Imágenes de páginas
PDF
EPUB

Mr. HUMPHREYS said the Mutiny Act defined as an intemperate man anyone who got drunk three times in a month, or something of that sort.

The PRESIDENT recollected a celebrated case in which the Eagle was concerned, where the late Lord Chief Baron laid it down that no amount of after-dinner conviviality would constitute intemperance, but that the man who drank brandy in the morning was the really intemperate.

Mr. BROWN asked Mr. Humphreys whether the causes of death were traced, and whether the connection between those causes and the reason for putting up the life, had been investigated.

Mr. HUMPHREYS said he had got the data in some cases, but not in all. The early records were faulty. So far as he could ascertain, a great many of the lives had died from causes quite irrespective of the disease for which the addition was originally made.

Mr. WALFORD said that he had had occasion recently to go through a great deal of the history of diseased life insurance. Since the advent of the Clerical and Medical in 1824, no less than 50 different companies had started, more or less with the view of insuring diseased lives. A considerable percentage of these companies had had tables specifically prepared for their business, but not one of them furnished any clue to the materials from which they were deduced. He had taken a great deal of trouble to obtain publications of parliamentary committees, reports on Friendly Societies, and other official documents, from which people expected to obtain information, in order to ascertain whether there were any sources of information open to the companies; but he could not find anything clear or definite on the subject. There was no doubt that the officials of the Asylum Company did take the trouble to go through some army agents' books and trace the lives, more particularly with reference to the influence of foreign residence on health; and thus got a large collection of facts, which were no doubt the most trustworthy data which could at that time be obtained. But how the facts thus collected were applied to the tables, did not appear clear. The impression on his mind after careful observation was that hardly any of the companies had made the business pay. That might arise from several causes; probably from the fact that they did not get enough of it to make it pay. There was, he thought, one obvious reason, and that was that in cases of bad colds, as also for intemperance and other common forms of disease, -the companies had put on a small extra charge; but for gout, hernia, and palpable diseases of that sort, they had put on a large addition sufficient to drive the business away. Now, he believed that the specific charges for what would be regarded as serious diseases had paid very well, but that small additions for that class of ailments which were considered trivial had not paid. It might be taken for granted that cases of consumption, for instance, which had been slightly surcharged, generally resulted in a loss to the companies. It was quite clear that no tables could be constructed which would be applicable to all cases, the only method was to regard each case on its own merits, submitting it to the best medical scrutiny they could obtain, and quoting a rate in accordance with the medical officer's report. There had been several attempts in America to found diseased life insurance

companies, and he had had the honour of being consulted upon the subject. He had looked into the facts and made investigations, but the conclusion was inevitable that nothing could guide the office but the experience and skill of their medical staff. With regard to the diseased life experience públished by the Institute, they did not take the rated-up age, but the true age; and that would no doubt account for the difference between the Institute table and the table of the Eagle, the expectation under which was higher all the way through, up to the extreme ages, than the Experience table. That would naturally be so, and it harmonized very well with the rating-up applied to most of the cases which Mr. Humphreys had submitted to them. The question, which was one of great interest, had hitherto been enveloped in the greatest obscurity, and anything which tended to elucidate it would always be welcomed by every member of that Institute.

Mr. A. H. BAILEY thought they would all agree with Mr. Walford that any attempt to elucidate this obscure subject was welcomed by all of them. The result of his experience was that during the fifty years in which the insurance of diseased lives had been studied and practised, very little progress had been made, and no real information obtained as to the proper premiums to charge. In 1824, the date of the establishment of the Asylum and the Clerical and Medical Offices, it was thought possible to fix the proper premium to be charged for a man, say, in an advanced stage of phthisis, or for a man both of whose parents had died of consumption, or for a man suffering from organic disease of the heart. His own notion was that if a life was below the ordinary standard, it was much below it; and therefore that small additions were useless, whilst large additions the public would not pay. He thought therefore they were reduced very much to the state of things existing fifty years ago, with this slight difference, that the lives which are admitted now as diseased lives, and for which an extra premium is charged, would have been taken fifty years ago at the ordinary rates. Statistics are readily obtainable, by which comparisons can be made of the numbers living with the numbers dying, and ratios of mortality deduced; but how is it possible to determine the mortality amongst persons exposed to any particular disease? In the case of gout, for example, a common disease enough, -they could not determine what was the increased mortality due to that disease; nor, indeed, to any other. Mr. Walford had alluded to the Asylum, and in the latest number of his Insurance Cyclopædia, which had come out quite opportunely for this discussion, he had with his usual industry and research brought together almost all the available information on the subject. He (Mr. Bailey) had in his possession one of the early prospectuses of the Asylum Company, wherein it was stated that "the Directors had by great care and research ascertained the true law of mortality for various diseases." No traces of that discovery were to be found in the books and papers of the Asylum that came into the possession of the London Assurance Corporation, and no law beyond mere guesswork seemed to have been acted upon in fixing the premiums. Some results of the Asylum business might be of interest. The London Assurance contributed with several other companies to the mortality experience collected by the Institute of Actuaries;

and before he parted with the cards, he thought it well to get out the particular mortality of the London Assurance, which of course included the Asylum with its considerable number of diseased lives. He found there were no less than 558 deaths amongst diseased lives up to 31st December 1863; and in comparing those with the healthy lives, he found that, taken throughout, the annual mortality per-cent was 3:55 against 1.99 for healthy lives, which was not far short of double.

At

the ages from 25 to 45 it was as nearly as possible double. Omitting the first ten years of assurance, in order to get rid of the effect of selection, it was found that, instead of what was hoped and might have been expected, the mortality amongst the diseased lives diminishing, it steadily increased, and he had no doubt whatever that the additions could not possibly have compensated for that increased mortality in any shape or way. There were about 8,000 policies issued by the Asylum, of which there were between 500 and 600 remaining; and if he lived a few years longer, he did not despair of seeing the greater part of this experience worked out; and then, if his health permitted, he hoped to be able to give to the Institute the whole of the results connected with the mortality experience of the Asylum. But, so far as the assurance of diseased lives was concerned, he had no doubt whatever that the scheme had been a failure. As he had said, he believed that no progress whatever had been made to solve this difficult question, and it is now just as difficult for a man with an undoubted mortal disease upon him to get his life assured as ever it was. [Mr. WALFORD-More difficult.] He believed it was. The doctors have acquired more experience and knowledge, and there is a greater attempt at discrimination now than formerly, but he firmly believed that the solution of the problem to find a rate for every case that offered is as far off as ever.

Mr. MACFADYEN thought that there was no question in which insurance practice was more chaotic than that of which Mr. Humphreys's paper treated; and its frequent discussion, though it might not lead to scientific accuracy of treatment, would at least help to bring out clearly the true difficulties of the matter, and perhaps in time might lead to less diversity of practice. He did not quite see how Mr. Humphreys arrived at the conclusion that on the whole the ordinary surplus had been realized on the lives taken at extra by the Eagle office. It might be so; but he did not see the proof of it in the paper. It did not follow from the interesting fact arrived at by Mr. Humphreys, namely, that the expectations of life in the invalid cases were as good as those of healthy lives of corresponding premiums. Expectations of life might be equal, but premium rates might be very different. Neither, in such a conglomerate mortality, would it do to conclude that the profit had been as great as on normal risks, because the extra premiums deduced from the under-average mortality table, showed something like the average extra received. And it would not do to accumulate from year to year the premiums received after deducting the corresponding claims, because the future mortality among the current policies was unknown. It seemed to him, then, not at all an easy matter to ascertain that the premiums charged had been such as to provide the ordinary surplus. Even admitting that in the past this had been so, they were not much nearer the end of the difficulties.

In under-average risks it was to him rather doubtful whether past experience could altogether be relied on for future guidance. For example, if he remembered aright, the recent investigation by the Scottish Faculty of Actuaries showed that persons afflicted with hernia are positively better lives than the normal risks. Is hernia, then, calculated to lengthen life, and is it in future to be an inducement for an office to take an assurance? Again, family history had only lately among medical men received much attention, and many a person that would now be charged extra for consumptive taint, would have escaped notice in under-average statistics. Altogether, he saw no hope of ever getting beyond a very rough classification of extra premiums. Still, things might be better than now. If, instead of as at present trying to predict the length of individual life,-for that was really what it came to,-they would be content to have two or three great classes for such cases as could be taken at all, there might be some chance, with care in selection and the publication of such experience as Mr. Humphreys had brought before them, of arriving in time at safe working tables for these two or three classes. No doubt, the rougher the classification, the less likely was the individual case to have its mortality closely defined by it. But so long as the deviation was not great enough to affect the class mortality severely, this was not absolutely necessary. In fact, risks are taken every day in ordinary assurance business that the premium does not exactly represent; for it can not be supposed that all lives taken at the ordinary rates are of the same vitality.

Mr. HODGE said that, although the observations of Mr. Humphreys were valuable in many respects, they were not so valuable as those observations which applied to ordinary purposes, inasmuch as they did not enable them to judge what premiums ought really to be charged upon diseased lives. From the observations deduced from healthy lives it was possible to estimate with scientific accuracy the value of a pecuniary interest depending upon a life at a certain age; but when they came to deal with the mortality of persons suffering from some disease, they immediately had in question the intensity of the disease, each person suffering from it in a different degree of intensity. Unless they could make a great many classifications of diseases, he did not see how they could do anything in the way of anticipating the future. As Mr. Humphreys had pointed out, the method of dealing with the question is purely empirical; and the only point is whether there is any faith to be placed in the judgment of medical men on the subject. Now, the paper before them was valuable, as showing that what they hardly believed could be done, had been done in the Eagle with considerable success. That company had, as the result of a great deal of experience and judgment exercised upon such subjects, succeeded in estimating the increased risk of disease. There was another point in which he thought the paper was a valuable one. All persons connected with insurance offices were, probably, not aware that there is a general impression among a large portion of the public that when a man has anything the matter with him,—any taint in the character of his health, the offices are apt to take advantage of it to extort from him a heavier premium than the circumstances demand, so as to make a large profit out of him. Now,

it is quite clear from the experience of the Eagle in regard to these cases that that has not been done; and he thought it might be satisfactory to those who, being subject to disease, are prevented from obtaining insurances at the ordinary rates, to know that they are fairly and justly dealt by, and that they can insure without paying a heavier premium than the circumstances of the case render necessary. So far that is satisfactory. There is no doubt the process has been a tentative one, and they knew very well that most of the offices which have undertaken this kind of business have at first been unsuccessful. The Asylum failed entirely; the Clerical and Medical, established about the same time as the Asylum, was, according to the evidence of Mr. Pinckard, in the early part of its career a loser by this kind of business; and the Medical Invalid was obliged to transfer its business, but whether it was because they found the insurance of diseased lives unprofitable or not, he did not know. It was reported at the time that they would insure persons suffering from an attack of cholera. With the exception of the transactions of that Institute, he did not believe there had ever been any information upon this subject at all to be relied upon. He remembered very well that the directors of the Asylum did publish a statement to the effect that they had satisfactory information with regard to various diseases and climates. He happened to know a great deal about the getting up of the Asylum, and he believed that the data about which so much was made were mere moonshine. He recollected a gentleman who was intimately connected with the promotion of the company being strongly advised not to give up the data which he possessed upon the subject, and he as strenuously asserted his intention not to do so, for the simple reason that he had none to communicate. And as to the promoter having a knowledge of diseases in foreign countries, he (Mr. Hodge) happened to know that the man was quite ignorant as to the part of the globe in which the different countries were. No other information of the kind is accessible, and therefore they were greatly indebted to Mr. Humphreys for the accumulation of facts which he had brought before them. He (Mr. Hodge) did not think they would ever get beyond an empirical method of treating these cases. They must be dependent upon the judgment of the medical officers. It was satisfactory to find that the result of the experience in the case of the Eagle justified their judgment, and that they could proceed upon the same principles as had guided them in their decisions hitherto.

Mr. R. P. HARDY said that, considering the unsatisfactory mode in which medical assessments are usually made, he thought the results shown by the tables most encouraging. The medical men never consider, in assessing a rate for a diseased life, what the effect will be upon the premium. They put on an addition of five, seven, or ten years, but never six, eight, or nine years; and if they are asked for a reason why they add seven instead of six, they cannot give a reply. It was not twelve months ago that a joint life insurance was proposed upon a gentleman in a high position and his wife. The wife was a delicate woman, and it was doubtful whether the change of climate she was about to get, would not develop rather than retard the phthisis which was hereditary in her family. The medical man

« AnteriorContinuar »