Medical Underwriting: Global Health Brief – Liquid Biopsy
Liquid biopsies are noninvasive tests that could potentially lead to early detection of cancer by identifying the genetic material cancerous tumors shed into the bloodstream and other bodily fluids. It is now possible to test for biomarkers such as circulating tumor cells (CTCs) and circulating tumor DNA (ctDNA). As these tests gain a foothold in clinical practice, insurance professionals must understand liquid biopsies and the implications for underwriting and product development.
For life insurers, a major source of mortality risk mitigation is prudent underwriting at the time of application, which should ultimately reduce future claim costs. One way to refine the underwriting process is through measuring the impact of underwriting using insurance claims experience.
The prevalence of cardiovascular disease - hypertension, coronary heart disease, heart failure or stroke - increases with age. Often, multiple cardiac conditions coexist with other illnesses, and this makes risk assessments for applicants aged 70 and above extremely complex for underwriters.
Designing Life Insurance Application Forms Fit for Changing Times
When filling out an application for insurance, a person typically faces questions that are comprehensive, somewhat complex, and perhaps even a barrier to getting the business done. This is particularly true of life insurance application forms dominated by health-related questions. The underwriters’ aim - to get profound levels of disclosure - is frequently at odds with the marketing department desire for simplicity; customers despair at what they see as extensive and difficult questioning.
To Tell the Truth: Applicant Nondisclosure of Obesity and HIV and Hepatitis C
Applicants’ self-disclosed Human Immunodeficiency Virus (HIV) and hepatitis C virus (HCV) status as well as body mass index (BMI) are important risk factors for morbidity and mortality in both accelerated and traditional (full) underwriting processes. In combination with self-disclosed smoking and medical history (diabetes, hypertension, heart failure, high cholesterol), which was discussed in a previous issue of Contingencies, these conditions constitute a majority of the leading medical inputs to the risk-assessment process.
A tumor with a very serious prognosis, mesotheliomas are primary neoplasms that arise from either the pleura surrounding the lung or the peritoneum. Most mesotheliomas are diffuse and malignant, while a minority (less than 25 percent) are localized and benign in activity. It’s important to recognize these growths as they have serious and rapid progressions when diagnosed in many cases.
Although Ladder company has only 37 employees, it can issue fully, but quickly, underwritten policies while the applicants are sitting in front of their computers, with coverage limits ranging from $100,000 to $8 million.
LexisNexis Risk Classifier – Stratifying Mortality Risk Using Alternative Data Sources
Munich Re assessed LexisNexis Risk Classifier, a predictive modeling tool developed and owned by LexisNexis Risk Solutions, Inc. that accurately stratifies mortality risk using public records, consumer credit history and motor vehicle history. Insurers considering alternative data-based mortality scores should begin with a retrospective validation study on their own experience data.
The purpose of this paper is to discuss the insurability implications of low normal/ below normal ALT in the elderly… in the hope that insurers will consider adding appropriate guidelines for this finding at older ages.