Dread Disease Insurance towards local experience Wolfgang Droste - PowerPoint PPT Presentation

Dread Disease Insurance towards local experience Wolfgang Droste IAAHS - Colloquium 2004 29 April 2004 A Berkshire Hathaway Company

? A Berkshire Hathaway Company

Contents 1. Gen Re’s Survey 2. International Comparisons 3. Trends in Cancer Incidence 4. For Your Consideration 3

Contents 1. Gen Re’s Survey 2. International Comparisons 3. Trends in Cancer Incidence 4. For Your Consideration 4

Gen Re’s Survey • Background information • Claims analysis – Admitted claims – Cancer claims – Declinature – Incidence rates 5

Market Coverage • Hong Kong (15), Malaysia (9) and Singapore (7) • 4.0 million lives in force on 31.12.2000 Singapore 33% Hong Kong 22% Malaysia 45% Market Survey and Product Features 6

In-force by sex • Number of in-force policies issued to women > number of in-force policies issued to men (for age 20 – 40) 90,000 Number of In-force Policies 80,000 70,000 60,000 50,000 Male 40,000 Female 30,000 20,000 10,000 0 0 10 20 30 40 50 60 70 Age Market Survey and Product Features 7

Average Sum Insured • Average claim amount < Average sum insured As at 31/12/2000: $US Claims In-force Difference – Hong Kong: 34,922 39,077 -10.5% – Malaysia: 9,102 9,338 - 2.5% – Singapore: 20,672 23,698 -12.8% Market Survey and Product Features 8

Sales Volume • No. of new policies � stable – Around 650,000 policies each year • New business sum insured � increasing – US$12.5 billion (1996), US$14.5 billion (2000) • Proportion of age 0 -19 policies (in-force) � increasing – 3% (1993), 17% (1998), 15% (2000) Market Survey and Product Features 9

Claims Analysis • Background information • Claims analysis – Admitted claims – Declinature – Cancer claims – Incidence rates 10

Survey Basis • 16,507 claims in total • 13,832 Dread Disease claims (of which 87% admitted) • 9,518 Admitted claims with cause of claim provided Admitted claims (counted by number of policies): Singapore 45% Hong Kong 23% Malaysia 32% 11

Cause of Claim by Territory Cause of Claim by Territory 100% Others 90% Total Permanent Disability 80% 70% Other heart surgery excluding Coronary Artery Bypass Surgery 60% Coronary Artery Bypass Surgery 50% Kidney Failure 40% Stroke 30% 20% Heart Attack 10% Cancer 0% Hong Kong Malaysia Singapore Overall Cause of Claim 12

Cause of Claim by Duration Breakdown by sex and duration Male Female Sex Duration 0 1 2+ 0 1 2+ Number of Claims 727 720 2887 763 805 3616 Cancer 49.5% 53.6% 50.7% 81.8% 83.1% 84.9% Heart Attack 19.5% 19.3% 21.1% 1.6% 1.5% 1.8% Stroke 7.6% 9.3% 9.0% 4.2% 3.4% 4.1% CABS 4.3% 4.7% 4.4% 0.4% 0.4% 0.2% Kidney Failure 2.3% 3.2% 3.6% 3.0% 2.1% 2.2% Other heart surgery 2.8% 2.2% 2.1% 0.7% 0.5% 0.6% excluding CABS TPD 1.8% 1.5% 1.4% 0.4% 0.2% 0.6% Others 12.2% 6.1% 7.7% 8.0% 8.8% 5.5% Cause of Claim 13

The Most Common “Other” Causes of Claim “Other” Claims Hong Kong Malaysia Singapore “Other” claims 168 217 142 (cause reported) Benign brain tumor Paralysis Benign brain tumor 1st place 14 (8%) 20 (9%) 25 (18%) Encephalitis Paralysis Benign brain tumor 10 (7%) 2nd place 12 (7%) 19 (9%) Coma 10 (7%) Blindness Coma 13 (5%) Multiple Sclerosis 3rd place 10 (6%) 8 (6%) Coma 13 (5%) Cause of Claim 14

Cause of Claim by Age – Males Claims: 103 1781 2388 62 100% 90% Others 80% Total Permanent Disability 70% Other heart surgery 60% excluding CABS Coronary Artery Bypass 50% Surgery (CABS) Kidney Failure 40% Stroke 30% 20% Heart Attack 10% Cancer 0% 0-19 20-39 40-59 60+ Cause of Claim 15

Cause of Claim by Age – Females Claims: 68 2297 2780 39 100% Others 90% Total Permanent 80% Disability 70% Other heart surgery excluding CABS 60% Coronary Artery Bypass 50% Surgery (CABS) Kidney Failure 40% Stroke 30% 20% Heart Attack 10% Cancer 0% 0-19 20-39 40-59 60+ Cause of Claim 16

Claims Analysis • Background information • Claims analysis – Admitted claims – Declinature – Cancer claims – Incidence rates 17

Declinature Rate Declinature rate by calendar year 25% 20% Hong Kong 15% Malaysia Singapore 10% Overall 5% 0% 1996 1997 1998 1999 2000 Declinature 18

Declinature Rate Declinature Rate by Sex and Territory 19% Male 11% 11% Hong Kong Malaysia Singapore 18% Female 9% 12% 0% 5% 10% 15% 20% Declinature 19

Declinature Rate Declinature Rate by Cause of Declinature Suicide Not Covered Definition Not Met Within Waiting Period Non-disclosure Others 0% 5% 10% 15% 20% 25% 30% * Only 11% of declined claims gave the reason for declinature. Declinature 20

Declinature Rate Declinature Rate by Cause of Claim Cancer Stroke Heart Attack Coronary Artery Bypass Surgery Kidney Failure Others 0% 5% 10% 15% 20% 25% 30% Declinature 21

Claims Analysis • Background information • Claims analysis – Admitted claims – Cancer claims –Incidence rates 22

Selection Effect: Insured Lives’ Cancer Rates • Comparing survey results with population statistics on cancer • Notes: – Population statistics may include more than one primary cancer site – No population data for Malaysia available – Source of population statistics: • Hong Kong Cancer Registry – New cancer cases in year 2000 (all sites excluding skin) • Singapore Cancer Registry Report No. 5 - Cancer Incidence in Singapore 1993-1997 (all sites excluding skin) Cancer Claims 23

Selection Effect – Hong Kong Crude Cancer Incidence rates - Male Insured Insured lives (1996-2000) Population (2000) lives/Population No. of Claims Cancer incidence Cancer incidence Ratio Duration Duration (all sites but skin) Duration Age 2+ All 2+ All 2+ All 20-24 4 16 0.112 0.137 0.209 54% 65% 25-29 29 61 0.292 0.293 0.371 79% 79% 30-34 53 84 0.383 0.350 0.498 77% 70% 35-39 106 169 0.770 0.764 0.898 86% 85% 40-44 123 180 1.419 1.328 1.661 85% 80% 45-49 59 99 1.354 1.452 2.612 52% 56% 50-54 34 51 2.028 1.953 3.878 52% 50% 55-59 12 17 2.465 2.395 6.239 40% 38% Cancer Claims 24

Selection Effect – Hong Kong Crude Cancer Incidence rates - Female Insured Insured lives (1996-2000) Population (2000) lives/Population No. of Claims Cancer incidence Cancer incidence Ratio Duration Duration (all sites but skin) Duration Age 2+ All 2+ All 2+ All 20-24 15 33 0.337 0.239 0.235 143% 102% 25-29 53 82 0.423 0.339 0.417 102% 81% 30-34 107 165 0.765 0.694 0.758 101% 92% 35-39 169 248 1.465 1.282 1.373 107% 93% 40-44 154 247 2.131 2.01 2.302 93% 87% 45-49 93 156 2.274 2.215 3.237 70% 68% 50-54 53 76 2.949 2.528 4.015 73% 63% 55-59 29 38 5.107 4.517 5.073 101% 89% Cancer Claims 25

Selection Effect – Singapore Crude Cancer Incidence rates - Male No. of Claims Cancer incidence Cancer incidence Ratio Duration Duration (all sites but skin) Duration Age 2+ All 2+ All 2+ All 20-24 7 8 0.0924 0.0773 0.174 53% 44% 25-29 21 26 0.1878 0.1776 0.161 117% 110% 30-34 38 52 0.3126 0.3244 0.301 104% 108% 35-39 51 74 0.4121 0.4530 0.508 81% 89% 40-44 66 84 0.6740 0.6542 1.107 61% 59% 45-49 50 62 0.8407 0.8067 2.572 33% 31% 50-54 42 54 1.7463 1.8026 3.025 58% 60% 55-59 27 31 3.5905 3.2425 5.179 69% 63% Cancer Claims 26

Selection Effect – Singapore Crude Cancer Incidence rates – Female Insured Insured lives (1996-2000) Population (2000) lives/Population No. of Claims Cancer incidence Cancer incidence Ratio Duration Duration (all sites but skin) Duration Age 2+ All 2+ All 2+ All 20-24 10 20 0.1201 0.1709 0.221 54% 77% 25-29 49 55 0.3732 0.3158 0.249 150% 127% 30-34 78 97 0.5974 0.5529 0.576 104% 96% 35-39 155 203 1.2260 1.1868 1.061 116% 112% 40-44 221 272 2.1095 1.9324 1.98 107% 98% 45-49 243 294 3.5937 3.2787 4.398 82% 75% 50-54 129 155 4.1693 3.9236 3.979 105% 99% 55-59 58 70 5.1019 4.7975 4.885 104% 98% Cancer Claims 27

Site of Cancer (Insured Lives - Male) Hong Kong, Malaysia & Singapore Bone and connective tissue, skin and breast 14% 10% Digestive organs and peritoneum 4% 12% Genitourinary organs Lip, oral cavity and pharynx Lymphatic and haematopoietic tissue 27% Other and unspecified 25% Respiratory and intrathoracic organs 8% Cancer Claims 28

Site of Cancer (Hong Kong Insured Lives - Male) Hong Kong Bone and connective tissue, skin and breast 10% 10% Digestive organs and 10% 3% peritoneum Genitourinary organs Lip, oral cavity and pharynx Lymphatic and haematopoietic tissue 28% Other and unspecified 32% Respiratory and intrathoracic organs 7% Cancer Claims 29

Site of Cancer (Hong Kong Population - Male) New Cancer Cases in Year 2000 (Age 20-49) Bone and connective tissue, skin and breast 5% 13% Digestive organs and 9% 3% peritoneum Genitourinary organs Lip, oral cavity and pharynx Lymphatic and haematopoietic tissue 29% Other and unspecified 34% Respiratory and intrathoracic organs 7% Cancer Claims 30