What we think

Our take on issues present and future.

  • Over-diagnosis

    In August 2018 the British Medical Journal published a lengthy review article1 dealing with the issue of over-diagnosis. This is defined as the diagnosis of a condition (often subsequently treated) that would otherwise not cause symptoms or harm to a patient during his or her lifetime.   Over-diagnosis arises in a number of ways, including: The broadening of disease definitions via lowering of diagnostic thresholds and the recognition of risk
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  • Interesting times in a land ‘down under’

    Australia has always been an interesting market protection business-wise. And in the past few months it has become even more interesting.   In 2016 there were some startling revelations on the ABC TV news programme Four Corners. The programme revealed a ‘disturbing culture’ at an insurer where critical illness and TPD claims were being denied. The firm’s ex-chief medical officer claimed that he was put under increasing pressure to deny
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  • Alcohol – a postscript

    The press release for the journal article1 referred to in our previous thoughtpiece has some interesting statistics relating to alcohol around the world as part of its ‘notes for editors’. The following relate to 2016.   Highest prevalence of alcohol consumption   Males   Females   Country Prevalence %   Country Prevalence % 1 Denmark 97.1 1 Denmark 95.3 2 Norway 94.3 2 Norway 91.4 3 Argentina 94.3 3 Germany
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  • Alcohol risk in perspective?

    The publication by The Lancet recently of an article discussing the risk to health posed by alcohol1 seems to have put paid for all time to the notion that moderate drinking does no harm or is even ‘good for you’. It has thus caused a bit of a stir in some quarters.   The authors found that there was no ‘safe’ limit for consumption of alcohol and that even having
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  • Underwriting engine banana skins

    SelectX has, over the years, been involved in a number of projects supporting underwriting rules engines (UREs). We have helped firms choose the best URE for their needs. This can involve defining business requirements, assessing the merits of different products based on objective criteria and short-listing contenders for in-depth consideration.   We have written rule sets for insurers, reinsurers and software providers. And we have carried out strategic reviews for
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  • Cancer risks: Are we getting them right?

    Researching cancer mortality over the past few months has proved to be a bit of an eye-opener, and in three ways: firstly the level of excess mortality seen in a number of cancers, secondly the duration over which an extra risk persists, and thirdly that excess mortality may extend over a considerable period.   Some of the high excess death rates (EDRs) were noted stage II/III disease, where mortality was
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  • Turning the world on its head

    Turning the world of insurance on its head, that is. We are just back from the Society of Actuaries’ annual ‘Underwriting Issues and Innovations’ seminar in Chicago, where we go to learn what is happening in what one might call paradoxical North American markets where underwriting sophistication and tradition have very different meanings compared with most other places.   In North America, and in the US especially, underwriting to the nth
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  • Underwriting and calculators

    On our travels we speak to a lot of people about underwriting manual developments. One topic which comes up time and again is calculators: great invention or the work of The Devil?   Some underwriting manuals have had simple calculators for many years, for example for pulmonary function tests, financial ratios and BMI, all of which are designed to help the underwriter by speeding up and simplifying assessment. In recent
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  • Is it time to ditch rating tables?

    By Dr Kevin Somerville   Ah, rating tables – convenient, elegant and simple. They’ve been used for decades and even a trainee underwriter can use them. So much easier to understand than those calculators and so much easier to compare the offerings in the various underwriting manuals and complain that ratings are too high or low… Besides there’s the current mantra in the market: simplicity. Tables have the virtue of
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  • Jigglypuff or out of puff?

    Do you know a Jigglypuff from a Squirtle? If not then you may have missed one of the biggest things of 2016. Pokémon GO was one of the most popular apps of 2016 with over 500 million downloads.   It is a free, location-based, augmented reality game developed by Niantic in collaboration with Nintendo through the Pokémon company. Players use the GPS capability of their mobile device to find, capture
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