Creating Life Expectancy Assessments with Missing Medical Information
In order for life underwriters to create a consistent, accurate, precise life expectancy assessment of an individual, the underwriter must have all of the medical and lifestyle information (i.e. health information) related to that individual. Unfortunately, this is not always possible. There are multiple factors that result in medical information missing from a life expectancy assessment, and there are several ways life underwriters work around this obstacle.
Detecting Missing Medical Records
When clients submit health information for underwriting, it is rare for them to tell underwriters records are missing. Most clients that order life expectancy assessments, do not know whether the records they submit are complete. In fact, it is the underwriter who discovers that the medical records they have might be incomplete, when all of the pieces of the puzzle don’t fit into a complete picture.
For example, an underwriter may receive the medical records of an 80-year old male and note records from a primary care physician, a psychologist, a gastrointestinal specialist, and a cardiologist because the insured has depression, irritable bowel syndrome and a cardiovascular issue. There may be indications in both the gastroenterological records and the primary care records that testing was recommended three months ago for polyps found in the patient’s most recent colonoscopy. However, if the underwriter does not see the records for those tests in the insured’s file, they can note that they are missing - but they cannot know why they are missing. Did the insured just not schedule the tests? Were the test records not requested or sent? Did the diagnostic lab not send test results to the specialist such that they were left out of the records sent to the underwriter?
Underwriters Filling in Information Gaps
The first step life expectancy underwriters take to fill in important health record gaps is to ask the client if the records are available. If not, life expectancy assessments are made based on the medical information provided, and a note that information pertinent to an accurate assessment was not available is included in the report.
In other cases, if the subject of an assessment is severely impaired and has a very extensive medical record file, but has no records for the past few years, then the underwriter can note the omission, request the missing records, or in certain cases, an assessment cannot be completed. For example, if the subject has a cancer diagnosis and stops treatment, this decision will have a significant impact on the life expectancy assessment. If it is known the insured has made this decision, having health information that confirms that is helpful, but in such a case, the missing records could mean this, or something very different. Once again, in those circumstances an underwriter can note their concern, but they cannot assess information they do not have.
Electronic Health Records (EHR) Streamlining Medical Documentation
Fortunately, underwriters are experiencing these medical record gaps less frequently now due to the evolution of the electronic healthcare record keeping system. According to the Office of the National Coordinator for Health Information Technology, EHRs are “real-time, patient-centered records that make information available instantly and securely to authorized users. While an EHR does contain the medical and treatment histories of patients, an EHR system is built to go beyond standard clinical data collected in a provider’s office and can be inclusive of a broader view of a patient’s care.”
However, due to EHRs potential to supply life underwriters with the entirety of someone’s medical history, there can be a lot of data that is not needed. It is also possible for inaccurate data to be passed along over time in an EHR such that erroneous data appears valid without a proper vetting process in place. The data found in an EHR is not necessarily “clean,” correct or useful. It is therefore the responsibility of the underwriter to determine what is important to the life expectancy assessment, what is “junk,” and what is “noise.”
As a business that provides life expectancy underwriting services, we are often faced having either not enough information or too much information. However, our trained team of professionals and experienced underwriters know how to extract the meaningful information from the file and produce an accurate, consistent, individualized life expectancy assessment. Contact ISC Services if you are searching for thorough, thoughtful life expectancy assessments for your life settlement clients, senior living communities, or financial advisors.
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