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Business quality control in issuing life insurance.

Fraud investigation and fraud control are entirely different processes. Similarly the auditing of a life insurance company and the issuing of life insurance policies and business quality control are not the same. Business quality control and fraud control have much in common. In this article, these similarities are explored and a case is made that companies issuing life insurance policies should consider the business quality control approach rather than the more traditional investigatory methods.

Commerce↗

[The significance of "coronary risk" for life insurance].

In many countries heart and circulatory diseases are still the commonest cause of death (over 50%). This is particularly important for the life insurer because heart and circulatory diseases, including coronary heart disease, represent a relatively important risk in life insurance and that is often difficult to insure against. With the help of some diagrams (from the literature), an attempt is made, firstly to demonstrate the epidemiological relationships between "risk factors" and coronary heart disease, and, secondly, to show the relationship between the extent and localisation of arteriosclerosis in the coronary vessels and its influence on mortality, which is decisive for the life insurer. In the last three decades, new and more favourable factors for the insurability of coronary heart disease have come into existence. This circumstance is being and has been increasingly taken into account in risk assessment for life insurance. To the degree that the significance of the coronary heart disease risk for the life insurer has decreased, the acceptance of coronary risks has increased. There are three factors, above all, that determine the insurability of coronary heart disease: a) the age of the insuree; b) the presence of "cardiac risk factors"; c) the state of the coronary vessels of the insuree (existence of corresponding clinical findings).

Coronary Disease↗

Life insurance after malignant disease.

Forty-five life insurance companies responded to a questionnaire on insurance industry attitudes towards patients with a history of malignancy other than skin carcinoma. Although the criteria for acceptance, provisions of the policy, and philosophy about adjuvant treatment varied, all companies would underwrite such patients provided that at application there was no evidence of persistent or recurrent disease or severe complications of therapy. The concept of excess mortality (observed death rates versus standard expected death rates) is used with other factors in calculating premiums. Legal and ethical responsibilities of physicians associated with insurance applications are briefly discussed.

Canada↗

Statistical analysis of HIV seropositive results from 1988-1993 performed on life insurance applicants.

This review of statistical data, derived from HIV antibody testing performed on life insurance applicants over a period of five and one-half years, reflects the evolving nature of the HIV epidemic in the United States and demonstrates how the findings in the life insurance low risk population mirror the trends and changes that are occurring in the general population.

Actuarial Analysis↗

[Cause of death statistics (I). Resources for risk evaluation in life insurance?].

Vital statistics as they are generally used are of no help for evaluation of risks in life insurance since they are biased by the high number of the elderly population beyond age 70. Therefore the causes of death were compiled for the age groups from 15 to 70 that are of importance in life insurance. Tumors are the number one cause of death and not cardiovascular diseases which so far have been considered to be the number one. They take second place. Even in the male population cardiovascular diseases are the number one cause of death only from age 60 on upwards. Further cross-sectioning according to decades of age shows the typical causes of death for any particular age group. Below age 30 non-natural causes s. a. accident and suicide take with over 50 per cent first place. Females have a much lower mortality as is generally known; they contribute only one third to the overall mortality of the age group under consideration.

Adolescent↗

Genetic information and life insurance: a proposal for an ethical European policy.

Developments in molecular biology will enable development of tests for genetic predisposition to multifactorial diseases. People identified with increased risk might be able to prevent or delay the onset of illness by medical treatment and/or changing their environmental exposure. But tests might also help organizations, such as employers, insurers, and government bodies, to minimize their future economic risks. This article searches for an ethical and feasible European policy for the use of genetic information in life insurance. It first argues that genetic information is not so relevantly different from at least one other kind of medical information, that of HIV infection, that it justifies unlike policy treatment. European life insurance is then claimed to be a non-primary social good which should be handled by the private market. The problem of adverse selection is argued to be a reasonably serious threat. Insurers should therefore be allowed to demand some genetic risk information in order to secure the sustainability of insurance schemes. However, the moral principles and values of autonomy, privacy, non-discrimination, non-deterrence, solidarity and confidentiality, put limits on insurers justified information demands. The article ends up advocating a regime of limited community-rated private life insurance, first proposed by a Dutch committee. It stipulates that insurers should be forbidden to demand genetic tests as a condition for an insurance contract, but be allowed to ask for existing genetic information when the sought insurance cover is above a certain limit.

Confidentiality↗

Genetic information and life insurance.

Genetic testing will become the future standard of medical care. Life insurers will also need access to genetic information if the insurance industry is to survive intact and if cover is to remain affordable.

Genetic Diseases, Inborn↗

Genetic discrimination in life insurance: empirical evidence from a cross sectional survey of genetic support groups in the United Kingdom.

OBJECTIVES: To gather empirical evidence on any discrimination based on genetic information shown by the insurance industry in the United Kingdom and to assess how society is likely to handle future genetic information from tests for polygenic multifactorial conditions. DESIGN: Postal questionnaire survey. SUBJECTS: Sample (n=7000) of members from seven British support groups for families with genetic disorders and a representative sample (n=1033) of the general public who answered questions on applying for life insurance as part of an omnibus survey. MAIN OUTCOME MEASURES: Subjects were asked about their experiences with insurers, the medical profession, employers, and social services. Experiences with insurers are reported here. RESULTS: Altogether 33.4% of the study group had problems when applying for life insurance compared with 5% of applicants in the omnibus survey. Thirteen per cent of study respondents from subgroups who represented no adverse actuarial risk on genetic grounds reported that their treatment by insurers seemed to represent unjustified genetic discrimination. CONCLUSIONS: Life insurers may not be operating a consistent policy for assessing genetic information or acting in accord with the actuarial risks brought to them. The inconsistency suggests error rather than a corporate policy of discrimination based on genetic characteristics. Any future proposals for genetic testing for common or multifactorial disorders should be examined carefully.

Age of Onset↗