Following our articles with the Premium & Lives results and Business Performance results, here is an overview of the Underwriting results from the Gen Re Medicare Supplement Market Survey. The survey looked at insurer’s 2025 results, with 46 questionnaires completed, representing 96 companies with Med Supp business.

Percentage of Applications Processed Through Underwriting

On average, 34% of all Med Supp applications received in 2025 went through the underwriting process, although responses varied considerably across companies, ranging from 6% to 76%. The majority of companies (16 or 84%) reported underwriting less than half of their applications, whereas three companies (16%) indicated that more than 50% of their apps underwent underwriting.

Outcomes of Underwritten Applications

In 2025, 77% of underwritten applications were approved. Of those approved applications, 74% were ultimately placed, while 3% were approved but not taken.

On average, 19% of underwritten applications were declined, although outcomes varied across companies with one company reporting a decline rate of 61% for its underwritten applications.

Utilizing Automated Underwriting Systems

Adoption of automated underwriting (AU) systems remains moderate, with 43% of responding companies (9 of 21) currently using the technology. Among companies that do not currently use AU, three (14%) indicated plans to implement the technology within the next 24 months.

Among current users, reliance on AU systems is extensive, with an average of 98% of underwritten applications processed through these platforms in 2025. Five companies reported fully automating the underwriting workflow, directing 100% of underwritten applications to their AU systems.

On average, 48% of applications processed through an AU system were approved, 37% were referred to an underwriter for further review, and the remaining 15% were declined. Results varied considerably across companies. One company reported an approval rate of 91%, while another indicated that 97% of applications processed through its AU system were referred to underwriting.

Utilizing Voice Signature Technology for Electronic Apps

Adoption of voice signature technology remains limited, with 29% of the companies currently using it to authenticate electronically submitted applications. Among non-users, only one company (5%) expects to implement the technology within the next 24 months.

One company utilizes an internal voice signature process, while a few others mentioned using Lumen Technologies with Genesys and Waterfield Tech.

Verification of Medicare Enrollment Information

Verification approaches vary considerably between open enrollment and GI applications. For open enrollment applications, 74% of companies rely exclusively on agents to verify applicant information, while fewer do so for GI applications (31%). Securing supporting documentation is the predominant verification method for GI applications, used by 69% of the companies compared with just 11% for open enrollment applications. Fewer companies verify information through Medicare card copies or online portals. Other approaches cited include obtaining Medicare confirmation letters and requiring applicants to complete verification forms.

Agent Access to Underwriters and Assessing Applicant Insurability

More than 50% of companies permit agents to consult with underwriters prior to application submission to evaluate an applicant’s insurability.

Pre-screening practices involve reviewing current underwriting guidelines, declinable conditions, medications used, and eligibility criteria. Companies may also leverage risk assessment tools and prior claims experience to inform underwriting decisions.

The survey results indicate that Underwriting remains an important component for Medicare Supplement carriers, especially as State Guarantee Issue rules broaden. On average, underwritten applications account for approximately one-third of total applications, with nearly three-quarters of underwritten applicants ultimately approved.

Reach out if you’d like more info, including if you want to see the survey’s participating companies.

Stay tuned for upcoming articles with highlights from the survey’s Claims and Distribution Results sections.

Read the other articles released in this series.