Category: HEALTH - actuview - the international streaming platform for actuaries

Panel Discussion on Longevity Rethought – How Medical Progress and AI are Changing Life and Health Insurance

Thu, 02 Oct 2025 08:20:02 +0000

This session explores how medical breakthroughs and AI are reshaping life and health insurance. It examines whether longevity is becoming more predictable, how AI is shifting healthcare from treatment to prevention, the implications of unequal access to new technologies, and how insurers can turn longevity risk into strategic opportunity through innovation in product design, risk modeling, and customer engagement.

Fair Enough? Building Trustworthy and Equitable AI in Healthcare

Thu, 25 Sep 2025 15:54:20 +0000

AI is transforming healthcare, but hidden biases in data and algorithms can undermine trust and lead to unequal outcomes. This session explores fairness in medical AI, using real-world case studies and the FAIR-MED/XFAIR-MED frameworks to show how bias can be detected, explained, and addressed. Attendees will gain practical insights into building AI systems that are not perfect, but “fair enough” to support safe and equitable decision-making.

AFDP 2024: Property & Casualty I

Wed, 10 Sep 2025 10:34:38 +0000

In this session, participants will receive an introduction to the fundamentals of Property and Casualty (P&C) insurance. The module begins with an overview of the global insurance industry, highlighting the significance and market dynamics of P&C insurance. Key components such as underwriting, pricing, claims, and reserving will be explained, emphasizing their importance in effective insurance management. Basic definitions and methodologies for pricing and reserving will be introduced. The session concludes with an exploration of the unique challenges and growth opportunities in developing countries, illustrated with relevant case studies.

AFDP 2024: Pensions Benefits and Social Security

Wed, 10 Sep 2025 10:31:26 +0000

The first session of “Pensions” course will be dedicated for the classical Pay-As-You-Go (PAYG) pension systems. PAYG systems work following an intergenerational solidarity, where the contributions paid by the current generation of workers are used to pay the benefits of the current generation of retirees. Such a system is very sensitive to demographic changes, such as longevity and population aging, and is still very popular in developing countries, but constitutes a small share of the multi pillar systems adopted in many Industrialized countries. The first part of the pensions' course will be dedicated to learning further about the financing mechanism of PAYG system, their strengths and weaknesses, and to presenting sustainability analysis cases, in which we consider Algeria as an example. The other types of pension systems, such as the fully funded, the notional account, and the universal systems will be developed in the second session of the course, i.e. Pensions II.

DENK LAUT – der Podcast: Episode 1 der neuen Reihe zum Thema Medizinischer Fortschritt – Krebs

Fri, 05 Sep 2025 12:00:54 +0000

Welche Auswirkungen hat eine höhere Lebenserwartung auf die Lebens- und Krankenversicherung? Dies ist die zentrale Frage der neuen Podcastreihe zum Thema „Medizinischer Fortschritt“. Dr. Olaf Schmitz, Mitglied der DAV-Arbeitsgruppe Medizinischer Fortschritt, spricht mit Dr. Sandra Mitic, Fachärztin für Chirurgie und Viszeralchirurgie und Chief Medical Officer bei der Gen Re, über Krebs. Wie sieht der medizinische Fortschritt bei Prävention, Diagnose und Behandlung aus? Was wird in den nächsten Jahren passieren und was bedeutet dies für die Lebenserwartung? Welche Auswirkungen auf die Krankheitskosten sind zu erwarten?

The European Actuary No. 43 | Making Sense of Mediation in Insurance

Thu, 28 Aug 2025 15:09:23 +0000

Arnoud Chneiweiss explains the French mediation scheme and advocates for clarity and simplicity in insurance contracts for the benefit of consumers.

Find the full TEA issue here.

Better Healthcare and Lower Cost? Real Examples of Using AI to Improve the Delivery of Healthcare

Wed, 27 Aug 2025 17:30:43 +0000

As healthcare systems strive to deliver better outcomes at lower costs, artificial intelligence (AI) is proving to be a powerful enabler of transformation. This webinar, tailored for actuaries, showcases real-world applications of AI improving delivery, enhancing outcomes, and reducing costs. We will hear from Tanya Dillard Stark, SVP at CirrusMD, a pioneer in chat-first virtual care, and Stephen Bonner, CEO of SkinIO, whose AI platform enables early skin cancer detection via smartphone-based exams. Attendees will explore how AI is reshaping risk assessment, cost forecasting, and care navigation, with practical insights into the actuarial implications of these advancements. Join us to learn how actuaries can play a pivotal role in leveraging AI to build a more efficient, equitable healthcare system.

Post-Pandemic Alcohol Consumption

Tue, 26 Aug 2025 14:19:01 +0000

RGA’s Kaitlyn Fleigle, Actuary, Strategic Research, Global Actuarial Pricing and Research, unveils surprising trends in US alcohol-induced mortality rates post-pandemic. She shares an analysis that not only highlights COVID-19’s impact but also reveals an unexpected decline in recent years, offering hope for this public health issue.

Medical Fraud Detection

Mon, 18 Aug 2025 07:31:29 +0000

Explore innovative strategies and analytical techniques used to uncover and prevent fraud in healthcare claims. This engaging video sheds light on the tools and approaches that help protect both patients and insurers from costly misconduct. Find the report here.This is just a taste of the expert-led content available through PD Edge Plus. Learn more here.

IAAHS JoCo 2025 – Episode 9: Evaluating the Cost Effectiveness of New and Innovative Healthcare Technology

Fri, 08 Aug 2025 11:41:37 +0000

New technology, including the use of artificial intelligence and digital solutions, are being integrated into the healthcare system to drive efficiencies, improve the quality of care, and reduce cost.

This session will address various actuarial methodologies deployed to evaluate these new solutions to identify if cost savings are reasonable and achievable. It will address which methodologies are best for the available information and identify the advantages and disadvantages of each approach.

IAAHS JoCo 2025 – Episode 8: Sustainable Minds Integrating Neuro-Inclusivity into Actuarial Practice for a Resilient Future

Fri, 08 Aug 2025 11:38:48 +0000

Sustainability is a multidimensional concept requiring systemic thinking across environmental, economic, and social domains. While actuaries have traditionally focused on financial and environmental resilience, we will argue that human diversity—particularly neurodiversity—is equally vital. Neurodiversity recognises that cognitive variations such as autism, ADHD, and dyslexia are natural differences, offering significant potential for innovation and adaptability.

In this presentation, we will examine the challenges neurodivergent individuals face, including exclusionary recruitment processes and inadequate workplace accommodations. We will propose actionable strategies to address these barriers, including skill-based hiring, individualised workplace supports, and neurodiversity-focused leadership training. Further, we will advocate for developing metrics to measure the impact of these initiatives, leveraging actuarial expertise to assess long-term value.

We will draw on global case studies, such as SAP’s Autism at Work program and the International Actuarial Association’s growing emphasis on diversity, to highlight best practices. By integrating neuro-inclusivity into actuarial workplaces, professional societies, and global standards, we will demonstrate how actuaries can drive systemic change.

Ultimately, we aim to show that neuro-inclusivity is not just an ethical imperative but a strategic opportunity. By embedding these principles into the profession, actuaries will enhance innovation, strengthen decision-making, and position themselves as leaders in shaping a more inclusive and sustainable future.

IAAHS JoCo 2025 – Episode 7: E-Mergency Room: Predictive Modeling of Supplementary Healthcare Expenses using Machine Learning and Deep Learning Techniques

Fri, 08 Aug 2025 11:33:24 +0000

With the outbreak of Covid-19 pandemic, the Brazilian supplementary healthcare sector became a conducive environment for using complex data analysis and modeling tools. In this study, we apply different Machine and Deep Learning techniques (SVM, XGBoost and RNN) to predict healthcare expenses and evaluate if these techniques would present better performance in comparison to traditional ones, such as time series and regressions. Prediction scenarios were generated upon expense official databases between 2015-2022, considering two panoramas: (i) real, and; (ii) counterfactual, in which we assume the non-existence of the pandemic data for 2020. Using RMSE as the performance indicator, we find out that XGBoost model presented the best performance for the real panorama, with better fit in 32.2% of the scenarios. For the counterfactual panorama, we observe that RNN and SVM models obtained better fit in 22.3% of the cases. It is noteworthy that, until now, no studies were identified that address the use of predictive Machine and Deep Learning models into the Brazilian healthcare expenses. We also expect that this study offers insights for decisions made by the several players in this sector, such as operators and regulators, especially when it comes to pricing and development of healthcare products.

IAAHS JoCo 2025 – Episode 6: Role of Actuaries in Promoting Financial Sustainability in KSA Public Health Sector

Fri, 08 Aug 2025 11:30:34 +0000

The Kingdom of Saudi Arabia (KSA) is initiating a significant overhaul of its healthcare system, aiming to create an integrated, beneficiary-centered, value-based model that will provide health coverage to 20 million beneficiaries, supported by a budget of USD 50 to 60 billion. This presentation will highlight key aspects of healthcare financing reforms in the public sector designed to enhance value and ensure financial sustainability for the health sector. It will then explore the establishment of the National Casemix Center of Excellence and its role in promoting and accelerating these reforms throughout the entire healthcare funding value matrix, particularly how actuarial functions will aid this transformation, including responsibilities for estimating and indexing the budget of USD 50 to 60 billion to the health benefit package and the system’s financial sustainability. The concluding part of the presentation will provide an overview of KSA’s strategies for implementing these financial reforms, particularly through a population-based funding approach, highlight examples of actuarial contributions to this transformation such as budget estimation, financial monitoring and reporting, and population health analytics, and invite questions and feedback.

IAAHS JoCo 2025 – Episode 5: The Digital Health Revolution and What It Means for Health Risk Management

Fri, 08 Aug 2025 11:27:02 +0000

Digital health innovations are making healthcare more accessible and more effective. This paper will consider digital health innovations from the perspective of enhancements in the delivery of healthcare services (including in low resource settings), making healthcare more personalized to improve outcomes and how data analytics can support more effective delivery of care and management of costs.Telemedicine has expanded healthcare accessibility, breaking down geographical barriers and providing remote consultations, which is particularly vital for rural and underserved populations. AI and machine learning algorithms enable early diagnosis and risk assessment by analyzing vast amounts of data, leading to faster and more accurate decision-making in patient care. Additionally, predictive analytics are enhancing risk management by identifying potential health crises before they occur, thus allowing healthcare providers to implement preventive strategies.Digital health tools are facilitating a shift from reactive to proactive healthcare, where continuous monitoring and data-driven insights enhance patient engagement and self-care. This revolution not only improves health outcomes but also optimizes resource allocation, reduces costs, and enhances overall healthcare system efficiency.

IAAHS JoCo 2025 – Episode 4: Sustainability of Healthcare Spending in Selected OECD Countries

Fri, 08 Aug 2025 11:24:22 +0000

Total healthcare spending as a percent of GDP has long been regarded as a critical measure of the sustainability of a country’s healthcare system. Expected growth in this measure affects both publicly and privately financed healthcare programs, and is a critical input (for example, in the Society of Actuaries’s Getzen model) in developing the actuarial projections used in the analysis of program sustainability and program reform. After several decades of rapid growth, total healthcare spending as a percent of GDP has largely stabilized in most OECD countries since the early 2010s. In this presentation, we explore the causes of this slowdown, including demographic, economic, technological, and policy factors. We also consider whether the slowdown is likely to be enduring. By examining spending data from a variety of OECD countries that have different healthcare prices, utilization patterns, and financing and delivery systems, we will attempt to distinguish between policy drivers that are limited to a single country and more fundamental drivers that are influencing cost trends across multiple countries. Our conclusions, while tentative, should be of interest to anyone concerned with long-term healthcare spending projections, including actuaries, health economists, and policy analysts.

IAAHS JoCo 2025 – Interviews Episode 3: Sustainability in Healthcare: Actuarial Approaches for Funding Innovative Therapies

Fri, 08 Aug 2025 11:21:54 +0000

Innovative gene and cell therapies have the potential to cure previously incurable conditions and to transform millions of lives. However, their high cost are already challenging healthcare budgets and creating new risks. Insurance coverage and patient affordability are critical considerations in the funding of innovative therapies and the sustainability of healthcare systems. Even the most innovative therapies must be accessible to patients to have a meaningful impact. Actuaries and clinical professionals in health insurance companies play a pivotal role by determining coverage and reimbursement rates for new treatments. Successful negotiations with insurers can ensure that therapies are included in health plans, making them accessible and more affordable for patients. Reinsurance mechanisms, risk pooling, and outcomes based reimbursements strategies can help manage the risks associated with one-time very high cost treatments that often replace the costs of life time maintenance therapies, disease progression, and disability. Additionally, patient assistance programs and subsidies can help reduce out-of-pocket costs, ensuring broader access to cutting-edge treatments.

IAAHS JoCo 2025 – Interviews Episode 2: Private Health Coverage Challenges in South America: The Argentinian Case

Fri, 08 Aug 2025 11:19:37 +0000

At the Center for Research in Insurance of the Universidad de Buenos Aires we have been researching the evolution of private health coverages in Argentina during the latest years. These coverages face several challenges, some that are conjunctural, and some others that are structural. They are related not only to the main variables considered when pricing, but also to judicial and legislative risks. These latest also require structuring new sources of data in order to manage those risks. In our presentation we will give an introduction to the Argentinean health system after the latest reforms, current situation and perspectives, as well as a project for actuarial regulation to improve financial sustainability of Private Health Insurance Entities.

IAAHS JoCo 2025 – Interviews Episode 1: How Dissatisfied Customers & Legal Action Reshape Health Insurance

Fri, 08 Aug 2025 11:17:08 +0000

The judicialization of private health insurance is a widespread phenomenon in Brazil and it generates not foreseen expenditures and distress to all parts involved in it. The literature studies how complaints management aspects can influence the customer satisfaction. Meanwhile, other authors discuss on how heuristics can affect the customer’s expectation related to the health insurance. In both cases, when the consumer feels, somehow, unsatisfied it can result in the health judicialization. In Brazil’s scenario, the regulatory autarchy and the national council of justice indicates, respectively, an exponential raise in the complaints and lawsuits of private health insurance in the last years. Given that, the present study investigated if health quality and customer satisfaction factors, measured by the autarchy’s monitory indicators, can influence the amount destinated to the health insurer judicial claims and costs reserves. To verify those relations, the research utilized a linear regression panel data model, using information from each of the health insurers from 2018 to 2022. The results showed that health quality has a positive and significant effect with moral damage dispute. On the other hand, customer satisfaction has a negative and significant effect with the judicial reserves. Therefore, it can be perceived that companies with lower customer satisfaction expends more with health judicialization, while excessively health resources usage increases moral dispute when the consumer has that level of usage ceased.

The future of wellness is actuarial!

Fri, 08 Aug 2025 08:39:03 +0000

What if you could train like an actuary? This video introduces a bold new idea: using actuarial science to optimize fitness, nutrition, and recovery. Drawing from tools like survival analysis, Markov chains, and utility theory, Mouna presents a personal wellness model that forecasts injury risk and balances long-term health with performance.But this isn't just another fitness app. Unlike traditional apps that track steps or calories in isolation, this concept brings actuarial thinking to the table: quantifying risk, simulating health trajectories, and offering strategic insights grounded in predictive modeling.Inspired by her own fear of burnout and injuries, Mouna reimagines how actuaries can empower lives, not just measure risks. This innovative approach has applications not only in fitness but also in personalized insurance solutions, where prevention becomes a new form of protection. Tradition taught her to model risk. Diversity helped her question assumptions. Innovation gave her the tools to act. She believes strongly that the future of wellness is actuarial.

Healthy Life Expectancy

Fri, 08 Aug 2025 08:21:15 +0000

What I’m most passionate about as an actuary, is bridging the gap between life expectancy and healthy life expectancy. The average life expectancy is over 80 years, but the healthy life expectancy is in the 70s in Japan 2023. So, that means, on average, a lot of people spend about 10 years in poor health at the end of their lives. I would like to ask all actuaries around the world. How can we bridge this huge gap? And how can we create a world of well-being society? I believe actuaries have a unique and powerful role to play. If actuaries around the world unite to analyze, quantify, and truly understand health, we can help shape a future where more people live longer, healthier, and more fulfilling lives!

Redefining Insurance A Journey Toward Inclusion

Fri, 08 Aug 2025 07:53:47 +0000

Join me on an engaging journey as I delve into a crucial topic: diversity and inclusion within the insurance industry. As an actuary with a passion for change, I share personal insights and stories that highlight the challenges and opportunities faced by the LGBTQ+ community in accessing fair insurance coverage.Throughout this exploration, I reflect on historical barriers and present-day hurdles, emphasizing the importance of inclusive practices that cater to diverse needs. From gender-affirming care to recognizing non-traditional family structures, I discuss the vital changes needed to ensure equitable access to insurance for all.This video captures the spirit of innovation needed to drive meaningful change. I discuss practical steps actuaries and industry leaders can take to foster inclusivity, from implementing unbiased underwriting practices to increasing LGBTQ+ representation in decision-making roles.As I prepare to represent Canada at the 2026 International Congress of Actuaries, I invite you to be part of this journey toward a more inclusive future. Together, we can champion diversity and pave the way for a fairer, more equitable insurance landscape. Join me in making a difference, one step at a time.

Can epigenetics predict your future?

Fri, 08 Aug 2025 07:51:56 +0000

Gene expression refers to how often or when proteins are created from the instructions within your genes. While genetic changes can alter which protein is made, epigenetic changes affect gene expression to turn genes “on” and “off.” The epigenome is a collection of chemical compounds that rest on or attach to your DNA. This is what the prefix “epi” refers to – it means “above” in Greek. The epigenome makes sure cells only see the part of the blueprint they need, essentially “activating” or “deactivating” genes. By obtaining epigenetic information from a non-invasive saliva sample, an insurer can attain information about an insureds’ current health and wellness statuses, resulting from their environment and behavior (for example diet, exercise, alcohol, tobacco, and drug use), with more precision than conventional paramedical testing methods. The use of epigenetic testing in life insurance underwriting can provide accurate information about insureds’ current and varying health and wellness statuses, while steering clear from the perceived unfairness of unchangeable genetic information. It can also contribute to accurate risk classification, an alignment of interests between insureds and insurers while upholding the essential regulatory norms of information symmetry and transparency.

Can Insurance Make You Younger?

Fri, 08 Aug 2025 06:53:11 +0000

Can insurance actually help you live longer — even feel younger? In this video, we explore how the world of insurance is evolving from passive risk coverage to proactive health engagement. Drawing on recent trends around biological age, wearable data, and behavioral nudges, the video challenges the outdated assumptions behind how insurance evaluates health. Instead of pricing policies based on age or BMI, we discuss how sleep quality, heart rate variability, and lifestyle habits can now drive personalized insurance models. We look at how insurers are already turning movement and mindfulness into “health currency,” and how actuaries can help quantify these metrics in a credible, data-driven way. If done right, insurance could become a catalyst for healthier behavior, longer lives, and better risk outcomes — for everyone.

Health Protection For Informal Workers

Fri, 08 Aug 2025 06:03:26 +0000

This video introduces HealthCare, a mobile application designed for Zimbabwe's informal sector to provide affordable communty-based health protection. It is built on the principles of traditional savings, and it uses actuarial modeling and digital tools. It enables transparency and peer-to-peer risk sharing. The application allows members to contribute amounts to a group health fund, submit claims and get payouts. By combining tradition, diversity, and innovation, HealthCare sets to empower underresourced communities to protect one another and build financial resilience in the event of health challenges.

Recovery Ready

Thu, 07 Aug 2025 14:43:02 +0000

Recover Ready is an innovative new project designed to help patients better understand the post-operative recovery process. It provides essential knowledge about what to expect after surgery and how to support their own recovery effectively. Patients can take short quizzes to reinforce their understanding and ensure they are prepared for each stage of recovery. By increasing awareness and engagement, Recover Ready empowers patients to take an active role in their healing journey—leading to better outcomes and a smoother recovery experience.