Underwriters: Check Out The CAM

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Complementary and alternative medicine, or CAM, is a hodgepodge of medicinal to quasi-medicinal remedies. Somechiropractic and acupuncture, for examplehave crossed the line into (more or less) conventional medicine. Others lie on the fringes of medicine in the Western world.

Regardless, CAM is a hidden risk factor for life insurance. Why so? Because virtually no underwriting guidelines include consideration of these aspects of health care.

This, in turn, constitutes a very avoidable error, with implications for insurability at any age.

CAM is turning into big business. In any given year, Americans are said to spend more out-of-pocket dollars on CAM than on care from primary care physicians. The use of herbs is a growing trend, as witnessed by the profusion of retail outlets and books on the subject now widely available throughout the country. An estimated 36% of U.S. adults age 18 and up are using some form of CAM, according to a survey of 31,000 U.S. adults conducted as part of the Centers for Disease Control and Preventions 2002 National Health Interview Survey.

From a risk management perspective, every CAM intervention has some significance. But herbal therapy, broadly including all digestibles (even if derived from shark cartilage), is of particular concern for the life underwriter. Many Americans are now herb aficionados. (In Germany, herbs routinely are prescribed as medicine. Believe it or not, St. Johns Wort is the Rx of choice for mild/moderate depression.)

In North America, consumers are on their own where oversight is concerned. There is almost no CAM regulation. The Internet, not surprisingly, is the leading venue accessed by those who want to learn more. CAM Web sites abound, but unfortunately, these sites seldom help underwriters, leaving them at wits end when trying to sort out why a proposed insured might be taking a given herb.

The bad news? Underwriters seldom pay attention to herbs when herb use is mentioned on life insurance applications or cited in doctors reports. The latter, of course, is the exception to the rule anyway, as most herb users avoid telling their doctors what they take (not a wise decision, for the record, given that some herbs interfere with prescription drugs, while others are flat out toxic).

Who uses herbal medicine? Several recent epidemiological investigations indicate that men and women of all ages use herbal “remedies,” as they are often called. Many are over age 35, including seniors, and have college educations and health insurance.

Few medical professionals question their patients about the use of CAM. And, as noted above, it is commonly known that few will admit to using CAM anyway, even if asked by their physician.

What is the meaning for underwriting?