Heart Attack A View from the Industry

1. Heart AttackA View from the Industry Peter Martin LADUCA Wellington, 1 November 2005

2. Student Days • Heart attack: • Severe pain • Often shocked • Major ECG changes • Enzymes raised after days

3. Student Days • Treatment • 6 weeks in bed • Anticoagulants

4. Diagnosis Treatment Changes in 40 Years

5. Diagnosis Lesser ECG changes or no change New enzymes which are more specific and rise earlier New diagnostic techniques Treatment Changes in 40 Years

6. 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

7. The Insurance Industry • Crisis • Critical Illness • Trauma • Major Health Problems • Most include “Heart Attack” as an insured risk.

8. The Insurance Industry • Often using definitions of heart attack which are based on old concepts and old diagnostic tests

9. 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

10. The Challenge for the Industry • Incorporate an understanding of the new ways of diagnosis and treatment into policy definitions

11. 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

12. 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

13. Doing Nothing is Not an Option • Stay with restrictive definitions • Explicit descriptions • Widen definitions • Enlarged claims • Still need for careful descriptions