Four Ways Health Insurance Companies Use Risk Assessment To Set Rates
Thursday, May 6th, 2010 by adminHealth insurance companies provide health insurance for the purpose of helping individuals, groups, and families be protected from an unexpected financial loss due to deterioration in health or in the event of death. In turn, the person who is insured will pay a monthly or yearly premium to the insurance company. In order to provide this service in the most cost-efficient manner, while still turning a profit, health insurance companies must first determine what the chances are of the insured becoming ill, sustaining an injury, or dying. This is done through risk assessment. When assessing the health of an individual, the insurance company will require a completed questionnaire. This questionnaire will evaluate the health status and quality of life that the individual has. The answers determine the level of risk the applicant poses and gives suggestions as to how he or she can improve health and make lifestyle changes that can help lower their risk. There are several factors that are taken into consideration when performing this risk assessment. Following are four of the major aspects that are reviewed.
Age: Naturally, as we grow older, the chances of contracting a disease or illness, becoming injured, and dying increase. As well, we may not be able to perform even the simplest of every day tasks. Therefore, long term health insurance may be needed. This means that we may require around the clock home care or we may need to reside in an assisted living facility. So, the younger a person is, the lower the insurance premiums usually are.
Current health: The current state of a person’s health is very important. This tells the insurance companies how healthy you are at the time you apply for insurance. A nurse will check your height and weight, blood pressure, pulse rate, and cholesterol level.
Medical history: The medical questionnaire will ask you about past medical conditions you may have experienced. Perhaps you are prone to asthma, you have injured your back a few years ago, or you have a family history of cancer or diabetes. It will also single out any pre-existing conditions you may have, which is a medical condition present when you are applying for insurance. This can cause your premiums to increase, this condition may be excluded from coverage, or you may be denied for coverage completely.
Behavior and lifestyle: A person who smokes or who drinks excessively, or participates in dangerous activities such as car racing, rock climbing, or sky diving, will pose a higher risk than someone who lives a sedentary lifestyle. They constantly put themselves in situations that can threaten their health or life. By changing some of these behaviors, you can help to lower your insurance premiums.

