Transforming clinical lab data into digital underwriting insight
This case study highlights the value of incorporating third‑party clinical laboratory data to support faster decisions and meaningful automation in life insurance underwriting.
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Background
As life insurance underwriting continues to shift toward automation and instant decision-making, access to high-quality medical data and intelligent rule design has become essential.
Through a strategic partnership with ExamOne, Hannover Life Reassurance Company of America has embedded real-time clinical laboratory data into hr | ReFlex Select. By combining underwriting expertise, medical insight, and digital solution design, Hannover Re enables insurers to scale data-driven underwriting, supporting faster decision-making and contributing to disciplined mortality outcomes.
Description of solution
At the core of hr | ReFlex Select is a digitally enabled rules engine that brings underwriting logic directly into the evaluation of LabPiQture clinical laboratory data, replacing what has traditionally been a manual and time-intensive review process. Rule logic ranges from straightforward determinations to advanced hierarchical decision frameworks, each rigorously designed and tested to mirror how an experienced underwriter interprets complex lab patterns. This approach supports underwriting decisions that remain clinically relevant and risk-appropriate while enabling meaningful automation.
Hierarchy rules play a critical role by determining which lab result takes precedence when multiple related tests are present. As an example, using glucose metabolism for applicants may present overlapping measures such as A1c, serum glucose, or pregnancy-related testing, which can otherwise create conflicting or redundant signals. The hierarchy dynamically adapts to clinical context, prioritizing A1c in most cases while shifting to other indicators when factors such as hypoglycemia, pregnancy, data recency, or test reliability warrant it. This helps prevent over-debiting and supports underwriting outcomes that reflect a current and clinically appropriate view of risk.
"Innovation in underwriting is not about adding more tools. It is about making better decisions, faster, and with greater confidence. This work reflects how we are evolving our approach to risk by combining strong underwriting discipline with smarter use of data and automation."
Implementation and process considerations
All rules align with Hannover Re’s hr | Ascent underwriting manual and are supported by trusted, evidence-based medical sources such as UpToDate and Mayo Clinic. Rule development reflects close collaboration across underwriting, medical, analytics, and the hr | ReFlex team, with medical expertise at the centre of every decision.
Custom calibration provides insurers with a clear mechanism to adopt advanced digital underwriting while maintaining control over products, underwriting classes, and risk philosophy. Through calibration, rules can be precisely tailored across age and gender, lab reference ranges, and durational thresholds. The result is a customized rule set that reflects each insurer’s underwriting approach, supported by a clear calibration deliverable that documents rule configuration and underwriting class alignment.
Expected benefits
As insurers expand their use of electronic health data and digital decisioning, the demand for underwriting solutions that scale efficiently and streamline operations continues to accelerate.
hr | ReFlex Select for LabPiQture enables insurers to operationalize clinical lab data within automated workflows, helps to reduce manual review, supports consistency, and contributes to disciplined mortality outcomes. The solution exemplifies Hannover Re’s innovation-led approach to embedding clinical intelligence into production-ready underwriting platforms.
How Hannover Re can support you
Building on established success in the United States, Hannover Re is well-positioned to support insurers globally as they integrate medical laboratory data into the next generation of automated underwriting. Contact your local Hannover Re representative to explore how electronic health data can be transformed into actionable underwriting insight.
Disclaimer:
The information presented in this case study, as well as in any other descriptions of projects or cooperations, is for general informational purposes only and does not constitute legal advice, regulatory guidance, medical advice, or any form of professional advisory service. To avoid any wording that could be interpreted as implying medical effectiveness, this document must not be understood as containing, asserting, or suggesting any medical efficacy claims. Nothing in this document shall be construed as a legally binding offer to enter into any contract or agreement of any kind. All results, performance indicators, and outcome descriptions reflect the specific conditions and parameters of the referenced project(s) or product launch(es). They are not guarantees, promises, or assurances of comparable or future performance in any other context. No warranty is given – whether express or implied – particularly that comparable or similar results can or will be achieved elsewhere. Any potential success of comparable initiatives critically depends on the lawful and compliant ability to contact policyholders, including the validity of any required consent under the applicable legal framework. All third‑party entities mentioned in this document, including insurtech companies, are independent businesses and operate separately and autonomously from Hannover Re. Their services, solutions, or technologies are neither endorsed nor guaranteed by Hannover Re and are subject to their own terms and conditions, unless explicitly stated otherwise. References to third‑party trademarks or brands are made solely for descriptive purposes and remain the property of their respective owners. No affiliation, sponsorship, approval, or endorsement by those owners is implied. Statements in this document regarding benefits, compliance requirements, risks, risk assessments, or business cases are based on our subjective experience, judgment, or interpretation. They do not replace - and must not be relied upon as a substitute for - independent assessment, verification, or due‑diligence activities by customers or other stakeholders. In particular, all aspects relating to data protection requirements (including but not limited to GDPR considerations) and AI‑related regulatory obligations must be independently assessed, verified, and evaluated by interested parties in light of their own legal and operational frameworks. The use of the terms such as “partner” or “partnered” without further qualification solely indicates that we cooperated on specific activities or exchanges with third parties; it does not imply a legal partnership, joint venture, affiliation, or any form of shared corporate structure. Each party acts independently and on its own behalf. Hannover Re and/or affiliated companies of the Hannover Re Group assume no liability for the accuracy, completeness, or future applicability of the information provided in this document.
