Lyme disease mortality

[tymesup]

Lyme disease is rarely fatal. Since it affects people's health adversely, however, it must affect their mortality. Does anyone have ideas how to approximate this effect?

Thanks for any help!

[david rigby]

Approximate for what purpose?

Possible that the Mortality and Morbidity Report from the CDC has information on incidence of the disease, and maybe on the number of deaths. However, it is extremely unlikely that the number of deaths will be more than a statistical "blip" (not a technical term) in the total. Also, while not necessarily intended, your statement implied that the disease can affect mortality over a period of time (not just acutely); in such cases, death may be related to the disease, but the passage of time may diminish the likelihood that the disease makes it to the death certificate as a cause of death: if not on the death certificate, then no one can measure its impact.

[Andy the Actuary]

Lyme disease is rarely fatal. Since it affects people's health adversely, however, it must affect their mortality. Does anyone have ideas how to approximate this effect?

Thanks for any help!

for what it's worth: http://en.wikipedia.org/wiki/Lyme_disease

[tymesup]

A client is scheduled to receive disability payments for the next twenty years. She is being offered a lump sum as an alternative.

The CDC Report and a Lyme disease website have counts and rates of the diagnosed cases for various periods and states, but not deaths. Even these figures are questionable, since it's frequently unreported and/or misdiagnosed.

I tried running numbers with the RP-2000 tables for disabled and healthy females. The q's are between 7 and 3 times as large; the annuities are about 10% lower; the difference between 6% and 8% interest is 15%.

It will be interesting to see what the insurer has offered and her estimate of the interest rate. I suspect she's going to take the lump sum, since she doesn't trust the insurer.

[Andy the Actuary]

Preferring to be quartered rather than dealing with settlements and attornies, I only offer the following: Get your statistics from a qualified epidemiologist as you are in no position to support. This might involve your client spending money. Otherwise you will embark on a very long you-know-what-kind-of contest over the assumptions.

Your best starting point would be to ask insurer to state the assumptions they will be using. This would certainly be discoverable upon deposition so they would likely share up front. You may find that the mortality assumption is acceptable and then you can zero in on the interest assumption (which might also be acceptable).

Has the insurer given your client reason to distrust or doe your client simply distrust insurance companies?

[tymesup]

Lyme disease is rarely fatal. Since it affects people's health adversely, however, it must affect their mortality. Does anyone have ideas how to approximate this effect?

Thanks for any help!

for what it's worth: http://en.wikipedia.org/wiki/Lyme_disease

One of the studies referenced had 100 subjects for 180 days. While there were "adverse events" (including a life-threatening pulmonary embolism), nobody died. While it's a small sample, this agrees with the notion Lyme isn't a fatal disease. On the other hand, they do compare late stage Lyme to congestive heart failure.

Deer contribute to the spread of Lyme, another plus for an animal that is either loved or hated. Guineafowl may be an effective controller of the ticks.

Borrelia is a 14% Scrabble word; now I know what it means.

[masteff]

A google search w/ keywords {lyme long term effect} found this article: http://findarticles.com/p/articles/mi_m120...47/ai_16415843/

You could determine what the long term effects are and see if those translate into a change in mortality.

[david rigby]

A client is scheduled to receive disability payments for the next twenty years. She is being offered a lump sum as an alternative.

Is such a lump sum permitted under the qualified plan? If this is a payment under a QP, we don't care what the insurer wants to do, only what the plan permits.

[tymesup]

Preferring to be quartered rather than dealing with settlements and attornies, I only offer the following: Get your statistics from a qualified epidemiologist as you are in no position to support. This might involve your client spending money. Otherwise you will embark on a very long you-know-what-kind-of contest over the assumptions.

Your best starting point would be to ask insurer to state the assumptions they will be using. This would certainly be discoverable upon deposition so they would likely share up front. You may find that the mortality assumption is acceptable and then you can zero in on the interest assumption (which might also be acceptable).

Has the insurer given your client reason to distrust or doe your client simply distrust insurance companies?

I'm hoping the client is just satisfying herself that the offer is reasonable. The insurance company took their time granting her claim; she's under the impression they are shaky financially.

If a half-wit is quartered, is the end result an eight-wit?

[tymesup]

A client is scheduled to receive disability payments for the next twenty years. She is being offered a lump sum as an alternative.

Is such a lump sum permitted under the qualified plan? If this is a payment under a QP, we don't care what the insurer wants to do, only what the plan permits.

The benefit is not under the qualified plan. Now that you mention it, a Relative Value Disclosure would state their assumptions and make life easier.

I figured this was the best place to find some helpful actuaries, which has been reconfirmed.

[Andy the Actuary]

The "Relative Value" Regs were well-intentioned but in practice accomplish little more than adding more paper to the election package. The assumptions can produce strange results depending upon how high the interest rate and how old the mortality table, especially where lump sums are paid. I have designed a very simple one-page election package. I've test marketed it and it has met with resounding success:

"[ ] I hereby elect for the Plan Administrator to give me my $^& &*#%@& money at once."

[Belgarath]

If a halfwit is quartered, I'd vote that the result is a nitwit. I remember my Dad commenting on some political figure that, "He must be twins. One person couldn't possibly be that stupid."