Melanoma is the deadliest form of skin cancer. About 9,000 Canadians are diagnosed annually causing approximately 1,200 deaths per year (1). As a cancer long known to plague mankind, the father of Western medicine, Hippocrates, described these potentially deadly skin lesions as “the fatal black tumour”. For millennia, there was a poor understanding of the causes and possible treatments. That changed in the 19^th century when physicians noted the propensity of melanoma to metastasize and later how excising certain lymph glands might prevent the spread of this skin cancer (2). Continue reading “Melanoma: Through Thick and Thin” →

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Melanoma: Through Thick and Thin

The incentive to improve and innovate has been around for as long as the business world itself. The American engineer, Frederick Taylor, deemed that work is worthy of observation and analysis (1). In the early 20^th century, Taylor pioneered the time study of work and workers, requiring the observer to use a stopwatch while standing next to the worker, timing task completion (2). In the early 1990s, business consultants Michael Hammer and James Champy coined the term “Reengineering”, launching a movement that aimed to upend the conventions of usual business practices, exhorting managers to take a fresh look at every function and task (3). Continue reading “ChatGPT and Underwriting: Can We Chat?” →

When primitive men and women discovered fire, it changed their very existence. Food and shelters could be heated, not to mention providing illumination and some degree of protection from the animal kingdom predators that roamed the planet. Not quite as dramatic except to those of us in the life insurance industry, the employment of actuarial science in the late 17^th century provided kindling to the underwriting fire. This included the production of life tables and application of compound interest to the challenge of calculating the present value of the future liability, the very foundation of life insurance premiums.

What does this have to do with gender? In the early days, not very much. It was all an actuary could do to wade through individual birth and death records to calculate premiums based on the still most important risk factor, the age of the life being insured. No distinction between male and female was made and, as a result, unisex pricing was the norm. Around 1880, the rate of male mortality started to rise and astute actuaries the world over eventually began to reflect those differences in the pricing of life insurance rates. (1). The mortality/gender gap is especially pronounced in older lives, where 57% of all those aged 65 are female and by age 85 women make up 67% of the population (2). In Canada, women, on average, live 4 years longer than men, making the actuarial argument that men should pay more for life insurance (3). While Canadian insurance companies take these differences into account when pricing life insurance, it is not always the universal view. Since 2012, the European Union prohibits pricing based on gender for life, health and even auto insurance, raising the age-old question of fairness; should a lower risk group, in this case women, subsidize the higher-risk group, male policyholders (4)? Continue reading “The Gender Risk: What’s the Difference?” →

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The Gender Risk: What’s the Difference?

“The following article references an opinion and is for information purposes only. It is not intended to be investment advice. Seek a duly licensed professional for investment advice.”

Financial underwriting. These two words put together are sometimes the subject of heated debate and occasionally, more than mild disagreement between Advisors and underwriters. Even usually agreeable underwriters are known to argue strenuously amongst themselves and on differing sides of a financially challenging case. Unlike medical underwriting where guidelines cover a wide and deep array of conditions and risk scenarios, financial guidelines take up much less space in most underwriting manuals, highlighting the art rather the science of decision making in those cases.

But in every case, the higher the insurance amount applied for, the more thorough the financial underwriting – with extra attention paid to the financial information provided, including the nature of the applicant’s net worth – right down to the types of investments and currencies they hold. How does cryptocurrency, not brand new but still a relative newcomer in global finance, impact financial underwriting? In this Risk Bit, we’ll touch on the topic to get a sense of whether having a bit of Bitcoin is a friendly addition to the file information or whether an excess of Ethereum turns the underwriter into a file foe. Continue reading “Cryptocurrency and Financial Underwriting: Friend and Foe?” →

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Speculating on Life and Death… and Cryptocurrency

This is neither an endorsement or advice about the treatment of mental health.

It goes without saying that good mental health is foundational to overall health and well-being.

In underwriting, a report of confirmed or even suspected history of depression or related conditions gets a lot of attention and policy issue can range from standard rates to rated premium to sometimes no offer at all, where the risk is deemed too high to accept.

Treatments for depression, bipolar disorder, schizophrenia or other conditions in the mental health spectrum continue to evolve. The use of psychedelics is a newer facet of treatment. Natural substances that induce a hallucinatory state have been around for millennia. These include everything from cannabis, now legal in Canada, and include opium poppy to ayahuasca, the latter a product of brewing a particular vine or shrub commonly found in South America (1). Continue reading “The Evolving World of Mental Health Treatments” →

Underwriters see an unprecedented number of cases of suspected or confirmed cognitive decline, the inevitable result of our aging population. While cognitive decline can be demonstrated by a degradation or loss of a number of functions such as learning, language or complex attention skills, the apparent loss of memory is the most common presenting complaint. Even cases where the memory loss has not had a major impact on daily living, a suspicion of even mild cognitive impairment (MCI) is enough to have the insurance application turned down.

But what about the other side of the memory coin, specifically can we remember too much or remember in ways that are unhealthy? How does this work and is there a name for this condition? Let’s delve a little deeper. Continue reading “Healthy Forgetting: Remember This” →

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Healthy Forgetting: Remember This

Last time in this space, we discussed how physical or emotional stress affects the human heart. This time, we will focus on why maintaining a favorable balance between a commitment to our jobs and the need to prioritize our lives outside of the workplace is both a life-affirming and possible life-saving necessity.

Let’s start by looking back to the early 1990’s, when researchers in Japan started to study and report on a phenomenon where it appeared ostensibly healthy, middle-aged, mostly men, started to die suddenly. The term coined for the cause of death in this group was “karoshi”, meaning death from overwork. The common thread running through these cases was a history of chronically long work weeks, logging in at 60 hours and often more. The cause of death was disturbing in its’ repetition, most often heart disease, stroke or suicide (1).

More recently, and perhaps due to the pandemic and a growing body of knowledge increasingly difficult to ignore, there is renewed interest in the burden and toll of an unhealthy work life. Continue reading “Work-Life Balance: Tipping the Mortality Scale” →

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Work-Life Balance: Tipping the Mortality Scale

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” →

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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” →

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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” →

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Shining a Light on Seasonal Affective Disorder (SAD)