Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 2.085
Filtrar
1.
J Law Med ; 29(3): 760-782, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-36056665

RESUMO

While most comparable jurisdictions have adopted more restrictive positions, life insurers in New Zealand remain permitted to request the disclosure of predictive genetic test results from applicants, driving up the cost to obtain life insurance for those with known susceptibilities to genetic disease. The permissive approach is now an outlier, and risks disincentivising health care and research innovation, facilitating irrational discrimination, and compounding existing health inequities. This article examines the New Zealand position through a consequentialist lens. It analyses justifications for the status quo, as well as international approaches, before concluding that genetic non-discrimination regulations governing New Zealand's life insurance industry should be introduced to enhance public wellbeing.


Assuntos
Seguro de Vida , Justiça Social , Revelação , Testes Genéticos , Nova Zelândia
2.
Cancer Epidemiol Biomarkers Prev ; 31(7): 1511-1512, 2022 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-35775218

RESUMO

PURPOSE OF THE STUDY: This study examined racial/ethnic differences in health and life insurance denial due to cancer among cancer survivors after the passage of the Affordable Care Act (ACA). METHODS: A cross sectional study was conducted using Behavioral Risk Factor Surveillance System data from 2012 through 2020. The dependent variable asked: "Were you ever denied health insurance or life insurance coverage because of your cancer?" Cancer survivors were included if they were diagnosed with cancer after the Affordable Care Act (N=14,815). Descriptive statistics using weighted percentages summarized the results. Logistic regressions provided odds of insurance denial due to cancer across racial/ethnic groups: Non-Hispanic White, Black, and Other/mixed race; and Hispanic. Models adjusted for age, sex, income, and employment status. Interaction terms for age, sex, income, and employment were included in regression models to assess for effect modification. RESULTS: Weighted chi-squares identified statistically significant differences (p<0.05) between those who were denied or not denied insurance across sex, age, race/ethnicity, income, and employment. Adjusted weighted logistic regressions found significantly higher odds of insurance denial for Blacks (OR:3.01, 95%CI:1.78, 5.08), Other/mixed race (OR:2.10, 95%CI: 1.13, 3.90), and Hispanics (OR:2.16, 95%CI:1.05, 4.46) compared to Non-Hispanic Whites. Sex, income, and employment status were significant effect modifiers. Compared to White women, Black women were significantly more likely to be denied health and life insurance. Compared to Whites with incomes >$25K to <$50K and >$50K to <$75K, Blacks were more likely to be denied insurance (OR:3.50, 95%CI:1.42, 8.66 and OR:7.72, 95%CI: 2.40, 24.81). CONCLUSIONS: Despite health insurance denial for pre-existing conditions being illegal under the ACA, cancer survivors report racial/ethnic disparities in health and life insurance denial due to their cancer diagnosis. This denial may be particularly harmful for people of color who are already financially vulnerable due to their cancer diagnosis and exacerbate racial/ethnic cancer disparities.


Assuntos
Sobreviventes de Câncer , Neoplasias , Estudos Transversais , Etnicidade , Feminino , Disparidades em Assistência à Saúde , Humanos , Cobertura do Seguro , Seguro Saúde , Seguro de Vida , Patient Protection and Affordable Care Act , Estados Unidos/epidemiologia
4.
Artigo em Russo | MEDLINE | ID: mdl-35670398

RESUMO

The Maritime industry plays one of the key role in world economy, occupying central position in becoming unified system of global transportations. At that, crew members ensure necessary vessel seakeeping and high-quality and safe delivery of cargo under contract of sea transportation. In accordance with requirements of the legislation any employer is obliged to insure health and life of employees under professional duties performance. However, this issue has its own specific aspects in shipping. The article considers in detail procedure of insuring health and life of the crew members, considering current trends in medical care support under professional duties performance on voyage. The key problematic aspects are identified. The corresponding recommendations are proposed.


Assuntos
Seguro de Vida , Navios , Humanos , Ocupações , Assistência ao Paciente
5.
Artigo em Inglês | MEDLINE | ID: mdl-35206354

RESUMO

This study examined racial/ethnic differences in health/life insurance denial due to cancer among cancer survivors after the passage of the Affordable Care Act (ACA). Behavioral Risk Factor Surveillance System data were obtained from 2012-2020. The dependent variable asked: "Were you ever denied health insurance or life insurance coverage because of your cancer?" Cancer survivors were included if they were diagnosed with cancer after the Affordable Care Act (N = 14,815). Unadjusted and adjusted logistic regressions for age, sex, income, and employment provided odds ratios of insurance denial due to cancer across racial/ethnic groups: Non-Hispanic White, Black, and Other/mixed race; and Hispanic. Statistically significant differences (p < 0.05) were found between those who were denied or not denied insurance across sex, age, race/ethnicity, income, and employment. Adjusted regressions found significantly higher odds ratios of insurance denial for Blacks (OR: 3.00, 95% CI: 1.77, 5.08), Other/mixed race (OR: 2.16, 95% CI: 1.16, 4.02), and Hispanics (OR: 2.13, 95% CI: 1.02, 4.42) compared to Whites. Differences were observed across sex, income, and employment. Cancer survivors report racial/ethnic disparities in health and life insurance denial due to their cancer despite policy changes. This may be harmful for those who are already financially vulnerable due to their cancer diagnosis and exacerbate racial/ethnic cancer disparities.


Assuntos
Sobreviventes de Câncer , Neoplasias , Acesso aos Serviços de Saúde , Disparidades em Assistência à Saúde , Humanos , Cobertura do Seguro , Seguro Saúde , Seguro de Vida , Neoplasias/epidemiologia , Patient Protection and Affordable Care Act , Estados Unidos/epidemiologia
6.
J Psychiatr Pract ; 28(1): 54-61, 2022 01 06.
Artigo em Inglês | MEDLINE | ID: mdl-34989346

RESUMO

Much has been written about the history of suicide and, notably, about societies that condemned both the act and the actor, resulting in a perpetuation of suicide being stigmatized in many cultures. One aspect of this perceived stigmatization involves exclusionary clauses in life insurance policies that reject paying benefits to survivor-beneficiaries of the decedent if the decedent has died by suicide within a prescribed time frame. From the perspective of the individual, life insurance is designed to protect the estate of a decedent from a significant financial burden. From the insurer's perspective, there are essentially 2 reasons for having a suicide exclusion clause: limiting risk and preventing or discouraging fraud. This column examines these rationales in light of the estimated few suicides that do occur during exclusionary clause time frames. Observations are made about the effect of these clauses on those impacted by the loss of a loved one who died by suicide within the exclusionary time frame. An examination of the perspectives of both the life insurance industry and the impacted survivors of suicide decedents raises questions about what are reasonable and appropriate exclusionary clause time frames that protect both the insurer and survivor-beneficiaries. The forensic expert consulting on such cases should be cognizant of these competing perspectives and engage in therapeutic assessment whenever possible, identifying opportunities to promote thoughtful suicide postvention.


Assuntos
Seguro de Vida , Suicídio , Humanos , Suicídio/prevenção & controle , Sobreviventes
7.
J Health Econ ; 81: 102556, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34847443

RESUMO

Genetic tests that predict the lifetime risk of common medical conditions are fast becoming more accurate and affordable. The life insurance industry is interested in using predictive genetic tests in the underwriting process, but more research is needed to establish whether this nascent form of genetic testing can refine the process over conventional underwriting factors. Here, we perform Cox regression of survival on a battery of genetic risk scores for common medical conditions and mortality risks in the Health and Retirement Study, without returning results to participants. Adjusted for covariates in a relevant insurance scenario, the scores could improve mortality risk classification by identifying 2.6 years shorter median lifespan in the highest decile of total genetic liability. We conclude that existing genetic risk scores can already improve life insurance underwriting, which stresses the urgency of policymakers to balance competing interests between stakeholders as this technology develops.


Assuntos
Seguro de Vida , Seguro , Testes Genéticos , Humanos , Aposentadoria , Fatores de Risco
8.
J Med Genet ; 59(8): 817-826, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34544841

RESUMO

BACKGROUND: In 2019, the Australian life insurance industry introduced a partial moratorium (ban) limiting the use of genetic test results in life insurance underwriting. The moratorium is industry self-regulated and applies only to policies below certain financial limits (eg, $500 000 of death cover). METHODS: We surveyed Australian health professionals (HPs) who discuss genetic testing with patients, to assess knowledge of the moratorium; reported patient experiences since its commencement; and HP views regarding regulation of genetic discrimination (GD) in Australia. RESULTS: Between April and June 2020, 166 eligible HPs responded to the online survey. Of these, 86% were aware of the moratorium, but <50% had attended related training/information sessions. Only 16% answered all knowledge questions correctly, yet 69% believed they had sufficient knowledge to advise patients. Genetics HPs' awareness and knowledge were better than non-genetics HPs' (p<0.05). There was some reported decrease in patients delaying/declining testing after the moratorium's introduction, however, 42% of HPs disagreed that patients were more willing to have testing post-moratorium. Although many (76%) felt the moratorium resolved some GD concerns, most (88%) still have concerns, primarily around self-regulation, financial limits and the moratorium's temporary nature. Almost half (49%) of HPs reported being dissatisfied with the moratorium as a solution to GD. The majority (95%) felt government oversight is required, and 93% felt specific Australian legislation regarding GD is required. CONCLUSION: While the current Australian moratorium is considered a step forward, most HPs believe it falls short of an adequate long-term regulatory solution to GD in life insurance.


Assuntos
Testes Genéticos , Seguro de Vida , Austrália , Humanos , Inquéritos e Questionários
9.
J Cancer Res Clin Oncol ; 148(1): 155-162, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34642793

RESUMO

PURPOSE: Limited research suggests that cancer survivors have problems with insurance. Our study aimed to gain insight into the proportion of very long-term (14-24 years post-diagnosis) survivors of breast, colorectal, and prostate cancers who had problems with health (HI) and life (LI) insurance. METHODS: We used data from CAESAR (CAncEr Survivorship-A multi-Regional population-based study). Participants completed questions on change in insurance providers since cancer diagnosis, problems with requesting (additional) HI or LI, and how potential problems were resolved. We conducted logistic regression to determine factors associated with change in statutory HI. RESULTS: Of the 2714 respondents, 174 (6%) reported having changed HI providers. Most switched between different statutory HI providers (86%), 9% from statutory to private, and 5% from private to statutory. Respondents who changed statutory HI providers were more likely to be prostate cancer survivors (OR 2.79, 95% CI 1.01-7.68) while being ≥ 65 years at time of diagnosis (OR 0.58, 95% CI 0.35-0.96) and having ≥ 2 comorbid conditions (OR 0.61, 95% CI 0.40-0.92) were associated with reduced odds for change. Problems in changing HI were minimal and were resolved with additional contribution. Of the 310 respondents who tried to get LI, 25 respondents reported having difficulties, of whom the majority had their request rejected. CONCLUSION: Most cancer survivors did not change their HI nor tried to buy LI after cancer diagnosis. Problems with changing statutory HI were generally resolved with additional contribution while the main problem encountered when buying LI was rejection of request.


Assuntos
Sobreviventes de Câncer/estatística & dados numéricos , Seleção Tendenciosa de Seguro , Seguro Saúde/estatística & dados numéricos , Seguro de Vida/estatística & dados numéricos , Idoso , Neoplasias da Mama/terapia , Neoplasias Colorretais/terapia , Feminino , Alemanha , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias da Próstata/terapia , Inquéritos e Questionários
10.
Am J Public Health ; 111(11): 1960-1968, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34709856

RESUMO

The earliest sickness survey of the US Public Health Service, which started in 1915, was the Service's first socioeconomic study of an industrial community. It was also the first to define illness as a person's inability to work. The survey incorporated the Metropolitan Life Insurance Company's definition of illness, which, instead of sickness rates, focused on duration of illness as a proxy of time lost from work. This kind of survey took place in the broader context of the reform movements of the Progressive Era and the social surveys conducted in the United States, which led to the creation of the Federal Commission on Industrial Relations, where the Service's sickness survey originated. The Service's focus on the socioeconomic classification of families and definition of illness as the inability to work enabled it to show the strong link between poverty and illness among industrial workers. The leader of the survey, Edgar Sydenstricker, and the Metropolitan Life Insurance Company came up with new ways to measure the health of the population, which also influenced the Service's studies of the effects of the Great Depression on public health and the National Health Survey of 1935-1936. (Am J Public Health. 2021; 111(11):1960-1968. https://doi.org/10.2105/AJPH.2021.306454).


Assuntos
Inquéritos Epidemiológicos/história , Seguro de Vida/história , United States Public Health Service/história , História do Século XX , História do Século XXI , Humanos , Estados Unidos
11.
BMC Med Ethics ; 22(1): 63, 2021 05 21.
Artigo em Inglês | MEDLINE | ID: mdl-34020638

RESUMO

BACKGROUND: The use of genetic test results in risk-rated insurance is a significant concern internationally, with many countries banning or restricting the use of genetic test results in underwriting. In Australia, life insurers' use of genetic test results is legal and self-regulated by the insurance industry (Financial Services Council (FSC)). In 2018, an Australian Parliamentary Inquiry recommended that insurers' use of genetic test results in underwriting should be prohibited. In 2019, the FSC introduced an industry self-regulated moratorium on the use of genetic test results. In the absence of government oversight, it is critical that the impact, effectiveness and appropriateness of the moratorium is monitored. Here we describe the protocol of our government-funded research project, which will serve that critical function between 2020 and 2023. METHODS: A realist evaluation framework was developed for the project, using a context-mechanism-outcome (CMO) approach, to systematically assess the impact of the moratorium for a range of stakeholders. Outcomes which need to be achieved for the moratorium to accomplish its intended aims were identified, and specific data collection measures methods were developed to gather the evidence from relevant stakeholder groups (consumers, health professionals, financial industry and genetic research community) to determine if aims are achieved. Results from each arm of the study will be analysed and published in peer-reviewed journals as they become available. DISCUSSION: The A-GLIMMER project will provide essential monitoring of the impact and effectiveness of the self-regulated insurance moratorium. On completion of the study (3 years) a Stakeholder Report will be compiled. The Stakeholder Report will synthesise the evidence gathered in each arm of the study and use the CMO framework to evaluate the extent to which each of the outcomes have been achieved, and make evidence-based recommendations to the Australian federal government, life insurance industry and other stakeholders.


Assuntos
Seleção Tendenciosa de Seguro , Seguro de Vida , Austrália , Coleta de Dados , Testes Genéticos , Humanos
13.
Urol Clin North Am ; 48(2): 269-277, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33795061

RESUMO

Although physicians enjoy extensive educational backgrounds, financial planning typically is not a significant component of the curricula they have completed. As a result, many physicians could benefit from greater financial acumen, and their preparation for retirement might be lacking in light of their relatively high-income levels. This article by a private wealth advisor with 29 years of industry experience provides physicians with the basic building blocks to understand and manage their finances. It focuses on 3 pillars of financial planning: (1) protecting themselves, their families, and their assets; (2) reducing their taxes; and (3) growing their wealth.


Assuntos
Administração Financeira/organização & administração , Administração da Prática Médica/economia , Urologistas/economia , Financiamento Pessoal/economia , Humanos , Seguro de Vida/economia , Pensões , Aposentadoria/economia , Impostos/economia , Testamentos/economia
14.
J Insur Med ; 49(1): 19-23, 2021 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-33784738

RESUMO

A new syndrome called "Long COVID" has emerged amongst the survivors of acute COVID-19 infection. Its protracted and debilitating nature will almost certainly result in many short and long-term disability claims. Insurers need to understand the nature of Long COVID, including its definition, its prevalence, its natural history, and underlying risk factors. This article will summarize current knowledge of Long COVID and provide a perspective on its evolution and its impact.


Assuntos
COVID-19/economia , COVID-19/fisiopatologia , Sobreviventes , Humanos , Seguradoras , Seguro de Vida , Medição de Risco , SARS-CoV-2 , Síndrome
15.
J Insur Med ; 49(1): 11-18, 2021 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-33784743

RESUMO

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.


Assuntos
COVID-19/economia , COVID-19/epidemiologia , Seguro de Vida/economia , Diretores Médicos/organização & administração , Humanos , Pandemias , SARS-CoV-2
16.
20.
J Hum Genet ; 66(5): 539-542, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33177703

RESUMO

Since the 1990s, insurance has been the primary field focused on the social disadvantages of using genetic test results because of the concerns related to adverse selection. Although life insurance is popular in Japan, Japan does not currently have any regulations on the use of genetic information and insurers have largely kept silent for decades. To reveal insurers' attitudes on the topic, we conducted an anonymous questionnaire survey with 100 insurance company employees and recruited nine interviewees from the survey respondents. We found that genetic discrimination is not generally considered as a topic of human rights. We also found that insurers have uncertain fears and concerns about adverse selection in terms of actuarial fairness but not regarding profits. When it comes to preparing guidelines on the use of genetic information by Japanese insurers, we believe that public dialog and consultation are necessary to gain understanding of the people.


Assuntos
Testes Genéticos , Seguradoras , Seleção Tendenciosa de Seguro , Seguro de Vida , Adulto , Atitude , Feminino , Testes Genéticos/ética , Homicídio , Direitos Humanos/ética , Humanos , Seguradoras/economia , Seguradoras/ética , Seguradoras/normas , Japão , Masculino , Pessoa de Meia-Idade , Política Organizacional , Justiça Social/ética , Suicídio , Inquéritos e Questionários , Revelação da Verdade/ética
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...