Authored by: Doug Ingle, FALU, FLMI, Doug Ingle Underwriting Analysis LLC


Government Abstract

A latest article revealed by Medical Reference Lab and ExamOne confirmed the protecting worth for tobacco testing exceeded $4 billion. Utilizing the identical time-frame (2015-2022) and 18 million report dataset, we now describe the extra worth related to testing for undiagnosed diabetes and hypertension price $2.6 billion. The protecting worth for simply these three findings alone identifies over $6.7 billion of extra mortality that can’t be discovered elsewhere within the underwriting file.

There are tens of millions of Individuals with diabetes or hypertension who’re unaware they’re in danger. Paramed exams and blood work may help determine these people. A brand new research captures worth within the insurance coverage applicant inhabitants, and is made attainable via a joint collaboration of American Para Skilled Techniques, Medical Reference Labs, ExamOne, and IMS Paramed.

Undiagnosed Diabetes

In line with a 2020 Nationwide Diabetes Statistics Report from the CDC[i], 34.1 million members of the grownup US inhabitants (13.0%) have diabetes and a couple of.8% (7.3 million) don’t realize it. Meaning 21.5% of diabetics are unaware of their danger. The laboratory readings used to determine diabetics on this CDC research have been a HbA1c of 6.5% or larger or a fasting plasma glucose of 126 mg/dL or larger. Life insurance coverage candidates is probably not fasting at time of blood draw. Due to this fact, HbA1c of 6.5% or increased and glucose of 200 mg/dl or larger are used to determine diabetes based mostly on insurance coverage lab testing. Making use of these metrics to the insurance coverage applicant knowledge, and utilizing the lab slip reply to the query a few identified historical past of diabetes, identifies people unaware of their diabetes in an insurance coverage applicant setting. Surprisingly, 27.8% with abnormally excessive readings didn’t report a historical past of diabetes on their lab slip.

Underwriting scores are derived by averaging debits from a number of underwriting manuals and capped at 300 debits for the best dangers. Glycemic values are thought-about non-fasting at time of blood draw, additional lowering debit assignments. Protecting worth is restricted to candidates that don’t admit to a historical past of diabetes whereas producing ratable findings. Meaning, worth is restricted to substandard mortality danger solely. This research makes no try and outline extra mortality worth related to most popular danger lessons. Debits are transformed to current worth mortality {dollars} utilizing the 2015 VBT (Valuation Primary Desk) ALB (Age Final Birthday) smoker distinct tables with a 3% curiosity and three% lapse charge and 10-year pricing horizon. Insurance coverage face quantities are based mostly on the lab slip.

These shock findings generate $1,577,046,959 of current worth of future mortality for the primary 10-years put up problem.

Undiagnosed Hypertension

Hypertension is called the silent killer. In line with the Nationwide Middle for Well being Statistics (NCHS) Information Temporary 278[ii], 29% of U.S. adults had hypertension and 15.9% have been unaware of their hypertension. On this NCHS research, hypertension is outlined as a blood strain studying of 140/90 or larger. Utilizing the lab slip query to determine candidates that admit to a historical past of hypertension, we discover that 14.9% of insurance coverage candidates with readings of 140/90 or larger mentioned they didn’t have hypertension on the lab slip.

This research additionally applies common blood strain scores from a number of underwriting manuals and the debits are transformed to protecting worth {dollars} utilizing the identical VBT metrics as these used within the diabetes research. These debits, are reserved for substandard (not most popular) findings, and solely counted if the applicant has not admitted to a historical past of hypertension. Have been it not for testing, these mortality dangers would play out undetected.

The current worth of future mortality related to unknown hypertension is $1,067,475,196 for the primary 10 years put up problem.


Including mortality {dollars} from the hypertensive and diabetes research collectively, leads to a complete advantage of $2,644,522,155 for the primary 10-years put up problem on a gift worth foundation for these 18 million candidates from years 2015-2022. Worth is restricted to shock findings. This testing supplies one other avenue for figuring out undetected medical situations in society. When added to the $4,086,029,825 of protecting worth related to cotinine testing, this leads to a grand whole of $6,730,551,980 of protecting worth from tobacco, diabetes, and blood strain testing alone. These findings symbolize simply 3 of many exams carried out at time of bodily examination and fluid draw that can’t be unmasked by different underwriting proof.

[i] https://www.cdc.gov/diabetes/pdfs/knowledge/statistics/national-diabetes-statistics-report.pdf. Accessed 11-1-2022.

[ii] https://www.cdc.gov/nchs/merchandise/databriefs/db278.htm. Accessed 11-1-2022.


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