Parts 1 and 2 of this series established that access to electronic health record (EHR) data is now viable at scale, and that FHIR structured records deliver step function changes in completeness and flexibility over legacy EHR outputs (CDA/CCD). This installment makes the business case for using EHR data in the underwriting process.
In three consecutive articles published in On The Risk throughout 2025, Munich Re Life documented the effectiveness of EHR data in more than 800 underwriting cases across multiple carriers and every major evidence scenario. It’s the most comprehensive independent validation to date—and the findings are clear: EHR data reduces underwriting time and cost.
The Evidence Bill Is Higher Than It Needs to Be
The Attending Physician’s Statement (APS) has been the industry’s default evidence tool for decades, and its cost has become an assumed expense in underwriting. For every new policy, APS costs can range from $75 for a single record to hundreds of dollars if multiple records are needed. Compare that to the average $55 EHR record retrieval cost that Munich Re found in their study. EHR data can be accessed for 50 to 75 percent less than traditional APS and traditional record retrieval fees, a per-record savings of anywhere from $20 to over $100 per record.
Leveraging EHR data during triage to simplify evidence gathering makes the math even more compelling. Munich Re found that in an EHR-first approach, 73% of APS-eligible cases were fully decided on EHR data alone with no APS required. The APS was only needed for the 27% of cases where EHR data was insufficient. Munich Re’s direct cost comparison showed the EHR-for-Triage approach broke even immediately. And that is at minimum. A carrier processing 50,000 APS-eligible cases annually and triaging the majority with EHR data is looking at millions in annual evidence savings — without changing underwriting standards.
Cycle Time Is a Revenue Number
Cycle time is used to measure organizational performance in underwriting decisions, and it has a direct impact as a revenue number. While most APSs frequently take several weeks, Munich Re’s research shows that 50% of electronic health records are delivered within one hour and 90% within 48 hours. That gap is the window in which applicants reconsider, agents lose momentum, and policy applications are abandoned. That’s lost revenue.
Munich Re puts it plainly in their December 2025 article: Delayed cases “represent lost hard dollars in terms of evidence costs, distribution agents’ sunk time, and lost future revenue and profit from policies not issued.” EHR data shortens the evidence window from weeks to minutes, keeping applicants engaged when their intent is highest — and the placement lift that follows is worth multiples of the direct evidence cost savings.
Risk Quality Doesn’t Suffer — In Most Cases It Improves
So what about evidence quality? The persistent objection to moving away from the APS that we hear is risk quality. The Munich Re research addresses this across every scenario tested. In accelerated underwriting programs, EHR data produced a 35% mortality improvement — catching undisclosed conditions, BMI changes, and tobacco use that would have created slippage. Mortality savings averaged $971 per policy against a $55 EHR retrieval cost, a net benefit of $916 per policy. When they measured EHR data vs. standard lab panel results, EHR data delivered an 8% mortality improvement over labs and exams at lower cost and with less applicant friction.
The head-to-head APS replacement scenario tells an interesting story. When underwriters used EHR data alone, they occasionally reached a different and less accurate risk decision than they would have with an APS. But here’s the context: in 87% of cases, the EHR and the APS led to the exact same underwriting decision. The APS added nothing. Ordering an APS by default means paying a significant cost premium on the vast majority of applications where it changes nothing, just to catch the minority where it does have an effect. A disciplined triage approach — order the APS when the EHR data is thin or the risk profile warrants it — captures the protection without the waste.
The Implications for Underwriting Economics Are Hard to Ignore
Direct evidence savings of 50 to 75 percent per record. Mortality protection that pays for itself many times over. Cycle times that recover placement revenue the APS workflow structurally forfeits. Munich Re’s 800-plus-case study across multiple carriers provides the objective, independent proof the industry needed.
Greenlight delivers health record data via FHIR – a more robust and complete format than the legacy formats used in the Munich Re studies. The real-world results should be even better.
The question is no longer whether electronic health record data is ready. It is how quickly your organization builds the workflows to take advantage of it. Carriers that build EHR-first triage workflows can reduce cost, improve risk selection, and recover revenue currently lost to slow, document-based processes.
Ready to see what this looks like on your book? Contact us to find out how Greenlight can deliver this ROI for your organization.
This is Part 3 of a three-part series. Read Part 1: “Three Changes Have Finally Made EHR Evidence Underwriter-Grade” and Part 2: “From Documents to Data — The Shift Every Life Underwriter Needs to Understand.” | Munich Re data referenced from On The Risk Vol. 41 n.1 (March 2025), n.3 (September 2025), and n.4 (December 2025). www.ontherisk.com . Referenced with the permission of On The Risk.
