Swiss Re has expanded its Life Guide to include new underwriting guidance for life insurance applicants using repurposed longevity drugs.
The update addresses medications originally developed for other conditions – such as metformin and rapamycin – that are increasingly being used for their potential to extend life expectancy. In some cases, these drugs are self-prescribed, and their long-term effects remain uncertain.
The August 2025 update is part of Swiss Re’s ongoing adjustments to its underwriting framework in response to emerging life and health risks. Life Guide, used by more than 800 insurers in over 100 countries, processes more than 23 million underwriting queries annually.
The new edition also features an enhanced chronic kidney disease calculator, updated prostate cancer risk tools, and expanded medical risk assessment resources.
In recent years, Swiss Re has paired these updates with broader digital enhancements to its underwriting tools. This includes Life Guide Scout, a generative AI–powered assistant that allows underwriters to input complex questions and receive evidence-based answers in seconds. The technology aims to improve decision-making speed and knowledge transfer, supporting consistent application of underwriting guidelines.
Other improvements have addressed specific medical risk areas, such as an upgraded Coronary Artery Disease calculator with interactive visuals designed to simplify and streamline cardiovascular risk assessment.
The Life Guide has also been evolving in line with changes in medical risk definitions, including new approaches to assessing obesity that go beyond body mass index to incorporate metabolic health and fat distribution.
Natalie Kelly (pictured above), Swiss Re’s head of global underwriting, claims and research and development, said the toolkit’s role is to stay ahead of developing risks and provide practical support.
“With repurposed medications, the clinical picture is still evolving. This update gives underwriters practical decision-making support – especially in cases where use of these drugs may be experimental or self-prescribed,” Kelly said.
Metformin, a type 2 diabetes treatment, is being studied for possible anti-aging effects linked to improved insulin sensitivity and reduced inflammation. Rapamycin, developed as an immunosuppressant for transplant patients, has been used off-label in attempts to increase lifespan.
Some drugs in this category carry potential risks. Rapamycin, for instance, can suppress the immune system and has limited long-term safety data in humans. Swiss Re’s updated guidance outlines how underwriters should evaluate such disclosures, including when to apply ratings or refer cases to medical officers.
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