When the claim is contestable
Within the contestability window, every line of the application matters, and whether the application was true rarely lives inside your CMS. Owl reads the medicals, the application and the death certificate, then layers in pre-application Rx history, EHR pulls, beneficiary context and fraud signals.
14 mo
Within contestability window
2 events
Pre-application disclosures missing
I21.4
COD tied to undisclosed condition
The application was 24 months ago. The world remembers everything that happened around it.
One claim: $1.5M Group Life, 14 months in.
Anonymized composite. Decedent R.T., 51, COD acute MI 2025-09-30. Application dated 2024-06-12. Within the policy’s 24-month contestability window.
External data only. None of this lives in your CMS. Owl gathered it from public records, professional networks, registries and the open web, then resolved it to this claimant.
Pulled atorvastatin (40mg) prescribed 2024-01-08, 5 months before the application. The application’s Q14 answered “no” to “heart disease, hypertension, or related.” Material-misrepresentation pattern.
Datavant / state HIE pull confirms I10 hypertension diagnosed 2023-11-02, 7 months before application. Causally related to COD.
Most recent beneficiary designation dated 2025-09-19, naming a cousin. Public records show the designated cousin moved into decedent’s residence 6 weeks before the change. Undue-influence pattern; flagged for legal review.
A civil filing in another county lists the most-recently-named beneficiary in a contested-estate matter against another family member, dated 2024-12-04.
Partially disclosed. The application (2024-06-12) answered “no” to question 14 (heart disease, hypertension, or related). The external EHR shows a hypertension diagnosis (I10) on 2023-11-02 and atorvastatin prescribed 2024-01-08, both predating the application. Cause of death (I21.4, acute MI) is causally related to the undisclosed condition. Under the policy’s 24-month contestability clause and applicable state law, the file is supportable for rescission with refund of premium.
Chain: 2023-04 spouse (original) → 2024-08-19 spouse (re-confirmed at coverage renewal) → 2025-09-19 cousin (11 days pre-DOD). The cousin moved into decedent’s residence 6 weeks before the change of designation. Public records show an active estate-related civil filing involving the cousin. Recommend hold on disbursement pending legal review and beneficiary interpleader if challenged.
What the world says about your Group Life claimants, none of which lives in your CMS.
Internal claim data is half the picture: it tells you what the claimant told you. OwlSignal continuously gathers external data (public records, professional and corporate registries, court dockets, social and open web) and matches it back to the claimant. These are the families that move the needle on Group Life.
The application was a snapshot. Owl pulls the rest of the world from that period (Rx history, MIB, EHR) and tests every answered question against external evidence. None of it is in your CMS today.
Beneficiary changes pre-death require context the file can’t supply. Address moves, cohabitation, marriage / divorce, court-record co-occurrence: sourced externally and matched.
Court filings, criminal records, civil-estate matters, sanctions, adverse media: surfaced for both the decedent and the beneficiaries, because Group Life adjudication often reaches both.
Bankruptcy filings, judgment liens, large recent debt: the financial-distress pattern that, paired with a contestable application, sometimes signals deliberate misrepresentation.
The producer or broker who wrote the application, scored against cross-carrier outcomes, useful when contestability findings cluster around a single source of business.
Numbers from L&H carriers running Owl on Group Life in production.
Built for the regulatory shape of Group Life.
Lives where your Group Life files live.
Claim systems
FINEOS, Guidewire ClaimCenter, DCS, DXC
Document intake
Box, OnBase, Documentum, ImageRight
Pharmacy
Surescripts, ScriptCheck, MIB Rx history
EHR / records
Epic, Cerner, MRO, Verisma, Ciox/Datavant
Public records
USPS NCOA, county property + court, vital records
Identity & SSO
Okta, Azure AD, PingFederate, SAML, SCIM
Bring us a contestable file. We’ll show you what the application missed.
Two-week pilot. Your records, your tenant, your contestability rules. We measure misrep discovery, cycle time, and decision quality against your own ground truth.