It’s Complicated: Some Challenging Critical Illness Claims

Critical illness (CI) products are popular and the benefits associated are based on meeting stated policy definitions. Actuaries play an active role in pricing these products need to be up to date on the specific disease statistics and components of critical illness definitions. Aligning the CI definitions with clinical practice is not an easy task, however, and the rapid pace in medical advances can lead to difficulties in applying CI definitions during the claims stage. In this video, Dr. Sheetal Salgaonkar of RGA, discusses three challenging CI claims, focusing on key claim learnings as well as underwriting insights.