Mild cognitive impairment (MCI) has been on the rise as a "diagnosis" in the medical records being reviewed on senior market insurance applications and settlements. On the life side, this is causing increased challenges in getting policies approved by underwriting, and hence increased frustrations at the broker level. Brokers by and large are under the impression that these are merely typical, age related changes and underwriters have the belief that this is early stage dementia-They are both correct! On the settlement side, this is often the cause of unwarranted aggressive life expectancy estimations, a problem for the investor. Here are some insights to help both sides successfully navigate through this impairment.
According to the AGS (American Geriatrics Society); MCI is the intermediate stage between cognitive changes of normal aging and dementia. Although MCI typically shows up years prior to a formal diagnosis of dementia, and there is some increased risk of MCI progressing to dementia, it is not a definitive measure for development of dementia. Approximately 12% of those over the age of 70 that have MCI are3-4 times more likely to develop AD (Alzheimer's Disease).
Mayo clinic developed a general criteria utilized for the identification of MCI: 1) Self reported memory complaints, 2) Objective memory impairment, 3) Preserved general cognitive function, 4) Intact activities of daily living (ADL), 5) Not meeting criteria for dementia.
In the thousands of senior medical records reviews I have completed over the years, it is important to really evaluate the symptoms and patient presentation when the AP (attending physician) has indicated MCI. I have found a number of instances when all criteria have not been met yet the AP indicates this as a diagnosis-always troublesome for the underwriter to make the appropriate assessment yet retain case documentation that will not haunt them on future underwriting audits!
It is clear, based upon the research to date, that MCI is a risk factor for dementia, much the same as hyperlipidemia is a risk factor for coronary artery disease. As such, it would be reasonable to expect a mild rating, but declinations of insurance based upon this single factor would be unwarranted.
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Contact our Expert/Blogger:
Traci Davis, President/Chief Underwriter
tdavis@advanceduwsolutions.com
www.linkedin.com/in/tddavisaus
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Senior assessments require experienced medical underwriters that understand the differences in impairment mortality on applicants and insureds over the age of 65. AUS has that underwriting expertise-contact us today to find our more about our suite of underwriting services!
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newbus@advanceduwsolutions.com
Monday, September 20, 2010
Sunday, August 29, 2010
Life Insurance vs. Settlement Indices-July 2010
Medical Information Bureau (MIB) released results of July 2010 activity reflecting life insurance applications entering the market. For a second month in a row, there was a notable decline in applications of -3.9%. It is important to note that although this is following declines in June, these declines are consistent with the cycle of business that is "historically" typical during the summer months.
Applications on Senior ages continues an upward tick. Ages 60+ noted a +7% increase , year-over-year.
Life settlement trends, provided by Amrita Financial noted a stable level compared to June 2010. The index posted 460 points for July.
As there continues to be a trend towards senior market applications and settlements, it's becoming even more critical that the underwriters utilized to evaluate the risks associated with seniors are specialized and experienced. AUS, Inc. -Founded and managed by Senior Market Underwriting Consultants
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www.advanceduwsolutions.com
newbus@advanceduwsolutions.com
Contact Traci Davis-Underwriting Expert!
tdavis@advanceduwsolutions.com
www.linkedin.com/in/tddavisaus
Applications on Senior ages continues an upward tick. Ages 60+ noted a +7% increase , year-over-year.
Life settlement trends, provided by Amrita Financial noted a stable level compared to June 2010. The index posted 460 points for July.
As there continues to be a trend towards senior market applications and settlements, it's becoming even more critical that the underwriters utilized to evaluate the risks associated with seniors are specialized and experienced. AUS, Inc. -Founded and managed by Senior Market Underwriting Consultants
Contact Us!
www.advanceduwsolutions.com
newbus@advanceduwsolutions.com
Contact Traci Davis-Underwriting Expert!
tdavis@advanceduwsolutions.com
www.linkedin.com/in/tddavisaus
Thursday, July 15, 2010
Diabetic Miracle Drug and Acute Heart Attacks!
A common drug utilized for control of Type II diabetics, Avandia, was recently brought before an FDA panel of experts to evaluate the potential risk of increased cardiac incidents and death. The concerns with the drug date back to 2005 when the FDA requested that the product manufacturer (Glaxo) conduct a meta-analysis of the drug effects due to mounting concerns related to increased cardiac risk. The analysis presented to the FDA did indicate increased risk of acute coronary events. The FDA then completed it's own analysis which concurred with the Glaxo results and a boxed warning was applied.
The issue was again brought before the FDA this past week by a Dr. Steven Nissen-cardiologist at the Cleveland Clinic. Dr. Nissen completed his own study, based upon more than 35,000 patients and a combined 56 studies, Dr. Nissen's findings indicated troubling incidences of increased cardiac risk and death associated with the use of this drug. His findings indicated a 28-39 % increased risk of cardiac incidences in otherwise healthy patients. Younger patients were found to have excessive myocardial infarction events and older patients had increased cardiac death.
Amazingly, the FDA expert panel decided against pulling the drug from the market -even in light of the compelling study details outlined by Dr. Nissen. The final voting tally noted the following; (13) votes for pulling the drug from the market ; (17) votes for increased label warnings and possible usage restrictions; (3) voted against any changes.
I would suspect that this will not be the last time we hear about issues with this drug. Glaxo has apparently paid out a number of settlement fees to individuals and families that have been impacted by the drug effects-however, this is the most financially lucrative medication for that company so it is doubtful that they allow removal of this drug from the market without a tremendous fight. After all, drug companies are in the market to make money, not save lives....Right?
The issue was again brought before the FDA this past week by a Dr. Steven Nissen-cardiologist at the Cleveland Clinic. Dr. Nissen completed his own study, based upon more than 35,000 patients and a combined 56 studies, Dr. Nissen's findings indicated troubling incidences of increased cardiac risk and death associated with the use of this drug. His findings indicated a 28-39 % increased risk of cardiac incidences in otherwise healthy patients. Younger patients were found to have excessive myocardial infarction events and older patients had increased cardiac death.
Amazingly, the FDA expert panel decided against pulling the drug from the market -even in light of the compelling study details outlined by Dr. Nissen. The final voting tally noted the following; (13) votes for pulling the drug from the market ; (17) votes for increased label warnings and possible usage restrictions; (3) voted against any changes.
I would suspect that this will not be the last time we hear about issues with this drug. Glaxo has apparently paid out a number of settlement fees to individuals and families that have been impacted by the drug effects-however, this is the most financially lucrative medication for that company so it is doubtful that they allow removal of this drug from the market without a tremendous fight. After all, drug companies are in the market to make money, not save lives....Right?
"Perhaps better we not obscure the idea that happiness and misery, kindness and greed, and good works and bad deeds are in the capacities of us all, not merely a select few"
David P. Mikkelson, snopes.com, September 8, 2003
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Contact Traci Davis (blogger/medical underwriter)
Thursday, July 8, 2010
Reflections on June Indices
June indices were released for both the life insurance and life settlement industries. Both reflecting a downward trend. Are these merely a reflection of "summertime cycles" or a reflection of the continued uncertainty in the economy?
Medical Information Bureau (MIB) is a firm that gathers data on the submission of all life insurance policies by participating carriers. Their index indicated a overall reduction of 3.9%on life insurance applications. Applications received from proposed insureds (PI's) aged 0-44 were down -7.2%, PI's aged 45-59 were down -3.1%, and for the first time this year PI's in the 60+ age group reduced to single digit growth vs. a consistent trend in past months of double digit growth. Compared to 2009 trends, these numbers are atypically low for the summer months.
Amrita LS index reflected a reduction in policy transactions as well. A decline of 14.3% over the prior month. Following on the heels of two prior months reflecting sharp gains-so what happened? The potential reasons given were inconsistent buying power - access to capital and reflection of an unbalanced recovery between funding sources and providers.
It appears that the struggling economic recovery continues to haunt all industries, including ours, and we will most likely continue to see a year of inconsistent numbers. A challenging reality!
Medical Information Bureau (MIB) is a firm that gathers data on the submission of all life insurance policies by participating carriers. Their index indicated a overall reduction of 3.9%on life insurance applications. Applications received from proposed insureds (PI's) aged 0-44 were down -7.2%, PI's aged 45-59 were down -3.1%, and for the first time this year PI's in the 60+ age group reduced to single digit growth vs. a consistent trend in past months of double digit growth. Compared to 2009 trends, these numbers are atypically low for the summer months.
Amrita LS index reflected a reduction in policy transactions as well. A decline of 14.3% over the prior month. Following on the heels of two prior months reflecting sharp gains-so what happened? The potential reasons given were inconsistent buying power - access to capital and reflection of an unbalanced recovery between funding sources and providers.
It appears that the struggling economic recovery continues to haunt all industries, including ours, and we will most likely continue to see a year of inconsistent numbers. A challenging reality!
"Our imagination is the only limit to what we can hope to have in the future"
-Charles F. Kettering
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Contact Traci Davis (Founder/Chief UW/Philospher)
Monday, July 5, 2010
The Centenarian Code-Genes and Longevity
The associated press released a story this past week on how close genetic researchers are getting to establishing specific genes shared by those robust elderly that are living past the age of 100, with the ability to specifically cull out factors of lifestyle.
Researchers have found that there are common gene variations shared by individuals living past the age of 100. A very early step in determining which genes reflect potential vulnerability for diseases with mortality impact. The study did note the importance of lifestyle factors.
The research team, studying specific genetic markers, were able to predict mortality with 77% accuracy. For those of us with a specific focus on predicting longevity this may become a critical factor, and possible tool, as the research evolves.
Stay tuned as AUS leads the field of underwriting in utilizing genetic markers in longevity estimations!
Contact Us!
www.advanceduwsolutions.com
newbus@advanceduwsolutions.com
Connect with Traci Davis (President/Chief Underwriter/Blogger):
www.linkedin.com/in/tddavisaus
tdavis@advanceduwsolutions.com
303-367-1129
Researchers have found that there are common gene variations shared by individuals living past the age of 100. A very early step in determining which genes reflect potential vulnerability for diseases with mortality impact. The study did note the importance of lifestyle factors.
The research team, studying specific genetic markers, were able to predict mortality with 77% accuracy. For those of us with a specific focus on predicting longevity this may become a critical factor, and possible tool, as the research evolves.
Stay tuned as AUS leads the field of underwriting in utilizing genetic markers in longevity estimations!
Contact Us!
www.advanceduwsolutions.com
newbus@advanceduwsolutions.com
Connect with Traci Davis (President/Chief Underwriter/Blogger):
www.linkedin.com/in/tddavisaus
tdavis@advanceduwsolutions.com
303-367-1129
Tuesday, June 8, 2010
Emerging Malignant Melanoma Treatment
Bristol-Meyers released information on a new drug therapy which has promise for significant impact on Malignant Melanoma (MM) survival.
A clinical trial of 676 patients - who had previously undergone treatment (some with advanced stages (3/4) tumors) indicated a near doubling of life expectancy. 12-month survival increased from 25% to 46% and 24-month survival increased from 14% to 24%.
The new drug (Ipilimumab) acts as a targeted T4 cell suppressant (immunosuppressive affect) for patients that carry a specific HLA gene. Data on the percentage of MM treated patients with this gene was not covered in the releases.
Although the drug has not achieved FDA approval, it is available at (75) cancer centers in the U.S. on a "compassionate-use trial" basis.
In addition to treatment of MM, there is indication that it may be a powerful therapy for other advanced cancers of the breast, prostate, and lung.
This blogger wonders if we are on the edge of "silver bullet" cancer therapy-what a hopeful thought!
Website: www.advanceduwsolutions.com
Email Us: newbiz@advanceduwsolutions.com
Connect with the Prez;
www.linkedin.com/in/tddavisaus
http://twitter.com/TraciDavisAUS
A clinical trial of 676 patients - who had previously undergone treatment (some with advanced stages (3/4) tumors) indicated a near doubling of life expectancy. 12-month survival increased from 25% to 46% and 24-month survival increased from 14% to 24%.
The new drug (Ipilimumab) acts as a targeted T4 cell suppressant (immunosuppressive affect) for patients that carry a specific HLA gene. Data on the percentage of MM treated patients with this gene was not covered in the releases.
Although the drug has not achieved FDA approval, it is available at (75) cancer centers in the U.S. on a "compassionate-use trial" basis.
In addition to treatment of MM, there is indication that it may be a powerful therapy for other advanced cancers of the breast, prostate, and lung.
This blogger wonders if we are on the edge of "silver bullet" cancer therapy-what a hopeful thought!
Contact us for all of your underwriting needs!
Website: www.advanceduwsolutions.com
Email Us: newbiz@advanceduwsolutions.com
Connect with the Prez;
www.linkedin.com/in/tddavisaus
http://twitter.com/TraciDavisAUS
Wednesday, May 19, 2010
April Indices-Oh the Ups and Downs!
April was positive for Life Settlements however Life Insurers continue to struggle. Let's see what the experts had to say;
Amrita LS index noted that in April 2010 there was an unexpected, and quite positive, jump in life settlement transactions over the prior month. The reported numbers climbed an astonishing 92.8 points over March. Amrita indicates that the jump was largely attributed to an increase in market activities and "renewed bullish expectations".
On the flip, Medical Information Bureau (MIB) indicated that individually underwritten life insurance was off -1.4% in April over March. Comparitively, the index has been fluctuating between mild growth and losses since January 2010. Senior life insurance applications continue to reflect growth - with a continued upward trend of +10.5% on applicants aged 60+. MIB indicates that the April numbers are consistent with "seasonal norms".
Have you considered conducting your underwriting and LE business from a different perspective? AUS has been busy incorporating new services from Red Flag Underwriting (exceptional tool for portfolio tracking) to obtaining medical records and pharmaceutical profiles.
Our prices are reasonable and our customer focus is second to none! Give us a call for a full list of our services!
www.advanceduwsolutions.com
www.linkedin.com/in/tddavisaus
http://twitter.com/TraciDavisAUS
Amrita LS index noted that in April 2010 there was an unexpected, and quite positive, jump in life settlement transactions over the prior month. The reported numbers climbed an astonishing 92.8 points over March. Amrita indicates that the jump was largely attributed to an increase in market activities and "renewed bullish expectations".
On the flip, Medical Information Bureau (MIB) indicated that individually underwritten life insurance was off -1.4% in April over March. Comparitively, the index has been fluctuating between mild growth and losses since January 2010. Senior life insurance applications continue to reflect growth - with a continued upward trend of +10.5% on applicants aged 60+. MIB indicates that the April numbers are consistent with "seasonal norms".
Have you considered conducting your underwriting and LE business from a different perspective? AUS has been busy incorporating new services from Red Flag Underwriting (exceptional tool for portfolio tracking) to obtaining medical records and pharmaceutical profiles.
Our prices are reasonable and our customer focus is second to none! Give us a call for a full list of our services!
www.advanceduwsolutions.com
www.linkedin.com/in/tddavisaus
http://twitter.com/TraciDavisAUS
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