Digital Health Screening for Term Life Conversion Campaigns: How It Works

Digital health screening for term life conversion is an idea that should have arrived sooner than it did. The term conversion privilege has been a standard feature in life insurance policies for decades, letting policyholders switch from term coverage to permanent without a new medical exam. But carriers have historically done a poor job of actually getting people to use it. According to a 2026 study from the SOA Research Institute and LIMRA analyzing 2009 through 2023 data from 17 contributing companies, term conversion incidence rates have been declining over the study period. Most policyholders who could convert simply let their term expire or lapse instead.

The SOA Research Institute and LIMRA's updated term conversion study found that conversion rates have decreased across the 2009–2023 observation period, with anti-selection in mortality emerging as a consistent concern for carriers accepting converted policies.

What term conversion actually is and why carriers should care

A term life insurance conversion lets a policyholder exchange their term policy, or a portion of it, for a permanent life insurance policy. The appeal for the policyholder is straightforward: they keep coverage without taking a new medical exam, even if their health has deteriorated since they originally applied. Investopedia describes the conversion privilege as guaranteeing coverage and set premium payments regardless of the insured's current health status.

For carriers, term conversion is a double-edged situation. On one hand, it retains a policyholder who might otherwise leave entirely. LIMRA reported that individual life insurance new premium hit a record $17.5 billion in 2025, with term premium reaching $3.1 billion. Permanent products, particularly indexed universal life, drove the biggest share of growth. Converting existing term policyholders into permanent products feeds that growth without the full cost of new customer acquisition.

On the other hand, conversion creates an anti-selection problem. The SOA's Product Development News published a reinsurer's perspective noting that term conversions have been around for quite some time, yet their impact on product profitability remains something of a mystery. Policyholders who know their health is declining have more incentive to convert, because they get permanent coverage without medical underwriting. Those who are healthy often just buy a new policy at competitive rates or let the term lapse. This asymmetry drives up mortality costs on the converted book.

Factor	Traditional conversion campaign	Conversion with digital health screening
Medical data available at conversion	None (original underwriting only)	Real-time biometric data from smartphone scan
Ability to segment by current health	Very limited	High — heart rate, HRV, respiratory rate captured
Anti-selection visibility	Detected only in aggregate, after claims	Visible at individual level before conversion
Policyholder engagement method	Direct mail, phone calls, email	Digital touchpoint with immediate health insight
Conversion offer personalization	Generic pricing tiers	Risk-informed product recommendations
Time from outreach to conversion decision	Weeks to months	Can happen in a single digital session

Why most term conversion campaigns underperform

The typical term conversion campaign looks like this: the carrier identifies policyholders whose terms are expiring in the next 12 to 24 months, sends a letter or email explaining the conversion option, and waits. Maybe a call center follows up. The policyholder, who probably forgot they had a conversion privilege in the first place, either ignores the outreach, calls back confused, or converts only because they recently got bad news from a doctor.

This approach has a few obvious problems. The outreach is generic because the carrier has no current health data on the policyholder. Everyone in the expiring cohort gets roughly the same message. The conversion offer is priced based on the original underwriting class and attained age, but the carrier has no idea whether the policyholder's risk profile has changed substantially since issue. And the process feels administrative rather than valuable to the policyholder. There is no engagement hook, no reason for the healthy policyholder to care.

Life Design Analysis, a platform used by insurance agents and carriers, published a template for running term conversion campaigns that emphasizes early outreach and agent involvement. Their approach centers on identifying the conversion window and reaching policyholders before the deadline. But even their process acknowledges that conversion campaigns compete with apathy. The policyholder has to be motivated enough to take action on something they may not fully understand.

How digital health screening changes the conversion equation

A digital health screening adds a biometric data layer that changes the dynamics of term conversion in two directions simultaneously.

For the carrier: visibility into current risk

When a carrier runs a conversion campaign enhanced with digital health screening, they invite the policyholder to complete a brief smartphone-based health check as part of the re-engagement process. The screening uses remote photoplethysmography, or rPPG, to capture cardiovascular indicators through the phone's camera. A 30- to 60-second facial scan extracts heart rate, heart rate variability, respiratory rate, and blood oxygen estimates without physical contact.

This gives the carrier something they have never had at the conversion decision point: a current biometric snapshot. Instead of relying solely on the original underwriting from 10 or 20 years ago, the carrier now has a real-time health signal. That signal does not replace clinical underwriting, but it adds context that was previously unavailable entirely.

For actuarial teams, this is useful data. The SOA's term conversion study highlighted that post-conversion mortality experience is a persistent concern. Having a current biometric reading at the point of conversion gives the carrier information to segment the converting population beyond just age and original underwriting class.

For the policyholder: a reason to engage

Here is where conversion campaigns actually get interesting. The digital health screening gives the policyholder something tangible in return for their attention. Instead of a dry letter about their conversion deadline, the carrier offers a free health check. The policyholder completes a 30-second scan and receives insight into their cardiovascular indicators.

That health check becomes the engagement mechanism. The policyholder who feels healthy gets confirmation and a prompt to consider their coverage options while they are already engaged. The policyholder with concerning indicators gets a reason to think about securing permanent coverage before their conversion window closes. Either way, the interaction delivers value that a form letter never will.

The anti-selection problem, with better data

Anti-selection in term conversion has been an actuarial headache since the conversion privilege was invented. The SOA's 2012 analysis from a reinsurer's perspective laid out the core issue: if year-over-year term renewal rates adequately cover expected mortality including anti-selection upon conversion, the pricing can work. But if conversion takes carriers by surprise, the converted block can become disproportionately expensive.

Digital health screening does not eliminate anti-selection, but it changes the carrier's position relative to it. Without screening, the carrier accepts conversions blind. With screening, the carrier has a biometric signal that indicates where the converting policyholder falls on a risk spectrum.

This does not mean the carrier can deny conversion. The conversion privilege is contractual, and the policyholder has the right to convert regardless of current health. But the carrier can use the biometric data in several other ways:

• Product recommendation: Route lower-risk converters toward products with better margins and route higher-risk converters toward products designed for that profile
• Pricing tier selection: Where the conversion terms allow flexibility in product selection, use biometric data to guide which permanent product is offered
• Reserve adequacy: Update expected mortality assumptions on the converting block in near-real time rather than discovering adverse experience in claims data two years later
• Reinsurance negotiations: Approach reinsurers with actual health data on the converting population rather than relying on assumptions about anti-selection rates

Implementing a digitally-enhanced conversion campaign

A carrier that wants to add digital health screening to its conversion campaigns does not need to rebuild its technology stack. The workflow is simpler than it might sound.

Identify the conversion-eligible population

Pull policyholders whose terms expire in the next 18 to 24 months. Segment by face amount, original underwriting class, and age band. Prioritize cohorts where permanent product margins are strongest.

Design the outreach with a health check offer

Instead of "your term is expiring, here are your options," the message becomes "get a free health check and see where your coverage stands." The health screening is the lead, not the conversion pitch. This reframes the outreach from administrative to valuable.

Deploy the digital health screening

The policyholder receives a link, opens it on their smartphone, and completes a 30- to 60-second rPPG scan. No app download required. No appointment. No nurse visit. The scan captures cardiovascular indicators and transmits results in real time.

Use the data to personalize the offer

Based on the biometric results combined with the original underwriting data, the carrier generates a personalized conversion recommendation. Healthy policyholders might receive an offer emphasizing wealth accumulation features of permanent products. Those with elevated cardiovascular indicators might receive messaging focused on securing guaranteed coverage before the conversion window closes.

Track and iterate

Measure conversion rates, engagement rates with the health screening, and post-conversion persistency. Compare against the control group that received traditional outreach.

Current research and evidence

The research base for camera-based health screening in insurance has been growing steadily. LIMRA's 2025 data showed the individual life insurance market hitting record premium levels, with term premium at $3.1 billion and overall new premium at $17.5 billion. The market is growing, and carriers are looking for advantages in both new sales and retention.

The SOA Research Institute and LIMRA's 2026 term conversion study, covering 2009 through 2023 data from 17 industry participants, provided updated conversion incidence tables, post-conversion mortality experience, and lapse patterns. The study confirmed that anti-selection remains a real and measurable factor in conversion blocks, which strengthens the case for any data that gives carriers better visibility into the health status of converting policyholders.

Research on rPPG technology itself continues to mature. Camera-based photoplethysmography has been demonstrated in clinical settings, with studies comparing smartphone-derived cardiovascular measurements against reference medical devices. The technology captures blood volume pulse signals through changes in skin reflectance detected by standard camera sensors.

HIT Consultant reported in late 2025 on the convergence of digital health and life insurance, noting that younger professionals are rethinking financial security through the lens of digital health, seeing life insurance as part of a broader ecosystem of wellness and connected technology rather than an isolated financial product.

The future of term conversion

Term conversion campaigns have been an afterthought at most carriers for too long. The SOA and LIMRA data shows declining conversion incidence, which means either policyholders do not know about the option, do not see the value, or find the process too cumbersome to bother with. Digital health screening addresses all three of those failure points.

The technology is already being applied in other insurance workflows. Carriers use digital health assessments for new policy applicant screening, for final expense underwriting, and for group enrollment. Extending the same technology to conversion campaigns is a natural next step.

What makes this worth watching is that both sides get something out of it. The carrier gets biometric data it has never had at the conversion point. The policyholder gets a free health check and a more personalized insurance conversation. The result should be higher conversion rates, better risk segmentation on converted blocks, and lower anti-selection costs over time.

Solutions like Circadify are developing smartphone-based rPPG screening specifically for insurance workflows, making it possible to embed a health check directly into a digital conversion campaign without requiring any hardware, clinic visits, or scheduling overhead.

Frequently Asked Questions

Does digital health screening replace the no-exam conversion privilege?

No. The conversion privilege is contractual. The policyholder retains the right to convert without a medical exam regardless of whether they complete a health screening. The screening provides supplemental data that the carrier uses for product recommendations, pricing guidance, and reserve management. It does not gate the conversion itself.

What biometric data does a smartphone-based screening capture?

A standard rPPG screening using a smartphone camera captures heart rate, heart rate variability, respiratory rate, and blood oxygen saturation estimates. The scan takes 30 to 60 seconds and requires no physical contact. The data provides a snapshot of cardiovascular function at the time of the scan.

How does this help with anti-selection in term conversion?

Anti-selection occurs because policyholders who know their health has worsened are more motivated to convert than healthy policyholders. Digital health screening gives the carrier a biometric reading at the point of conversion, allowing better segmentation of the converting population. The carrier can adjust product recommendations, update reserve assumptions, and approach reinsurers with actual health data rather than relying on historical assumptions.

Can this approach increase conversion rates among healthy policyholders?

That is the hypothesis, and it makes intuitive sense. Healthy policyholders who receive a generic conversion letter have little reason to act. A health screening that confirms their good health, paired with a product offer emphasizing wealth accumulation or legacy planning, gives them a specific reason to engage. The health check creates a touchpoint that generic outreach cannot.