Aegon (AEG) and Ethos (LIFE) issue life policies with no medical exam

Between August 3 and August 20, 2026, Aegon (AEG), Ethos Technologies (LIFE) and Reinsurance Group of America (RGA) each described the same change on their earnings calls: life insurance underwriting without a medical exam has become the working method in the US individual life market, with carriers scoring prescription records and medical-claims billing data in place of a paramedical exam and a lab panel.

From a nurse visit to a prescription file

Before an insurer issues a life policy it has to confirm the applicant's health, a step called underwriting. The standard method was to send a nurse to draw blood and run an exam, ship the sample to a laboratory, and wait several weeks. The carrier pays for that, and a set of vendors exists to perform those exams and lab panels for life insurers. That is the step being replaced. Carriers now pull an applicant's prescription records and medical-claims billing data in real time, fill the gaps with a questionnaire that adapts to the previous answer, and decide on the spot. Aegon's CFO said underwriting standards have not been relaxed and that the company is using additional information to price the risk it takes on [1]. Ethos runs the same engine as a platform and says each application is scored against hundreds of thousands of data points [2].

The technique used to be confined to final expense insurance, small whole-life policies of a few thousand to a few tens of thousands of dollars sold to middle-income and older buyers, where underwriting was already light. What moved is the product boundary. In November 2025 Aegon's Transamerica applied it to indexed universal life, a permanent product with a higher face amount and a cash value account, covering $50,000 to $500,000 of face for ages 18 to 70 with no medical exam [3]. How many applications an underwriting department can clear in a day is no longer the ceiling on new business. Volume now depends on how many buyers a distributor can reach, which gives peers a reason to follow.

Cycle time, instant-decision rates and policy counts all moved

Aegon reported that new life sales grew 54% in the first half of 2026, and its CEO put the before-and-after at a couple of weeks of paperwork against under 12 minutes [1]. Ethos reported second-quarter revenue of $190 million, up 113% year over year, with 95% of applications decided instantly [2]. RGA, which reinsures policies written by carriers, said volumes in its strategic underwriting programs are on track to double this year [4]. The three sit at different points in the chain, and each attributed new business to the same process change.

The industry aggregate argues for more caution. LIMRA put second-quarter US individual life new annualized premium at $4.7 billion, up 3%, while policy count rose 8%, with the increase concentrated in final expense. Indexed universal life premium of about $1.1 billion fell 11% over the same period, its first decline since the second quarter of 2023 [5]. Counts growing faster than premium means the policies being added are mostly small ones, so what the industry is showing is a shift in share rather than expansion.

The constraint on new business moves from underwriting to distribution

Once risk selection becomes a capability, whoever owns it holds the entry point to the business. RGA said underwriting has moved from a value-added service to a primary driver of reinsurance value, and that one relationship which began as an underwriting program ended in a much larger in-force transaction [4]. The pressure lands first on the exam and lab orders being replaced, and on channels that have not changed the evidence they collect. Primerica's issued policies fell 12% and issued premium fell 9% in the second quarter, and Globe Life's American Income unit reported net life sales down 2% with average producing agent count down 7%. Both attribute the decline to spending pressure on middle-income households and to agent attrition, and neither mentions underwriting [6][7].

Prudential complicates that split. On August 5 it said individual life application submissions are at record levels and named automated underwriting and faster decision-making among the supports for growth [8]. It also distributes through agents and brokers, so the cleaner dividing line looks like buyer segment and customer acquisition rather than who owns an engine. Two measures are worth tracking: the pace at which Gen Re's figure moves, after its December 2025 survey of 30 US individual life carriers found only about 12% of 2024 applications eligible for a fully automated decision [9], and the gap between policy count growth and premium growth in LIMRA's coming quarters.

Companies exposed to this change

• Quest Diagnostics (DGX): Its ExamOne unit is the largest North American provider of risk assessment services to life insurers, which is the exam and lab work being replaced, so every instant decision is one order not placed. Quest has not addressed this on any 2026 call, so the exposure is inferred from the mechanism rather than disclosed [10].
• CNO Financial (CNO): Colonial Penn is the largest TV-marketed direct-to-consumer final expense brand in the US, selling to the same buyers Aegon reached. CNO's second-quarter life new annualized premium fell 9%, which it attributes to shifting viewer media habits, and it has not disclosed a change in how it underwrites [11].
• SelectQuote (SLQT): Its Life segment sells final expense by telephone, so if underwriting no longer caps issuance, revenue depends more on how many buyers it can reach. The company has said final expense commissions rose more than 8% year over year [12].

Sources

[1] Drillr · Aegon (AEG) · 2026-08-20 · earnings call

To give you an idea, before we launched this, you would take a couple of weeks to get the paperwork done. This is now under 12 minutes.

[2] Drillr · Ethos Technologies (LIFE) · 2026-08-03 · earnings call

[3] PR Newswire · Transamerica launches FFIUL II Express · 2025-11-04 · company press release · https://www.prnewswire.com/news-releases/transamerica-launches-ffiul-ii-express-to-deliver-100-instant-decision-life-insurance-302603284.html

[4] Drillr · Reinsurance Group of America (RGA) · 2026-08-07 · earnings call

[5] InsuranceNewsNet · LIMRA Q2 2026 US individual life insurance sales · 2026-08-11 · industry statistics · https://insurancenewsnet.com/innarticle/limra-individual-life-sales-continue-growth-trend-in-q2-led-by-whole-life-and-vul

[6] Drillr · Primerica (PRI) · 2026-08-06 · earnings call

[7] Drillr · Globe Life (GL) · 2026-07-23 · earnings call

[8] Drillr · Prudential Financial (PRU) · 2026-08-05 · earnings call

[9] Gen Re · Individual Life Next Gen Underwriting Survey · 2025-12-17 · industry survey · https://www.genre.com/us/knowledge/publications/2025/december/surveylhilnextgen25-en

[10] Quest Diagnostics · ExamOne services for life insurers · 2026-08-21 · company materials · https://www.questdiagnostics.com/business-solutions/other-industries/life-insurers

[11] Drillr · CNO Financial (CNO) · 2026-07-31 · earnings call

[12] Drillr · SelectQuote (SLQT) · 2026-05-05 · earnings call

This is only here to surface industry changes and companies that may have been overlooked - it is not a stock recommendation.