Cystic fibrosis was rarely encountered by Life and Health underwriters until relatively recently. However, advances in our understanding of this inherited lung disease, and the emergence of more effective treatments, mean that children born with the disease are now surviving into adulthood and living much healthier lives.
Survival for infected individuals continues to improve as newer, less toxic drugs and simpler one-tablet daily regimens are increasingly available. RGA's Hilary Henly explores what underwriters need to know about HIV in part one of a two part series.
Significant and rapid progress in genetics research and data analytics is currently enabling an unprecedented expansion in science’s understanding of the genetic underpinnings of rare and common diseases. Large-scale cohort studies such as the UK Biobank are helping scientists build powerful prognostic models for a number of diseases, including breast cancer and coronary artery disease, and hastening the development of a new tool for quantifying the inheritability of common diseases: Polygenic risk scores.
Lest anyone think the previous exchange is fanciful or seems a bit paranoid, it is already happening. It is known as using accelerated underwriting using external data and over two dozen U.S. insurers are currently using it.
While it sounds like something Joe Friday of Dragnet or the FBI would do, medical surveillance involves the following of a condition before deciding whether or when to take a definitive action of treatment. The waiting period can precede a possible surgery, a medical intervention, or an institution of therapy that disrupts the status quo. That’s what surveillance truly is: Waiting and watching before deciding whether to take an action that will disrupt the status quo.
Genetic testing is becoming more accessible and commonplace, with new genetic links to diseases regularly being identified. However, the many constraints on the use of predictive genetic tests in insurance means that the easy availability of direct consumer testing is an issue that the industry must consider very carefully.
The pressure is on for carriers to provide the best customer experience, while implementing consistent, comprehensive and accurate underwriting policies. Advanced e-underwriting systems can help insurers respond.
Earlier this year researchers at Heidelberg University Hospital announced the development of a blood test that can detect breast cancer cells in patients - with higher accuracy than mammography.
Epigenetics is poised to improve the underwriting process, moving beyond deep venous puncture blood collection and a lengthy approval process that takes months to complete.
There was a time in the very early days of life-insurance underwriting, somewhere actually in the 1700s, when the only useful and predictive piece of data recognized was age. And using it affected a simple equation: as the certainty of death approached year by year, so was risk duly assessed. It would take another two hundred years or so before we began to understand that gender also directly impacts the science of mortality. We now utilize a wealth of information to analyze and quantify risk, and yet, it appears, we may have still only scratched the surface. Today, we could be standing at the precipice of a quantum leap in how we understand, interpret and eventually underwrite an ever-expanding inventory of exposures.
