• 보험의학회지
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• 제22권
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• pp.171-181
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• 2003

• 보험의학회지
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• 제27권1호
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• pp.18-20
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• 2008

I have taught various case audit underwriting methods to underwriters for many years. Underwriting requires specialized medical knowledge and experience of comprehensive individual risk analysis. Decisions in individualized underwriting depend on the insurance company's management philosophy and vision, marketing strategies, culture, product line etc. They also depend on the information acquired through proposal forms, inspection reports, laboratory results and disclosures. Underwriters match this acquired information to each insurance product, search appropriate medical resources, assess the probabilities of future claims, and decide what, if any, further medical information should be gathered. Sources include doctors' reports, medical records, biopsies, blood and urine tests, CT, MRI, Holter monitoring, sonography etc. Insurance medical directors help and teach underwriters to analyze individual medical risks and make effective.

• 보험의학회지
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• 제22권
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• pp.31-53
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• 2003

• 보험의학회지
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• 제21권
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• pp.107-119
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• 2002

• 보험의학회지
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• 제23권
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• pp.84-104
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• 2004

• 보험의학회지
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• 제27권2호
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• pp.80-84
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• 2008

Now, we have experienced that the loss ratio of cancer insurance with prevalence of cancer increased. The insurance companies interest how the loss ratio of cancer insurance decrease. To decrease the loss of ratio of cancer, underwriting is very important. The underwriting of cancer are very important factors which are family history, habitual behavior and past history. We have spend the most of time under the occupational situation. Occupation may be very important factor causing cancer. But we neglect the occupation history. This article show how the underwriting of the occupational cancers in the field of occupation are managed Generally, Occupational cancers show special characteristic features. We know the characteristics of occupational cancer under the variety of occupation. For the underwriting of occupational cancer in Korea, we also understand the epidemiology of Korean occupational cancer with the varieties of occupation This article shows the characteristics of occupational cancer and epidemiology of Korean occupational cancers.

• 보험의학회지
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• 제26권
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• pp.21-30
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• 2007

ECG is included in certain medical examinations of insurance application, ECG has low specificity and sensitivity. So ECG is not usually used to diagnose specific diseases. But, ECG is not invasive and costs low. So ECG is usually used in underwriting. Actually in underwriting we meet various ECG patterns and diagnosises. Understanding of various ECG patterns is different between insurance medicine and clinical medicine. So We have to learn various ECG patterns and effects on mortality and morbidity. First considerations of ECG readings are age, sex, blood pressure, family history, smoking historyalcohol history and hyperlipidemia. These are predictors for possibility of disease. Also it is important to review recording ECG with proper skill. In this review I consider several ECG diagnosises that we meet frequently, which is, LVH, RVH, ST abnormalities, LBBS, RBBB, A-B blocks, several kinds of arrhythmia. We have to consider long term mortalities and morbidities of specific ECG patterns although applicants have no symptom and sign. And then we have to make underwriting manual according to specific ECG diagnosises and patterns and underwrite precisely ECG patterns according to insurance products. Nowadays coronary heart disease and other heart diseases are increasing in Korea. So we have to learn various ECG patterns and research mortalities and morbidities of abnormal ECG patterns. Also we have to apply to more broad, precise underwriting skills about ECG patterns and diagnosises.

• 보험의학회지
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• 제24권
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• pp.97-117
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• 2005

Internally Korean insurance market is that whole life products' growth are becoming slowdown that's why new insurance products have appeared on the market in consideration of consumer's needs recently. Externally domestic insurance market competitions has drifted from insurance industry to whole financial industry since bankasurance started. Life insurance companies should open up a new market to survive from severe competitions. Worksite marketing can be an alternative. An insurer make arrangements with an employer about an insurance terms which an insurer offers in Worksite marketing. Then eligible individuals enroll in the plans at their own discretion and pay 100 percent of the premium for coverage through payroll deductions. An employer doesn't need to pay extra money for additional benefit but can raise employee's loyalty and satisfaction of company through worksite marketing. An employee can be covered at discounted premium rate and less strict underwriting guidelines to an insurer compared to individual insurance. In developed countries specially U.S insurance market, Worksite marketing is getting very popular and growing rapidly due to the advantages. Worksite marketing has both individual insurance characters and group insurance characters. Individual insurance characters are that employees enroll in the plans at their own discretion and pay 100 percent of the premium for coverage. Group insurance characters are that actively at work and participation etc. An insurer have to reflect these two characters on Worksite marketing when an insurance company work out a plan for developing products and underwriting guidelines. When an insurer devise worksite products, one should consider participation level which means percentage of eligible employees participating. Participation is related to anti-selection. As we know underwriting is essential for every kind of insurance, especially underwriting plays major role in worksite marketing. We can see that in the below. Firstly, it has a function in calculation of premium rate. When calculate premium rate for worksite products underwriters have to estimate expected participation level and risk factors. So underwriters and acturies keep in close contact with each other. Secondly, underwriting methods are important. When an insurer underwrite worksite products, there are three kinds of underwriting methods. These are Simplified issue underwriting, Full underwriting and Guaranteed issue underwriting. Simplified issue underwriting typically requires no medical examination, but usually requires supplying satisfactory answers to one or several health and/or lifestyle questions. Full underwriting requires a complete medical history questionnaire that may further require an exam. Guaranteed issue underwriting means that coverage is issued without the employee having to provide evidence of insurability. When insurer set the GI limit are usually based on the type of industry, number of eligible employees, the average amount of coverage and participation level. In addition to insurer should have a clear definition of eligible employee on the insurance provision and application form. It will minimize possibility of trouble claims and anti-selection. An insurer also establish preexisting condition exclusion and special guidelines for late entrants. When an insurer introduce Worksite marketing to Korean insurance market, an insurer has to examine market research to analyze potential market and strategy of sales most of all. Also an insurer should review real situation of the U.S, England and Japanese market etc. There are a lot of new technologies about worksite marketing process that an insurer should learn. When an insurer consider many things which we explained it can be a real alternative.

• 보험의학회지
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• 제26권
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• pp.31-39
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• 2007

Background and main issue: In the Korean insurance market, an outstanding issue is the decrease of margin of risk ratio. This affects the solvency and profitability of insurance companies. Insurance medicine, which has been developed in Western countries, is so-called medical risk selection or medical underwriting. Medical risk selection is based on clinical follow-up study and mortality analysis methodology. Unfortunately, there have been few clinical follow-up studies, and no intercompany disease analysis system is available in the Korean insurance market. In practice, we use underwriting guidelines, which were developed by some global reinsurance companies. However, these guidelines were developed under clinical follow-up studies performed abroad. So, we cannot rule out underestimation of excess mortality factors such as mortality ratio, excess death rate, and life expectancy. It is necessary to perform medical assessment in claims administration. Comparing the insured's statement by medical records with products' benefit according to this procedure, we can make sound claim decisions and participate in the role of sound underwriting. We can call this scientific procedure as the verification of medical claims review. Another area of medical claims review is medical counsel for claims staff. Result: There is another insurance medicine in addition to medical risk selection. Independent medical assessment by medical records of insured is medical claims review. Medical claims review is composed of verification and counsel.

• 보험의학회지
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• 제27권1호
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• pp.24-32
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• 2008

The number of disabled person is increasing, and also the demand of welfare is increasing. In the developed country, the range of disabled person is broad, because the definition of disability is different among countries. On 10/Apr, 2007, the law to forbid discrimination against disabled person was announced and then it will be operated on 11/Apr, 2008, in Korea. It will need to evaluate conflict between this law and underwriting guideline. There is obvious difference between disabled and non-disabled on risk selection of medical and environmental aspect. More than 50% of disabilities are related to the diseases rather than accident. The role of underwriter is to evaluate the future risk of morbidity (admission and/or operation etc). The insurance company is required to make new product for disabled person and the underwriter has to examine the application of disabled without discrimination, and with respect for the disabled as a human right.