Real-life examples
Holistic view of health vs. source-by-source rules Data: Inhalers and controller medications + ICD codes for asthma. We recognize this as moderate-to-severe asthma—not just a one-off script.
Smart conflict resolution vs. blind assumptions Data: Cancer drug but no cancer diagnosis. Some cancer drugs are also used in IVF. We flag this ambiguity and directly ask the
Human review where it counts Data: MIB report
If MIB conflicts with our other data, we don’t force a decision—we escalate
applicant for clarification.
to a human underwriter.
ethos.com
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