Digital Health Assessments for Final Expense Insurance: A Guide

The digital health assessment final expense insurance question stopped being hypothetical about two years ago. The final expense market is one of the fastest-growing segments of individual life insurance in the United States, with LIMRA reporting that final expense and smaller-face whole life policies drove overall whole life sales growth through the first half of 2025. But the underwriting process for these products still runs on phone interviews, paper applications, and health questionnaires that create real friction for an older applicant population. Digital health assessments collect biometric data without that friction, and carriers are starting to notice.

According to Custom Market Insights, the global final expense insurance market reached a valuation of $7.06 billion in 2025 and is projected to grow at a 4.62% CAGR through 2034, reaching $10.60 billion. Meanwhile, MoneyGeek's 2026 analysis found that average end-of-life costs in the United States hit $88,300, with final-year medical expenses alone averaging $80,000 based on data from Lancet Regional Health – Americas.

Why final expense underwriting is different from standard life

Final expense insurance occupies its own corner of the life insurance market. Face amounts typically range from $5,000 to $50,000, premiums are small, and the target population skews older, generally between ages 50 and 85. Underwriting economics here look nothing like a $500,000 term policy for a healthy 35-year-old.

The Society of Actuaries published a research report on simplified issue underwriting that made an observation worth quoting directly: simplified issue "works well for final expense, due to its nature of small face amounts, where the high costs associated with fully underwritten business would be inconsistent." Put plainly, spending $200 to $400 on a full paramedical exam and lab work for a policy with a $15,000 face amount does not pencil out.

So final expense has historically relied on two underwriting approaches: simplified issue (a short health questionnaire, no exam) and guaranteed issue (no health questions at all, but with graded benefits and a waiting period). Both approaches trade underwriting precision for speed and accessibility.

Even so, simplified issue underwriting still involves friction. Phone interviews take time to schedule. Applicants get confused by health questions. Agents sometimes interpret answers inconsistently. And the older demographic that buys final expense is generally not eager to spend their afternoon on a phone call about their medical history.

Underwriting approach	Medical exam required	Health questions	Typical decision time	Face amount range	Best for
Full traditional underwriting	Yes (paramedical + labs)	Extensive	4-8 weeks	$100K+	Large face amount policies
Simplified issue	No	8-15 questions	1-7 days	$5K-$50K	Final expense, smaller WL
Guaranteed issue	No	None	Immediate	$5K-$25K	Applicants with serious health conditions
Digital health assessment + simplified issue	No (smartphone scan)	Abbreviated	Minutes to hours	$5K-$50K	Final expense with better risk data

What a digital health assessment actually captures

A digital health assessment for insurance uses the applicant's smartphone camera to capture biometric signals through a process called remote photoplethysmography, or rPPG. The technology reads subtle color changes in facial skin caused by blood flow. From a 30- to 60-second camera session, the system can extract cardiovascular indicators including heart rate, heart rate variability, respiratory rate, and blood oxygen estimates.

A 2025 study published in PMC by researchers working with Nervotec's contactless rPPG technology conducted measurements in a preoperative evaluation clinic, comparing camera-based readings against standard reference devices including automated cuffed blood pressure monitors and pulse oximeters. The research demonstrated that camera-based capture can produce physiological measurements from standard device cameras without physical contact.

For final expense underwriting, this matters because it gives carriers biometric data they currently do not collect at all. A simplified issue application today asks whether the applicant has been diagnosed with certain conditions, but it captures zero real-time physiological measurements. A digital health assessment adds an objective data layer on top of the subjective questionnaire without adding friction. The applicant points their phone camera at their face for 30 seconds. That is the entire additional step.

The final expense applicant experience problem

The people buying final expense insurance are predominantly over 60. Many are over 70. They are buying coverage to make sure their family does not get stuck paying for a funeral, which according to the National Funeral Directors Association averaged between $7,000 and $9,000 for a viewing and burial service in recent years, and more when you add cemetery costs, flowers, and a reception.

These applicants tend to have specific characteristics that make traditional underwriting processes especially burdensome. They often have multiple chronic conditions that make health questionnaires long and confusing. They may have hearing difficulties that make phone interviews frustrating. They are more likely to be on fixed incomes and less likely to tolerate a process that feels invasive or time-consuming.

LIMRA's research on life insurance purchase behavior has consistently shown that process friction is one of the top reasons applicants abandon applications or fail to follow through on approved policies. For final expense specifically, RGA's research on the segment noted that mastering the market "demands a deep understanding of the applicant and the product design."

A digital health assessment compresses that experience. Instead of a 20-minute phone interview with a tele-underwriter asking about medications, hospitalizations, and diagnoses, the applicant answers a shorter set of screening questions on a tablet or smartphone while their biometric data gets captured passively through the camera. The carrier gets more data with less applicant burden. That tradeoff matters most when the applicant is 74 and not interested in recounting their medical history over the phone.

How carriers benefit beyond the applicant experience

The economics of final expense are tight. Commissions, marketing, and acquisition costs eat into small premiums quickly. Anything that reduces the cost per issued policy matters.

Digital health assessments help in a few concrete ways. Per-application costs drop because there are no paramedical exam fees, no scheduling overhead, and no follow-up calls when the examiner cannot reach the applicant. Decision speed improves because biometric data transmits in real time rather than waiting days for lab results. Carriers get better risk segmentation because they are currently making simplified issue decisions on questionnaire responses alone, and adding biometric signals gives actuarial teams a richer dataset for pricing. Not-taken rates go down because, as we have written elsewhere on this site, every week of delay between application and issuance increases the chance the applicant walks away. And fraud exposure decreases because a live biometric capture confirms a real person is sitting there, which addresses a real concern in final expense where agents sometimes complete applications without the insured's full involvement.

Digital health assessments and the guaranteed issue gap

Guaranteed issue final expense policies exist because some applicants cannot pass even simplified issue underwriting. They have recent cancer diagnoses, recent hospitalizations, or other conditions that would trigger a decline on a simplified issue application. Guaranteed issue gives them coverage, but at a cost: graded benefits (typically returning only premiums plus interest if the insured dies in the first two to three years) and higher premium rates.

Digital health assessments could help narrow this gap. With better biometric data, carriers might be able to offer simplified issue coverage to some applicants who currently get pushed into guaranteed issue. If a 68-year-old has a history of controlled hypertension but current biometric readings that show stable cardiovascular indicators, that data point could support a simplified issue offer where the questionnaire alone might have triggered a decline or deferral.

This is still speculative. Actuarial teams need mortality data from digital health assessment cohorts before they change risk classification models. But the logic runs in one direction: more data about an applicant's current health status should allow more precise risk assessment, and that should expand who qualifies for better-priced products.

What the distribution channel needs to know

Final expense insurance is sold predominantly through independent agents and field marketing organizations. The agent sits with the applicant, often in their home, and walks them through the application. Any technology that gets inserted into this process needs to work within that distribution model.

A digital health assessment fits naturally. The agent can hand the applicant a tablet or ask them to use their smartphone. The scan takes less than a minute. The agent does not need medical training or technical expertise to facilitate it. The data transmits directly to the carrier's underwriting system.

For agents, the appeal is practical: faster decisions mean faster commissions. An agent who can get an applicant from "interested" to "issued" in a single sitting closes more business than one who says "we'll call you back in a few days with a decision." In final expense, where average premiums are modest and agents rely on volume, that compression of the sales cycle directly affects income.

Current research and evidence

rPPG research has come a long way. Groups at TU Delft, the University of Oulu, and MIT Media Lab have been publishing on camera-based physiological measurement for over a decade now.

A 2022 paper by researchers behind the ReViSe system (published on arXiv) demonstrated remote vital signs measurement using smartphone cameras, applying computer vision techniques to facial video to extract blood volume pulse signals and derive heart rate and respiratory rate measurements. The approach used statistical algorithms applied to facial skin pixel-level color variations caused by blood flow.

FaceHeart, a company focused on camera-based vitals, has described the underlying mechanism as detecting "micro-blushing," the subtle pixel-level color variation in facial tissue that corresponds to the cardiac cycle. Their published research confirms that standard cameras can capture heart rate, blood pressure estimates, respiratory rate, and oxygen saturation indicators.

For the insurance industry specifically, the Society of Actuaries' work on simplified issue underwriting identified the core tension: carriers want better risk data, but they cannot justify the cost of traditional evidence-gathering for small face amount products. Digital health assessments sit squarely in that gap. They provide objective biometric data at a fraction of the cost of a paramedical exam, delivered in a fraction of the time.

The future of final expense underwriting

The final expense market is growing because the underlying need is growing. The U.S. population over 65 will continue to expand through the 2030s, funeral costs keep rising, and a substantial portion of American households lack sufficient savings to cover end-of-life expenses without insurance.

LIMRA's 2026 report confirmed that U.S. individual life insurance new premium topped $17.5 billion in 2025, setting a new sales record. Karen Terry, corporate vice president and head of LIMRA Insurance Research, specifically noted that "final expense and other smaller-face whole life policies continue to drive overall WL sales growth." The segment is not slowing down.

As the market expands, carriers that figure out how to underwrite efficiently at scale while keeping friction low for applicants will take disproportionate share. Digital health assessments are a straightforward path to that. The technology works on devices applicants already own, captures data carriers currently lack, and compresses timelines in a segment where every day of delay costs placement.

Frequently asked questions

What is final expense insurance and who buys it?

Final expense insurance is a type of whole life insurance with face amounts typically between $5,000 and $50,000, designed to cover funeral and burial costs. Buyers are predominantly adults over 50, often on fixed incomes, who want to ensure their families are not burdened with end-of-life expenses. Average funeral costs in the U.S. range from $7,000 to $9,000 for basic services, and total end-of-life costs average $88,300 according to MoneyGeek's 2026 analysis of Medicare, Medicaid, and private insurance claims data.

How does a digital health assessment work for insurance?

The applicant completes a 30- to 60-second scan using their smartphone or tablet camera. The system uses remote photoplethysmography (rPPG) to detect blood flow patterns through subtle color changes in facial skin. From this scan, it extracts cardiovascular indicators including heart rate, heart rate variability, respiratory rate, and blood oxygen estimates. The data transmits directly to the carrier's underwriting system, supplementing the traditional health questionnaire.

Does a digital health assessment replace the health questionnaire?

Not entirely. Carriers still ask screening questions about diagnoses, medications, and hospitalizations. The digital health assessment adds an objective biometric data layer on top of those questions. The combination gives underwriters both self-reported health history and real-time physiological measurements, which is more data than either source provides alone.

Can older applicants use digital health assessments?

Yes. The assessment requires only that the applicant sit in reasonable lighting and face a smartphone or tablet camera for 30 to 60 seconds. No special apps need to be downloaded, no wearable devices are needed, and the agent can facilitate the process during the application visit. The technology works with the front-facing cameras found on standard smartphones and tablets that most people already own or can access through their agent.

Solutions like Circadify are working to bring contactless biometric screening to the insurance industry, including the final expense segment where applicant experience and underwriting efficiency both need improvement. To learn more about how digital health assessments can fit into your insurance application workflow, visit gethealthscan.com's integration resources.