Predictive Modeling in Long-Term Care Insurance

The accurate prediction of long-term care insurance (LTCI) mortality, lapse, and claim rates is essential when making informed pricing and risk management decisions. Unfortunately, academic literature on the subject is sparse and industry practice is limited by software and time constraints. In this article, we review current LTCI industry modeling methodology, which is typically Poisson regression with covariate banding/modification and stepwise variable selection. We test the claim that covariate banding improves predictive accuracy, examine the potential downfalls of stepwise selection, and contend that the assumptions required for Poisson regression are not appropriate for LTCI data. We propose several alternative models specifically tailored toward count responses with an excess of zeros and overdispersion. Using data from a large LTCI provider, we evaluate the predictive capacity of random forests and generalized linear and additive models with zero-inflated Poisson, negative binomial, and Tweedie errors. These alternatives are compared to previously developed Poisson regression models.Our study confirms that variable modification is unnecessary at best and automatic stepwise model selection is dangerous. After demonstrating severe overprediction of LTCI mortality and lapse rates under the Poisson assumption, we show that a Tweedie GLM enables much more accurate predictions. Our Tweedie regression models improve average predictive accuracy (measured by several prediction error statistics) over Poisson regression models by as much as four times for mortality rates and 17 times for lapse rates.