Evidence of insurability automation that readies the simple approvals and summarizes the medical cases
Simple EOI approvals stop waiting behind complex medical cases.
See one case, screen by screen ↓Software that takes an EOI form from the moment it arrives — by mail, portal or email — through reading, matching to the election, health screening and an underwriting decision, to the approved amount in enrollment and billing. Evidence of Insurability Automation does the reading, matching, screening and sorting with agents, and the medical underwriter makes every decision.
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When an employee elects supplemental life, spouse life or a disability buy-up above the plan's guaranteed issue amount, or joins late, the carrier needs evidence of insurability. The forms come in by mail, the employee portal and email, and they land in one long queue worked by date. A form with all eleven health answers No sits behind a diabetic case with an incomplete physician statement, and in open-enrollment season the amount above guaranteed issue is not in force for weeks.
The rest of the cost stays hidden. When a form never arrives, is declined or is approved at a lower amount, payroll can keep deducting on the elected amount, and the gap only shows up when a claim is paid on the approved amount. A batch approval without a written reason per form is also hard to defend: an auditor or a reinsurer sees a bulk approval, not underwriting.
Estimated split for one form with nothing to underwrite in open-enrollment season, worked by hand in one queue and with the solution.
Seven agents read, match, screen and sort every form with its reason; the underwriter approves the fast lane in one click and decides the rest.
Monday 12 October 2026 at Larkspur Life & Group, open enrollment for 1 January 2027 coverage. 112 evidence forms have arrived since Friday evening. Here is the morning, screen by screen, in the working solution.
Since Friday 17:00, 38 forms came in on the 06:15 mail room scan, 61 through the employee portal and 13 to the EOI inbox. The form reader, election matcher, health screen and lane sorter have been through all 112. Approve now holds 40, Needs underwriter 47, Needs more information 25.
“Sorted at 07:41 · 6 min 40 s” — fast-lane rules version 7.
Nadia Brooks, 38, Cobalt Ridge Logistics, employee life $300,000 against a $150,000 guaranteed issue. The form came through the portal on Friday at 20:35; the election matched, all 11 answers No, build 5′7″, 166 lb, seven years of prescriptions with nothing flagged, no MIB codes. Rule FL-1: total $300,000 within $500,000, age 38.
“$150K over GI · all 11 answers No · build in table · Rx and MIB clear”
Priya reads the reasons and approves the lane as batch B-1012-01: $7,560,000 of life coverage, $4,410,000 of it above guaranteed issue, plus 5 late-entrant disability elections. The 40 decisions are recorded with their reasons, the approved amounts go to enrollment and billing, and 40 approval letters are drafted.
2 forms drawn for second review by Hal Brennan, due Tue 13 Oct.
Needs underwriter shows every case with the amount, the amount over GI, why it needs her and the suggested decision: 28 health answers Yes, 7 above the fast-lane amount, 5 aged 60 or over, 4 builds outside the table, 3 answers the records did not match. Teresa Vance's physician statement came in on Friday.
Teresa, 47, elected $400,000 of employee life, so $250,000 needs approval. She answered Yes to Q2, blood pressure since 2019 and cholesterol since 2021, which matches the lisinopril 90-day fills with no gaps. Dr. Alan Pruitt's statement, requested 22 Sep and in by fax Fri 9 Oct 16:48, shows 128/82, 132/84 and 126/80.
Manual 4.2 Hypertension: controlled (under 140/90 on the last three readings) on up to two medicines, no heart or kidney findings — approve to $750,000.
The summarizer suggests approve in full at $400,000; the decision is hers. She approves, and the run log closes: form read, election matched, health screen with Yes to Q2 and Q11, the physician statement chased for 17 days, the summary written, and the decision sent to enrollment and billing.
The summarizer suggests; the underwriter decides.
25 forms are waiting on someone and 10 requests are drafted. Marco Delgado left question 9 blank and did not sign page 3, so the authorization cannot be used and the prescription and MIB checks have not run. The request asks for exactly those two things and says his guaranteed coverage stays in force meanwhile.
“If we do not hear from you by 11 December, the request closes and only the guaranteed amount applies.”
Every payroll deduction above guaranteed issue is matched to an approval across the 7 employers. Six do not match: three forms never received, one declined on 12 Jun, one approved lower on 3 Apr and one still pending since 14 Aug. That is $1,240,000 of coverage, $437.00 a month, $2,460.80 deducted so far.
“If Andre Whitfield died today, his beneficiary would be paid $100,000, not the $300,000 he has paid for since February.”
One click sets billing deductions to the approved amounts for all 6 employees, calculates the $2,460.80 in refunds to return through each employer's next payroll, sends notices to 5 employers and 2 brokers, and invites Andre Whitfield, Joyce Ambrose and Felipe Ortega to send their form within 60 days.
Version 7 of the fast-lane rules runs on 2,140 forms the underwriters decided in September: 781 would go to Approve now, and 780 of those were approved in full by a person. The one difference, reviewed by Rebecca, was a margin note about recent weight loss; version 8 is drafted to send margin notes to an underwriter. The report is saved for the medical director's sign-off.
“Version 7 holds. 99.9% agreement with underwriters on the fast lane; no form with a health Yes reached it.”
The same open-enrollment Monday, seen by the four people who carry it — what their week looked like, and what it looks like now.
Seven agents read, match, screen and sort every form with its reason; the underwriter approves the fast lane in one click and decides the rest.
Reads every evidence form from the mail scan, the employee portal and the EOI inbox: applicant, coverage, amount, the 11 answers, height and weight, signatures and the authorization date.
Finds the employee's election and current coverage, the plan's guaranteed issue amount, the amount above it and whether the employee is a late entrant.
Checks the answers against the build table, 7 years of prescription history and the MIB record, and reports agreement or contradiction with the record that shows it.
Applies fast-lane rules version 7 and writes the one-line reason that puts each form in Approve now, Needs underwriter or Needs more information.
For each underwriter case, summarizes the answers, prescriptions, MIB and physician statements, quotes the manual section that applies and suggests a decision.
Drafts the request for what is missing — an answer, a signature, an authorization, a physician statement — and tracks reminders on day 10 and day 24 and close-out on day 60.
Sends approved amounts and effective dates to enrollment and billing, and every day compares payroll deductions with approved amounts, listing each difference with its cause.
Approves and decides; a second underwriter on declines and samples. The agents propose; a named person decides.
The underwriter asks in plain words. Every answer cites its source: the form, the physician statement, the manual, the rules, the batch or the billing file.
Why is Teresa Vance with an underwriter and not in Approve now?
She answered Yes to question 2 — blood pressure since 2019 and cholesterol since 2021 — and any Yes leaves the fast lane. Her physician's statement came in Friday: the last three readings were 128/82, 132/84 and 126/80, which is inside manual 4.2 for $400,000. The suggestion is approve in full; the decision is yours.
What exactly did I approve in today's batch?
Forty forms: 27 employee life under FL-1, 8 spouse life under FL-2 and 5 late-entrant disability under FL-3 — $7,560,000 of life coverage. Each line carries the reason that put it there, for example “$150K over GI · all 11 answers No · build in table · Rx and MIB clear”. Two are drawn for Hal Brennan's second review.
Who is paying premium on coverage that was never approved?
Six employees, on $1,240,000 of coverage — $437.00 a month, $2,460.80 so far. Three never sent a form, one was declined, one was approved lower and one is still pending. Under the policy, the extra amount is not in force until approved, so a claim would pay only the approved amount.
What is still missing for Marco Delgado?
Two things: question 9 is blank and page 3 is not signed or dated. Without the signature the authorization cannot be used, so the prescription and MIB checks have not run. The request is drafted for Owen to send; it closes on 11 December.
13 screens from the working solution, on its sample data. Pick one to see it large.
Guaranteed issue, authority, clocks and sources are settings. Changes are versioned and need the head of group underwriting's approval.
| Setting | Default | Choose from |
|---|---|---|
| Guaranteed issue by plan | From each group policy | Employee and spouse amount per employer, e.g. $150,000 · $30,000 |
| Underwriter authority | $1,000,000 a life | An amount per underwriter; the head of group underwriting has no limit |
| Declines and lower amounts | Always a second underwriter | On · off |
| Fast-lane batch sample | 5% | Share of each batch drawn for second review |
| Reminders | Day 10 and day 24 | Days after a request is sent |
| Close-out | 60 days | Request closes; guaranteed issue only |
| APS follow-up | 10 days | Days before calling the physician's office |
| Authorization valid | 90 days | Days from signature |
Every figure is labelled: a target the solution is built to, an estimate, a typical published result, or a proven one.
“demo” = seen in the working solution, on its sample data · “target” = the design goal, measured in the live solution · “estimated” = our estimate · “typical” = published figures (Gen Re survey of 20 group carriers — 1.8M+ EOI applications a year; LIMRA, U.S. workplace life and disability sales H1 2026 — workplace life +7%). People, employers, brokers and the carrier named on this page are fictional — characters and sample data in the working solution.
Software that takes an EOI form from the moment it arrives — by mail, portal or email — through reading, matching to the election, health screening and an underwriting decision, to the approved amount in enrollment and billing. Evidence of Insurability Automation does the reading, matching, screening and sorting with agents, and the medical underwriter makes every decision.
The lane sorter applies your fast-lane rules. In the working solution, FL-1 covers employee life up to $500,000 total, age 18 to 59, all 11 health answers No, build within the table, no flagged prescription classes in 7 years, no MIB codes and a signed authorization within 90 days. Any form that fails a test goes to an underwriter or to more information, with the reason.
No. The underwriter approves every batch and decides every case. Agents never approve or decline, a record alone never declines anyone, and declines and lower amounts always need a second underwriter.
The health screen compares the answers with 7 years of prescription history, the MIB record and the build table, and only runs under a signed authorization dated within 90 days. If page 3 is not signed, the checks do not run and a request is drafted instead.
Yes. The coverage sync compares payroll deductions with approved amounts every day and lists each difference with its cause — form never received, declined, approved lower or still pending. In the working solution it found 6 employees and $1,240,000 of coverage, and one click sends the corrections to billing and employers.
Yes. Guaranteed issue per plan, underwriter authority, the second-review sample, reminders, close-out, APS follow-up and how long an authorization is valid are all settings. Changes are versioned and need the head of group underwriting's approval.
The Agentic Solution Engine builds and deploys it from your requirements — your EOI form layouts, underwriting manual, guaranteed issue table and a sample of decided forms — and it goes live once every quality gate has passed. We will walk you through it on your own forms first.
Yes. The underwriter reads every reason before approving a batch, decides every medical case from a cited summary, and no request for missing information goes out until the underwriting assistant sends it. Every decision is recorded with the name and time.
Any census layout quote-ready the day the RFP arrives, every change on the record.
1-min demoGroup Premium ReconciliationOnly the real billing differences left for a person to resolve.
1-min demoDisability Claims AdjudicationExaminers decide on a full file, not a half-gathered one.
1-min demoWe'll run Evidence of Insurability Automation on a sample of your own decided forms.