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July 28, 2004 at 08:00 PM
Older-Age Underwriting: Its Distinctly Different, And With Good Reason
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To determine insurability of clients age 65 and over on the same basis as is done at younger ages all but guarantees a botched job.
This is because factors that the life insurance industry knows contribute to premature death in young and middle-aged adults differ dramatically from those linked to excess geriatric mortality. The following examples give clear evidence of this too often overlooked reality.
Frailty (vs. Vitality): At younger ages, vitality is a given. Not so in the “golden years,” where the capacity “merely” to carry out routine activities of daily living (now known simply as ADLs) has been shown to be a more imposing predictor of survival than diabetes. Regrettably, only a handful of life insurance companies employ a long term care version of the paramedical
exam designed to probe physical capacity.
Smoking: A number of studies have shown that tobacco indulgence in the seventh decade and beyond translates to largely insignificant extra risk in males and none whatsoever in females. To overemphasize this risk-taking behavior at the expense of other considerations is to mistake the sapling for the proverbial forest.
Blood Pressure: While definite hypertension impacts longevity at all ages, the reality is that its mortality slope becomes distinctly U-shaped late in life. This is to say, when systolic and/or diastolic readings are too low, the implications are, in fact, more ominous than when the readings fall into modestly debited ranges. It is a frank shame that we do not yet recognize the sinister nature of high “pulse pressure” (the difference between the systolic and diastolic readings) for what it really means.
Cholesterol: At younger ages, lower is better. Not so later on, when a low or, worse, falling cholesterol (in those not on lipid-lowering prescription drugs, of course) is a proven harbinger of early demise.
Heavy Drinking: Abuse of alcohol is worrisome at all ages. However, 3 distinct realities must be borne in mind when assessing the impact of such abuse in those over age 65.
