An actuarial model of arrhythmogenic right ventricular cardiomyopathy and life insurance

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dc.authoridKleinow, Torsten/0000-0001-8027-1430
dc.authoridHacariz, Oytun/0000-0003-4393-9555
dc.contributor.authorHacariz, Oytun
dc.contributor.authorKleinow, Torsten
dc.contributor.authorMacdonald, Angus S.
dc.date.accessioned2024-09-29T16:02:42Z
dc.date.available2024-09-29T16:02:42Z
dc.date.issued2022
dc.departmentKarabük Üniversitesien_US
dc.description.abstractMany countries ban insurers from using genetic test results in underwriting. One study [Howard, R. C. W. (2014). Report to CIA research committee: Genetic testing model: If the underwriters had no access to known results. Canadian Institute of Actuaries (CIA).] stated that such a ban in Canada would expose life insurers to adverse selection, causing premiums to increase by 12%. More than a quarter of this cost was attributable to a single disorder, Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC). We model ARVC in a life insurance market, following the methodology of [Hacariz, O., Kleinow, T. & Macdonald, A. S. (2021). Genetics, insurance and hypertrophic cardiomyopathy. Scandinavian Actuarial Journal 2021, 54-81.], including 'cascade' genetic testing (CGT), so the role of family history in underwriting is modelled explicitly. We review (in the Appendix) the published epidemiology of ARVC, in particular the existence of an effective treatment, which we also include in our model. Our results are consistent with those of [Macdonald, A. S. & Yu, F. (2011). The impact of genetic information on the insurance industry: Conclusions from the 'bottom-up' modelling programme. Astin Bulletin 41(02), 343-376.] and [Hacariz, O., Kleinow, T. & Macdonald, A. S. (2021). Genetics, insurance and hypertrophic cardiomyopathy. Scandinavian Actuarial Journal 2021, 54-81.], namely, that in realistic scenarios premium increases would be negligible. We also consider the possibility of life settlement companies 'gaming' insurers by learning of adverse genetic test results, and conclude that to profit from purchasing policies from affected individuals, they would have to predict the future trajectory of the epidemiology of ARVC better than the epidemiologists themselves.en_US
dc.identifier.doi10.1080/03461238.2021.1930136
dc.identifier.endpage114en_US
dc.identifier.issn0346-1238
dc.identifier.issn1651-2030
dc.identifier.issue2en_US
dc.identifier.scopus2-s2.0-85106208827en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.startpage94en_US
dc.identifier.urihttps://doi.org/10.1080/03461238.2021.1930136
dc.identifier.urihttps://hdl.handle.net/20.500.14619/5668
dc.identifier.volume2022en_US
dc.identifier.wosWOS:000653330400001en_US
dc.identifier.wosqualityQ2en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.language.isoenen_US
dc.publisherTaylor & Francis Ltden_US
dc.relation.ispartofScandinavian Actuarial Journalen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectAdverse selectionen_US
dc.subjectgenetic epidemiologyen_US
dc.subjectcascade genetic testingen_US
dc.subjectarrhythmogenic right ventricular cardiomyopathyen_US
dc.subjectlife insuranceen_US
dc.titleAn actuarial model of arrhythmogenic right ventricular cardiomyopathy and life insuranceen_US
dc.typeArticleen_US

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