Prognostic features of menopausal and postmenopausal applicants for life insurance

The increasing proportion of the aged in the population is posing significant new challenges to politics, society and medicine as well. Gerontology and geriatrics are playing a role in all areas of preventive and curative medicine. Since the life expectancy of women is approximately eight years longer than that of men, gynecology draws special significance from the fact that the greater part of an aging society will primarily be comprise of women. The medical treatment and care of women in climacteric and postmenopause in the past is seriously inadequate by today's standards. The attitude in earlier years of not making any great investment of cost or personnel in patients over 75 can, in view of the vitality of modern-day senior citizens, no longer be justified or maintained. The necessity of establishing old-age gynecology becomes more and more clear and urgent. The decrease of ovarian function in menopause is without doubt an important turning point in the life of a woman. The first signs of aging are inescapable. Following these years a woman still has more than one third of life expectancy ahead of her which she would like to and should spend in good mental, spiritual and physical health. The principle of postmenopausal hormone replacement has shown itself to be amazingly successful in treating climacteric disorders and their effects on the entire organism. Treatment over many years with as board a spectrum as possible of preventive hormones to combat the long-term consequences of hormone deficiency, like osteoporosis-related fractures, heart attacks, or strokes, is one of the great medical advances of our time. Furthermore, the significance of preventing a number of genital concern manifestations through hormone replacement therapy cannot be overestimated. Gynecology has taken a remarkable step toward its goal of enabling aging women to spend the third part of their lives free of unnecessary diseases and suffering. In 1994, after consultation with representatives of European countries during the World Congress of the International Menopause Society, a statement was published by the menopause society of German-speaking countries. In this consensus paper, a stand was taken on hormone replacement therapy in postmenopause. The purpose of this paper was to serve as an aid in formulating and interpreting the text in the package inserts that are enclosed with hormone preparations. The most important passages were to once again summarize the present status of knowledge on hormone replacement therapy and its risks and benefits: (Estradiol is the estrogen normally produced by a woman's ovaries that exercises all functions of the natural follicle hormone. It is used to treat all symptoms of estrogen deficiency). Estrogen eliminates, or mitigates, all typical symptoms of estrogen deficiency in menopause, including hot flashes, night sweats and other complaints frequently observed like nervousness, sleep disturbance and depression, with great reliability. Estrogen stimulates the cell division of an aging organism, of mucous membranes, of supportive and connective tissue. It improves the blood circulation and the salt and water content. Furthermore, estrogen prevents or eliminates deterioration in the urogenital area and the disorders that result from such deterioration. Estrogen prevents or retards bone deterioration, osteoporosis and spinal, lower arm and femur fractures. By positively influencing HDL- and LDL-cholesterol, blood vessels and circulation, long-term estrogen replacement inhibits the development of arteriosclerosis and nearly halves the frequency of heart attacks and strokes. The mortality rate of women over 50 is therefore decreased significantly and life expectancy increased. (Benefits to the blood vessels of such preventive treatment can already be seen after five years of estrogen therapy and their benefits continue for several years after treatment is stopped.     

Statistical analysis of HIV seropositive results from 1988-1993 performed on life insurance applicants

This review of statistical data, derived from HIV antibody testing performed on life insurance applicants over a period of five and one-half years, reflects the evolving nature of the HIV epidemic in the United States and demonstrates how the findings in the life insurance low risk population mirror the trends and changes that are occurring in the general population.     

Screening life insurance applicants with hemoglobin A1c: a pilot study of cost-benefit

Hemogloblin A1c (HgbA1c) values are superior to those of random serum glucose, serum fructosamine, and urine glucose as a means of detecting carbohydrate intolerance. Further, HgbA1c values have been shown to correlate with mortality in a continuous fashion beginning at levels between 5.0% and 6.0%. Unfortunately, the expense of HgbA1c testing is considerably higher than that of routine serum chemistry testing. Diabetes is an increasingly common disorder clearly associated with mortality. Also, the current demographic trends towards increasing age and increasing prevalence of obesity underscore the value to underwriters of identifying carbohydrate intolerance.     

Update on coronary artery calcium imaging

This update of coronary calcium imaging discusses methods of detecting and measuring coronary artery calcium and their correlation to coronary artery disease risk. The value of EBCT to traditional non-invasive cardiovascular tests is compared. A negative EBCT test makes the presence of atherosclerotic plaque, including unstable plaque, very unlikely. Negative EBCT may be consistent with low risk of a cardiovascular event over the next 2-5 years. Conversely, positive EBCT confirms the presence of a coronary plaque. The greater the amount of calcium, the greater the likelihood of occlusive disease, but there is a not a 1:1 relationship and findings may not be site specific. A high calcium score may be consistent with moderate to high risk of cardiovascular event within the next 2-5 years. Limitations and cautions concerning the general use of EBCT for screening are discussed.     

Cultural practices and life insurance consumption: An international analysis using GLOBE scores

This cross-disciplinary study examines how national culture practice affects cross-country variations in life insurance consumption. To proxy for national culture dimensions, we use the refined measure of the GLOBE project which includes several additional cultural dimensions not included in Hofstede's analysis. Using 1966–2004 data across thirty-eight countries, our analysis reveals a strong relationship between life insurance consumption and the practice scores of in-group collectivism as well as power distance. These relationships continue to hold, even after controlling for other country-level variables such as national income, expected inflation rate, banking sector development, investor protection index, dependency ratio, life expectancy, and religion.     

Martingales in life insurance

Abstract

This paper presents a general probabilistic model, including stochastic discounting, for life insurance contracts, either a single policy or a portfolio of policies. In § 4 we define prospective reserves and annual losses in terms of our model and we show that these are generalisations of the corresponding concepts in conventional life insurance mathematics. Our main results are in § 5 where we use the martingale property of the loss process to derive upper bounds for the probability of ruin for the portfolio. These results are illustrated by two numerical examples in § 6.     

人寿保险的互联网经营策略

近几年来，我国无论是互联网用户数量还是上网计算机数量都呈现成倍增长的态势，截至2004年12月31日，互联网用户已发展到9400万。随着互联网用户的增加，网上资讯、休闲娱乐等内容日益丰富，政府机关、教育部门、银行、证券、保险、商业机构纷纷上网。电子商务也发展迅速，目前网上商店已超过600家，并以每天2家的速度增加。中国互联网已经营造出较好的虚拟社会环境，已构成重要的生活和工作空间。     

Medical professionalism in the life insurance industry

Steadily increasing competition has changed the underwriting environment in most life insurance companies. This article attempts to explore how heightened competition presents a new challenge for medical professionals employed in the industry.     

Cost-benefit analysis of electron beam CT as a life insurance coronary disease risk assessment tool

Electron beam CT (EBCT) or ultrafast CT is a diagnostic imaging technique that can identify calcium deposits within coronary arteries. Intra-coronary calcium is associated with coronary artery atherosclerosis. EBCT imaging has been advocated as a "better" way to screen for coronary artery disease. By producing a measure of the amount of calcium present, it may provide a non-invasive risk assessment tool that can predict the risk of future coronary events and death. Medical literature concerning identification and assessment of coronary risk using EBCT in the clinical setting is reviewed. The primary purpose is to illustrate one approach to a simple "back of the envelope" cost-benefit analysis (protective value) comparing EBCT with exercise electrocardiography as a life insurance coronary disease risk assessment tool. The performance and results of this analysis are contingent on a number of critical assumptions that are outlined in the text. The analysis limitations, and the future research required to refine the results are reviewed. With optimum levels of EBCT test performance, favorable thresholds of test costs, and long-term mortality data useful for assessment of value preservation, EBCT might prove to be a valuable risk assessment tool from a cost-benefit perspective under certain circumstances. Answers to key clinical research questions from prospective studies in asymptomatic cohorts are essential for refinement of a cost-benefit estimate.     

Optimal hedging of demographic risk in life insurance

A Markov chain model is taken to describe the development of a multi-state life insurance policy or portfolio in a stochastic economic?Cdemographic environment. It is assumed that there exists an arbitrage-free market with tradeable securities derived from demographic indices. Adopting a mean-variance criterion, two problems are formulated and solved. First, how can an insurer optimally hedge environmental risk by trading in a given set of derivatives? Second, assuming that insurers perform optimal hedging strategies in a given derivatives market, how can the very derivatives be designed in order to minimize the average hedging error across a given population of insurers? The paper comes with the caveat emptor that the theory will find its prime applications, not in securitization of longevity risk, but rather in securitization of catastrophic mortality risk.