Version: November 12, 2009

The Core Body of Knowledge is an educational guide for the Medical Director. It provides principles of Insurance Medicine, tools, and resources.

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

The Education Committee will provide the American Academy of Insurance Medicine the structure and means to acquire medical knowledge in order to help medical directors of life, health, disability and long term care insurance to be well informed and effective in their roles. This committee will also assist underwriters and others with an interest in insurance medicine in achieving their educational objectives.

Role of the Insurance Medical Director

The insurance medical director applies current medical knowledge to enhance the company’s ability to place profitable business by undertaking research, training, and developing underwriting guidelines. An expanded role may include participation in claims, marketing, actuarial, legal, and other areas of company operation.

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

F. Critical illness insurance

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.