Risk Matters is an occasional series of articles for life assurance professionals in the UK. Its purpose is to share knowledge gleaned by Gen Re as we carry out research into the risks that affect the profitability of life protection business.
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Issue: March, 2012 Language: English
Summary:
Long term "worklessness" is one of the greatest risks to public health. Despite concerns about the overall state of health in the nation, the number of days of sickness absence taken each year by UK workers are falling. An Independent Review of Sickness Absence has concluded that the insurance industry has a clear place in helping employers manage sickness absence. This edition of Risk Matters reflects upon the implications of the Review and opportunities for the insurance industry.
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Issue: January, 2012 Language: English
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This edition of Risk Matters looks at the evidence of excess alcohol consumption and considers if improved underwriting techniques could have a positive impact on claims management. |
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Issue: November, 2011 Language: English
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The current UK care system is widely regarded as inadequate, over-complex, unfair and unsustainable. The most recent review of the future of adult social care was reported by the Dilnot Commission in July 2011. Since then many commentators have contributed to the ongoing debate about how best to fund the obvious future needs of individuals. This edition of Risk Matters looks at the aftermath following the publication of the Dilnot Commission's report and considers the next step for insurance providers. |
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Issue: September, 2011 Language: English
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An alternative type of IP contract is emerging in the UK market where the insured benefit is the exact amount policyholders receives if they claim. This article looks at the practical implications of offering such a contract. |
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Issue: July, 2011 Language: English
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The incidence of falls increases with age and is linked to increased disability and mortality in older people. A new edition of the reference work for those seeking to develop evidenced based interventions for the prevention of falls in the elderly has been issued. This edition considers how the recommendations it contains can inform the assessment process of LTC applicants who are at risk of falls. |
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Issue: July, 2011 Language: English
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A new mental health strategy for the UK was launched by Government in 2011. In common with the coalition's prevailing themes of big society / small government the underlying message is that mental health is everyone's business. Choice and local decision making on treatment and care represent the future. With significant savings required to the public health budget, the more serious aim is how early intervention and prevention can be achieved through accessible, quality services that help people keep mentally well. This article looks in more detail at the proposals and their possible impact. |
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Issue: June, 2011 Language: English
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This issue of Risk Matters summarises the learning points from key sessions from the Gen Re Dynamics Seminar 2011 held in the US and offers an insight to the potential benefit for UK professionals attending this meeting in the future. |
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Issue: May, 2011 Language: English
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This article discusses the options available, including Cardiovascular Magnetic Resonance, Cardiac Computerised Tomography and 3D Echo, and the various advantages and limitations of less invasive cardiac tests. |
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Issue: March, 2011 Language: English
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This edition of the LTC Quarterly explores the question of SMCs and the value of obtaining information of this type at underwriting stage. |
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Issue: March, 2011 Language: English
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On 1 March 2011, the European Court of Justice (ECJ) ruled that with effect from 21 December 2012 the use of gender as a factor in calculating insurance premiums and benefits will be banned in the European Union. This issue of Risk Matters looks at the possible consequences from consumer behaviour to the measures to be taken by life insurers to align themselves with this ruling. Obviously, mortality and morbidity differences between men and women will remain. Insurers need to use the transition period to adapt products, pricing and processes to avoid any block of business, both in-force and future new business, getting out of balance. New risk attributes will be derived and new homogeneous risk classes established. |
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Issue: February, 2011 Language: English
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A recent High Court ruling has provided some clarity to an area of claims that was previously muddled and even disputed. This article summarises the findings and considers the implications this may have for insurers and consumers. |
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Issue: January, 2011 Language: English
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Only a small proportion of kidney transplants in the UK are DCD (after cardiac death) but new studies may help boost this further and could pave the way for an increased number of transplantations. This article looks at the background to this development. |
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Issue: December, 2010 Language: English
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This edition of the LTC Quarterly considers whether the generation known as the Baby Boomers is likely to enter later life with better or worse age-specific rates of morbidity and disability than earlier cohorts. |
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Issue: November, 2010 Language: English
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Chronic Obstructive Pulmonary Disease (COPD) has become the preferred name (rather than emphysema or chronic bronchitis) for a lung disease that is a significant public health problem. It is estimated that there are over three million people in the UK with significant airway obstruction but only about 900,000 have received the diagnosis and therefore appropriate treatment. The European Respiratory Society (ERS) predicts that by 2020 COPD will account for over six million deaths annually making it the third leading cause of death worldwide. |
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Issue: November, 2010 Language: English
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The recent Opinion of the Advocate General of the Justice of the European Union in the Test-Achats case has raised questions over the validity of the opt-out provisions under Article 5(2) of Directive 2004/113/EC (the Gender Directive) that permits differential insurance premiums between men and woman. This Risk Matters summarises the current position and considers the implications that this Opinion may have for insurers. |
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Issue: September, 2010 Language: English
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This edition returns to cognitive problems which have proved the most difficult risk to assess and manage. |
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Issue: July, 2010 Language: English
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This edition of Risk Matters looks at the risk malaria poses. |
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Issue: July, 2010 Language: English
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In Risk Matters March 2007, we reviewed new evidence that clearly demonstrated the causative role played by cannabis in the development of psychosis. In this issue of Risk Matters we consider why the research supports a cautious approach to underwriting those who use cannabis. |
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Issue: May, 2010 Language: English
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Declining function is associated with depression and depression is itself associated with a decline in function. This edition of the LTC Quarterly looks in more detail at this process which is potentially identifiable at underwriting and modifiable at claim. |
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Issue: April, 2010 Language: English
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The measurement of cholesterol in the skin (SC), or "skin sterol" has been put forward as a candidate to eliminate the need for testing blood for lipids and avoiding the inconvenient requirement for examinees to fast prior to the test. This edition of Risk Matters examines the claims for this test and its potential for cardiovascular risk assessment. |
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Issue: March, 2010 Language: English
Author:
Chris Ball
Summary:
Parkinsons Disease (PD) is the second most common degenerative brain disorder. This paper concentrates upon both the non-motor symptoms whose management can reduce the likelihood of claim or the length of claim and the recent research suggesting changing patterns of PD mortality. |
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Issue: March, 2010 Language: English
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Ensuring people return to work has long been the aim of insurance disability products such as Income Protection (IP). Recent changes in the Governments approach and recommendations from the National Institute of Clinical Excellence (NICE), the independent body that offers national guidance to promote good health and treat ill health, have raised the profile of this issue. |
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Issue: January, 2010 Language: English
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In this edition we consider the wider impact on insurers of proposed reforms to UK insurance law. |
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Issue: November, 2009 Language: English
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In this issue we consider the risk of sudden cardiac death in elite athletes and explore the methods used to identify those at high risk. |
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Issue: November, 2009 Language: English
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This edition concentrates on osteoarthritis and osteoporosis, conditions that directly affect the mechanical supports of the body, the bones. |
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Issue: October, 2009 Language: English
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In this issue we consider the potential implications on income protection of recent court cases relating to workers rights on sickness. |
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Issue: September, 2009 Language: English
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This edition looks at recent evidence concerning the frequency and burden of falls, the value of exercise programmes and the prediction of future falls. |
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Issue: September, 2009 Language: English
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This article describes the changes to the HbA1c measurement and how underwriters should interpret them. |
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Issue: September, 2009 Language: English
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The purpose of the third Risk Matters Symposium was to bring together senior opinion makers within the life insurance industry to discuss, in an informal atmosphere, a specific issue that the industry is facing. |
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Issue: July, 2009 Language: English
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In July 2009, the UK Government published a long-awaited Green Paper to kick-start debate on the future of adult social care in England. This issue summarises the funding options proposed in the Green Paper and looks at the implications for the insurance industry. |
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Issue: July, 2009 Language: English
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This article considers the effect smoking bans have had on passive smoking and overall heart attack rates. |
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Issue: June, 2009 Language: English
Author:
Ian Cox
Summary:
This article gives a summary of the current situation of the swine flu and our views on risk management in the light of recent developments. |
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Issue: May, 2009 Language: English
Summary:
This edition of the LTC Quarterly departs from the traditional approach of reviewing a broad swathe of publications looking for papers of particular relevance to LTC. |
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Issue: May, 2009 Language: English
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The Equality Bill was introduced in the House of Commons on 24th April 2009. The Bill is a wide ranging measure addressing covering many areas of possible discrimination. Key amongst these to insurance companies will be the area of age discrimination in financial services. The Bill is currently at a very early stage and there are many steps to final legislation. This short article looks at some of the headline issues arising from the Bill, particularly in the area of age discrimination. |
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Issue: April, 2009 Language: English
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Swine Influenza (swine flu) is a respiratory disease caused by the type A (H1N1) influenza virus. Swine flu affects pigs throughout the year, causing them illness but few fatalities. It is the nature of flu viruses to "reassort" their genetic components allowing new ones that mix swine, human or avian flu viruses to emerge. Humans do not normally contract swine flu but infections can and do happen. Swine flu viruses have been reported to have spread from person-to-person, but in the past this transmission has been limited and not sustained. However, in late March and early April 2009, cases of human infection A (H1N1) viruses were reported in the US and Mexico. Although the world is better prepared to manage the risk associated with a potential pandemic having addressed similar emotions with severe acute respiratory syndrome (SARS), ebola virus and avian flu, it is worth considering the possible impact of the current swine flu outbreak. |
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Issue: March, 2009 Language: English
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The papers from this quarter consider issues relating to risk scoring and risk factors to see if the promise behind these methods may be justified. |
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Issue: December, 2008 Language: English
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The UK insurance industry developed its first set of standardised critical illness definitions in 1999. This article describes the approach taken by the South African insurance industry when it recently developed its first set of standardised definitions. |
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Issue: November, 2008 Language: English
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This issue focusses on studies on the importance of activity and exercise on an individual's future well being. The studies support the idea that understanding the lifestyle of the applicant is vital in assessing their long term care risk. Active involvement in hobbies or sport and healthy diet all help to stave off future problems. Other studies in this quarter look at the risks and management of a range of medical conditions and the services in relation to LTC products and assessments. |
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Issue: October, 2008 Language: English
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In this article, we explore the difficulties in analysing and handling Child CI claims and look at how providers generally manage their risks via benefit design. |
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Issue: August, 2008 Language: English
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Gen Re led two workshops designed for senior claims managers. The participants examined a wide range of practical implementation, management issues and possible implications for the UK insurance industry, arising from the new Association of British Insurers (ABI) non-disclosure claims guidance. This article captures the main details of the discussions. |
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Issue: July, 2008 Language: English
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There are three major strands to the review of the last quater (April - June 2008) papers with relevance to long term care insurance, which we discuss in this issue. |
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Issue: July, 2008 Language: English
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This article considers the benefits of managing hypertension with combination therapy and what under writers must consider in reviewing applicants that disclose such regimens. |
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Issue: June, 2008 Language: English
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The EU Gender Directive had to be implemented across the EU by 21 December 2007. This article looks at how a sample of EU countries are dealing with the Directive from a life insurance viewpoint. |
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Issue: May, 2008 Language: English
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This LTC Quarterly Digest reviews the last quarters published literature on LTC selecting those studies that are most relevant to the insurance market, particularly for underwriters and pricing actuaries who are looking at the major risk factors for underwriting assessment and claims management. |
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Issue: May, 2008 Language: English
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The second in the Risk Matters Symposium Series dealt with the Needs of the Retired. |
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Issue: April, 2008 Language: English
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The report from the Association of Public Health Observatories in December 2007 received a great deal of publicity as it highlighted the growth in hazardous drinking. |
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Issue: March, 2008 Language: English
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This LTC Quarterly Digest reviews the last quarter's published literature on long term care selecting those studies that are most relevant to the LTC insurance market, particularly for underwriters and pricing actuaries who are looking at the major risk factors for underwriting assessment and claims management. |
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Issue: March, 2008 Language: English
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This edition of Risk Matters is an extract taken from a comprehensive study of telephone underwriting undertaken by Gen Re LifeHealth in the UK. |
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Issue: February, 2008 Language: English
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On 9 January 2008 the ABI published guidance on the fair treatment of claims for UK life, critical illness, income protection and other long-term insurance contracts (Guidance). This article reviews the implications of the Guidance, from a claims management perspective and provides suggestions for future action by insurers. |
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Issue: December, 2007 Language: English
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The EU Gender Directive will be implemented on 21 December 2007. From this date insurers and reinsurers will need to publish data to justify premium / benefit differences between males and females. HMT has been consulting on the issue for the last few months and the results of that Consultation have just been released. This article summarises the issues and the main points from the Consultation Response Paper. |
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Issue: November, 2007 Language: English
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Most underwriters are familiar with applicants who have juvenile onset Type I diabetes. There are studies of the long term prognosis for this condition. The changing nature of juvenile diabetes is presenting a new challenge. 15 years ago under 3% of juvenile diabetics had Type II diabetes; this has risen to 45%. Type II diabetes has traditionally been associated with a much older age of onset and a relatively benign course. Younger onset disease appears to be behaving in a very different way. |
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Issue: September, 2007 Language: English
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Rheumatoid Arthritis is an inflammatory and potentially destructive arthritis producing significant morbidity and raised mortality. Diagnosis was traditionally made clinically with confirmation sought through the measurement of serum Rheumatoid Factor (RF). Developments in the understanding of the underlying immunological processes of the disease have both changed and improved the diagnostic tests. Changes in imaging from traditional x-ray to MRI scanning allows closer monitoring of the progress of the disease, and new disease modifying anti-rheumatological drugs (DMARDs) have a significant impact on the symptomatology and progression of the illness. |
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Issue: August, 2007 Language: English
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Cocaine use is on the rise in the UK. Less in the young population than in those who are entering the phases of their life cycle when insurance becomes an issue for them. Because of this changing pattern, companies cannot rely on the risk being subsumed by their standard population ratings. The risks of taking the drug, in addition to the mental health problems, are of serious damage to the heart and the brain. Sudden death in a young adult of stroke or heart attack always raises the suspicion of cocaine use. Testing has become simple, cheap and reliable and insurance companies shouldbe reconsidering their policies. |
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Issue: July, 2007 Language: English
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Recreational scuba diving is one of the fastest growing hobby sports in the world. It is difficult to estimate how many divers there are worldwide, but it is known that over a million new people qualify to scuba dive each year through various approved agencies. In the UK around two million participate in dives each year. This article explores the risks associated with diving and considers the potential impacton risk selection. |
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Issue: June, 2007 Language: English
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The CIIT00 table is the first publicly available CI insured lives table in the UK. It provides insured rates for ACI and SCI, by sex, smoker status, duration and CI condition. |
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Issue: May, 2007 Language: English
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The Dementia UK report (March 2007) may not seem essential reading for life underwriters or actuaries. However, the report to the Alzheimers Society produced by Kings College and the London School of Economics has two stark messages for the insurance industry on its front cover. Firstly that by 2025 one million people in the UK will have dementia and secondly, dementia costs £17 billion pounds a year. The health, social and economic changes predicted in the report suggest a major shift is likely to the circumstances of many UK residents. Whilst there has been only limited interest in providing an insurance solution, the report suggests that a significant change in attitudes towards this issue is underway and that insurance companies will have a much larger role to play in the future. |
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Issue: April, 2007 Language: English
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Although commonly seen as a disease of old age, Parkinsons is found in a small number of younger people too. It is tricky to diagnose making it difficult to establish effective treatment in the early stages. It may be problematic for underwriters to risk profile associated symptoms where primary care has been reticent to label a patient as having the disease. Importantly, it is a disease that has a high rate of misdiagnosis and therefore special care is needed when interpreting equivocal claims evidence. |
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Issue: March, 2007 Language: English
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Social and even medicinal cannabis use is increasingly common and underwriters have in consequence developed a rather relaxed attitude to it in risk assessment. Emerging data suggests that cannabis may be more dangerous than LSD and ecstasy and linked to serious, long-term illnesses which may force a rethink about how this drug is approached by underwriters. |
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Issue: February, 2007 Language: English
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Medical tourism is already a booming trade around the globe but there are potential problems for patients and life insurers alike. This article discusses the implications for those undergoing such treatment and for underwriters and claims technicians who manage these risks. |
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Issue: January, 2007 Language: English
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From 1 September 2006 the 00 mortality tables were recognised as standard mortality tables in the UK. At Gen Re we analysed the Term Assurance T00 tables and provided feedback to the CMI on the pros and cons of the new tables during the consultation period.This article discusses some of the features of the new tables to assist users during this period of transition. |
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Issue: December, 2006 Language: English
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This article considers the background trends and implications that alcohol consumption as a social phenomenon holds for underwriters and claims managers. |
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Issue: December, 2006 Language: English
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The Misuse of Drugs Act 1971 classifies Ecstasy as a Class A drug.
This article discusses the implications of Ecstasy abuse and the hidden dangers to risk selection. |
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Issue: November, 2006 Language: English
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Mild Cognitive Impairment (MCI) is a syndrome that has been defined as a cognitive decline greater than expected for an individual's age and educational level but one that does not interfere notably with activities of daily life. The key impact for underwriters is that within 5 years, more than 50% of MCI sufferers will have progressed to a dementing illness. MCI can therefore be regarded as a significant risk factor for the development of dementia which can have a direct claims impact on Critical Illness (CI) and Long Term Care (LTC) policies. This article discusses the implications of MCI for underwriters. |
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Issue: November, 2006 Language: English
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The inaugural Risk Matters Symposium was held at Claridges earlier this year. The subject of this symposium was Income Protection. The discussions were wide ranging reflecting the make up of the group: ranging from business unit directors and marketing directors to actuaries and medical underwriters. |
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Issue: November, 2006 Language: English
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Gen Re held two half day training workshops for underwriters at the end of October in both Edinburgh and Bristol. This article provides a brief over-view of the topics we discussed and their importance to risk assessment. |
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Issue: October, 2006 Language: English
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This article discusses the implications for insurers of biomarkers for Alzheimer's disease. |
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Issue: September, 2006 Language: English
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In response to increased military activity post 9/11, the life insurance industry has imposed some controls over the risk assessment of Armed Forces personnel. The general aim is to offer fair terms and access to appropriate covers whilst controlling volatility and lapse risk. In the UK, the risk assessment approach has remained largely unchanged over a long period. Against a backdrop of increasing military activity and global uncertainty, we examine whether the traditional approach for assessing Armed Forces personnel still holds good. |
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Issue: September, 2006 Language: English
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Over the last 30 years, the UK has seen the number of people claiming Incapacity Benefits treble. The Department of Work and Pensions is stepping up its reform of the benefits system and has published the Welfare Reform Bill. This article looks at the implications of the bill for the Income Protection market. |
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Issue: July, 2006 Language: English
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The FSA has published a proposal which may have a significant impact on the finances of writing life protection business and on the reinsurance buying decision. This article discusses two possible implications of the proposals, which are intended to come in to force in the 4th quarter 2006. |
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Issue: June, 2006 Language: English
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This article discusses the implications and interpretation of estimated Glomerular Filtration Rate (eGFR) results. The eGFR is to be used as the basis for classifying chronic kidney disease. It is a more specific and sensitive marker than traditional renal function tests for both kidney disease and, more importantly, cardio vascular risk. |
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Issue: May, 2006 Language: English
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This issue looks at two factors used by life insurers to differentiate their target market: smoking habits and BMI: and considers whether any refinements to the existing rating system will be to the benefit of the majority of thec urrently insured population. |
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Issue: April, 2006 Language: English
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In the second part of our examination of the funding of Long Term Care (LTC), we consider a recent report published by the Kings Fund, an independent charitable trust that undertakes research and analysis into the provision of
improved health services. |
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Issue: April, 2006 Language: English
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In this issue we consider the potential for developing new products following clarification of future LTC funding based on a recent court ruling. |
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Issue: March, 2006 Language: English
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This issue considers the problems that arise with the current way the options attaching to life insurance policies are reinsured. It goes on to recommend a new way of reinsuring these options which overcome some of these problems. |
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Issue: February, 2006 Language: English
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In this issue we consider the use of family history information in underwriting assessment. The article considers the various justifications for utilising this type of data in a society that is increasingly interested in how genetic information is obtained and processed. |
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Issue: January, 2006 Language: English
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In the second issue we give a brief overview of the likely effects on the UK, in particular the life industry, if the current strain of bird flu causes a pandemic. |
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