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Heart Attack A View from the Industry Peter Martin LADUCA Wellington, 1 November 2005.

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Presentation on theme: "Heart Attack A View from the Industry Peter Martin LADUCA Wellington, 1 November 2005."— Presentation transcript:

1 Heart Attack A View from the Industry Peter Martin LADUCA Wellington, 1 November 2005

2 Student Days Heart attack: Heart attack: Severe painSevere pain Often shockedOften shocked Major ECG changesMajor ECG changes Enzymes raised after daysEnzymes raised after days

3 Student Days Treatment Treatment 6 weeks in bed Anticoagulants

4 Changes in 40 Years Diagnosis Diagnosis Treatment Treatment

5 Changes in 40 Years Diagnosis Diagnosis Lesser ECG changes or no changeLesser ECG changes or no change New enzymes which are more specific and rise earlierNew enzymes which are more specific and rise earlier New diagnostic techniquesNew diagnostic techniques Treatment Treatment

6 Changes in 40 Years Diagnosis Diagnosis Lesser ECG changes or no changeLesser ECG changes or no change New enzymes which are more specific and rise earlierNew enzymes which are more specific and rise earlier New diagnostic techniquesNew diagnostic techniques Treatment Treatment Bedrest! Anticoagulants! New interventional techniques New drugs

7 The Insurance Industry Crisis Crisis Critical Illness Critical Illness Trauma Trauma Major Health Problems Major Health Problems Most include “Heart Attack” as an insured risk.Most include “Heart Attack” as an insured risk.

8 The Insurance Industry Often using definitions of heart attack which are based on old concepts and old diagnostic tests Often using definitions of heart attack which are based on old concepts and old diagnostic tests

9 The Insurance Industry Often using definitions of heart attack which are based on old concepts and old diagnostic tests Often using definitions of heart attack which are based on old concepts and old diagnostic tests Chest painChest pain Major ECG changesMajor ECG changes Often old, rarely used enzymesOften old, rarely used enzymes

10 The Challenge for the Industry Incorporate an understanding of the new ways of diagnosis and treatment into policy definitions Incorporate an understanding of the new ways of diagnosis and treatment into policy definitions

11 Options for the Industry Stay with old definitions Stay with old definitions Claims experience will not changeClaims experience will not change Some people with genuine heart attacks will be declinedSome people with genuine heart attacks will be declined Promotional material will need changesPromotional material will need changes

12 Options for the Industry Stay with old definitions Stay with old definitions Claims experience will not changeClaims experience will not change Some people with genuine heart attacks will be declinedSome people with genuine heart attacks will be declined Promotional material will need changesPromotional material will need changes Widen Definition Widen Definition Larger number of claims Larger number of claims Actuarial implications Promotional material may still need to be revised

13 Doing Nothing is Not an Option Stay with restrictive definitions Stay with restrictive definitions Explicit descriptions Widen definitions Widen definitions Enlarged claims Still need for careful descriptions


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