© 2019 by Sandler Occupational Medicine Associates, Inc.

Life Expectancy/Rated Age Experience

The science of life expectancy evaluates and identifies the factors that influence one’s lifespan and provides methods to estimate individual life expectancy. Estimation of life expectancy can be used where it is necessary to evaluate an individual’s future medical expenditures related to health conditions and personal factors.  

SOMA has been providing life expectancy and rated age evaluations to insurance companies for almost 20 years. These requests often involve individuals with complex health histories, where our medical expertise in identifying and evaluating the impact these factors have on the individual’s life expectancy is essential. Our experience covers a very wide variety of illnesses and injuries with varying degrees of complexity. Some examples include:

  • Closed-head trauma

  • Paraplegia / Quadriplegia

  • Musculoskeletal, including upper and lower extremity and back

  • Pain management issues

  • Respiratory related issues/injuries

In our process, SOMA reviews the individual’s medical records and analyzes the personal health history, with a focus on identifying the factors which impact life expectancy based on statistical data and published medical research. This information is used to derive life expectancy and rated age estimates for the individual, and it is helpful to the client to then use the reported information to make determinations on claims reserves/budgets, future medical costs, case management resources, Medicare set-aside proposals, claim resolution or assist in the development of a structured settlement for the individual.

SOMA can assist with your life expectancy and rated age reviews in a timely manner, providing the information required to manage and/or resolve your claims.

Experience

Insurance companies need to ensure adequate financial resources to cover the anticipated future medical needs of insured individuals with chronic health conditions who may be receiving benefits, as a result of injury or illness. Estimated life expectancy is a significant determinant of long-term expenditures for individuals in these situations. For almost 20 years, SOMA has assisted many claim representatives from insurance companies and third-party administrators with their claims by providing an opinion on life expectancy and rated age determination to help with management and projection of claim expenditures. These requests often involve individuals with complex health histories, where medical expertise in identifying and evaluating the impact on the individual’s life expectancy is essential.  

 

By reviewing the individual’s medical records and analyzing the personal health history, with a focus on identifying the factors which impact life expectancy based on statistical data and published medical research, SOMA is able to derive life expectancy and rated age estimates for the individual. We provided the findings to the claims representatives, who then use the information to make determinations on claims reserves/budgets, future medical costs, case management resources, Medicare set-aside proposals, and claim resolution. This information has also been used to assist in the development of a structured settlement for the individual.

Over the past 20 years and continuing today, SOMA has been asked to review a variety of claims from insurance companies and third-party administrators with specific emphasis on life expectancies and rated ages. These reviews have involved varying subjects such as musculoskeletal, closed head trauma and paralysis to name a few. These reviews also run the spectrum of having occurred from different events such as environmental exposure, work-related job duties, and motor vehicle accidents etc. In some instances we have been tasked to review more recent records, analyze the factors and provide an updated assessment.