The Journal of the Korean life insurance medical association (보험의학회지)

The Korea Life Insurance Medical Association (한국생명보험의학회)
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Disc and underwriting - A proposal of life underwriter in terms of insurance benefits -

디스크질환과 언더라이팅 -보장급부를 중심으로 고찰한 생명보험 언더라이터의 제안-

  • Byun, Hye-Jin (Underwriting Department, ING life insurance Korea)
  • Published : 2008.09.30
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Abstract

Herniate disc disease is one of the biggest problem in claim of insurance as well as in medical. Herniate disc disease have recently increased, and it is ranked 8th in claim reasons recently. As an underwriter and physical therapist, I want to study interrelationship of insurance and disc disease. I think it is necessary to know about knowledge of medical, so this study is given some space to structure of spine, cause of herniated disc disease, role of disc, methods of classification of disable (McBride method and AMA method), and spine disability stage. disc surgery is divided laparoscope disc surgery and spine surgery. I analysis it some factors- gender, age, occupation, re-surgery, and state of after surgery - through searching medical papers. I suggest below conclusion to underwriter because it can be useful to make questionnaire, and underwriter can expect prognosis. conclusion The negative factors of disc surgery (compare to other cases) were as follows: 1. endoscope disc surgery: $20{\sim}40year$ old man, hospitalization period more than 5 days. 2. spine surgery: $45{\sim}70year$ old woman, hospitalization period more than 15 days. 3. re-surgery experience: exist 4. working condition: a person who draws a small income, non-regular worker, working period is less than 1 year. 5. method of surgery: pedicle screw fixation. spine fusion surgery, artificial disc surgery. 6. post surgery condition: appearance of muscle weakness, paralysis, reference pain, lordosis, kyphosis, and complication. smoker or take a drink.

다음은 위의 모든 결과를 바탕으로 디스크 질환의 입원기간이 길어지고 재발이 일어날 수 있는 나쁜 조건 (NEGATIVE)과 그 반대인 좋은 조건(Positive)을 table로 정리하였다. 좋은 조건은 같은 추간판 탈출 기왕력자라고 하더라도 예후에 긍정적인 가능성을 주는 조건이다. 따라서 심사할 때 table를 토대로 고지내용이 좋은 조건인지, 나쁜 조건인지 판단 할 수 있고 추가 질문사항을 요청하는데 도움이 될 수 있을 것이다. 만약 입원을 했더라도 며칠을 입원했는지. 재수술을 하였다면 어떻게 했는지, 직장인의 경우 현재 어떤 조건인지, 수술을 했다면 구체적으로 수술명이 무엇인지, 수술 후 술, 담배를 하였는지, 수술 후 현재 상태가 어떤지에 따라 인수 여부를 결정하는데 도움이 될 것이라고 생각한다.

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