The Irish playwright, Oscar Wilde, observed that the heart was made to be broken. Indeed, the experience of being alive is almost certain to contain at least one heartbreak, perhaps even adding to the richness of our humanity or sowing the seed of a future happiness. The medical community has long questioned whether heartbreak or its’ frequent companion, severe or chronic physical or emotional stress, can damage the human heart, the muscle responsible for each life sustaining breath. Let’s take a look at possible answers to those questions. Continue reading “What becomes of the broken-hearted? Stress and the Human Heart”
Prostate cancer continues to be a scourge on the Canadian health landscape as the most commonly diagnosed and third leading cause of cancer-related death among men (1). It currently accounts for about 20% of all new cancers in men and approximately 4,500 deaths annually (2). Underwriters increasingly are presented with prostate cancer in the medical history and we will see even more cases as our population continues to age.
But the landscape also points to a good news horizon. Thanks to improved screening and treatment, prostate cancer mortality continues to fall, dropping from its’ high of 45.1 deaths per 100,000 men in 1995 to 22.7 per 100,000 in 2021 (1). One of the more remarkable advances in the screening and diagnosis of this malignancy is the use of imaging studies, such as the prostate MRI. From the earliest images 40 years ago using magnetic resonance imaging technology, the current prostate MRI uses state-of-the-art image modalities such as dynamic contrast-enhanced (DCE) and spectroscopic views to get a better look in order to detect clinically significant prostate cancer (3). The impact on detection, accuracy and diagnosis is a major contributor to improved prostate cancer mortality. Prostate MRIs are also increasingly utilized to monitor for prostate cancer recurrence after treatment, no doubt also contributing to improved mortality. Continue reading “Looking Good: Prostate Cancer’s Sharper Image”
Nearly 10 per cent of Canadians ages 12 and older have a mood disorder (1). One definition of mood disorder is a general emotional state or mood that interferes with one’s ability to function. Major depression disorder (MDD), anxiety and bipolar disorder (BP) are the commonly thought of mood disorders. However, are you aware that seasonal affective disorder, a form of depression, is also a mood disorder? Continue reading “Shining a Light on Seasonal Affective Disorder (SAD) and Underwriting”
A look back in time helps demystify insurance underwriting
Life insurance underwriting has been around a long time. Since the first life insurance policy issued in 16th century England, the practices supporting fair and competitive life insurance risk selection have evolved often apace with emerging technologies, but the principles that undergird underwriting remain remarkably unchanged.
Living benefits, via disability and critical illness insurance, are considered relative newcomers to the marketplace. Still, the earliest forms of these coverages have been available for a long time. The second American president, John Adams, signed the Act for the Relief of Sick and Disabled Seamen in 1798 (1). The law required seafarers to put aside twenty cents per month from their wages in order to fund medical care for other sailors who fell sick or became disabled. This group of seamen were so vital to trade and commerce, that the law created a provision for the building of hospitals for sick seamen. This is perhaps one of the earliest examples of what we now consider accident and sickness and disability insurance.
Critical illness is the youngest member of the life and living benefits insurance family. It was the brainchild of South African Dr. Marius Barnard who launched the first version in 1983 under the ominously titled Dread Disease Insurance. The premise was groundbreakingly simple: get diagnosed with a covered illness, survive 30 days and collect the claim payment. Critical illness made its way to our shores a few years later and remains a powerful protection tool that continues to benefit Canadian insurance buyers, often in ways that have been described as life changing and life saving. Continue reading “Life vs. Living Benefits Underwriting: Consider the Differences”
When we first visited the topic of the novel coronavirus in March 2020, just over 100,000 cases had been reported worldwide. At this time, in late March 2021, the World Health Organization reports well over 120 million cases and regrettably, the loss of nearly 3 million lives. The global pandemic that is COVID-19 has affected 223 countries. In Canada, we are closing in on 1 million cases and almost 24,000 deaths (1). We have already discussed the economic and social devastation wrought by the virus. The good news has been both a new and renewed understanding of containment and mitigation to halt the spread of human-to-human viruses and the unprecedented speed of delivery of what appears to be highly effective vaccines. Mass vaccination should help usher in a new era of normalcy.
But what about our children? How have our kids fared during this time? Let’s look at COVID-19 and its’ impact on the youngest members of our society. First, the most obvious question: can children get COVID-19? Yes. One study out of Europe reports 14% of cases in those aged 0-19 years. Early in the pandemic, household transmission was likely predominant. With return to school, even on a limited basis, inconsistent safe distancing and mask wearing, along with poor ventilation in older school buildings, have contributed to child-to-child transmission rates. This is especially the case with the emergence of the more highly transmissible variants such as B117, now likely to become the dominant variant and increasing the need to accelerate mass vaccination programs (2). Continue reading “Children and COVID-19 – Are the Kids Alright?”
“Loneliness is the ultimate poverty” (1). So said the everyday philosopher Pauline Philips, better known to millions as “Dear Abby”, the legendary advice columnist. The theme of loneliness runs deep in our past and present society, inspiring music, literature, film and a long list of commercial endeavours to alleviate what another great legend, Bob Dylan, described as “endless emptiness” (2). It’s all a little grim. In more clinical terms, it can be described as a subjective feeling related to the lack of social relations or simply a sense of disconnectedness or isolation (3).
So, why discuss loneliness in an underwriting setting and why now? Well, the simple answer is that when it comes to medical reporting, loneliness as a component of psychiatric disorders has long been a red flag for concern. That same report would typically also reveal a history of depression, insomnia, disturbed appetite and other markers of reduced well-being. In more extreme cases, there can be the misuse of alcohol, marked stress and drug use. Physicians have long recognized that loneliness can predispose the sufferer to a broad range of illness, including cardiovascular and immune system diseases (4). In older populations, isolation can accelerate cognitive decline, interfering with day-to-day functioning and the quality of life (5). In younger people, social stress and isolation are cited as precipitating factors for suicide, which accounts for 24% of all deaths among 15-24 year-olds living in Canada (6). In fact, every day we lose ten Canadians to suicide (7). Continue reading “Loneliness – How Risky Can It Get?”
Since its completion in 2003, the Human Genome Project has garnered a great deal of attention for genetic testing. All of this focus has resulted in the identification and mapping of the three-billion pairs of human gene structure, known as the genome. Today, geneticists can perform many different types of analyses that have never been seen before, including deep sequencing, RNA sequencing and epigenomics, the overall study of the complete set of epigenetic modifications on the genetic material of a cell – all of these allow scientists to study the expression of genetic patterns from person-to-person and more.
Genetic therapy is a developing area of our unprecedented understanding of the human genome. Imagine being able to add a normal, healthy gene where a person has inherited a defective gene variant? In some cases, this may improve outcomes from a disease and in the best cases, cure or prevent it altogether. Continue reading “Gene Therapy – The Fix Is (Almost) In”
There was a time not too long ago when the term “travel bug” simply referred to someone with a penchant for adventure, someone with a desire to travel and see the world. Today, that term has a far more sinister meaning as travel is discouraged, airlines are more of less grounded and many Canadians are hesitant to even visit family in the same city for fear of spreading the COVID-19 virus. Whether it be a day-trip to the beach or weeks of wandering around Europe, travel has been indefinitely put on hold. As of the start of December 2020, there have been over 65 million cases and over 1.5 million deaths worldwide due to COVID-19, with no assurance that this will end any time soon (1).
So, the question remains – what is the impact on your clients who travel or plan to travel and how does the underwriting community view the travel risk as 2020 draws to a close? Continue reading “Travel and Underwriting – What in the World is Going On?”
Since the first case of COVID-19 was reported in Canada in the spring of this year, we have definitely learned a few things about this virus. We know now that the coronavirus, known as COVID-19, is highly infectious and that although most of its’ victims are elderly and/or medically vulnerable, too many fatalities have occurred across the age spectrum and among those with no obvious pre-existing risk factors to define who or where the virus will strike next. Something that makes all of us more than a little uneasy.
On the positive side, we now understand how to better curb infection by hand washing, social distancing and wearing a mask, and as Canadians, we can be proud of our collective efforts to flatten the curve of rising new cases and deaths, at least thus far. Having said that, now is the time to focus on the mortality and morbidity impact for the more than 110,000 COVID-19 survivors in Canada; today the question is how will these cases be treated when applying for life insurance, critical illness or disability coverage? Continue reading “The COVID-19 Rating Guide: Get Ahead of the Curve”
Genetic testing has been an incredible success in helping patients determine both their current health status and future health risks. The results of a genetic test can help confirm or exclude a suspected genetic condition; they can also help determine the chance of developing or passing on a genetic disorder – certain types of cancers, Alzheimer’s and Parkinson’s disease to name just a few .
So, what is genetic discrimination, and what happens if your client would like to buy insurance but they have been genetically tested and are worried their results will work against them? Continue reading “The Genetic Non-Discrimination Act: A Supreme Thumbs-Up”