Cognitive testing in life insurance is becoming more and more prevalent, particularly as the number of older age applicants grows. You can expect testing now as a routine at age 70 or older, and although the platform isn’t rigorous, it can derail an application almost irreversibly if performance is poor.
older age underwriting
When one looks at a curve of the mortality rates by age in developed countries, we notice a very regular pattern. Especially the middle-age groups - age 30 to 70+, for example - seem to have close to an exponential curve in mortality rates.
The frailty index (FI) holds a robust and consistent correlation with mortality and morbidity and is a stronger predictor of mortality than chronological age. Frailty status may be a promising risk factor to add into the underwriting mix, particularly for disability products.
For a long time, Alzheimer’s could only be definitively diagnosed after a patient’s death based on neuropathological findings in the brain. Positron emission tomography (PET) scanning and spinal fluid technologies can improve on purely clinical diagnosis, but their cost and a lack of any cure means they are hardly used.
Many of today’s older-age evaluations include additional screenings to measure cognitive and frailty risks: clock drawing, delayed word recall and walking speed. These assessments may add time to the application process and increased cost for the insurer. However, recent studies indicate they could be replaced with a simple blood test: Cystatin C.
While wearables and apps are most closely associated with promoting physical fitness, technology is increasingly being put to use in lifestyle monitoring of the elderly and others in need of care.
Hilary Henly, Head of Underwriting, Ireland and Director, Divisional Underwriting Research, presents an innovative review of some non-traditional predictors of mortality and morbidity. She discusses the impact of loneliness, social engagement, and social activity. Given the aging population and newer approaches to older age underwriting, this topic will be of significant interest to the reader.
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.
The Older Age Underwriting Practices Survey Subcommittee of the Society’s Committee on Life Insurance Mortality and Underwriting Surveys has completed its report on the results of a survey designed to elicit feedback regarding underwriting guidelines, requirements, assumptions and practices utilized in the assessment of older age applicants. This survey was sent to US and Canadian direct life insurance companies.