Coronary heart disease in the elderly--underwriting and pricing issues

The purpose of this analysis was to estimate the degree of excess mortality in elderly people with coronary heart disease.

Pertinent studies were found via an Internet search of English language articles in the National Library of Medicine. Excess mortality was estimated by the traditional calculations used in mortality methodology.

Mortality ratios for coronary heart disease were very high at young ages and tapered with advancing age, reaching levels at ages 80 and older of 130% to 180%. Comparison with other mortality studies indicated that this pattern was typical for most impairments. Present value calculations showed that relative risk (mortality ratio) was lower at older ages, but absolute risk (mortality cost) was much higher.

Mortality ratios for coronary heart disease and most common impairments are generally lower in elderly people. This has important underwriting and pricing implications. Disregarding what might be considered "low" mortality ratios in the elderly means that large additional risks are accepted with no additional premium.