WHICH CANCERS ARE SIGNIFICANT WHEN UNDERWRITING LIFE INSURANCE

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WHICH CANCERS ARE SIGNIFICANT WHEN UNDERWRITING
LIFE INSURANCE?

• Siegfried Akermann
• Allianz Life Insurance

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• If you are fed up with theory
• and are craving for practical information for
  underwriting
• Then you are at the right place here

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• CANCER is the main cause of death for life
  insurance and not CARDIOVASCULAR DISEASES

• Mortality is what counts for underwriting life
  insurance and not morbidity
• So causes of death may give valuable information

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Source of data

• Mortality statistics of Germany
• Statistisches Bundesamt
• Gesundheitswesen
• Fachserie 12, Reihe 4
• Todesursachen in Deutschland
• 1991 2001

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Causes of death total population
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• Are data of the total population representative
  of the life insurance clientele?

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Life insurance applicants
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Life insurance vs population
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• life insurance ages 15 65
• the ideal life insurance client is young,
  healthy, pretty, and rich

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Absolute mortality of the German population
Age 15 - 65
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Causes of death Age 15 to 65
Cancer
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Causes of deathage 15 - 65
Cancer
Cancer
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Absolute tumor mortality
Age 15 65
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Tumor mortalityage 15 - 65
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Tumor mortalityage 15 - 65
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Tumorsage 15 - 30
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Tumorsage 15 - 30
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Tumorsage 30 - 45
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Tumorsage 30 - 45
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Tumorsage 45 - 65
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Tumorsage 45 - 65
lung
breast
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Gastrointestinal tumors15 - 65
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Gastrointestinal tumorsabsolute mortality
Age 15 - 65
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Chest tumors15 - 65
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Chest tumorsabsolute mortality
Age 15 - 65
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Tumors of the female organs15 - 65
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Tumors of the female organsabsolute mortality
Age 15 - 65
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Breast cancerabsolute mortality
Age 15 - 65
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Tumors of the male organs
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Tumors of the male organsabsolute mortality
Age 15 - 65
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The most frequent cancersage 15 - 65 (males and
females)
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The most frequent cancersage 15 - 65
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The most frequent cancers age 15 - 30 (males
and females)
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The most frequent cancersage 15 - 30
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The most frequent cancers age 30 - 45 (males
and females)
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The most frequent cancersage 30 - 45
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The most frequent cancers age 45 - 65 (males
and females)
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The most frequent cancersage 45 - 65
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The most frequent cancers age gt 65 (males and
females)
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The most frequent cancersage gt 65
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The most frequent cancers age 1 - 15 (males and
females)
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The most frequent cancersage 1 15
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The most frequent malignant tumors
Age 45 - 65
Age 30 - 45
Age 1530
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The most frequent malignant tumors
Age 45 - 65
Age 1530
Age 30 - 45
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The most frequent malignant tumors
Age 15 30
Age 30 - 45
Age 45 - 65
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What do we see at underwriting?
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Which tumors do we see at underwriting?

• Hodgkinss disease
• Leukemia, childhood
• Testicular cancer, seminoma
• Cervical cancer, dysplasia gtgt tumor
• Breast cancer

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Which tumors do we have to look for?

• Age 15 30
• Brain tumors
• Leukemias
• Lymphomas
• Tumors are very rare,
• special screening is not neccesary

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Which tumors do we have to look for?

• Age 30 45
• lung tumors
• stomach
• Tumors are rare, special screening is not
  necessary

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Which tumors do we have to look for?

• Age 30 45
• Breast, uterus, ovary specific female tumors
• Lung tumors
• Tumors are rare, special screening is not
  necessary
• Females should be asked for the results of their
  annual gyn check ups

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Which tumors do we have to look for?

• Age 45 65
• lung tumors
• Colon, stomach
• Tumors high incidence, special screening
  recommended
• Specific questions, smoking history etc.
• Chest X ray? In Germany banned by law
• APS or medical exam

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Which tumors do we have to look for?

• Age 45 65
• lung tumors
• Smoker vs. Non smoker tariff
• Tests for nicotine metabolites
• cotinine
• Questions as to smoking habits

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Which tumors do we have to look for?

• Age 45 65
• Breast, uterus, ovary specific female tumors
  outstanding importance
• Lung tumors
• colon
• Tumors high incidence, special screening is
  recommended
• Question as to the results of annual gyn check
  ups, mammography
• APS or med. exam

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New problem in women
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Which tumors do we have to look for?

• Age 45 65
• Other possible screening measures
• fecal occult blood
• reliability, chance of fraud, practibility
• Tumor markers
• low specificity for tumor screening, cost

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Which tumors do we have to look for?

• Age 45 65
• Other possible screening measures
• Mammography
• not allowed by law
• Insurance gyn exam
• Invasion of privacy, not acceptable

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Which tumors do we have to look for?

• Age 45 65
• Other possible screening measures
• Genetic testing for
• breast and female cancers (BRCA1,2)
• Colonic cancer (FHP)
• Not allowed because of voluntary commitment of
  life insurers in Germany
• not accepted by public
• Would not cover all persons at risk

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Thank you