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Explore the evolution of heart attack diagnosis and treatment over 40 years in the insurance sector. Discover industry challenges, options, and the need for updated definitions in policies. Learn about the impact on claims and promotional materials.
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Heart AttackA View from the Industry Peter Martin LADUCA Wellington, 1 November 2005
Student Days • Heart attack: • Severe pain • Often shocked • Major ECG changes • Enzymes raised after days
Student Days • Treatment • 6 weeks in bed • Anticoagulants
Diagnosis Treatment Changes in 40 Years
Diagnosis Lesser ECG changes or no change New enzymes which are more specific and rise earlier New diagnostic techniques Treatment Changes in 40 Years
Diagnosis Lesser ECG changes or no change New enzymes which are more specific and rise earlier New diagnostic techniques Treatment Bedrest! Anticoagulants! New interventional techniques New drugs Changes in 40 Years
The Insurance Industry • Crisis • Critical Illness • Trauma • Major Health Problems • Most include “Heart Attack” as an insured risk.
The Insurance Industry • Often using definitions of heart attack which are based on old concepts and old diagnostic tests
The Insurance Industry • Often using definitions of heart attack which are based on old concepts and old diagnostic tests • Chest pain • Major ECG changes • Often old, rarely used enzymes
The Challenge for the Industry • Incorporate an understanding of the new ways of diagnosis and treatment into policy definitions
Stay with old definitions Claims experience will not change Some people with genuine heart attacks will be declined Promotional material will need changes Options for the Industry
Stay with old definitions Claims experience will not change Some people with genuine heart attacks will be declined Promotional material will need changes Widen Definition Larger number of claims Actuarial implications Promotional material may still need to be revised Options for the Industry
Doing Nothing is Not an Option • Stay with restrictive definitions • Explicit descriptions • Widen definitions • Enlarged claims • Still need for careful descriptions