Who is THE ENEMY WITHIN?
“He” has no one name, no essential gender.
What “he” has is the incredibly untimely capacity to rapaciously rob your company of its future…and compelling evidence suggests this is indeed what is coming to pass across the global life and health industry.
For much of this underwriter’s 30 years of practice, he had to endure being denounced as head of “the sales prevention department” by angry producers who tired of waiting weeks (if not months) for a “thumbs up” on new business.
Those days will soon be gone…forever.
There was a posting recently at lifeunderwriting.com wherein the underwriter bemoaned the fact that his company would not fund his enrollment, and that of his peers in the department, in the State of the Art™ Continuing Education Program.
This is a classic case of missing the forest for the trees, as they say. And not just because it happens to focus on the education program into which I and my colleagues at SelectX-UK have invested so much of our energy and devotion.
Hank has written a comprehensive research paper on a new test ideally suited for mortality and morbidity risk screening. It will serve well in tandem with NT-proBNP and other blood tests, as an alternative to treadmill ECGs and other slow, costly requirements we currently use.
Adding a dash of salt on the wound, a new study says consumers today are even less aware that banks offer life coverage than they were four years ago.
Dabbling in the realm of the audacious, one might dare to describe our collective response to the life insurance needs of the middle market as "90% lip and 10% service." Since banks are the delivery vehicle of choice to this vast, underserved market, why are bancassurance sales, relatively speaking, in free fall?
Enter everybody's favorite fall guy: underwriting.
In days of yore, the most doleful lamentation from those who coveted bank distribution was the galling disconnect between the instant-gratification expectations of buyers and the cold, hard fact that the rigors of underwriting could only accommodate applicants with the patience of saints.
Our capacity to configure customer-cozy risk assessment strategies is at hand. Informed deployment of 21st century underwriting assets all but guarantees actuarially sound, reinsurer-attractive and customer-friendly life products for bank-mediated dissemination.
Considering the predictable mix of business in a bank setting, rapid and cost-effective risk triage can be achieved with three primary resources: teleinterviews, prescription profiles and Medical Information Bureau records. The risk-history questions broached in this context must be carefully honed based on contemporary medical realities. By doing so, we can fashion far superior applications for this market.
By carrying off teleinterviews on a "warm transfer" basis mode and inter-digitating them other information, we can empower credible decision-making that is entirely harmonious with bank distribution tolerances.
Risk factors for short- to intermediate-interval excess mortality in middle-market applicants can be handily addressed with a combination of adroit interviewing and wizened analysis of pharmaceuticals prescribed within the past several years. The few cases needing further assessment would be quickly pinpointed in this process. And, thanks to teleinterview recordings, egregious attempts at material nondisclosure will be more manageable than ever, even after the fact.
Will there be coverage thresholds where more invasive requirements, such as blood and urine tests, will be needed? Sure, but thresholds at rather eye-popping altitudes can be countenanced when the yield from our core assets (teleinterviews and prescription profiles) is optimized.
Novel concepts such as "risk-taking behavior" and the "healthy-adherer effect" can be retrofitted to existing underwriting paradigms, balancing the loss of protective value that's implicit in walking away from traditional screening requirements.
It is incredibly safe to say that we have only scratched the surface where these alternative approaches are concerned. Unlike other options, they facilitate rapid turnaround time and should resonate with consumers because they bring the process that much closer to being driven by health-habit choices which we, ourselves, make every day.
The much-ballyhooed bottleneck between underwriting and life sales through banks is rightly dismissible as urban legend.
So much for the mythic mystery of how to serve the middle market.
Hank George, a Best's Review columnist, is the principal in his own consulting and training firm, Hank George Inc. He may be reached at HankGeorge@aol.com.
What are the two biggest underwriting-related concerns of senior management in direct-writing life insurers?
#1 – Reducing new business acquisition costs
#2 – Reducing application-to-issue cycle time
Both of these issues are conspicuous high priority agenda items in most companies.
The matter of business acquisition costs is, if anything, accentuated by the current economic environment.
This review of the world literature on cystatin C, a novel marker for renal impairment, encompasses all relevant studies published up to the end of November, 2008. It was undertaken to contribute to essential efforts aimed at replacing conventional screening practices, most notably the deployment of chest x-rays, treadmill stress tests and resting ECGs. For a variety of reasons, these entities are no longer appropriate choices for routine use in underwriting.
This literature review demonstrates clearly that cystatin C is superior to creatinine and creatinine-based eGFR equations as an indicator of mild-to-moderate impairment of kidney function. It further reveals that cystatin C is an independent marker for the risk of cardiovascular disease, potentially synergistic with NT-proBNP as a screening duo at older ages. Moreover, cystatin C may confer additional risk assessment advantages in terms of premature physical frailty, early cognitive impairment and assessing the severity of liver disease.
There do not appear to be any significant impediments to the deployment of cystatin C in risk appraisal. Therefore, in consideration of the foregoing, it is this author’s opinion that cystatin C should now be further evaluated for deployment as both a screening and reflexive test in mortality and morbidity risk underwriting.
In late 2006, I was asked by a friend to create an e-dialogue with a 79 year old friend of hers whom we will refer to as “Patient MB.” This retired business executive had been diagnosed with desmoplastic melanoma several years earlier. When my friend happened to mention that she had a friend who knew a bit about melanoma, Patient MB asked to get in touch with me. As a result, he and I exchanged a number of e-mails and I wound up doing a fair amount of reading on desmoplastic melanoma.