CRO Assembly: The curse of plenty

The first session of the CRO Assembly focused on demographics. Population pyramids around the world are inversing.

There are around 600 million over 65s in the world currently; by 2050 that figure is projected to 1.5 billion. Those elderly citizens will need support, and with declining working populations in many states, they will have to increasingly seek their own provision. That represents a huge opportunity, according to Francis Blumberg. Insurers are not getting much of the cake, just 5%. Improved client targeting and profiling, as Swiss Re has undertaken, will help insurers market their products.

The shift in demographics has had an effect on squeezed generations below, as reported by Bronwyn Kirwan. However, with creativity, it is possible to provide greater financial security for younger workers through insurance products, such as income cover for those in the gig economy. Creative solutions can also be brought to the fore in providing elderly care, as presented by Stephan Dyckerhoff of Buurtzorg Neighbourhood Care. By paring back managerial layers to a minimum, and allowing local nursing-led care, Buurtzorg is allowing affordable at-home elderly care in a model being successfully exported around the globe.

A question of health

Part of the reason for mortality gains in the general population has been success in combatting infectious disease. This should not be taken for granted, warned Nathan Wolfe of Metabiota, as there are frequent epidemics across the globe. These can be modelled, and can take us beyond a reference point which is too commonly the 1918 Spanish flu pandemic.

A number of potential health crises facing insurers and society more widely are man-made in origin, as discussed in the breakout sessions. Consultant cardiologist Aseem Malhotra attacked official guidelines on cholesterol, which may have indirectly led to a deterioration in diet and an unnecessary rise in the use of statins. One of the consequences has been a rise in diabetes, which has a concerning prevalence among poorer segments of society, according to Arjun Pensar of diabetes.co.uk. There are concerns that excessive use of antibiotics may be promoting resistance that could impact insurance books, as Urs Widmer and Ramiro Dip presented; while Patrik Kneubühler and Ramiro Dip reported how mortality gains are also being compromised in the US in particular by a synthetic opioid epidemic.

The finance industry, and insurers more specifically, have created ways to observe and analyse asset trends, according to Ashley Hirst. The next step for insurers is to seek to isolate patterns within the liabilities on their books, including within their life and health books. This systematic data-driven approach can help reduce dependence on key individuals within the underwriting chain, and provide insurers with a market edge.

A genome analysis, which twenty years ago would have cost millions, has come down to a little over USD 1000, and has created considerable interest in genomic medicine. Professor Nicholas Wood of University College, London, stated that genetic understanding has helped understand some neurological conditions, such as Huntington's disease; however, Alzheimer's disease and other degenerative mental conditions remain a complex interaction of a number of genes with environmental factors. The use of genetic data has considerable legal and compliance implications. Larry Brody, National Human Genome Research, believes the ability of individuals to gather meaningful health insights from genetic testing ahead of their doctors or insurers is restricted; although Florian Rechfeld suggested the insurance industry is still wary of risk of asymmetric knowledge as a result of genetic tests. The use of epigenetic testing and patterns could provide powerful signals for conditions such as Alzheimer's and obesity, according to Christoph Nabholz; while advances in genetic cancer diagnostics could be matched by gene therapy, in the form of CRISPR technology.

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Summary of the Swiss Re Institute's 14th CRO Assembly in May 2018. Written by Simon Woodward, Senior Business Development Manager, Swiss Re Institute .