The AURA Rules Engine contains five comprehensive rule sets. Insurers can use some or all of these sets to automate their underwriting.
Multiple Products
AURA handles stand-alone products as well as riders, and can underwrite multiple products during one underwriting session. There is no need to submit a separate application for each product. AURA generates independent decisions per product for each insured.
Disclosure Rule Set
The Applicant Response or Disclosure Rule Set is used to capture detailed medical information from applicants using electronic applications or tele-interviews. The Rule Set uses a reflexive question approach that contains between 8,000 and 10,000 risk factors, grouped into categories including:
- Diseases
- Injuries
- Surgeries
- Travel
- Medications
- Treatments
- Occupations
- Sports and Avocations
- Lifestyle
To streamline question design and to ensure consistency of decisions AURA provides pre-built questionnaires for more than 300 different common disclosures. Impairments such as diabetes and asthma, and questionnaires for foreign travel and alcohol use, allow insurers to quickly build reflexive questions.
Decisions and AURA Rules
AURA allows insurers to make their decisions with as much refined detail as possible. The flexibility of the Rule Sets’ design allows insurers to automate underwriting decision-making processes using their own existing guidelines.
AURA can make decisions in the following categories:
- Approved, with no disclosure(s)
- Approved, with irrelevant disclosure(s)
- Approved with ratings
- Postponed for a period of time
- Declined due to disclosure
- Applications pending further underwriting requirements
- Referred to an underwriter for a manual decision
- Any of the above, with exclusions and ratings identified
AURA also handles accumulated debits, credits, flat extras, percent extras, per mille and durations, all customized to your company’s underwriting guidelines.
Limits/Tables
AURA checks different tables as part of its automated decision-making process. It contains tables such as age/coverage, body-mass index (BMI) and cholesterol, and allows insurers also to configure their own tables for use in the rules.
Medical Information Bureau (MIB) Rule Set
RGA’s MIB Rule Set comes complete with decision recommendations for every possible code. The Rule Set screens assigns values to the MIB codes in categories from benign to adverse, which are then used to make decision recommendations.
MVR Rule Set
Connected to every U.S. state’s Motor Vehicle Department database. AURA’s MVR Rule Set puts every vehicular violation into categories and assigns decisions to the violations. Decision recommendations are ready to go.
Laboratory Rule Set
AURA’s prebuilt connections to medical information providers ExamOne and CRL, giving AURA the capability to order and accept electronic lab data on behalf of insurers. The Laboratory Rule Set applies complex decisions to the data, using all variables from the labs including values, reference ranges and reflex tests.
Rx Rule Set
In 2009, RGA conducted a study where drug histories of 1.1 million insurance applicants were examined, with the specific goal of identifying clear protective value data. RGA subsequently used that data to provide a base methodology for underwriting an applicant’s prescription drug history. More than 20,000 rules were created, covering 4,000+ commonly prescribed medications with a simple (1 through 10) severity scoring approach.
RGA hosts and maintains the pharmaceutical data Rule Set, and updates it every quarter. All decisions are pre-built into the rule set.
The benefits of using an Rx Rule Set include:
- Improved application speed through routing features
- Increased underwriting decision consistency
- Improved overall mortality experience
- Provides additional risk protection
- Uncovers doctors not mentioned in disclosures
- Verifies that refills have been followed as directed
- Reduces dependence on APS information
Life insurers can now take full advantage of RGA’s Rx scoring capability with:
- Expert results analysis
- Ongoing Rx rules creation and updating
- Fine-tuning to meet your company’s risk needs
- Ongoing actuarial and reinsurance support
- Careful auditing and management of results
- AURA’s rules engine for automated decisions
Click here for more information about the AURA Suite.