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Steadily increasing competition has changed the underwriting environment in most life insurance companies. This article attempts to explore how heightened competition presents a new challenge for medical professionals employed in the industry.
As the science of genetic testing progresses, the debate surrounding the uses of genetic information intensifies. In February, President Clinton signed an executive order prohibiting federal agencies from using such information to make hiring, promotion, or placement decisions. Concerns about privacy and discrimination have led many states to propose or enact statutes that prohibit health insurers from using genetic test results in their underwriting decisions. However, few statutes address access to these results by the life insurance industry. This Issue Brief summarizes the current debate on whether life insurers should have access to genetic testing information for breast and ovarian cancer, and provides actuarial insight into the potential effect of such testing on the voluntary term insurance market.
Part 1 describes briefly how the market for life insurance deals with HIV infection and how society has reacted to its policies. Part 2 examines the arguments for and against HIV testing: does it discriminate against individuals or is it just a logical extension of risk estimation procedures and underwriting techniques? In part 3 possible solutions are considered. Are solutions in the private sector, like banning HIV testing, warranted, should we look for a public solution that does not burden the private insurance industry, or is a mixed public-private solution desirable?
If a life insurance company provided free radon tests to clients, clients' life expectancies would be extended and profits would thereby be increased. This effect is quantified and it is found that the direct monetary benefits to the company could be substantial. Several subsidiary advantages are also discussed.
Public concern about genetic discrimination, particularly access to insurance following genetic testing, has been reported in the literature. This paper aims to separate myths from realities regarding genetic discrimination in life insurance and to underline the positive aspects of allowing insurers access to relevant genetic information for underwriting purposes. We present a review of the literature pertinent to discrimination in life insurance and a comparative analysis of industries guidelines. There are few reported cases in the literature of validated genetic discrimination. However, the benefits to be gained by allowing insurers access to relevant genetic data could justify fostering a more active role in the use of genetic information by insurance companies.
The high incidence of instant results of PTCA in patients with coronary artery disease and the favourable prognosis of long-term follow-ups are beneficial for proposers being accepted for life insurance, even though they belonged to the group of high-risk-patients before. In assessing life insurance policies it is necessary to take the individual course of the CAD, the PTCA itself and the remaining left ventricular function into consideration. Risk factors and other cardiac or non-cardiac impairments must be regarded additionally.
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The question if reports and examinations by medical doctors in the completion of a life insurance policy must be charged according to the official German schedule of fees for medical doctors (GOA) is answered differently in the literature. As the GOA has legal force, an account according to the GOA is prescribed if there is no other conclusion between insurance company and medical doctor. Indisputably an account according to the GOA must be made for additional medical achievements such as laboratory examinations, electrocardiography and x-ray examinations. Insurance companies that offer for the medical report or the examination a fee within the regular limits of the GOA-numbers cannot be blamed to offer an inadequate fee.
Ravencraft v. UNUM Life Insurance Company of America, 212 F.3d 341 (6th Cir. 2000): Although ERISA does not explicitly require it, the Sixth Circuit and most of the others require that a participant pursue all plan remedies before bringing suit. An action against a plan or plan fiduciary will be dismissed if the participant fails to exhaust the administrative remedies available to it under the plan unless he or she can show that pursuing those remedies would be futile, such as where the available remedies are inadequate or unfair. If a participant's case is dismissed solely because of the failure to follow the procedural steps for review under the plan, the dismissal should be without prejudice so that the participant can file suit again, if necessary, after he or she goes back to pursue the remedies available under the plan.
This retrospective of the eventful quarter of a century up to 1995 presents in brief sketches an international survey of developments with a bearing on insurance medicine. It identifies principle events in the field of clinical medicine that have had an effect on long-term prognoses and shows how they have been accounted for in the process of rating on the basis of insurance medicine prognoses. It highlights the main aspects of the scenarios from the 1970s down to the early years of the 1990s and illuminates in detail the developments in Germany. Finally, in the chapter "Life insurance medicine in the year 2000", there is a cautious "forecast on our own behalf", which names eleven points of development which contain possible messages for the future. In the final comment, the concern is expressed that life insurers and the insurance industry as a whole have not yet fully recognized the cost-benefit effect of insurance medical officers. A major role is played in this context by the increasingly important ethical guidelines.
The dramatic increase in genetic testing for adult-onset diseases has created a debate regarding whether or not insurance companies should be able to use genetic test results in underwriting. We use data from women who have been tested for the BRCA1 gene mutation along with data from otherwise comparable untested women to assess the potential for adverse selection in the life insurance market when tested individuals know their genetic test results but insurers do not. Our analyses show that women who test positive for the BRCA1 gene mutation do not capitalize on their informational advantage by purchasing more life insurance than those women who have not undergone genetic testing.
A comprehensive review of the literature of diabetes mellitus, its progression and complications is written with respect to the life insurance industry.
OBJECTIVE: The objective of this study is to assess the cost/value tradeoff of a routine treadmill requirement for life insurance applicants. For this purpose, we are interested in the treadmill's ability to provide unique information on the mortality risk in a population of apparently healthy and asymptomatic individuals, as opposed to the treadmill done for diagnostic or confirmatory purposes. MATERIALS AND METHODS: We performed a protective value study, solving for the face amount at which the mortality savings outweigh the various treadmill requirement costs. Multiple scenarios were evaluated, varying the following assumptions: percent of cases uniquely discovered through the treadmill, excess mortality associated with the treadmill, proportion of would-be applicants ending the process when confronted with a treadmill requirement, proportion of not-takens in the face of a positive treadmill, and various profitability requirements. While there is an array of information available from the treadmill, to avoid double counting effects we chose 2 representative and independent findings: abnormal ECG and low fitness (duration). Prevalence of findings and mortality associations were derived from published studies. RESULTS AND CONCLUSION: While many companies are moving to eliminate or restrict the use of treadmill testing, low break-even policy sizes were produced in virtually every iteration of our assumptions. In one variation, however, we ignored the possibility of any "fitness" findings. Under this assumption, results were roughly consistent with current industry practice. This suggests that some companies could enhance the value of their treadmill requirements by requesting Balke protocol treadmills and/or interpreting duration information. Others may want to reconsider current face amount thresholds for their treadmill requirement in light of this valuable risk-selection information.
The Veterans Administration is amending its regulations relating to insurance matters to (1) permit a Veterans Administration physician's assistant to conduct certain physical examinations that are required for insurance purposes, (2) reflect that the law permits the conversion or exchange of National Service Life Insurance policies to insurance on a modified life plan with reduction at 70, (3) update certain Agency insurance service personnel job titles, and (4) update insurance information pamphlet and policy form references. In addition, certain terms are being changed to eliminate gender reference in those regulations which are being amended. These changes result from a review of the Agency's insurance regulations.
We studied accelerated death benefit (ADB) claims at the Dai-ichi Mutual Life Insurance Company (Dai-ichi Life). The ADB provision is designed to pay all or a portion of the death benefit if the insured is expected to die within 6 months. Dai-ichi Life paid 243 ADB claims and did not pay 17 ADB claims between December 1994 and March 1998. Of the 260 ADB claims, 253 (97.3%) were caused by malignant neoplasm, 2 by intracranial hemorrhage, 2 by angina pectoris, 1 by dilated cardiomyopathy, 1 by hepatic cirrhosis, and 1 by bleeding gastric ulcer. The age range of the 243 paid claims at the time when the attendant physician predicted a life expectancy below 6 months was 21.6-72.6 years (48.7 +/- 8.7 years [Mean +/- SD]). By the end of March 2000, 236 cases were followed up among the above 243 paid ADB claims. Of the 236 followed-up cases, 149 (63.1%) died within 6 months and 203 (86.0%) died within 1 year. The range of survival periods of these 236 cases was 6-1516 days (210 +/- 237 days). Of the 217 dead cases due to malignant neoplasm, 45 (20.7%) died of gastric cancer, 44 (20.3%) of lung cancer, 24 (11.1%) of liver cancer, 16 (7.4%) of colon cancer, 13 (6.0%) of rectum cancer, and 12 (5.5%) of pancreatic cancer.
As financial pressures on non-profits rise, fund raisers are constantly searching for alternative income sources. Life insurance may be one of them.
Coronary heart disease morbidity and mortality are dynamic issues. Outcomes from medical and surgical treatments are having dramatic effects. For the life insurer it is vital to follow closely the changing history of the disease.
Healthcare organizations need to develop financially viable foundations as a future source of capital. Charitable life insurance is a method of deferred giving that can attract a broad range of potential donors and build future assets for the organization.