NAILBA Perspectives - September/October 2014 - (Page 38)

agency resources Hot Underwriting Issues T HANK GEORGE, FALU, CLU, FLMI his essay dissects four hot issues in life underwriting with notable implications for the brokerage market. Electronic cigarettes Since they came on the scene just seven years ago, the use of e-cigs has mushroomed. There are now over 300 brands on the market worldwide. These devices deliver nicotine as an inhaled vapor. They may also contain various fruit ﬂavorings...and are also said to be a handy means way of smoking hashish (marijuana on steroids)! Thus far, the weight of evidence suggests that the other contents of this vapor have little or no health signiﬁcance, certainly nothing like the countless carcinogens and other toxic substances in tobacco cigarettes. Less than 5% of current e-cig aﬁcionados have never smoked cigarettes. The substantial majority are current smokers, using e-cigs to cut down or quit, whereas the rest are ex-smokers trying to get the perceived beneﬁts of nicotine without relapsing to tobacco cigarettes. E-cigarettes are more effective than other nicotine delivery devices for these purposes. Will e-cig users test positive for cotinine at industry lab thresholds? It depends on the amount of nicotine in the cartridge and how often the device is used. Overall, it is likely that most will test positive and thus be indistinguishable, based on cotinine screening, from tobacco consumers. Is there any way to make this distinction? Yes-by further scrutinizing those who claim to be solely e-cig users 38 perspectives SEPTEMBER/OCTOBER 2014 with a blood test called thiocyanate. Industry laboratories can do this test, however there could be substantial added cost and the test is far from foolproof. The good money says that more insurers will do likewise, spurred on in some cases by the medicalization of this widely used "illicit" substance. How are underwriters dealing with e-cig use? For the most part, they view it as equivalent to wearing a nicotine patch. If you want to know all the gory details about e-cigarettes, a comprehensive literature review paper was published in July at www. insureintell.com. Electronic Medical Records Numerous industry pundits hailed the advent of the e-APS as a landmark favorable development. Maybe so... On the other hand, there are reasons to believe that electronic medical records could create as many-if not more-problems than they solve. Here are some sobering questions that might dampen our enthusiasm: ■ To what extent can patients modify their records? This is the Achilles' heel of e-records and practices could vary widely depending on how a given hospital or clinic system works. ■ Will physicians keep separate erecords about "sensitive" topics like psychiatric disorders, substance abuse, etc.? We have already seen examples of this with e-records. ■ Will hospitals and clinics try to recoup part of their hefty investment in an e-records system by substantially hiking up APS fees? ■ Will e-record acquisition time be signiﬁcantly shorter than the 12-13 days it currently takes to get conventional records? Some providers tell us this is not happening. It would seem prudent for insurers to track e-records, matching them carefully to what is disclosed by the applicant, medications cited in pharmacy records, etc. When my latest personal physician (they tend to ﬁre me after a year or so!) took my history, he asked me how much I drink. I told Medicinal Marijuana The array of medical conditions wherein marijuana provides therapeutic beneﬁts continues to enlarge, as does the number of people consuming pot (ostensibly) for these reasons. What is the prevalent underwriting viewpoint on medical marijuana? It presents something of a conundrum for us. As a rule, we do not rate people for taking medication. That is, except in a comparative handful of scenarios (immunosuppressives, high dose oral steroids, etc.) where the drugs themselves confer excess mortality. Therefore, the question of how to underwrite medical marijuana is really no different than underwriting its use in a recreational context. Despite robust evidence that occasional marijuana ingestion is not associated with signiﬁcant extra mortality, most companies continue to treat any pot use as akin to tobacco cigarette smoking. This said, some carriers are breaking ranks with their peers and offering occasional marijuana users non-tobacco rates. http://www.insureintell.com http://www.insureintell.com

Table of Contents for the Digital Edition of NAILBA Perspectives - September/October 2014

NAILBA Perspectives - September/October 2014
Contents
Chairman’s Corner
CEO Insights
Servicing Orphan Policy Holders: The BGA’s Role
NAILBA 33 Preview
Life Happens
Future of the Independent Marketing Organization
NAILBA Charitable Foundation
Member Profiles
Agency Successor Networking Group
Agency Resources
A Path Forward: Part 1 of 2
Reading Ahead
Calendar of Events
Index of Advertisers

NAILBA Perspectives - September/October 2014