Nonalcoholic steatohepatitis (NASH) is a more aggressive form of liver disease. It is inflammatory in nature, is much quicker in disease progression than the standard type and may result in liver cirrhosis and failure. Both in clinical practice and in underwriting, NASH is under-recognized in its incidence. It actually affects up to five percent of the United States population and its prevalence is on the rise.
Undoubtedly, after hours and hours of CNN and network news coverage, we are all “experts” on coronavirus, something we likely knew nothing about entering this new year. How it spreads, what to do to avoid it, how to practice social distancing, sheltering in place—all part of our new vocabulary in this stressful time. Just as it affects our daily lives, it also affects life insurance applications and how we are handling different steps in the process.
When cardiac events occur, such as a heart attack or the need for a revascularization procedure, there is quantifiable risk that can be identified and priced for.
Marfan’s syndrome is a systemic connective tissue disease that is inherited. It is characterized by abnormalities of the skeletal, cardiovascular and ocular systems predominantly.
Psoriasis is a common inflammatory skin condition that is characterized by bright red plaques, generally looking like silver scales, and most often present on elbows, knees and scalp.
Bronchiectasis is a disease that is characterized by chronic dilation and widening of the smaller bronchial tubes and bronchi and destruction of the bronchial walls. It can either be congenital (such as in cystic fibrosis, the cause of almost half the cases) or acquired via recurring inflammation or infection of the airways.
Celiac disease is a dietary disorder caused by an immunologic response to gluten, which is a storage protein found in many grains.
Lab results often fit a pattern, since the body’s physiologic system is generally in sync with each of its organ systems. If heart, liver, kidneys or metabolic results are affected, there will generally be a pattern where tests rise in conjunction with each other. Then there are “outliers,” profiles where one test stands front and center out of the normal and without any lab value friends to put it in perspective.
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.
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.
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