Journal of Insurance Medicine

OBJECTIVE: -Explore the impact of proactive outreach to a health plan population during COVID-19 pandemic in New Mexico. BACKGROUND: -By March 2020, the 2019 novel coronavirus (COVID-19) was a global pandemic, circulating in more than 114 countries. As more information about virus transmission, symptoms, and comorbidities were reported over time, recommendations for reducing the spread of the virus within communities was provided by leading health organizations like the Centers for Disease Control and Prevention (CDC)...

Detecting undisclosed methamphetamine and heroin abuse is a challenge for life underwriters and medical directors. A common clinical assumption is that if substance abusers experience liver damage, it will be indicated by elevated serum transaminases. The following case suggests that assumption may not be true for heavy substance abusers who consume no or minimal alcohol. This report describes a 44-year-old male with long-term use of inhaled combined methamphetamine and heroin ("speedballs") and minimal alcohol use, whose transaminases remained normal while episodes of acute liver failure and transient hepatic encephalopathy from hyperammonemia were observed...

Critical illness insurance was introduced 40 years ago. Medical directors continue to be challenged and frustrated with the complexities that critical illness claims offer. This article provides insights into the continued issues and possible solutions.

This report summarizes the incidence, relative frequency distributions and survival & mortality by age, sex, stage and grade, of adult invasive primary cancers of the lip in two entrant time-periods as recorded in the SEER Program of the National Cancer Institute for diagnosis years 1973-2014 (SEER Stat 8.3.5). While the occurrence rates and frequency are low in the United States, they are exceptionally important from a clinical and surgical standpoint because of the morphological and functional changes involved...

OBJECTIVES: -Determine the relationship between liver function test (LFT) results (GGT, alkaline phosphatase, AST, ALT and albumin) and all-cause mortality in life insurance applicants. METHOD: -By use of the Social Security Master Death File, mortality was examined in 15,272,955 insurance applicants for whom blood samples were submitted to the Clinical Reference Laboratory. There were 268,593 deaths observed in this study population, after an average follow-up time of 10...

This article summarizes the results of a retrospective population-based cohort study using the statistical database of SEER*Stat 8.3.54 (produced 3/5/2018 for diagnosis years 1973-2014) to assess, determine, compare, and summarize the occurrence, long-term survival, and mortality indices of 218,066 patients with oral cavity and pharynx cancers by age, sex, race, stage, grade, and disease duration.

This article reviews a 20-year retrospective population-based study using the statistical database of SEER*Stat 8.3.4 to compare the occurrence, long-term survival and mortality indices of 266,898 patients with cancer of the rectum and rectosigmoid junction (RSJ) juxtaposed by age, sex, race, stage, grade, disease duration, in two cohort entry time-periods, 1973-1994 & 1995-2014.

No abstract text is available yet for this article.

Long COVID is now a recognized complication of acute COVID-19 infection. As the COVID-19 pandemic moves into its third year, the prevalence of Long COVID continues to increase. Many individuals report symptoms lasting longer than a year, and a subset of this group is unable to work. This article will provide an update on Long COVID, with a particular focus on distinguishing it from other clinical entities. It will review several proposed disease mechanisms and will attempt to anticipate the impact on disability insurance...

No abstract text is available yet for this article.

As in most countries, patients, health care providers, and insurance organizations are key components of the health care system in Iran. High rates of growth and development in today's financial markets, have made the insurance industry with its unique calculations and models, a prominent player in this specialized economic sector.

Detecting undisclosed alcohol abuse in life insurance applicants has always been a challenge to life underwriters and medical directors. This case report describes a 38-year-old woman with classic signs, symptoms, behavior and biochemical markers of undisclosed alcohol abuse. Review of 10 years of medical records revealed chronic abnormally low serum creatinine results associated with abnormally elevated liver function tests, and repeated denials to attending physicians of ever consuming alcohol. Kidney function throughout the 10-year history was not impaired...

This article summarizes the results of a review of adult invasive primary cancers of the liver, intrahepatic bile ducts, gallbladder, exocrine and endocrine pancreas, as recorded in the SEER Program of the National Cancer Institute for diagnosis years 1973-2014 (SEER Stat 8.3.4).

Projections of life expectancy are widely used in medicine, actuarial practice, and in the medicolegal and insurance fields. For individuals considered to have average future survival, nationally-derived life expectancy tables are available, referred to as the Ogden Tables. In the United Kingdom, updated tables (the 8th edition) were published in July 2020. We have calculated impaired projected life expectancies for the United Kingdom based on age and gender, derived from the 8th edition of the Ogden Tables together with various assumed lifelong mortality ratios...

BACKGROUND AND OBJECTIVE: -The traditional role of the insurance medical director is evolving. RGA surveyed insurance medical directors to provide an overview of their roles, skill sets, future trends, and their increasing and changing contributions to the insurance industry in recent years and throughout the current pandemic. METHOD: -RGA conducted a first-of-a-kind global survey of medical directors in the insurance industry. The online survey took place from April to June 2021 and had seven key sections: medical experience and qualifications, roles and responsibilities, underwriting and claims capabilities, adapting to change, disease and product trends in insurance, challenges, and future opportunities...

OBJECTIVE.—: To propose an insurance product called special needs insurance. The insurance will pay parents a lump sum up to $100,000 if they have a child that is born with or develops a special needs condition such as Down syndrome, cerebral palsy or autism. BACKGROUND.—: Raising a child is expensive; raising a child with a special need can be hundreds of thousands of dollars more expensive. These additional costs include direct costs that are not covered by health insurance and indirect costs such as the loss of earnings when a working parent must tend to a special needs child...

We have recently constructed tables of the estimated life expectancies of impaired lives on the basis of mortality ratios and the cohort life expectancy tables given in the 8th edition of the Ogden Tables, which are derived from the ONS 2018-based population projections for the United Kingdom.1,2 The life expectancy of impaired lives may also be estimated using excess death rates. In this paper, we give tables of life expectancies for impaired lives using a range of excess death rates for males and females from age 0 to age 100...

Disability due to mental health disorders has been increasing in many countries over the past years. The COVID-19 pandemic may worsen this trend because of 3 different, and at times overlapping, pathways. This article describes each pathway, and by drawing on the experience of previous coronavirus epidemics and recent recessions, attempts to estimate the likelihood that claims due to mental health disorders will increase.

The sudden emergence of the COVID-19 pandemic in early 2020 presented a unique challenge for medical directors of life insurance companies. Company leadership required quick answers about many issues, but two in particular: 1) the magnitude of the pandemic's impact on the insured lives portfolio and 2) the underwriting of new applicants during a pandemic. This article will describe the experiences of a global team of reinsurance medical directors during a pandemic. It may also serve to provide guidance for medical directors facing a similar challenge in the future...

No abstract text is available yet for this article.