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Cholesterol screening and life assurance.

H A Neil1, D Mant

  • 1Department of Public Health and Primary Care, University of Oxford, Radcliffe Infirmary.

BMJ (Clinical Research Ed.)
|April 13, 1991
PubMed
Summary

Insurance companies assess life assurance proposals for high cholesterol applicants using specific criteria. Premiums increase mainly for severe hypercholesterolaemia, especially familial types, with fewer impacts from milder cases without other risk factors.

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Area of Science:

  • Cardiovascular Health
  • Insurance Underwriting
  • Public Health

Background:

  • Elevated cholesterol concentrations are a significant risk factor for cardiovascular disease.
  • Life assurance companies must accurately assess mortality risk for underwriting purposes.
  • Understanding how hyperlipidaemias influence life insurance premiums is crucial for consumers and the industry.

Purpose of the Study:

  • To investigate the underwriting practices of life assurance companies for individuals with elevated cholesterol.
  • To quantify the excess mortality ratings applied to such applicants.
  • To identify factors influencing premium adjustments for hypercholesterolaemia.

Main Methods:

  • A survey of 49 UK-based term life assurance companies was conducted.
  • Fictional male applicants aged 30 with varying cholesterol levels and cardiovascular risk factors were presented.
  • The primary outcome measure was the percentage excess mortality rating applied.

Main Results:

  • Companies utilize explicit criteria for assessing hyperlipidaemia risk, with consistent application across genders.
  • A cholesterol concentration of 8.1 mmol/l led to a median 50% excess mortality rating, significantly higher (median 135%) when combined with other cardiovascular risk factors.
  • Familial hypercholesterolaemia resulted in a median 75% excess rating, though with considerable variability.

Conclusions:

  • Life assurance premium increases are primarily associated with severe hypercholesterolaemia, particularly familial forms.
  • Milder hypercholesterolaemia, in the absence of other cardiovascular risks, is unlikely to significantly impact life insurance premiums.
  • Underwriting practices show variability, but clear risk stratification is evident for elevated cholesterol levels.

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