As an underwriter, it is common to review medical records indicating a history of "benign fatty liver disease" - especially in those patients with history of high BMI's that carry the majority of their weight through the mid section. Often times, there will be correlation to mildly elevated liver enzymes in a serum blood draw. In a number of underwriting assessments this finding, absent of any alcohol or hepatitis concerns, is typically treated as a non-debitable situation.
A recent research study has focused on the usefulness of utilizing specific laboratory panels to better identify non-alcoholic fatty liver disease (NAFLD) vs. advanced stage non-alcoholic steatohepatitis (NASH). The latter carrying a much higher rate of mortality impact from increased liver disease complications.
The study conducted on 541 patients in the NIH-funded NASH clinical research network found that there was correlation between specific lab/body habitus and biopsy proven advanced stage NASH. Specific areas of importance included; BMI, AST/ALT ratio, AST/platelet ratio, BARD score (BMI, AST/ALT ratio, diabetes), and cirrhosis discriminant score. Unfortunately, lab tests still are unable to clearly identify advanced NASH cases-but these tests are a step in the right direction for identifying situations that require further evaluation.
This will continue to be a problematic issue for underwriting professionals, especially in light of the increasing obesity issues that will affect increased diagnosis of NAFLD making it difficult to weed out those that are higher risk NASH cases.
Tuesday, March 30, 2010
Wednesday, March 10, 2010
Market Trends-Still struggling to find growth!
Two updated indices that track activity in life insurance and life settlement provided no encouragement for improvement in insurance related markets.
MIB (Medical Information Bureau) released February activity numbers yesterday, and the positive trend we saw in January was no where to be seen in the "flat" numbers reflected last month. The month was noted to be "off" -0.2% - all ages combined. One area that still shows promise for future growth is insurance applications on those over the age of 60-an age group that has historically reflected double digit growth over the past 13 months. February is a lower month of production historically so there is hope that moving into 2nd Q we could see moderate increases.
Amrita's Life Settlement Index also released February numbers reflecting a 73 point decline in transactions over January. The indication is that it is related to the policies in the market outpacing the funding to purchase and tightened provider buying perameters. As an LE provider in the space, the trend of lower production in life insurance seems to mirror life settlement as we have historically noted reduced case flow numbers in the first and early 2nd Q.
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MIB (Medical Information Bureau) released February activity numbers yesterday, and the positive trend we saw in January was no where to be seen in the "flat" numbers reflected last month. The month was noted to be "off" -0.2% - all ages combined. One area that still shows promise for future growth is insurance applications on those over the age of 60-an age group that has historically reflected double digit growth over the past 13 months. February is a lower month of production historically so there is hope that moving into 2nd Q we could see moderate increases.
Amrita's Life Settlement Index also released February numbers reflecting a 73 point decline in transactions over January. The indication is that it is related to the policies in the market outpacing the funding to purchase and tightened provider buying perameters. As an LE provider in the space, the trend of lower production in life insurance seems to mirror life settlement as we have historically noted reduced case flow numbers in the first and early 2nd Q.
Come Visit Us!
www.advanceduwsolutions.com
www.linkedin.com/in/tddavisaus
http://twitter.com/TraciDavisAUS
Tuesday, March 9, 2010
Smoking & Benefits of Reduction?
I recently came across an Israeli study that studied the effects of smoking cessation AND reduction in survivors of acute MI (myocardial infarction-acute heart attack). The focus was on long-term mortality in 1581 patients. Both genders were studied, the mean age of the patients was 54, 19% of those studied were women.
Participants in the study had their first cardiac event between 1992 and 1993 and were followed for more than 10 years. At baseline, 123 participants had never smoked, 70 were former smokers, and 234 were current smokers.
Results of the study indicated that of those that were persistent smokers, but noted to reduce at least 5 cigarettes daily status post MI, there was an associated 18% decline in mortality risk.
Although this was considered a "young" cohort of first time MI patients, it did reinforce a significant benefit smoking cessation, but more surprisingly, the benefit of moderate reduction in smoking.
For many smokers plagued with the challenges of quitting, these benefits of smoking reduction are at least a positive step toward encouraging smokers to make initial "first steps".
Participants in the study had their first cardiac event between 1992 and 1993 and were followed for more than 10 years. At baseline, 123 participants had never smoked, 70 were former smokers, and 234 were current smokers.
Results of the study indicated that of those that were persistent smokers, but noted to reduce at least 5 cigarettes daily status post MI, there was an associated 18% decline in mortality risk.
Although this was considered a "young" cohort of first time MI patients, it did reinforce a significant benefit smoking cessation, but more surprisingly, the benefit of moderate reduction in smoking.
For many smokers plagued with the challenges of quitting, these benefits of smoking reduction are at least a positive step toward encouraging smokers to make initial "first steps".
"It has been my experience that folks who have no vices have very few virtues" Abraham Lincoln (1809-1865)
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