organized and aligns perfectly with the way our underwriters conduct their reviews."  With the ability to streamline Post-Issue Audits and review medical records efficiently, underwriters can handle a higher volume of cases without compromising accuracy.

Conclusion

DigitalOwl's AI provides a secure portal that enables easy uploading of documents and downloading of reports. Additionally, our AI tool helps speed up the Post-Issue Audit process, allowing for seamless document uploads and facilitating underwriting audits.

With the ability to streamline underwriting processes, extract data efficiently, and save time, DigitalOwl's tool presents a promising advancement in the field of underwriting. By embracing innovative technology, underwriters can strike a balance between driving sales and ensuring profitable, well-guarded mortality rates.

Learn more about post-issue audits and see what DigitalOwl can do for you in our recent webinar, A Better Way to PIA: Strategies for Effective Post-Issue Audits, now available on-demand. If you have questions or want to discuss how we can make your post-issue audits more effective, contact us today!

Whitney Barnes
Sales Director, Life Solutions
,
DigitalOwl
About the author

Whitney Barnes has over 20 years of experience in the Life Insurance industry. She serves as Sales Director and helps life insurance carriers and others in the industry enhance and accelerate the medical records review process.