Insurtech Vitals Assessment: How to Run a Proof of Concept With Your Book

Running an insurtech vitals assessment proof of concept sounds straightforward until you actually try to get one approved internally. The technology evaluation is the easy part. The hard part is designing a pilot that answers the questions your actuarial team, your chief underwriter, and your reinsurer are all asking — which are three different sets of questions. Most POCs fail not because the technology didn't work, but because nobody agreed upfront on what "working" meant.

"An average of 59% of Individual Life applications qualify for an accelerated underwriting path, including fully automated decisioning." — Gen Re, 2025 U.S. Individual Life Next Gen Underwriting Survey

That stat from Gen Re's survey of 30 life insurance carriers tells you where the market sits. More than half of applications already qualify for accelerated paths at companies that have made the investment. For carriers still evaluating whether contactless vitals technology belongs in their underwriting stack, the question has shifted from "does this work?" to "how do we prove it works against our specific book?"

What an insurtech vitals assessment POC actually involves

A vitals assessment POC tests whether camera-based or sensor-based biometric data can inform underwriting decisions on a subset of your in-force or new-business book. You're running real applicant data (or a retrospective sample) through a new data source and comparing what it tells you against what your existing process already determined.

The goal isn't to replace your entire underwriting workflow overnight. It's to answer a narrow question: does this data source add signal that improves risk selection, and if so, how much?

Most carriers structure POCs in one of two ways:

Retrospective analysis. You take a sample of already-underwritten policies — typically 2,000 to 5,000 — and run the vitals data alongside existing underwriting outcomes. This is faster and cheaper because you don't need live applicants, but it has limits. You're testing against decisions that already happened, so you can't measure how the new data would have changed those decisions in real time.

Prospective pilot. You add the vitals assessment to your live application flow for a specific product line or face amount band, usually over 90 to 180 days. This gives you real behavioral data — completion rates, applicant friction, time-to-decision changes — but takes longer and requires more organizational buy-in.

The Appinventiv 2025 analysis of insurance AI implementations found that proof-of-concept pilots typically run $40,000 to $80,000 for a single use case with limited integrations, while department-level deployments with multiple workflows jump to $150,000 to $350,000. Vitals assessment POCs tend to fall on the lower end if you're running retrospective analysis, and toward the higher end for prospective pilots that require application flow integration.

How to scope the pilot so it actually answers the right questions

The biggest mistake carriers make is scoping the POC too broadly. You don't need to prove that contactless vitals technology works across your entire product portfolio. You need to prove it works for a specific use case where you have a measurable problem.

Scoping dimension	Too broad (will fail)	Right-sized (will get answers)
Product lines	All individual life products	Term life under $500K face amount
Population	All applicants	Ages 25–55, standard and preferred risk classes
Geography	Nationwide	3–5 states with highest application volume
Duration	"Until we have enough data"	120 days with predefined sample size
Success metric	"Better underwriting"	Mortality slippage under 15%, completion rate above 80%
Integration depth	Full API integration with underwriting engine	Parallel data capture, manual comparison

Gen Re's Frank Chechel noted in the 2025 survey results that top accelerated underwriting workflow goals include reducing time to issue (52% of respondents), managing mortality slippage (45%), and increasing sales (41%). Your POC should map to one or two of these goals, not all three. Trying to prove everything at once dilutes the results and makes it harder to get a clear yes-or-no answer at the end.

Picking the right slice of your book

This is where actuarial involvement becomes non-negotiable. The sample you test against determines what conclusions you can draw.

For a retrospective study, you want a sample that's large enough to be statistically meaningful and representative enough to extrapolate from. Munich Re's mortality slippage research has highlighted that accelerated underwriting programs, even after a full decade of existence, still lack the mortality data volumes that traditional underwriting has accumulated. That means your POC needs to be designed with enough statistical power to detect meaningful differences.

In practice, carriers that have run successful vitals assessment POCs tend to pull from their term life book in the $100K to $500K face amount range. This is where the highest volume of applications sits, where paramedical exams add the most friction, and where the financial upside of accelerated decisioning is clearest.

For prospective pilots, you'll want to define inclusion and exclusion criteria with your medical director. Typical inclusion: ages 25 to 55, no known pre-existing conditions flagged in the MIB check, standard to preferred risk classes. Typical exclusion: jumbo face amounts (where you want full underwriting regardless), applicants who trigger prescription drug database flags, and complex medical histories.

The metrics that matter (and the ones that don't)

Not every number you can measure during a POC is worth measuring. Here's what actually matters for the go/no-go decision:

Mortality slippage ratio. This is the one your reinsurer cares about most. Gen Re defines it as the ratio of expected mortality for policies that had exams waived to expected mortality for fully underwritten policies. Their 2025 Next Gen Analytics study, which includes over 14,000 policies and nearly $10 billion in face amount stretching back to 2019, is the industry's best benchmark. If your POC can demonstrate slippage within the range Gen Re reports for the broader industry, that's a strong signal.

Applicant completion rate. What percentage of applicants who start the vitals assessment actually finish it? Below 70% is a problem. Above 85% suggests the technology doesn't add meaningful friction. This number matters more than people think — a technically perfect data source that half your applicants refuse to use isn't useful.

Concordance rate. How often does the vitals assessment agree with the underwriting decision your existing process made? High concordance (above 80%) with the existing process means the new data source is seeing what traditional methods see. Where it disagrees is where it gets interesting — those are the cases you want your medical director to review manually.

Time-to-decision impact. If adding the vitals assessment adds two days to your cycle time, that defeats the purpose. Measure the actual clock time from application start to underwriting decision, with and without the new data source.

Cost per assessment. What does each vitals scan actually cost, fully loaded? Compare against your current per-policy paramedical exam cost. For most carriers, paramedical exams run $150 to $300 per applicant. If the vitals assessment comes in under $20 per scan, the unit economics are obvious.

Metric	Target for go decision	Red flag
Mortality slippage ratio	Below 15% above base	Above 25% above base
Applicant completion rate	Above 80%	Below 65%
Concordance with existing UW	Above 75%	Below 60%
Time-to-decision change	Neutral or faster	Adds more than 48 hours
Cost per assessment	Under $30	Over $100
False positive rate	Below 10%	Above 20%

Getting your reinsurer on board early

This is something carriers learn the hard way. If you run a POC without involving your reinsurer and then show up asking for treaty credit based on the results, you'll get pushback. Reinsurers want to help design the study so they trust the outcome.

Gen Re's 2025 survey found that 42% of companies price accelerated underwriting slippage using many factors, while 38% price it as a single factor. The remaining 21% don't price AU slippage at all in their pricing strategy. Your reinsurer's approach to slippage pricing will shape what your POC needs to demonstrate. Have that conversation before you finalize the pilot design.

Munich Re has published extensively on mortality slippage monitoring best practices and has been clear that the industry is getting closer to credible AUW mortality experience data, but isn't quite there yet. That's actually useful context for your POC — you're contributing to a body of evidence, and framing it that way makes reinsurers more receptive.

The 120-day pilot timeline

Here's a realistic timeline for a prospective vitals assessment POC. Retrospective studies can compress phases 2 and 3, but the setup and analysis phases take about the same time.

Weeks 1–4: Design and stakeholder alignment. Define the scope, success criteria, sample size, and decision framework. Get sign-off from the chief underwriter, chief actuary, medical director, and reinsurer. This is the phase most carriers rush, and it's the phase that matters most.

Weeks 5–8: Technical integration. Stand up the vitals assessment in your application flow (prospective) or build the data pipeline for retrospective analysis. For a POC, this doesn't need to be production-grade integration. Parallel data capture with manual comparison is fine.

Weeks 9–16: Data collection. Run the pilot. Collect vitals data alongside your existing underwriting process. For prospective pilots, you need enough applications to hit your predefined sample size — typically 1,000 to 3,000 completed assessments for statistical relevance.

Weeks 17–20: Analysis and decision. Crunch the numbers against your predefined success criteria. Have the actuarial team validate the mortality slippage analysis. Present findings to the steering committee with a clear recommendation.

What Bestow learned about the pilot approach

Bestow, one of the more visible insurtechs focused on life insurance distribution, has written publicly about their pilot methodology. Their approach emphasizes delivering working software to stakeholders as fast as possible to build confidence before scaling. The idea is that a pilot proves value incrementally — you show something working in week six, not week twenty.

That philosophy applies to vitals assessment POCs too. Don't design a pilot where the first results appear four months in. Structure it so you have interim readouts — applicant completion rates by week two, initial concordance data by week six, preliminary slippage analysis by week twelve. Stakeholders lose interest in black-box experiments. Regular updates keep the project alive organizationally.

Common failure modes and how to avoid them

No predefined success criteria. If you didn't agree on what "success" looks like before the pilot, you'll spend months arguing about interpretation after. Write the decision framework into the pilot charter: if metric X exceeds threshold Y, we proceed to Phase 2.

Sample too small. Running a POC on 200 applications and trying to draw mortality conclusions is statistically meaningless. Talk to your actuary about minimum sample sizes before you start.

No control group. For prospective pilots, you need a concurrent control group that goes through the standard process without the vitals assessment. Without it, you can't attribute any observed differences to the new technology.

Organizational fatigue. Deloitte's research suggests that more than 75% of insurers now partner with at least one insurtech provider. That means your organization has probably been through other pilots recently. Be realistic about how much change capacity your underwriting team has. A POC that overloads already-busy underwriters will get quiet resistance that torpedoes results.

Wrong product line. Don't pilot on your most complex products. Start with something high-volume and relatively straightforward — term life under $500K is the most common starting point for a reason.

Frequently asked questions

How long should a vitals assessment POC run?

Plan for 120 days of active data collection for a prospective pilot. Retrospective studies can produce results in 60 to 90 days since you're working with existing data. Add four weeks on each end for design and analysis.

What does a typical POC cost?

Industry data from Appinventiv puts single-use-case insurance technology POCs at $40,000 to $80,000. Vitals assessment pilots on the simpler end (retrospective, limited integration) can come in under $50,000. Prospective pilots with application flow integration run higher.

Do we need reinsurer approval before starting?

You don't need formal approval, but you need involvement. Share the pilot design with your reinsurer early. They may have specific data requirements or analytical frameworks they want applied to the results. Getting their input upfront means they're more likely to accept the conclusions.

Can we run a POC without IT integration?

Yes, for retrospective studies. You can run vitals data in batch against an existing sample without touching your application flow. For prospective pilots, you need some level of integration, but it can be lightweight — a parallel data capture that doesn't modify the existing underwriting workflow.

Where the industry is heading

The fintech.global 2026 assessment of the insurtech market noted that partnerships between carriers and insurtechs have moved from experimental to embedded in day-to-day operations. Vitals assessment technology is following the same trajectory that electronic health records, prescription drug databases, and motor vehicle reports followed before it — starting as an optional data source, then becoming standard.

Companies like Circadify are developing contactless vitals assessment technology specifically designed for insurance underwriting workflows. For carriers evaluating whether to run a proof of concept, the question increasingly isn't whether this data source belongs in the underwriting stack — it's how quickly you can validate it against your own book and move to production.