Health and Care

Predictive Machine Learning for Underwriting Life and Health Insurance

The dominant underwriting approach is a mix between rule-based engines and traditional underwriting. Applications are first assessed by automated rule-based engines which typically are capable of processing only simple applications. The remaining applications are reviewed by underwriters or referred to the reinsurers. This research aims to construct predictive machine learning models for complicated applications that cannot be processed by rule-based engines. Techniques such as natural language processing and clustering analysis are used to process free-text data such as descriptions of impairments and occupations. Various feature selection methods such as mutual information and recursive feature elimination are used to improve prediction accuracies. Machine learning algorithms such as XGB and Random Forest are used to predict underwriting decisions. XGB is the best performer with 99.5% accuracy on the training set and 80% accuracy on the testing set. Various tools such as word clouds and feature ranking functions are used to give underwriting insights. The paper concludes with data limitations and further researches.

What next for Mental Health in Insurance?

Content will be aimed at all actuaries looking to understand the issues surrounding mental health in insurance and in particular those looking to ensure products and processes widen access for and are most useful to, those experiencing periods of poor mental health. Fyona Murphy, Hymans Robertson’s Insurance and Financial Services; Maryse Nashime, PartnerRe; Dr Rajeev Dhar, NHS; Mohamed Elsheemy, Commercial Medicine Directorate in NHSE&I

The role of actuaries within the health sector varies considerably from one country to another, due to differences in the local evolution of health systems and the funding models for health services. Speakers: Alpesh Shah, Partner, PwC; Siao Wearn Leong, Senior Health Actuary, National University Health System; David Beddows, Senior Actuary, Swiss Re; James Robinson, PhD, Aon; David McDwyer, Lead Data Scientist, NHS Cheshire CCG; Rebecca Sloan, Consultant, LCP

Electronic Health Records could have an enormous impact on the future of life and health insurance. They are also a current hot topic in the news, with access to this data and the developments around it driving ever-increasing interest. This presentation from the IFoA's Electronic Health Records (EHR) Working Party aims to give a UK Insurance-focused overview of the current situation and recent innovative developments. No prior knowledge is required as we will start from the ground up, with a review of General Practitioner data and work up to insurance access for underwriting and claims management. We also introduce SNOMED Clinical Terms and look at what the future may hold. The speakers are a mix of Underwriters, Actuaries, Claims Managers and Academic Researchers with broad experience of and a keen interest in applying this rich data source to Insurance. Chair: Niall Fennelly, Associate Director Data Science & Actuary UnitedHealth Group Speakers: Philip Darke, Consulting Actuary at Mercer and PhD researcher at the Centre for Doctoral Training in Cloud Computing for Big Data, Newcastle University Gill Salton, Underwriting & Claims Development Manager SCOR Lloyd Williams, Underwriting Development Manager Munich Re Richard Bridge, Technology Operations Manager AIG Life

Climate change and sustainability – the health & care discussion
The elements of climate change that influence and impact on health & care, both in terms of the direct and indirect impact on mortality and morbidity, and the sustainability of healthcare globally are many. This webinar aims to bring that to life for health & care actuaries, starting with an update on the work of the Health & Care Climate Change Working Party, including a high level overview of areas for consideration. We’ll also signpost to some of the emerging climate change resources, and guides that are available for actuaries. This will be followed by two presentations covering our initial focus areas which are biodiversity, air quality, and temperature extremes. Climate change is understood to have a number of detrimental impacts on human health, some direct, some indirect. Nicola will present a summary of what is known so far. Bernd will explain how changing global patterns in heat and humidity are significant drivers of risk relating to human health and mortality, and highlight the need for more research in this area.

Actuarial Implications of Pandemic: Modelling Unemployment and Mortality Impact of Vaccination
In this webinar there will be two presentations showing the research from the Health and Care practice area on two key issues related to the Covid-19 pandemic: unemployment risk and the mortality impact of vaccination. Scott Reid will share the research on unemployment modelling. Covid-19 is causing a severe economic recession in the United Kingdom due to unprecedented government interventions, such as lockdowns, to control the virus (declared a pandemic on 11 March 2020, WHO). When considering the impact on income protection (group and individual business) or private medical insurance business, actuaries will have to make difficult judgement calls on future unemployment forecasts, given the correlation between unemployment and health/wellbeing. We will discuss the forecasts made by the OBR and BoE last year and how these compare to what has actually happened. We will also consider the merits of modelling this type of systematic risk. John Ng will discuss the mortality impact of vaccination. On 8th December 2020 the UK launched the world's first mass Covid-19 vaccination, in which priority groups were primarily structured by age. An age-structured mortality model was proposed because historical data shows that mortalities of the younger age groups are great predictors of the mortalities of the 80+ age group. Under the counterfactual ‘unvaccinated’ scenarios, the expected mortality of the 80+ age group could be predicted from the actual mortality experience of the largely unvaccinated younger age groups. We will discuss the construction of the Gompertz Network model, application of Lasso regularisation to handle multi-collinearity and estimation of mortality impact from actual vs expected analysis. The vaccination programme is estimated to have prevented 8,000 deaths by the end of February 2021. Mortality impact studies by Warwick University and Public Health England reported broadly consistent results. However, our approach is based on real-world data and does not rely on assumptions for vaccine uptake and effectiveness, thus yielding empirical evidence that the vaccines are already preventing deaths at scale in England. We will consider questions around the limitations and merits of this type of risk modelling.

Wearables in insurance a win win opportunity
This talk will explore the potential benefits that wearable tech can bring to health & protection insurers and their customers. The traditional approach of integrating wearables into insurance has largely focused on measuring steps and using rewards-based incentive programs to encourage more activity. This generally appeals to health conscious customers, providing a way for insurers to engage with and grow this segment of the market. The ability of emerging technology and analytics to give early warning of acute changes in health is likely to have broader appeal. We aim to include a case study from our systems biology partner LifeQ who have recently used data from wearables to develop an early warning system for COVID-19. Their clinically validated approach supports detection of both infectious and chronic diseases. A broader range of metrics monitoring sleep, respiratory function and cardiovascular health can be used to manage risk factors for disease. Insurers can use health coaching alongside wearables to drive long-term, sustained health improvements. By using wearables, insurers also benefit from richer insights into the morbidity and mortality risk structure of their portfolios. There’s also an opportunity to embed dynamic underwriting, supporting access to insurance for those with well-managed conditions such as diabetes.

Supporting Mental Health in a Virtual Workplace

COVID-19 has seen a marked increase in mental health issues. We all have mental health and poor mental health has serious consequences for individuals and our workplaces, with it costing UK businesses £33-42 billion annually. This presentation will provide practical advice on how to look after our own mental wellbeing while working remotely. It will include what we can do to support those around us and ideas for ways to support our teams during the current situation. Finally, we will look ahead to the effects that being able to return to the office can have on our mental health and how we can prepare for that.

Protection, Health and Care Conference 2020
July/August 2020

To read the full synopsis of each webinar please visit the Protection, Health and Care 2020 webinar series page and select the 'Programme' tab

Learnings from our first climate-change related disclosures (TCFD)

Cancer morbidity risk modelling – regional variation over time

Can we manage Diabetes risk for healthier outcomes

Gene Modification
Chief Medical Officer (CMO) for Gen Re Life/Health Research and Development, Dr John O'Brien, discuss the impacts of Gene Modification for life/health insurance.

Engagement and innovation for the next generation consumer
Using new and unique research and data from the UK, US, Sweden and China, this presentation investigates how consumers use the internet through their insurance journey and analyzes the role culture and generation plays in their online behaviour.

Mental Health Underwriting - updating for current medical practice
This session will cover how we have challenged conventional approaches to underwriting and risk selection in order to develop an approach that aligns current practices, customer and broader interests with robust risk assessment.

Dementia and insurance: cognitive protection
Speaker: Matthew Singleton, Swiss Re
Discusses the rising prevalence of dementia,and how we can manage this risk effectively whilst looking to see if insurance can do more. 

Mental resilience and predicting return to work in disability claims
Speaker: Stephanie McCahon and Nisha Price, Swiss Re
A prospective research study - the first to look at an insured population sample - designed to test whether psychosocial factors predict return to work in disability claims. 

Around the World in 80 claims: Results of Global IP Claims survey
Speakers: Clio Lawrence and Mary Enslin, Gen Re
Presented the results of an international survey of claims assessors. Bringing out key similarities and differences in claims practices in different locations and their impact on the management of disability claims. 

Impactability Modelling for Population Health Management
Speakers: Alpesh Shah, PwC and David Beddows, Optum
Provides an overview of the working party's research including defining impactability and impactability modelling. Also discusses examples of specific modelling approaches, and the practical challenges across the NHS as well as wider public perception and ethical issues. 

CMI Update
Speakers: Duncan Heald and Hamish Wilson, CMI
An update from the Continuous Mortality Investigation (CMI) with content focused on the work of the Assurances Committee and the Income Protection Committee.

Building a Shiny Death Toolbox
Speakers: Chris Reynolds and Florian Gomez, Partner Re 
Provides an overview of how and why we built a Death Toolbox using 'Shiny'.

Webinar Series: IFoA Protection Health and Care and Mortality and Longevity Symposium 2019
4-6 June 2019

Introductions and CMI Update
(Length 01:19:16)

Marriage Matters: A practical guide to modelling contingent dependants
(Length 00:48:57)

Drug innovation and longevity
(Length 00:49:28)

Trends in the cause-specific mortality experience in England and Wales
(Length 00:45:41)

10 longevity insights that I wish I'd known sooner
(Length 00:52:26)

Longevity trend risk over limited time horizons
(Length 00:55:55)

Waste not - calibrating mortality models using all information
(Length 00:54:01)

Launching an impaired life proposition in 10 weeks
(Length 00:45:51)

Population Health Management Working Party
(Length 00:48:37)

Antibiotic Resistance Working Party
(Length 00:49:57)

Developments in mental health underwriting
(Length 00:54:03)

Access, exclusion and trust in insurance
(Length 00:50:22)

Identifying avoidable admissions using international benchmarks
(Length 00:40:56)

Critical Illness: A tale of three continents
(Length 00:51:28)

Modifiable Risks
(Length 00:48:03)

Protection, Health and Care Conference 2018
21–23 May 2018

Plenary 1: New Solutions for an Older World
Plenary 2:  Current Issues in the Health System
Plenary 4: Protection, Health & Care in 2050
Plenary 5: Panel Discussion on Serious Illness

Protection, Health and Care Conference 2017
24-26 May 2017

Plenary 2 – What if our immune systems could fight cancer?
Plenary 3 – Consumer Behaviour
Plenary 4 – Medical technology and their impact on life and disability insurance
Plenary 5 – Low carb, high fat – a revolution in dietary guidelines
Plenary 6 – Adult Social Care - Data to Drive Strategy?

Momentum 2016
30 November - 2 December 2016

Plenary 1: Why networking is important for your career and the skills to succeed
Plenary 2 Lightning talks (hot topics in 60 minutes)
Plenary 3: Winners curse - Game theory and insurance pricing
Plenary 4: Panel discussion on Brexit

Health and Care Conference 2016
18-20 May 2016, video

Videos available:
Plenary 1: Rejuvenation Biotechnology: Why the Days of Age-related Morbidity and Mortality are Numbered
Plenary 2: From Financial Insurance to Health Insurance
Plenary 3: The Changing World of Work: Digitalisation and Flexible Working
Plenary 4: Genome Testing - The Implications for Insurance
Plenary 5: The Unknown Unknows: Predicting Tomorrow's World
Workshop A1: Health Insurance in 2050: A Medical Perspective
Workshop B3: Scottish Widows Protect: Ready, Steady, Launch!
Workshop C1: Expanding the Reach of Protection
Workshop D3: The Lost Generation - Overstated Mortality Improvements for Younger Lives?
Workshop E3: Fresh Thinking in Terminal Illness
Workshop F1: A Glimpse at Commercialising Innovation, Technology and Big Data

Health and Care Conference 2015
6-8 May 2015, video

Videos available:
Plenary 3: Business Skills Masterclass - Unconscious Bias
Plenary 5: Is the Language We Use to Describe Protection Putting People Off?
Plenary 6: The Election Results - What are the Implications for NHS Reform Over the Next Five Years
Workshop A2: Protection and Care Needs In Later Life
Workshop B5: Lessons from Down Under. The D2C Market in Australia and What the UK Can Learn
Workshop D5: Emerging Risks for PMI - Opportunity or Threat
Workshop E1: The Rise of Wearable Technology - What Does it Mean for the Insurance Market?
Workshop F1: Predictive Modelling and Big Data for PMI Pricing and Analytics

Momentum Conference 2015
2-4 December 2015, video

Videos available are:
Plenary 1: We Need to Talk about Sustainability - How are Actuaries going to Face Climate Change and Other 21st Century Issues
Speakers: Nico Aspinall, Towers Watson and Louise Pryor
Plenary 2: Behavioural Finance and Retirement Decision Making
Speaker: Iain Clacher, Leeds University Business School
Plenary 3: Expert Judgement
Speakers: Kieran Barnes, Bank of England and Stephen Makin, Hymans Robertson
Plenary 4: A Career as a Chief Investment Officer - Could You Have What it Takes?
Speakers: Jan Coetzee, Swiss Re; Alasdair MacDonald, Towers Watson and Ian McKinlay, Lloyds Banking Group

GIRO 2015 Plenary Videos
20-23 October 2015

Sessions available:
Plenary 1: Insurance in a Changed World
Plenary 2: Who Profits? Delivering an Ethical Return
Plenary 3: Alleviating Reserving Stress
Plenary 5: Modelling: The Next Generation
Plenary 6: Tomorrow's World: Customer, Investor or Risk?
Plenary 7: Keynote Speaker - Professor John Kay CBE
Plenary 8: Professional Skills - Members Behaving Badly?

Health and Care Conference 2014
21-23 May 2014, video

Sessions available: 
Plenary 1: State of the Nation: An Update on the Funding for Social Care
Speakers: Norman Lamb MP, Minister of State for Care and Support and Jules Constantinou, Gen Re
Plenary 2: The relevance of customer engagement in the insurance sector
Speaker: Jo Causon, Institute of Customer Service
Plenary 4: Hot topic debate
Speakers: Keith Jennings, Bill Baker, Phil Cleverley, Nick Reilly  
Plenary 5: Medical Advances: Opportunity or Threat
Speaker: Dr. Philip Smalley, RGA
Plenary 6: The Outlook for the Economy, the Public Finances and Health Spending
Speaker: David Smith, Economics Editor of The Sunday Times

Health and Care Conference 2013: Plenary sessions online
15-17 May 2013

Sessions available:
Plenary 1: Adapting in healthcare and in life 
Speaker: Tim Harford, Senior Columnist, The Financial Times
Plenary 2: The big picture: what the last five years (and the next and the next five) mean for you, your career and your business
Speaker: Belden Menkus, MenKus & Associates
Plenary 4: Brave new worlds of shared information
Speaker: Daniel Ryan, Swiss Re
Plenary 5: Protection gap or protection trap?
Speakers: Roy Chappell, SCOR Global Life UK and Darren Spriggs, Ageas Protect.