NAILBA Perspectives - January/February 2015 - (Page 44)
agency resources
Life Underwriting in 2020
HANK GEORGE, FALU, CLU, FLMI
I
am neither clairvoyant nor in
possession of a crystal ball.
This confessed, after 45 years
in life insurance risk assessment-
and with an obsessive focus on
tracking trends-I have some reasonably credible thoughts regarding
how underwriting will be configured
five years hence.
For better or worse, here goes...
Reliance on Medical Records
Attending Physician Statement
(APS) costs are rising and there
are reasons aplenty to worry that
e-records will not confer their
highly anticipated advantages. Add
the adverse impact of the APS on
turnaround time and it is inevitable
that medical record use will decline
overall (most notably under age 50).
Taking Risk Histories
Teleinterviews and the online equivalent will dominate. Fewer insurers
will countenance producers opting
out of teleinterviews on a case-bycase basis because this makes no
common sense.
Exams
The cost vs. yield ineffectiveness
of clinical medical examinations has
now been exposed. MD exams for
underwriting, if anything, are less
worthwhile. There is no basis for
continuing to use them.
With the rise in super-simplified underwriting, aggregate use
of paramedicals will progressively
decline, save for elder business.
In addition, a growing portion
will be done at fixed site facilities
rather than on a mobile basis.
Laboratory Testing
This, too, will decline overall, if
only because-save for producercollected oral fluid-it is wholly
paramedical-dependent.
On the other hand, certain high
yield markers such as NT-proB-
NP, HbA1-c and, likely, cystatin
C, will play a much greater role in
screening at older ages. Hepatitis
C screening will increase in concert with the anticipated rise in
cirrhosis and liver cancer deaths
from this notorious virus well into
the next decade. Conversely, PSA
use will decline.
Electrocardiograms
Their fate is sealed.
ECG and treadmill test screening
will dwindle in favor of NT-proBNP
because the latter simply has too
many advantages. Ideally, we will
stop doing all screening ECGs.
Pharmacy Records
Their use will be essentially universal by 2020. They simply offer myriad indisputable advantages on a
cost vs. benefit basis. Like MIB data,
Rx profiles are intrinsic to effective
risk assessment. So much so that
it is difficult to fathom why any
insurer would fail to maximize their
potent impact on mortality results.
Cognitive and Frailty Tests
Cumbersome, client-unfriendly, and
dubiously credible tools such as
Timed Get-Up-and-Go, gait speed,
clock drawing, and delayed word
recall are vulnerable to the embrace
of less egregious alternatives.
Their demise will not be mourned.
Recent evidence suggests the
cystatin C test could be one of
them, perhaps coupled with adding
teleinterview questions.
Outsourced APS Summaries
If an underwriter can review an
affordable and competently done
3 page summary of a 70-page APS,
the advantage to the insurer is
substantial.
Until now, there has been pushback from insurers, driven by uneven
44 perspectives JANUARY/FEBRUARY 2015
summary quality and underwriter
disgruntlement.
Both barriers can and will be
overcome. Use of this service should
increase markedly over the ensuing
half decade.
Outsourced Case Underwriting
Like APS summaries, outsourced
underwriting
has
noteworthy
potential as a resource for insurers. At present, this service is
mainly used during periods of peak
caseload volume and for "quick
quotes."
Expect more carriers to retain
firms to underwrite their business in
the future. With adept surveillance
practices in place, this should be an
appealing option for many insurers.
"Big Data"
The naïve rush to embrace these
putative resources will be tempered
as insurers look beyond alleged cost
savings and question their appropriateness in an underwriting context.
While lab-scoring models make
a clear contribution (so long as we
recognize their limitations), at least
some other "big data" offerings are
literally "wolves in sheep's clothing." One hopes wiser heads prevail
lest we take steps we are destined
to regret.
Remote Underwriting
A substantial (and growing) share
of underwriters work largely or
wholly from home. The win-win
here for underwriters and their
employers argues for this trend
continuing.
Indeed, carriers that refuse to
accommodate this coveted option
are finding it difficult to hire
underwriters!
Hopefully, we will prudently avoid bestowing this privilege
prematurely on underwriters that
Table of Contents for the Digital Edition of NAILBA Perspectives - January/February 2015
NAILBA Perspectives - January/February 2015
Contents
Chairman’s Corner
CEO Insights
The NAILBA of the Future
NAILBA Charitable Foundation
Life Happens
Shaking Up Sales Concepts in 2015
Agency Successor Networking Group
NAILBA 33 Highlights
Member Profiles
Reading Ahead
Agency Resources
Calendar of Events
Index of Advertisers
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