The Dangers Of Predictive Analytics In Life And Health Insurance

Currently the health and life insurance products we buy are static in the sense that right at the beginning of the policy term the insurance company makes an assessment of the morbidity or mortality risk of the person and then agrees to insure them at agreed-upon rates.

Now imagine a scenario of continuous health monitoring and a dynamic premium that reduces when people engage in what is deemed healthy behaviour. A scenario where the insurer provides various “incentives” like discounts on gym memberships , wearables like fitbit and preventive healthcare check-ups etc.

The first time I came across such an idea,2 lines of thought came to my mind simultaneously:

The first was a story narrated by my dad long back:It relates to 2 personages of our early years as a Republic. Both rivals,they had a running battle about who would live longer .One of them was a strict vegetarian and regularly practiced yoga,and had no weight issues.The other was a mountain of a man, a bon-vivant and a consumer of the likes of bear testicles that he considered aphrodisiacs.Both lived to ripe old ages,way past even today’s improved life-expectancy……..but it was the yoga practitioner who died first.My takeaway ?Living an abstemious life might make me feel virtuous,get me praise even but is no absolute guarantee of living longer than those who live it up.And there really is something to be said for really living in the time we have on earth !

The second line of thinking was about how perfect BMIs didn’t ensure best health outcomes in case of heart attacks etc. and examples of fit and healthy athletes who were outside recommended BMI range….. Then the case of the aunt who a doctor convinced was at borderline cholesterol risk in her 40s. Now over 2 decades later,she looks vastly more aged than her older siblings from all her dieting to stave off disease,even as her cholesterol levels remain the same as ever and she has till date no medical complaints of the cardiovascular variety ! Worse, the same doctor now believes that her elevated cholesterol levels are hereditary and present no particular risk of disease!Ditto for for other aunts and uncles having lived for decades fearing their sodium levels and glaucoma risk,only to figure out they killed their own happiness by unfounded worries brought on by unnecessary preventive health check-ups that they dutifully signed themselves up for.

With this sort of family background,I’m the sort that believes that I’m better off observing my own body and responding to its signals and giving such knowledge precedence over blindly following anything bruited as health and wellness best practices.So rather than listening to a lot of mutually-contradictory advice on say sleep habits,why not simply figure out what works best for me personally,judged by what refreshes me best,makes me feel energetic,keeps me more alert,keeps my immune system functioning best?Ditto for hydration,diet,recreation,socialization,exercise etc.etc.Moreover,rather than making visiting physicians a half yearly or yearly activity,I prefer to consult them only when I perceive a problem that a couple of days rest and the right food won’t correct.So the idea of complying with someone else’s diet, exercise and preventive testing ideas to reduce my insurance premiums doesn’t quite appeal to me.Moreover I like to spend as little time as possible in the company of the crowd that sets great store by the exclusivity of their gym memberships, sporting the newest and coolest exercise gear or even worse radical diets,fitness regimes and medical procedures to acquire some or other look.

As long as regular monitoring and varying premiums was going to be just one other option in the insurance market,I was OK with it.Not my thing.But then a whole lot of things are not my thing and I have few quibbles with people who opt for them,as long as I can opt out.However,there is the distinct possibility that being offered such a choice can’t be taken for granted.

Elsewhere in the world,many employers are opting to monitor data being generated by fitness trackers, to the extent they can see it on a dashboard and are holding their insured staff to account with rewards as part of a growing number of corporate-wellness programs they have adopted to reduce group insurance costs.Quite a few companies have punishments for unhealthy behavior recorded by a wearables . And its not just corporates but even local governments who have mandated their staff to participate in such programmes. In response many employee associations and unions are approaching courts to limit the penalties that employers can impose on employees refusing to participate in such programs or failing to meet the goals set in such programmes. Then there is a whole lot of litigation against employers refusing to employ those refusing to participate in such programes. And the latest round of litigation is to control who gets access to all the data that the wearables record or is generated as part of such group insurance programmes and how insurers and third parties may use them,not the least of which is ensuring how such data,especially genetic data, can’t be used in future against the interests of very people who provided them,how businesses can be built on the back of such health and fitness information.

In India,unlike say the US under the former President Obama,universal accessibility to health care has not managed to become a big debate.However,the widening gap between the quality of healthcare services accessible to different sections of the people and the rising costs of health care that will invariable transmit to higher premiums is bound to bring this issue to a head sooner rather than later.Pharma,health and wellness and insurance are big businesses and wearables are attracting a lot of big ticket investments .In any debate they are likely to be able to push their interests forward vigorously.It remains for the rest of us ,potential consumers of insurance ,who would rather decide what is best for ourselves,independently, to ensure that we are not coerced by law or public policy to participate in wellness programmes we don’t wish to or part with our fitness/health/genetic data cheaply to enrich others.