How far is too far? Faced with pressures from all sides, underwriters face choices about what tools to use, and whether they'll be allowed to use them.

To satisfy top management ("do it faster, cheaper, customer-friendlier, and as profitably as ever"), chief underwriters must sift and winnow options that would scarcely have seen light of day a few decades ago.

They have no choice.

The ways of the past are disharmonious with the demands of the present. In this context, of course, one refers to money-leaching, time-guzzling relics such as chest X-rays, stress tests and medical doctor examinations.

To upgrade our armamentarium, we must continue to dissect an array of novel options. Several (blood tests, paramedicals, oral fluid) are now institutionalized in contemporary underwriting. Indeed, the "poster child" in this regard, teleunderwriting, continues spawning joyous devotees and is destined to reconfigure the landscape of new business processing.

The use of pharmaceutical database information met early resistance, driven by angst over how customers would react. Thankfully, this anticipated pushback never materialized, largely because we were already asking about "medications taken" on our applications. In this sense, confirming medication use is really no different than using cotinine (nicotine) screens to root out "smoker's amnesia."

The utility of prescription profiles continues to be embellished as these reports gradually become widespread screening tests. One factor catalyzing their success is the use of prudent customer safeguards, such as requiring applicant authorization before proceeding.

Proactive life/health insurers are also studying new medical test options. The most encouraging of these is NT-proBNP, a circulatory disease marker. Easily done in conjunction with a routine blood profile, NT-proBNP could be the best demarcator ever for assessing atherosclerotic disease risk. Several insurers are experimenting with this test, and a major research paper on NT-proBNP in an underwriting context is expected in 2007.

All of the foregoing enhancements either have enjoyed or likely will experience diffuse acceptance across the industry. Then, there are some others ...

No matter how robust putative ROI evidence may be, in the end it is how a prospective risk-management tool is apt to play with consumers and regulators that belongs at the center of every value assessor's radar screen. If it unravels when confronted by customers and their advocates, then it is, in the end, unacceptable.

Decades ago, a prominent medical director fairly gushed over a new cancer marker as a possible insurance screening modality. One insurer put that test to the test. The outcome ... well, it could have been better. The marker was deeply flawed and soon discarded.

There are advocates of deploying credit histories as a criterion for issuing insurance. It is said that there are data to support this step, particularly as regards the links between unfavorable credit records and high early lapse rates.

Would it be an exaggeration to say that one fairly cringes at the notion of being refused life coverage on the specious basis of being "past due-90" on a credit card?

Another inventive strategem has come upon us more recently. Tragically saddled with congenital dyscalculia (a medical term for getting F's in second grade arithmetic despite doing the homework), this underwriter would flounder at articulating its mathematical underpinnings. Nevertheless, there are some conventionally apprehendable things that can be said of this process.

Apparently, there are gazillabytes of data "out there" on consumer purchases, such that one can ascertain how any given individual spends his money. Apparently, it is knowable that a given individual has purchased a novel instead of an exercise bike, grazed at a fast food outlet in lieu of a vegetarian diner.

Apparently, it is the intent of those who have harnessed this process to mesh these "lifestyle" data with conventional risk information for the purpose of rendering insurability determinations.

What hath God wrought? (apologies to Morse!)

In a society beset with crescendoing paranoia over electronic surveillance (a 12-letter word for "spying"), one shudders to think how so invasive an approach to underwriting would likely play out.

Is this really In our best interests? How will our customers react when they discover that their insurability status is impacted--even if only to a limited degree--because they opted to acquire a hammock in lieu of a tennis racket?

Think it over before it is imposed from high atop your corporate food chain!

Hank George, a Best's Review columnist, is the principal in his own consulting and training firm, Hank George Inc. He may be reached at [e-mail].