Drinking through the life insurance exam: Why insurers should be concerned about an elevated blood alcohol concentration level

When we talk about alcohol abuse and misuse, we can’t help but talk about the impact on mortality and a life insurer’s bottom line.

Traditionally, insurers have primarily relied on applicant self-admission, the MIB, motor vehicle reports (MVRs), and the occasional APS “surprise” to identify potential alcohol-related risks. But how effective are these tools?

Alcohol use by the numbers

alcohol on shelf

According to a recent study published in JAMA Network Open, the COVID-19 pandemic has increased alcohol consumption as people are trying to cope with uncertainty and stress. The study found that alcohol consumption increased among adults by 14% from 2019 to 2020. Women, in particular, exhibited a 41% increase in alcohol consumption over a 2019 baseline. Deaths attributed to excess alcohol consumption are high also. According to the National Institute of Alcohol Abuse and Alcoholism, an estimated 95,000 deaths annually are attributed to excessive alcohol consumption (approximately 68,000 men and 27,000 women). This is the third leading preventable cause of death, only behind tobacco and poor diet/physical inactivity.

Underwriting the drinkers

Some insurers may wonder if traditional underwriting tools are sufficient to identify potential alcohol abusers. A cost-effective test to identify and properly price alcohol risk is the blood alcohol concentration (BAC) assay. Simply adding this to your testing profile provides blood alcohol values and an indication of your applicant’s recent alcohol intake.  

In an analysis of ExamOne applicants, alcohol screening had a positivity rate of less than one percent. This is lower than marijuana and amphetamines, but higher than cocaine, methamphetamines and morphine. A person who screens positive at the time of their exam has a blood alcohol concentration level above 10 mg/dL, and most likely would have been drinking within five hours or less of the blood draw. Given that paramedical exams are typically scheduled well in advance and are most often performed during business hours on a weekday, or early in the day on Saturday, a BAC elevation at the time of collection can be strongly suggestive of problem drinking. On a more important note for insurers, individuals who have an elevated BAC level tend to have the same mortality rate as applicants who fall in our Risk IQ 99 percentile (nearly 10X median risk).

life insurance blood alcohol concentration positivity

Next steps

Many ExamOne clients have started screening all applicants and believe that the savings in accidental death claims more than cover the cost of the testing. Depending on face amount distributions, detection of a single case declinable on the basis of BAC may provide expected mortality savings more than equal to the cost of many months of blanket testing. If you are interested in adding this test to complement or enhance your current underwriting tools, please contact your Strategic Account Manager.