Gen Re Study Finds PAI Health Metric Supplements Protective Value of Traditional Life Insurance Underwriting

Stamford, USA
December 17, 2020

Gen Re Research & Development Team Validate PAI Score

Gen Re announced the results of a broad study covering 208,428 person-years that determined that the PAI Health proprietary physical activity metric and cardiorespiratory fitness data provides supplemental value to life insurance underwriting decisions above and beyond traditional life underwriting factors.

The study protocol used a data set from the U.S. National Health and Nutrition Examination Survey (NHANES) cycles including a study sample of 25,014 lives and 2,080 deaths, with 208,428 person-years of exposure.

The research validated the following four features and capabilities of PAI Health metrics, including estimated cardiorespiratory fitness (eCRF) and PAI Score, in an insurance setting:

• Data from the general population for those who use a fitness device with heart rate monitoring allows determination of eCRF and PAI Score.
• PAI Health metrics correlate with mortality.
• PAI Health metrics assess mortality risk independently of traditional underwriting factors.
• One-time assessment of eCRF or PAI Score predicts mortality risk for many years.

The PAI Health proprietary metric PAI (Personal Activity Intelligence) provides actionable insight into how much activity will improve or maintain their CRF and reduce their mortality risk. PAI Health leverages its expertise in biometric sensing and algorithm development for the health and wellness industry with a focus on risk management solutions for life and health insurers. The company’s suite of tools includes a mobile app, reporting dashboard, and API, which are designed to engage, assess, monitor, and guide members toward better health.

The Gen Re white paper provides insights into how Gen Re validated the PAI metric. “Our analysis validates that PAI can be used to predict mortality risk in Life Insurance underwriting,” said Gen Re’s Ammon Dixon, VP, Strategic Initiatives.

The PAI algorithms were derived from health studies involving 45,000 people over 25 years, and they have been further validated across broader populations of over 730,000 people, with over a million person-years of data.

Published research has shown that maintaining a PAI Score of 100 or more is associated with a significant reduction of risk for cardiovascular disease and all-cause mortality risk. PAI interprets the heart health impact from all physical activity based on the individual’s heart rate data collected from common wearable devices along with personal profile data. PAI can also estimate a user’s CRF, measured as Fitness Age and VO2 max, utilizing this same data.

To learn more about how to use it for insurance underwriting, read our white paper, and contact Gen Re:

About Gen Re

Gen Re delivers reinsurance solutions to the Life/Health and Property/Casualty insurance industries. We work closely with our clients to understand their strategic and operational goals, offering a wide range of products, tools and resources that aim to promote our clients’ ongoing growth and success.

Gen Re is a member of the Berkshire Hathaway family of companies and has earned superior financial strength ratings from each of the major rating agencies. We take our commitments very seriously. With $14.8 billion in capital and $11 billion in premiums, we only make promises we can keep.

About PAI Health

PAI Health allows organizations to assess, monitor and guide their people to better health, providing individuals with motivational guidance on personalized recommended physical activity levels. PAI Health’s mission is to optimize anyone's path to better health by making the science-backed Personal Activity Intelligence (PAI) metric a global health standard through partnerships with insurers, employee wellness programs, technology platforms, health care providers and other industry partners. For more information, visit

Gen Re
Sabine Denné
Head of Global Marketing & Client Communications

North America - Jim Greenwood
Senior VP, Head of Client Management, Marketing & Client Services

Int’l - Tasneem Harnekar
Digital Actuary

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Tricia Burton