Ask people who have bought a large life insurance policy what it took. Many will tell you the same story. Someone comes to the house. They take your blood pressure, draw blood and hand you a cup. Then you wait.

The industry calls it a paramedical exam. The visit usually takes less than half an hour. Some applicants also need an EKG or a treadmill test. The waiting takes longer. It usually takes at least a few weeks to find out whether you’re offered coverage.

Why it still exists

Life insurance is a promise to pay a large sum when you die. To price that promise, the insurer needs to know how likely you are to die early. Blood and urine tell them things you might not: cholesterol, blood sugar, signs of kidney or liver trouble, nicotine.

There’s also the honesty problem. People forget things on forms. Some shade the truth. A lab result doesn’t forget.

So the exam isn’t there to annoy you. It’s there because for decades it was the best tool the industry had.

What changed

More than a decade ago, insurers started skipping the exam for some applicants. They call it accelerated underwriting. The first programs launched in 2012.

Instead of blood and urine, the insurer checks data it can pull quickly. Prescription history, driving records, past insurance applications and, more and more, medical claims and electronic health records. For a healthy applicant buying a modest policy, that can mean a decision in days instead of weeks.

That’s real progress. And insurers keep raising how much coverage they’ll approve this way.

What it still can’t do

Accelerated underwriting has limits, and the limits tell you a lot. The exam is waived only for applicants who look like good risks on paper. Programs cap the coverage they’ll approve without one, and their age limits have barely moved. If you’re older, want a bigger policy or have a record that raises a question, the nurse still comes.

Data also has a blind spot. Prescription history and claims tell an insurer what has already happened to you. They don’t tell it how fast your body is aging right now. A clean record and a fast biological clock can belong to the same person.

The cost of the needle

Every step between a person and a policy is a reason to put it off. And plenty of people are putting it off.

In 2024, 42 percent of American adults, about 102 million people, said they needed more life insurance than they had. Seventy-two percent overestimated what a basic term policy costs. Add a stranger, a needle and weeks of waiting, and it’s no surprise many never get around to it.

Where it goes next

My view hasn’t changed since 2016. Insurers are built for stability, and that’s mostly a good thing. You want the company holding your family’s money to be careful. But a test designed for another era shouldn’t be the price of protecting the people you love.

The answer isn’t to know less about applicants. It’s to measure what matters, in a way people will do. Your epigenetic clock reads exactly that. And saliva can carry it, as long as the clock is built for saliva.

That’s the needle I’d like to retire.

Sources

Jon Sabes is a named inventor on U.S. Patent No. 11,817,214 and managing member of LongevityFP Technologies, LLC, which holds an exclusive license to FOXO Technologies’ epigenetics technology.