Version: September 6, 2001

This document describes the role of the medical director, the knowledge needed to fill that role, and the available resources to provide that knowledge. It is intended to be used as a guide for educational efforts and a benchmark with which to evaluate them. The focus is on common needs with emphasis on principles, tools and sources of knowledge rather than specific facts. As our roles evolve, so must this document and our educational efforts.

Mission Statement of the Continuing Medical Education Committee of the American Academy of Insurance Medicine

To provide insurance medical directors with quality education that develops and
increases knowledge and skills used in life, health, disability and long term care insurance.

This will be accomplished by lectures, workshops, the Introductory Course for
medical directors, the Triennial Review, the Annual Scientific Program,
and other appropriate programs approved by the American Academy of Insurance Medicine.

The Academy will also endeavor to assist other organizations with an interest in insurance medicine and who provide quality education to their memberships by providing joint sponsorship for approved programs.

Role of the Insurance Medical Director

The role of the insurance medical director is to obtain and utilize current medical knowledge for the purpose of evaluating expected and actual mortality, morbidity, disability and the value of medical interventions.

Basic Knowledge Required to Perform Effectively as a Medical Director

I. General insurance and insurance medical principles, practices, law and ethics in each of the following areas:
A. Life insurance underwriting and claims
B. Disability income underwriting and claims
C. Structured settlements
D. Long term care insurance
E. Health insurance underwriting and claims

II. Mortality and morbidity analysis, including an understanding and working knowledge of:
A. Population life tables
B. Mortality curves and life expectancy
C. Select and ultimate mortality
D. Common patterns for diseases and other health-related conditions, and rating approaches
E. Sensitivity, specificity and predictive values
F. Mortality methodology
G. Value and limitations of examinations, laboratory testing and other diagnostic methods
H. Protective value studies

III. Medical Information Bureau (MIB): function, legal aspects and medical director responsibilities

IV. The mortality/morbidity impact of health-related conditions and behaviors, and the effectiveness of current therapy, including each of the following subject areas:
- epidemiology (including who is at risk and relative importance and age specific considerations)
- mortality patterns (e.g. fixed vs. temporary extra, table, early vs. late, the impact of age)
- risk factors
- genetic factors
- screening techniques (availability and effectiveness)
- diagnostics (the physical examination, laboratory and other diagnostic studies – availability, accuracy and limitations)
- impact of therapy
- prognostic factors

The subjects listed under the following headings highlight commonly encountered conditions. This is not an all-inclusive list.