Life Insurance Applicants Research Articles

Generating Mortality Rate Intensity for Life Insurance Applications through Novel Method of Successive Differencing Under the Parsimonious Generalised Makeham’s Framework

Developing and implementing age dependent mortality rates in functional forms have presented critical modelling problems for life insurance and annuity firms thereby creating serious research gaps. A recurring problem with the existing life tables is that their underlying generating functions are not capable of showing any evidence that mortality at 10 declines. This observed irregularity in the age pattern of mortality is the prime motivation in the search for analytical functions which fully capture the observed variations of mortality with age. To fill the gaps identified, the study aims to develop specific life table function under the Generalised Makeham’s framework. The objectives of this study are to (i) compute the mortality rate intensities (ii) compute the curve of deaths densities (iii) compute the probability of deaths and then compare the common domain of definition of these measures. From the method of successive differencing employed to model, the male ageing parameter value fall within the globally accepted interval for the. This method is superior to the method of maximum likelihood estimation which mostly violates the permissible interval of validity. Computational evidence from our analysis proves that under the Generalised Makeham’s law, the mortality rate intensity declines at .

Mortality Risk of Low BMI in Life Insurance Applicants.

-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. -It has been demonstrated that low BMI is associated with higher mortality risk than normal or near-normal BMI. -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. -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. -Based on this study, low BMI is associated with elevated mortality in otherwise healthy applicants, but this association is dependent on age.

Still using genetic data? A comparative review of Canadian life insurance application forms before and after the GNDA

Still using genetic data? A comparative review of Canadian life insurance application forms before and after the GNDA

Implementing a Hybrid Model using K-Means Clustering and Artificial Neural Networks for Risk Prediction in Life Insurance

Accurate assessment of policy holder risk is critical for life insurance companies to properly price policies and manage long-term liabilities. However, the complexity of risk factors makes reliance solely on traditional actuarial models inadequate, especially with the proliferation of big data and unstandardized data from diverse sources. This study investigated the development and performance of a hybrid machine learning model combining artificial neural networks (ANN) and K-means clustering for enhanced risk prediction in life insurance underwriting. The exponential growth of unlabelled data presented challenges for predictive modelling. The proposed hybrid model leveraged the strengths of artificial neural networks in modelling nonlinear relationships and K-means clustering in unsupervised for pattern recognition to handle unstandardized data. Using anonymized life insurance application data from Kaggle, the hybrid model was evaluated against the artificial neural network algorithm alone. The results demonstrated that integrating K-means clustering and artificial neural network together with principal component analysis for pre-processing led to superior model performance, with testing accuracy improving from 90% for artificial neural network to 98% for the hybrid technique. Additional metrics like precision, recall and AUC also showed enhancements. The improved predictive capability highlighted the potential of the hybrid approach in transforming legacy underwriting practices towards a more sophisticated data-driven analytical evaluation of policy holder risk. However, limitations existed including the use of single sourced insurance dataset due to data privacy concerns. Further research on integrating diverse algorithms can help insurers unlock more value and gain a competitive edge through advanced analytical modelling and testing on larger real-world datasets. While challenges remain, this study provided key insights into a promising new technique for modernizing risk prediction in the life insurance industry in the era of big data.

Correlates and Predictors of NT-proBNP in Life Insurance Applicants.

-To document the various laboratory and demographic/historical correlates of NT-proBNP levels in applicants for life insurance, and to explore the accuracy of a prediction model based on those variables. -NT-proBNP blood test results were obtained from 1.34 million insurance applicants between the age of 50 and 85 years, beginning in 2003. Exploratory data analysis was carried out to document correlations with other laboratory variables, sex, age, and the presence of relevant diseases. Further, predictive models were used to quantify the proportion of the variance of NT-proBNP, which can be explained by a combination of these other, easier to determine variables. -NT-proBNP shows the expected, negative correlation with estimated glomerular filtration rate (eGFR) is markedly higher in those with a history of heart disease and is somewhat higher in those with a history of hypertension. A strong, unexpected, negative correlation between NT-proBNP and albumin was discovered. Of the variables evaluated, a multivariate adaptive regression spline (MARS) model automated selection procedure selected 7 variables (age, sex, albumin, eGFR, BMI, systolic blood pressure, cholesterol, and history of heart disease). Variable importance evaluation determined that age, albumin and eGFR were the 3 most important continuous variables in the prediction of NT-proBNP levels. An ordinary least squares (OLS) model using these same variables achieved a R-squared of 24.7%. -Expected ranges of NT-proBNP may vary substantially depending on the value of other variables in the prediction equation. Albumin is significantly negatively correlated with NT-proBNP levels. The reasons for this are unclear.

Prevalence of Antibodies to COVID-19 Due to Infection or Vaccination in US Adults.

-Determine the seroprevalence of SARS-CoV-2 infection and vaccination in a population applying for life insurance. -This is a cross-sectional study of 2584 US life insurance applicants, to determine the seroprevalence of antibodies to COVID-19. This convenience sample was selected on two consecutive days April 25-26, 2022. -For COVID-19, 97.3% are seropositive, and 63.9% have antibodies to nucleocapsid protein, a marker of prior infection. An additional, 33.7% have been vaccinated with no serologic evidence of infection. -Serum and urine samples from a nationwide group of insurance applicants for routine risk assessment were collected. The examination of applicants typically occurs, in their homes, their place of employment, or a clinic. The paramedic exam occurs 7-14 days after the insurance application. Before the exam, an office assistant calls the applicant and inquires if they have been in contact with a person with SARS-CoV-2, been ill within the last 2 weeks, felt sick, or recently had a fever. If the applicant answers yes, the exam is rescheduled. Before sample collection, the applicant reads and signs a consent form to release medical information and testing. Next, the examiner records the applicant's blood pressure, height, and weight. Then, a blood and a urine sample are collected and sent with the consent form to our laboratory via Federal Express. On April 25-26, 2022, we tested 2584 convenience samples from adult insurance applicants for the presence of antibodies to nucleocapsid and spike proteins from SARS-CoV-2. As a standard practice, we reported the client-specified test profile results to our life insurance carriers. In contrast, the COVID-19 test results were only available to the authors. Patient and Public Involvement.-There was no patient involvement in study design, reporting of results, or journal publication selection. There was patient consent to publish de-identified study results. No public involvement occurred in the creation or completion of the study. The authors thank the participants in this study for approving the use of their blood samples to further society's understanding of the SARS-CoV-19 pandemic. Ethics Review.-Western Institutional Review Board reviewed the study design and determined it to be exempt under the Common Rule and applicable guidance. Therefore, it is exempt under 45 CFR § 46.104(d)(4) from using de-identified study samples for epidemiologic investigation, WIRB Work Order #1-1324846-1. In addition, all test subjects had signed a consent allowing research of their blood and urine samples with the removal of personally identifiable information. -The combined seroprevalence for antibodies to nucleocapsid, a marker of prior infection, and antibodies to spike protein, an indicator of either previous infection or vaccination, was 97.3%. Higher infection rates occur in younger vs older age groups, with a non-statistical difference for vaccinated and acquired natural immunity. For the age group 16-84, the total estimated seroprevalence of COVID-19 in the US is 249 million cases. -The US population has widespread immune resistance to current variants of COVID-19 due to prior infection or vaccination. The infectivity of new variants and silent disease, independent of previous infection or vaccination, are the driving force behind the sporadic increase in clinical SARS-CoV-2 cases.

Prevalence of Antibodies to COVID-19 Due to Infection or Vaccination in US Adults.

-Determine the seroprevalence of SARS-CoV-2 infection and vaccination in a population applying for life insurance. -This is a cross-sectional study of 2584 US life insurance applicants, to determine the seroprevalence of antibodies to COVID-19. This convenience sample was selected on two consecutive days April 25-26, 2022. -For COVID-19, 97.3% are seropositive, and 63.9% have antibodies to nucleocapsid protein, a marker of prior infection. An additional, 33.7% have been vaccinated with no serologic evidence of infection. -Serum and urine samples from a nationwide group of insurance applicants for routine risk assessment were collected. The examination of applicants typically occurs, in their homes, their place of employment, or a clinic. The paramedic exam occurs 7-14 days after the insurance application. Before the exam, an office assistant calls the applicant and inquires if they have been in contact with a person with SARS-CoV-2, been ill within the last 2 weeks, felt sick, or recently had a fever. If the applicant answers yes, the exam is rescheduled. Before sample collection, the applicant reads and signs a consent form to release medical information and testing. Next, the examiner records the applicant's blood pressure, height, and weight. Then, a blood and a urine sample are collected and sent with the consent form to our laboratory via Federal Express. On April 25-26, 2022, we tested 2584 convenience samples from adult insurance applicants for the presence of antibodies to nucleocapsid and spike proteins from SARS-CoV-2. As a standard practice, we reported the client-specified test profile results to our life insurance carriers. In contrast, the COVID-19 test results were only available to the authors. Patient and Public Involvement.-There was no patient involvement in study design, reporting of results, or journal publication selection. There was patient consent to publish de-identified study results. No public involvement occurred in the creation or completion of the study. The authors thank the participants in this study for approving the use of their blood samples to further society's understanding of the SARS-CoV-19 pandemic. Ethics Review.-Western Institutional Review Board reviewed the study design and determined it to be exempt under the Common Rule and applicable guidance. Therefore, it is exempt under 45 CFR § 46.104(d)(4) from using de-identified study samples for epidemiologic investigation, WIRB Work Order #1-1324846-1. In addition, all test subjects had signed a consent allowing research of their blood and urine samples with the removal of personally identifiable information. -The combined seroprevalence for antibodies to nucleocapsid, a marker of prior infection, and antibodies to spike protein, an indicator of either previous infection or vaccination, was 97.3%. Higher infection rates occur in younger vs older age groups, with a non-statistical difference for vaccinated and acquired natural immunity. For the age group 16-84, the total estimated seroprevalence of COVID-19 in the US is 249 million cases. -The US population has widespread immune resistance to current variants of COVID-19 due to prior infection or vaccination. The infectivity of new variants and silent disease, independent of previous infection or vaccination, are the driving force behind the sporadic increase in clinical SARS-CoV-2 cases.

Package AdvEMDpy: Algorithmic variations of empirical mode decomposition in Python

AbstractThis work presents a $\textsf{Python}$ EMD package named AdvEMDpy that is both more flexible and generalises existing empirical mode decomposition (EMD) packages in $\textsf{Python}$ , $\textsf{R}$ , and $\textsf{MATLAB}$ . It is aimed specifically for use by the insurance and financial risk communities, for applications such as return modelling, claims modelling, and life insurance applications with a particular focus on mortality modelling. AdvEMDpy both expands upon the EMD options and methods available, and improves their statistical robustness and efficiency, providing a robust, usable, and reliable toolbox. Unlike many EMD packages, AdvEMDpy allows customisation by the user, to ensure that a broader class of linear, non-linear, and non-stationary time series analyses can be performed. The intrinsic mode functions (IMFs) extracted using EMD contain complex multi-frequency structures which warrant maximum algorithmic customisation for effective analysis. A major contribution of this package is the intensive treatment of the EMD edge effect which is the most ubiquitous problem in EMD and time series analysis. Various EMD techniques, of varying intricacy from numerous works, have been developed, refined, and, for the first time, compiled in AdvEMDpy. In addition to the EMD edge effect, numerous pre-processing, post-processing, detrended fluctuation analysis (localised trend estimation) techniques, stopping criteria, spline methods, discrete-time Hilbert transforms (DTHT), knot point optimisations, and other algorithmic variations have been incorporated and presented to the users of AdvEMDpy. This paper and the supplementary materials provide several real-world actuarial applications of this package for the user’s benefit.

Analisis Efektivitas Pendaftaran Calon Nasabah Baru pada PT Asuransi Jiwa Syariah Bumiputera Cabang Medan

Bumiputera Sharia Life Insurance is a privately owned company engaged in Life Insurance. The existence of insurance today is not a foreign thing for the world community. See the development of this insurance. make the existence of information systems difficult to ignore. Prospective customer registration system at PT. Bumiputera Syariah Life Insurance uses two systems, namely a manual registration system and an online registration system. While in the manual system, namely by writing data on prospective customers on the Life Insurance Application Letter form. This is considered less effective and efficient in supporting work productivity in the company. In this problem, the idea emerged in the form of a proposal to provide information and input in the process of registering new prospective customers who can use online and manual systems that can be useful for prospective customers to register for life insurance applications without having to come directly to the company. By implementing an online-based system in the prospective customer registration process, it will certainly make it easier for prospective customers to register. In this development, of course, a model is needed that can help analyze the online system. The existence of a prospective customer registration system through an online-based system is expected to make it easier for prospective customers who want to register themselves in insurance without having to go directly to the insurance company. also makes it easier for administrators to manage prospective customer data. And the registration process is made easier, faster and more accurate.
 Keywords: Information Analysis, Registration, Bumiputera Sharia Life Insurance, Manual, Online

Association of Liver Function Tests with Mortality in an Insurance Applicant Population.

-Determine the relationship between liver function test (LFT) results (GGT, alkaline phosphatase, AST, ALT and albumin) and all-cause mortality in life insurance applicants. -By use of the Social Security Master Death File, mortality was examined in 15,272,955 insurance applicants for whom blood samples were submitted to the Clinical Reference Laboratory. There were 268,593 deaths observed in this study population, after an average follow-up time of 10.9 years. Results were stratified by sex and by age less/greater than 60, creating 4 groups. Liver function test values were grouped using percentiles of their distribution within these age/ sex groups - so as to update the results generated in prior publications. Additional models were fit using different exclusions and percentile groups within single year age groups. Also, LFTs were treated as continuous variables and included in Cox models with age and smoking status. -Using the risk of the middle 50% of the population by distribution as a reference, relative mortality observed for GGT and alkaline phosphatase was linear with a steep slope from very low to high values. AST showed a J-shaped association with mortality. ALT showed a low-magnitude inverse correlation with mortality. Albumin demonstrated a higher-magnitude inverse correlation with mortality, especially at values below the median. The overall risk associated with LFTs was durable over at least 10 years of follow-up. -Liver function tests show a strong and durable correlation to mortality in a large group of insurance applicants. The durability over time suggests that even older values of LFTs found in medical records could be of use in mortality risk prediction.

Changes in Attitudes of Life Insurance Companies Towards Patients with Sleep Apnea Syndrome Undergoing Continuous Positive Airway Pressure in Japan.

Recent studies have revealed that sleep apnea syndrome (SAS) increases the risk of cardiovascular diseases and their risk factors, as well as the risk of traffic accidents. Although SAS screening and early treatment are important, truck drivers may avoid SAS screening to prevent the denial of their application for life insurance due to receiving continuous positive airway pressure (CPAP) treatment. Thus, this study investigated how life insurance companies handle patients on SAS treatment. We conducted a questionnaire survey on how they handle life insurance applications of patients with SAS on CPAP treatment for 46, 41, and 42 companies in 2009, 2015, and 2021, respectively, and analyzed the changes in their handling of life insurance applications of patients with SAS. The results revealed that while about 10 life insurance companies handle the application of life insurance of patients on CPAP treatment in the same way as healthy individuals, many life insurance companies handle them differently. This survey also revealed the differences in handling patients with SAS on CPAP treatment among companies and their policies regarding the reasons. The survey revealed that there are differences among life insurance companies in handling patients with SAS on CPAP treatment. It is important to provide information about the companies that would not give disadvantages to patients with SAS on CPAP treatment who purchase life insurance. It is also crucial to provide life insurance companies with evidence of reduced risk of traffic accidents in patients with SAS on CPAP treatment.

Genetic Discrimination in Access to Life Insurance: Does Ukrainian Legislation Offer Sufficient Protection against the Adverse Consequences of the Genetic Revolution to Insurance Applicants?

This paper presents an inter-disciplinary study of the risk for, and protections against, genetic discrimination in access to life insurance in Ukraine. It aims (i) to review questions related to genetic information, health status, and family history currently included in Ukrainian life insurance application forms; (ii) to analyze the Ukrainian legislation related to equity and nondiscrimination and to determine whether it provides adequate protection against genetic discrimination (GD). Research findings of our insurance application forms review show that Ukrainian life insurance companies ask broad questions about health and family history that may be perceived by applicants as requiring the disclosure of their genetic information. Our legal analysis shows that today there are no genetic specific law protecting Ukrainians people against GD in insurance. However, Ukrainian human rights legislation provides some protection against multiple grounds of discrimination and given the ratification by Ukraine of the European Convention on Human Rights it is possible that these grounds could be interpreted by tribunals as also including genetic characteristics. As a next step, Ukrainian researchers should develop a survey to obtain much needed data on the incidence and impact of GD in Ukraine. Following this it will be possible for policymakers to better assess whether there is a need for an explicit non-GD law in this country. Such a law would have the benefit of explicitly aligning Ukraine’s legal framework with that of many of its European partners.

Ryu-type extended Marshall-Olkin model with implicit shocks and joint life insurance applications

In this paper we suggest an improvement of the Extended Marshall-Olkin methodology by allowing an implicit effect of the common shocks affecting the elements of the system. Properties of this new model are studied. We propose an empirical application to a sample of censored residual lifetimes of couples of insureds extracted from a data set of annuities contracts of a large Canadian life insurance company. We obtain estimation of the model parameters using a two-stage maximum likelihood technique and discuss the obtained results.

Quantile hedging in a defaultable market with life insurance applications

The paper is devoted to quantile hedging in a market with defaultable securities. Both perfect and quantile hedging strategies are given for a European call option on a vulnerable equity. Application of quantile methodology to pricing the equity-linked life insurance contracts is demonstrated. A numerical example is provided to illustrate the effect of a default on the option price, on the probability of successful hedging, and on the insurance-related variables.

Suicide risk: automated underwriting versus medical experts.

In the early 20th century, the rating of higher risk, “substandard” applicants for life insurance was largely the purview of physicians known as medical directors of life insurance companies.[1][1],[2][2] Medical directors from the United States and Canada met annually between 1889 and 1991

Association of Carcinoembryonic Antigen with Mortality in an Insurance Applicant Population.

Objectives.- To quantify the mortality risks associated with elevated levels of carcinoembryonic antigen (CEA). Background.- Carcinoembryonic antigen is cell surface glycoprotein and has been associated with the presence of high grade or metastatic cancers of the colon as well as other malignant and non-malignant disease. Prior publications have demonstrated the utility of CEA levels in the determination of mortality risk in life insurance applicants. The aim of this paper is to further characterize this risk with a larger set of data containing additional person-years of follow-up, more outcomes, and additional variables potentially associated with occult malignancy. Methods.- By use of the Social Security Death Index, mortality was examined in 321,574 insurance applicants age 50 years and older, who submitted blood samples to Clinical Reference Laboratories for testing including CEA. Results were stratified by age group and by CEA level (<5 ng/mL, 5 to 9.9 ng/mL, 10+ ng/mL), though other thresholds were tested. Mortality comparisons were carried out using Cox models and tabular methods with the 2015 smoker-distinct Valuation Basic Tables as a comparator. Results.- Relative mortality is increased at CEA levels above 4.0 ng/mL in both smokers and non-smokers. This association is persistent in Cox models when albumin, BMI and cholesterol are included as covariates. The strongest association with mortality risk occurred in the first 3-4 durations. The 3-year cumulative mortality ratio when using the 2015 VBT as baseline was 6.51 when comparing the group with CEA levels of 10+ ng/mL, compared to those with levels below 5.0 ng/mL. Conclusion.- This study shows that CEA is strongly associated with the risk of early excess mortality in life insurance applicants, and this risk appears not to be mitigated by consideration of other markers thought to be associated with occult malignancy.

All-Cause Mortality for Life Insurance Applicants with a Family History of Coronary Artery Disease Before 60.

-To determine the all-cause mortality of life insurance applicants having a family history of coronary artery disease (CAD) before age 60. -Epidemiological studies have shown that a family history of premature CAD is an independent risk factor for CAD events. The strength of the association between family history and CAD is greatest with earlier age of presentation of CAD in the family member and when multiple family members are affected. Despite earlier insurance studies on this relationship, there is sparse current data on the association between family history of CAD and all-cause mortality in life insurance applicants. -Life insurance applicants with reported family history of Coronary Artery Disease (CAD) were extracted from data covering United States residents between October 2009 and October 2016. Information about these applicants was matched to the Social Security Death Master (SSDMF) file for deaths occurring from 2009 to 2012 and to another commercially available death source file (Other Death Source, ODS) for deaths occurring from 2009 to 2016 to determine vital status. Actual to Expected (A/E) mortality ratios were calculated using the Society of Actuaries 2015 Valuation Basic Table (2015VBT), select and ultimate table (age last birthday). All expected bases were not smoker distinct. Confidence bands around these mortality ratios were calculated. The variables of interest were applicant age, gender, number of family members with CAD before age 60, and the presence of cardiac or cardiovascular conditions. -Overall, the mortality of applicants with family members with a history of CAD before age 60 was slightly lower than expected mortality based on the 2015 VBT. Applicants with a cardiac or cardiovascular comorbid condition had a significantly higher mortality ratio. For applicants aged 25-54 and 65-75 with cardiac comorbid conditions, the mortality ratio was 2 times that of those without a cardiac comorbid condition. For those aged 55-64 with cardiovascular comorbid conditions, the mortality ratio was 2.9 times that of those without a cardiovascular comorbid condition. Females had a slightly higher mortality ratio for all age groups, number of family members with CAD before age 60, and cardiovascular conditions. -A family history of CAD before the age of 60 in an insurance applicant may be associated with increased all-cause mortality. Overall in this study, life insurance applicants had a mortality slightly lower than the expected mortality based on the 2015 VBT. However, applicants with a positive family history and a cardiac or cardiovascular comorbid condition had a significantly higher mortality ratio.

An Irregular Rhythm with Missing P Waves.

An electrocardiogram on a life insurance applicant with a history of surgically repaired congenital heart disease displays an irregular rhythm with occasional missing P waves.

Time to End the Use of Genetic Test Results in Life Insurance Underwriting.

The decreasing cost of genome and exome sequencing, including direct-to-consumer testing, produces information asymmetry between applicants and life insurance companies, which increases the risk of adverse selection. Rather than requiring applicants for life insurance to undergo genetic testing, life insurers ought to revise their policies and not use the results of genetic tests in the medical records of applicants for underwriting. Prohibitions on access to genetic test results already have been adopted without great upheaval in several other countries. There are two main reasons why this new approach should be used in the United States. First, genetic test results do not provide essential information that is not already available through traditional underwriting measures. Second, because many individuals at genetically increased risk of serious disorders currently decline testing out of fear of the economic consequences, policies prohibiting the use of genetic test results in life insurance will encourage genetic testing and facilitate timely surveillance and necessary medical intervention, thereby saving lives.

Application of the phase‐type mortality law to life contingencies and risk management

The class of phase‐type distributions has recently gained much popularity in insurance applications due to its mathematical tractability and denseness in the class of distributions defined on positive real line. In this paper, we show how to use the phase‐type mortality law as an efficient risk management tool for various life insurance applications. In particular, pure premiums, benefit reserves, and risk‐loaded premiums using CTE for standard life insurance products are shown to be available in analytic forms, leading to efficient computation and straightforward implementation. A way to explicitly determine provisions for adverse deviation for interest rate and mortality is also proposed. Furthermore, we show how the interest rate risk embedded in life insurance portfolios can be analyzed via interest rate sensitivity index and diversification index which are constructed based on the decomposition of portfolio variance. We also consider the applicability of phase‐type mortality law under a few non‐flat term structures of interest rate. Lastly, we explore how other properties of phase‐type distributions may be applied to joint‐life products as well as subgroup risk ordering and pricing within a given pool of insureds. Copyright © 2017 John Wiley &amp; Sons, Ltd.