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How Aggregated Clinical Data Impacts the Life Insurance Industry

Health Gorilla's Guide to Healthcare Interoperability Resources (FHIR)

Earlier this year, Health Gorilla, the leading aggregator of health data in the United States and Latin America, announced our entrance into the life insurance space. Before our announcement, we went through rigorous security certifications from government agencies and leading healthcare organizations. We are now SOC-2 Type 2 compliant, independently audited on a routine basis, and pursuing HITRUST certification. 

With the life insurance industry leveraging digital tools, deploying automated underwriting, and working to increase operational efficiencies, it's critical that they have access to an aggregated and actionable view of their applicant's complete medical history.

This is where Health Gorilla comes into play. Our platform securely provides insurance underwriters, reinsurers, and risk assessors with HIPAA-compliant, permission-based access to aggregated and normalized health data through our FHIR-based clinical APIs. Access to this data allows insurers to expedite and scale how they retrieve and analyze their customers' medical records, enhancing their ability to create more informed risk assessments and streamline their workflows.

While our entrance to the space was a very exciting step for our team and the industry at large, there are many questions about how clinical data is powering the life insurance industry. Below we provide an overview of clinical data, discuss how insurance companies use it, go over the benefits that it can have for applicants, and describe how our insurance solutions support the space.

Clinical Data in Life Insurance

According to the University of Washington's Health Science Library, clinical data comprises electronic health records, administrative data, claims data, patient and disease registries, health surveys, and clinical trials data. Insurers recognize the value of each structured data type in their enterprise, whether it is for underwriting, data science, actuarial pricing, policy administration or maximizing the lifetime value of each policyholder.

How Life Insurance Companies Use Clinical Data

Clinical data on its own is often challenging to understand, redundant or incomplete, and can be limited in utility in its raw form. But, when insurance organizations have access to aggregated and normalized data, there are a variety of ways they can use it to improve their processes and the consumers' journey. When leveraging Health Gorilla's data retrieval and enrichment services, life insurers can expect the following benefits:

  • Streamlined Underwriting: Access to normalized and deduplicated clinical data allows insurers to decrease time spent reviewing applications, medical history, and convoluted electronic health records (EHRs), which can speed policy issuance. 
  • More Informed Risk Assessments: A complete view of an applicant's medical history allows insurers to create more comprehensive and granular risk assessments for their applicants, enabling them to improve underwriting risk classification.
  • Improved insurer experience: Effective use of clinical data provides maximum protective value, decreases cycle time, and increases policy persistence for the best classes of risk. In short, producer and carrier performance metrics improve measurably. 
  • Develop improved risk modeling: Accessing clinical information in the form of structured data (not simply summaries, text, or images) give insurers the ability to retain the clinical data that serves as the basis for the underwriting decision, then perform analysis and experience studies in a richer manner than is possible today.

How Clinical Data Sharing Benefits Applicants

Applicants can also expect various benefits when insurers have access to their complete medical records. While they may worry about their clinical data being accessed by an insurer, it is important to remember that each applicant must provide consent and validate their identity before any information is exchanged. This ensures the applicants' information is secure and confidential and that complete and accurate information is retrieved before being integrated into various workflows. Below are a few ways applicants benefit from insurers having access to their clinical data. 

  • Enhanced experience: Expediting the time to gather digital health data reduces the stress and time typically attached to purchasing life insurance and is a great way to amplify an applicant's overall experience. Insurance policies going into effect faster allows applicants to financially protect their families sooner. 
  • Fewer exams: Insurers having access to robust digital health data may allow applicants to leverage their existing lab and medical records instead of providing a blood sample, enabling them to enjoy a quick and smooth application process.
  • Increased Engagement: Insurers having additional clinical data can form the basis of more direct and consistent communication with applicants, increasing ongoing engagement between the two parties.

Health Gorilla's Life Insurance Solutions 

The Health Gorilla platform allows insurers to accelerate and scale how medical records are retrieved and analyzed, allowing them to create more informed risk assessments, streamline their underwriting workflow, and enhance the policyholder's experience. We also offer a comprehensive master patient index and record locator services that match healthcare data to the appropriate applicant, which improves operational efficiency, policy retention, and customer satisfaction. 

  • Release of Information: Health Gorilla securely provides life insurance underwriters with permission-based access to medical data through its FHIR-based clinical APIs from thousands of care sites. Access to this data is second to none for retrieving available medical records for an applicant, improving their underwriting, risk assessment, customer engagement, and claims tracking.
  • Integrated Virtual Health Risk Assessment Services: Our telehealth services integrate with most underwriting and claims workflows and allow applicants to easily schedule an appointment with one of our board-certified physicians. A telehealth visit ensures that insurers have a complete and updated view of their applicants' health, improves client engagement with a one-on-one connection with a clinician, and provides insurers with access to the most comprehensive, normalized, and consolidated clinical data available in the U.S.
  • De-identified Data: This service allows insurers to build models from our set of available sources on a de-identified basis for building predictive models of risk, retention, upsell, and other customer outcomes. It can also be used to create population and longitudinal models, which are informed over time, enabling insurers to factor health outcomes for specific demographics and population samples into new product development, pricing, and other disciplines.

Still Have Questions about Health Gorilla's Life Insurance Solutions?

If you're considering expanding the data available to your underwriters, actuaries, claims professionals, and data scientists, the Health Gorilla team is here to help. We will work with you to configure the connection between our library of APIs and your application based on your organization's unique needs and workflows and provide access to the Health Gorilla API development sandbox. Our team of experts is available to answer any questions throughout your journey. If you have any additional questions or are interested in exploring a partnership with Health Gorilla, please contact us.