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PubMed2003

Policy implications of an annuity approach to integrating long-term care financing and retirement income.

The authors consider an integrated income and disability annuity as an alternative framework for long-term care financing, show that pooling disability and mortality risks can reduce the need for medical underwriting, and discuss private and public implications. Data from the National Mortality Followback Survey of 1986 were used to simulate current underwriting and minimal underwriting, excluding only those already eligible for benefits. Remaining disability, life expectancy, and premiums are compared under both underwriting assumptions. Under minimal underwriting, 98% of persons age 65 would be eligible to purchase disability protection through an integrated annuity, versus 77% under current underwriting. Premiums for both the income and disability components were lower with minimal underwriting. Combining income and disability protection may be able to expand private markets for long-term care financing beyond what appears possible in the long-term care insurance market. Public policy should avoid the distortion of choices created by focusing exclusively on an insurance model.

Aged↗
PubMed1995

HIV and AIDS--employers grapple with difficult issues.

HIV infection and AIDS pose special challenges to employers. Myriad laws affect how the employer must respond when an applicant or employee is infected with HIV or is ill due to AIDS. An overall compliance strategy should include thorough knowledge of those laws and a policy on HIV and AIDS, put in place before a crisis occurs.

Acquired Immunodeficiency Syndrome↗
PubMed2002

The use of nursing home and assisted living facilities among private long-term care insurance claimants: the experience of disabled elders.

Little is known about individuals in nursing homes (NHs) and assisted living facilities (ALFs) who receive private long-term care (LTC) insurance benefits. No one knows whether claimants and/or their families feel they are getting good value for their premiums, or whether the presence of private insurance influences the type of care people get. This brief provides descriptive information on disabled private LTC insurance policyholders receiving LTC benefits in these settings, comparing them to institutionalized elders who lack such insurance. The information shows that private LTC insurance benefits are targeted to individuals with significant functional and/or cognitive impairments; that claimants are satisfied with their policies although many report unmet needs; and that private LTC insurance gives claimants access to alternatives to nursing home care.

Aged↗
PubMed1999

Lifetime costs and compensation for injuries.

Little is known about how well individuals are compensated for injuries. This study uses data from a 1989 survey to estimate both the lifetime costs and compensation for injuries. Our findings show that about 55% of the cost is compensated by public or private programs. Compensation rates are lower for disabling injuries and those of long duration. The results also suggest that compensation system reforms that would place stricter limits on maximum compensation might not be a distributionally fair solution. The reasons are that costs are highly skewed, and the share of costs recovered by compensation programs is currently lowest for injuries that are long term, disabling, and the most expensive.

Chronic Disease↗
PubMed2002

[Current status and the future of insurance medicine].

The key objective of insurance medicine is the scientific based assessment of long term prognosis of a single person with respect to mortality, morbidity and disability. This is always determined in comparison to the standard population or an ideal standardised population. The evaluation of morbidity, mortality and disability is always linked to certain insurance products such as life insurance, disability cover, health insurance or derivates of these products. Additionally, insurance medicine creates the claims evaluation guidelines which are in accordance with established classifications and guidelines of other medical associations. Due to different and various reasons, insurance medicine in Germany has shown substantial deficits in the past years and decades, mostly in the areas of methodology, scientific basis, guidelines and quality control. In order to meet future challenges specific to this industry such as demographic change, longevity and new insurance covers, the discipline of German insurance medicine requires some reorganisation.

Adult↗
PubMed1998

[Nursing care in social change. Effects of nursing care insurance on the status of the disabled].

The effects of "Care-insurance" on the situation of those in need of home care, is the object of first implementation-studies of SGB XI. They largely agree on the high level of satisfaction found among those who draw the benefits of the insurance scheme, particularly among those who claim a cash premium; further they largely agree on the low level of influence of the "Care-insurance" on changes in the form of nursing. An account of the results of the milieu-oriented "Freiburger Pflegestudie", which investigates the effects of "Care-insurance" differentiated according to the various types of care-situations, forms the centre of the article.

Aged↗
PubMed1995

[MEDRISK--an expert system for medical risk assessment].

The Munich Reinsurance Company has developed a rule-based expert system for assessing substandard risk in life, disability and accidental death benefit. It is one of the most comprehensive medical expert systems yet conceived and currently includes entries for over 7500 impairment terms. Based on the most up-to-date insurance medical knowledge MEDRISK allows underwriters, irrespective of their level of experience, to process both simple and highly complex cases. The system which takes account of the interactive effect that can exist between different impairments as well as the influence which occupational factors can exert, always produces consistent and case-specific decisions. The number of impairments and types of insurance included in MEDRISK can be expanded. After tests at Munich Re and at a number of insurance companies, the system ist now ready to be launched in German speaking markets.

Artificial Intelligence↗
PubMed2003

Designing long-term disability plans: tax efficiency vs. maximizing wage replacement.

The tax treatment of long-term disability plans raises difficult questions for employers and employees, as it necessitates a tradeoff between tax efficiency and maximizing wage replacement for disabled workers. By using simplified case examples, this article illustrates the advantages and disadvantages of different plan design choices. The authors conclude that, in most cases, long-term disability coverage should be mandatory but that employees should be given the choice to decide whether their coverage is taxable.

Adult↗
PubMed2004

A delay they can ill afford: delays in obtaining Attendance Allowance for older, terminally ill cancer patients, and the role of health and social care professionals in reducing them.

Despite a growing interest in holistic care for the terminally ill, financial needs are often not addressed. This is reflected in the fact that some people with a terminal illness are not accessing disability benefits, despite eligibility. The present paper is based on a study investigating delays experienced by cancer patients in obtaining Attendance Allowance (AA) by special rules, and missed opportunities for professionals to assist with claims. The study took place in a hospice where patients were referred to social work professionals for assistance in claiming AA. In each case, the patient had been eligible for some time before the referral. Over a 5-month period, all 22 patients who were referred completed a questionnaire. Data were collected to show their personal characteristics, how they came to be referred for assistance and their level of knowledge of AA. The length of time that people had already been eligible and the time taken to claim were recorded to show the amount of lost benefit. The health and social care professionals whom these patients had seen since becoming eligible were also recorded. A wide range of people experienced delays in accessing AA. Their total lost income ranged from pound 110.60 to pound 1106.00. The median was pound 387.10 and four people died before being awarded AA. Only four patients were fully aware of their eligibility. Every person had seen between one and four professionals since becoming eligible for the benefit, without the meeting resulting in a claim. Increased income aids the management of illness, and information and assistance to claim disability benefits need to be made available in a consistent manner at the earliest opportunity. Health and social care professionals are in a position to provide this. However, changes to the claims process, proposed by the present author, could ensure that AA is received automatically, without delay and without extensive paperwork.

Aged↗