Australian researcher's perspectives on the Australian industry-led moratorium on genetic tests in life insurance.

Fear of insurance discrimination can inhibit genetic research participation. In 2019, an industry-led partial moratorium on using genetic results in Australian life insurance underwriting was introduced. This mixed-methods study used online surveys (n = 59 participants) and semi-structured interviews (n = 22 participants) to capture researchers' perceptions about the moratorium. 66% (n = 39/59) were aware of the moratorium before the survey. Of researchers returning genetic results, 56% (n = 22/39) reported that insurance implications were mentioned in consent forms, but a minority reported updating consent forms post-moratorium (n = 13/39, 33%). Most researchers reported that concerns regarding life insurers utilizing research results inhibited recruitment (35/59, 59%), and few perceived that the moratorium positively influenced participation (n = 9/39, 23%). These findings were supported by qualitative findings which revealed that genetic discrimination concerns were a major issue for some individuals, though these concerns could be eclipsed by the promise of a diagnosis through research participation. The majority thought a regulatory solution should be permanent (n = 34/51, 67%), have financial limits of at least ≥1,000,000 AUD (37/51, 73%), and involve government oversight/legislation (n = 44/51, 86%). In an era where an increasing number of research studies involve genomics as a primary or secondary objective, it is crucial that we have regulatory solutions to address participants' hesitation.

Pollution risk and life insurance decisions: Microgeographic evidence from the United Kingdom.

Recent research documents that exposure to air pollution can trigger various behavioral reactions. This article presents novel empirical evidence on the causal effect of pollution risk on life insurance decisions. We create a unique dataset by linking microgeographic air quality information to the confidential UK Wealth and Assets Survey. We identify an inverse N-shape relationship between pollution risk and life insurance adoption by exploiting the orthogonal variations in meteorological conditions. Over a given range above a threshold of exposure, rising pollution is associated with rising demand for life insurance, whereas at lower than the threshold levels of pollution, higher exposure risk reduces demand for insurance. Our findings indicate-for the first time-a nonlinear relationship between local pollution risk and life insurance demand.

How the Medical Director Should Use Data Sources.

The life insurance industry is transitioning towards precision underwriting driven by increased data availability and access to advanced analytical tools. Effectively utilizing diverse data sources in life insurance underwriting presents an opportunity for medical directors to fully leverage their skillset in this evolving environment. By navigating these changes, balancing the value of data against its limitations, and fostering collaborative approaches to enhance risk assessment and underwriting processes, medical directors can maintain a pivotal role in the life insurance companies of tomorrow.

Mortality Risk of Low BMI in Life Insurance Applicants.

OBJECTIVES: -This study seeks to quantify the mortality effect of low levels of body mass index (BMI) on life insurance applicants who, based on their laboratory profile and other information, appear to be suitable for life insurance coverage. BACKGROUND: -It has been demonstrated that low BMI is associated with higher mortality risk than normal or near-normal BMI. METHODS: -Data were collected from over 4.7 million life insurance applicants with available BMI tested between 1995 and 2021, and vital status was assessed via the Social Security Death Master File. Cox models treating BMI as continuous and as a categorical variable were constructed, controlling for age, and split by sex after excluding those with laboratory or biometric test results, which were far enough outside the normal range to imply elevated mortality. RESULTS: -Models treating BMI as a continuous variable and allowing an interaction term for age showed that low BMI was strongly associated with mortality at ages 50 and above in both sexes. In the categorical models, only the lowest category of BMI (below the 1st percentile) in men aged 40-60, the lowest 2 categories (below the 5th percentile) in women aged 40-60, and the lowest 3 categories (below the 10th percentile) in those aged 60-80 years, were significantly associated with elevated mortality. No elevated mortality was detected in those under age 40 with low BMI. CONCLUSION: -Based on this study, low BMI is associated with elevated mortality in otherwise healthy applicants, but this association is dependent on age.

Life and Disability Insurance for People with or at Risk of HIV: Aligning Policy with Evidence.

Antiretroviral medications have substantially improved life expectancy for people with HIV. These medications are also highly effective in preventing HIV acquisition in people who do not have HIV, a strategy known as HIV preexposure prophylaxis (PrEP). Despite these advances, some life and disability insurers continue to deny or limit coverage for people with HIV, and some have even refused to cover people who are using PrEP to protect themselves. These policies unfairly deny people with HIV, PrEP users, and their families the peace of mind and financial protection that can come with life and disability insurance coverage. This article summarizes the current evidence on HIV treatment and prevention, arguing that underwriting decisions by life and disability insurers should not be made based on HIV status or use of PrEP.

"Uninsurable because of a genetic test": a qualitative study of consumer views about the use of genetic test results in Australian life insurance.

Genetic testing can provide valuable information to mitigate personal disease risk, but the use of genetic results in life insurance underwriting is known to deter many consumers from pursuing genetic testing. In 2019, following Australian Federal Parliamentary Inquiry recommendations, the Financial Services Council (FSC) introduced an industry-led partial moratorium, prohibiting life insurance companies from using genetic test results for policies up to $AUD500,000. We used semi-structured interviews to explore genetic test consumers' experiences and views about the FSC moratorium and the use of genetic results by life insurers. Individuals who participated in an online survey and agreed to be re-contacted to discuss the issue further were invited. Interviews were 20-30-min long, conducted via video conference, transcribed verbatim and analysed using inductive content analysis. Twenty-seven participants were interviewed. Despite the moratorium, concerns about genetic discrimination in life insurance were prevalent. Participants reported instances where life insurers did not consider risk mitigation when assessing risk for policies based on genetic results, contrary to legal requirements. Most participants felt that the moratorium provided inadequate protection against discrimination, and that government legislation regulating life insurers' use of genetic results is necessary. Many participants perceived the financial limits to be inadequate, given the cost-of-living in Australia. Our findings indicate that from the perspective of participants, the moratorium has not been effective in allaying fears about genetic discrimination or ensuring adequate access to life insurance products. Concern about genetic discrimination in life insurance remains prevalent in Australia.

Sobrevida nas reperfusões miocárdicas cirúrgicas e nas angioplastias coronarianas pagas por seguros de saúde e privados no Estado do Rio de Janeiro, 2000 a 2007 / Survival in coronary artery bypass grafts and coronary angioplasties paid privately or by health insurance in Rio de Janeiro State: 2000-2007

Fundamentos: A cirurgia de revascularização miocárdica (RVM) e a angioplastia coronariana (AC) são procedimentos comuns na prática clínica, que precisam ser continuamente avaliados. Objetivos: Estudar a sobrevida nos indivíduos submetidos à RVM ou AC no Estado do Rio de Janeiro (ERJ), pagas por seguros de saúde e privados, no período de 2000 a 2007. Métodos: Estudo utilizando bancos de dados para identificar os indivíduos submetidos aos procedimentos e aqueles que morreram, para estimar a sobrevida. As informações sobre RVM e AC provieram das Comunicações de Internação Hospitalar (CIH) e sobre óbitos das Declarações de Óbitos. Foi realizado relacionamento probabilístico entre os bancos com o programa RecLink para identificar os indivíduos que morreram após os procedimentos. Resultados: Apenas 980 procedimentos foram notificados em oito anos em 937 indivíduos residentes no ERJ. No interior do ERJ foram realizadas 32,4 por cento das RVM dos 509 indivíduos submetidos ao procedimento, enquanto as demais foram feitas em outros estados, 66,6 por cento em São Paulo (SP). Foram identificados 428 indivíduos com AC, 71,7 por cento realizadas no interior do ERJ e as demais nos outros estados, 22,8 por cento em SP. Não foi encontrada qualquer...

Análisis de un proyecto experimental de salud laboral para funcionarios de la cooperativa autogestionaria para la salud integral Clínica Lic. Rodrigo Fournier Guevara / Analysis of an experimental design of labor health for civil employees of the cooperativa autogestionaria for the clinical integral health Lic. Rodrigo Fournier Guevara

Se analizan los resultados obtenidos en la ejecución de un proyecto de salud laboral en la Cooperativa Autogestionaria de Salud Integral, Clínica Lic. Rodrigo Fournier Guevara, cuyo objetivo principal fue implementar con los funcionarios de esta clínica metropolitana un programa de actividad física que permitiera propiciar la adopción de estilos de vida saludables. Se incorporaron elementos educativos en temas nutricionales, monitoreo de parámetros antropométricos pre y post participación en el programa y se diseñaron instructivos cualitativos y cuantitativos para detectar modificaciones conductuales y físicas en los funcionarios. La ejecución de este proyecto se realizó durante el período comprendido de febrero a diciembre del año 2004. Se observó disminución del estrés laboral y una actitud de cambio para incorporar nuevos estilos de vida. Aunque la finalidad específica del programa no era obtener la pérdida de peso en los funcionarios también se detectaron modificaciones en este aspecto.

Estimativa de mortalidade para a população coberta pelos seguros privados / Texto para Discussão (TD) 868: Estimativa de mortalidade para a população coberta pelos seguros privados

"Constrói, a partir de dados da Susep, tábuas de vida para os consumidores dos produtos vida e previdência privada. Uma equação matemática é ajustada, e pode ser decomposta em mortalidade infantil, mortalidade por causas externas e mortalidade por senescência. Calcula intervalos de confiança para as taxas de mortalidade e faz comparações com algumas tábuas selecionadas utilizadas pelo mercado."

Medicina de seguro: estudo sobre a conceituaçäo e área de competência médica no seguro privado / Insurance medicine: study at concept and area of medic competency in private insurance

Esta obra vem preencher um vazio editorial. Vai sem dúvida tornar-se livro de consulta obrigatória dos profissionais do seguro, sempre que tenham carência de informaçäo ou conhecimento sobre aspectos médicos das relaçöes entre segurados e seguradoras. Nos seguros de pessoas, em que a tradiçäo é a da lida com a biometria, desde muito tempo vem ocupando crescente espaço, a preocupaçäo, também, com a biologia e com a medicina. Este livro é de importância fundamental, aqui no Brasil, para os que tenham interesse, direto ou indireto, pelo assunto