Automated Mortality Methodologies for Large Database Analysis

Purpose: Life table mortality methodologies are electronically automated in order to provide timely, efficient, effective and accurate quantification of impairment-specific extra mortality inherent in many medical ailments and disabilities in order to:

1. Informationalize the structure of risk management; move medical science to risk management professional and business applications.
2. Optimize the predictive & protective value of evidence-based medical risk appraisal and life expectancy analysis for:
   1. Fact-based classification & pricing of insurable risk products.
   2. Revision and adaptation of medical underwriting manuals for electronic commerce.
   3. Leverage high value clinical information for economic and social gain.
   4. Simplify and streamline the predictive & protective value of medical-actuarial measurement of high volume – high risk impairments from info-sphere databases.
   5. Simplify understanding of “best case and what if” scenarios.
   6. Simultaneously calculate impairment specific life expectancy and develop age and sex-specific life expectancy tables to age 109 years based on the 1989-91 U.S. Decennial Life Tables.
3. Life expectancy determinations are necessary for Longevity Risk Products including:
   1. Annuities
   2. Disabilities
   3. Structured settlements
   4. Viaticals

Overview & general methodologic steps for determining mortality & life expectancy

1. Subjects studied: Breast cancer survival data by age, sex, stage and grade were obtained from a 1988-1999 cohort of the National Cancer Institute SEER (Surveillance, Epidemiology, End-Results) database (SEER*Stat 4.2.3)
2. Sex-specific annual survival must first be ascertained and translated to annual mortality.
3. With an original software program we have automated the conversion of survival to mortality using standard actuarial methods in two simultaneous electronic steps:
   1. conversion of the 12-year survival table to a 12-year mortality table
   2. conversion of 1-year annual mortality to a condensed mortality table with five durational intervals in order to derive the total excess death rate (EDR) (see slides 4-9 in the MS PowerPoint Illustration)
   3. EDRs are useful for Suggested Underwriting Pricing Projections for Mortality Risk Products such as life insurance in cancer patients (see slide 10)
4. Life expectancy is also calculated simultaneously by the software program.
5. Decimal values of the excess mortality values are added to annual mortality rates for females in the U.S. population to obtain projected mortality rates for a group with a set of risk factors similar to those in the hypothetical vignette illustration of Ms. Jane Doe.
6. These values are converted into a figure for reduced life expectancy, displayed in a life expectancy table from attained age 70 years to 109 years, and compared with the life expectancy of persons matched by age and sex in the latest Decennial U.S. Life Tables (see slides 11-13)
7. In the case of Ms. Jane Doe, annual calculations for life expectancy (e˚ ) are needed from age 70 (age at the time of her diagnosis and treatment of breast cancer) to age 109 to derive the most accurate possible calculation of remaining life expectancy.
8. Conclusions are easily prepared concerning
   1. remaining years of life expectancy
   2. percent reduction from normal expected life expectancy