Bills of mortality

“ The present extensive and beneficial system of assurance on lives, reversionary payments, annuities, and legacy duties on the latter species of testamentary property, is founded on calculations deduced from numerous bills of mortality.
6. The prosperity or decay of commerce, manufactures, or trade of any place, is shown by comparing bills of mortality of different dates.
III. Morally.—They mark:
1. The prevalence of moral or licentious habits.
2. The diseases of which the inhabitants of a place die; and, consequently, those arising from luxury or intemperance. ”

“ But in 1660 the Bills were remodelled, and henceforth only one Bill was issued. The list of casualties and diseases from the Bill for 1665—the year of the Great Plague—is here given as an illustration of the terminology in use at the time:
In 1728 the ages at death were included, and the Bills were embellished with an ornamental margin of skulls and crossbones, which was further elaborated in 1747 by the addition of hour glasses. ”

“ Child-bed is a formidable article in the bill, and is liable to much misinterpretation and error; all women dying within the month after delivery are indiscriminately classed under child-bed, whether they die in actual labour, or subsequently of acute fever, consumption, or any other disorder. Infants dying before baptism are not returned by the parish clerks in the bills of mortality. ”

“ Many proposals were put forward to improve the Bills and to give them a more scientific character, but for various reasons these all came to naught. The fate of an attempt which was made in 1754 illustrates the kind of prejudice which was apt to be encountered. A group of physicians, in conjunction with the parish clerks, presented a Bill to Parliament requiring that all the parishes in England should be obliged to keep exact registers of births, deaths, and marriages, instead of christenings and burials only, and that an annual general Bill should be prepared for the whole country. ”

“ It is curious to notice that when the Equitable Society of London, founded in 1762, applied for a charter, it was refused by the law officers of the Crown, on the ground that the success of the scheme depended upon the accuracy of certain tables of life and death "whereby the Chance of Mortality is attempted to be reduced to a certain standard. ”

“ Both parties are equally wrong. The agreement of the bills with each other does alone carry with it a strong proof that the numbers under the several articles are by no means set down at random, but must be taken from the uniform operation of some permanent cause. While the gradual changes they exhibit in particular diseases, correspond to the alterations which in time are known to take place in the channels through which the great stream of mortality is constantly flowing. ”

“ And, in proportion as this policy is carried further—in proportion as the enfeeblement of constitution is made greater, the required precautions multiplied, and the cost of maintaining these precautions augmented—it must happen that the increasing physiological expenditure thrown on these enfeebled constitutions must make them succumb so much the earlier: the mortality evaded in one shape must come round in another. ”

“ Leaving aside any difficulties in coming to a clear concept of imminent death, mistaken decisions may result from inadequate palliative care or a terminal prognosis that turns out to be error; coercion and abuse may stem from the large medical bills that family members cannot bear [p. 783] or unreimbursed hospitals decline to shoulder. ”

“ In the case of a prophylactic enforced by law, this illusion is intensified grotesquely, because only vagrants can evade it. Now vagrants have little power of resisting any disease: their death rate and their case-mortality rate is always high relatively to that of respectable folk. Nothing is easier, therefore, than to prove that compliance with any public regulation produces the most gratifying results. ”

“ Two Scientific Bases of Life Insurance—Mortality Law and Interest Rate The application of this mortality law to the cost of life insurance may now be illustrated in its simplest form. Let us take 1,000 men, all aged 40, who desire to insure their lives. They might take out policies in some existing company, but not necessarily—they can carry their insurance just as well themselves. So they enroll themselves into what may be called a life-insurance association. They agree that $1,000 shall be paid to the widows of all that die. ”

“ It appears, therefore, that in considering the means of relief from the evils connected with the number and expenses of burial, it should at the same time be borne in mind that the primary means of abatement and relief of the misery of frequent funerals will be found in the means of the removal of the developed and removable causes of premature mortality. ”

“ Court will not doubt that the standard to be adopted for your estimate of healthiness ought to be the lowest known death-rate; that every avoidable death represents an evil to society; and that, if a mortality of 12, or 13, or 14 per thousand per annum can be reached for one mixed population, there is ample room for discontent among any other population, which finds itself doomed to perish at double the rate of the first. ”

“ It is also to be remarked that it is found in general that the average amount of policies matured by death is higher than the average of all policies in force; and some actuaries incline to believe that tables of pecuniary loss might, for practical use, take the place of tables of mortality, since the actual claims are in units of money, not of lives. ”

“ The premium to be fixed is not that required by the probable duration of the life of a single insured individual, but that required by the average expectancy of life of men or women of the given age. Moreover, for human lives, mortality tables have been constructed which embody the results of large experience and long study. By their use the required premium may be fixed with an approximation to accuracy. ”

“ IV.—COMPARATIVE CHANCES OF LIFE IN DIFFERENT CLASSES OF THE COMMUNITY. Very dangerous errors arise from statistical returns and insurance tables of the mean chances of life made up from gross returns of the mortality prevalent amongst large classes, who differ widely in their circumstances. ”

“ LIFE insurance is based upon the theory that there is a law of mortality governing life; that is to say, that at all ages from birth to the utmost limits of life a certain proportion of individuals will die during fixed periods. ”

“ We must exclude the very old and the very young, so far as earning-power is concerned, or even regard them as of negative value—but where shall we draw the line?
The clue to the solution seems to be given in the practice of insurance companies, based on the principle that whilst the individual dies the race remains, and not merely the race, but the classes and divisions of the race remain to a great extent uniform. Life insurance is mainly concerned with age and mortality, but a similar principle may be applied to the occupations of the people. ”

“ Now, if any plan were devised for securing the publication of such insurances, the suspicions would travel as fast as the grounds for them. 2dly, it occurs, that eventually the evil checks itself, since a society established on the ordinary rates of mortality would be ruined when a murderous stimulation was applied to that rate too extensively. ”

“ Theoretically only one is indispensable; the mortality law. This enables the company to foresee, for a long period of years, its annual expenditures, and consequently to make provision for their payment. With this principle alone, however, life insurance would not be an accomplished reality, because its cost would be excessive. The interest element, by making life insurance cheap, brings it within the purview of the poorest citizen. It transforms life insurance from an unutilized theory into a most salutary fact. ”

“ The policies granted insurance against death or total disability without medical examination, at net premium rates based on the american Experience Table of Mortality and 3 1/2 per cent. interest; the United States bearing both the whole expense of administration and the excess mortality and disability cost resulting from the hazards of war. ”

“ Given a certain number of lives of a certain age, nothing is more clearly demonstrated than the order in which they will die. Given a certain amount of money, invested at a certain rate of interest, nothing is more self-evident than its precise accumulation in a given number of years. If all life-insurance companies thus used the same mortality tables—anticipated, in other words, the same number of annual deaths—and invested the premiums at the same rate of interest, the cost of the actual insurance would in all cases be the same. ”

“ Men who indulge more freely than the preceding group, but who were considered acceptable as standard insurance risks. In this group the mortality was 86 per cent. in excess of the average. In short, we find the following increase of mortality over the average death rate among insured risks generally:
This means that steady drinkers who exceed two glasses of beer or one glass of whisky daily are not, on the evidence, entitled to standard insurance, but should be charged a heavy extra premium. ”

“ When one reads the account of the condition of the densely crowded districts on the south side of the High Street, one is not surprised that the rate of mortality was 40 and over per thousand. That you now enjoy one of the lowest death rates in Europe—15.3 per thousand for last year—is due to the thoroughness with which measures of recognized efficiency have been carried out. ”

“ The statistics of the life-insurance companies make it clear that the death-rate is not higher in America among the classes that insure than in England. I am credibly informed that American companies expect a longer life among their clients than the English tables of mortality assume.
The endurance of fatigue and wounds in armies has been proved by our Civil War to be as good as that of the best English or Continental troops. ”

“ The imperfections of mortuary registries and of census returns are great, and corrections are largely conjectural. Until more complete methods of collecting the facts are practised, the experience of life insurance companies promises to furnish the only mortality tables having claim to authority. ”

“ The higher the age, the greater the value of selection; and, the older the members of a life-insurance company become, the more do they approximate the health of the community at large.
Another factor that operates as a selection against the mortality experience is what is called lapses. A large number of policies are constantly allowed to terminate through the indifference of the insured, and for various other reasons. But, while the healthy often forfeit their insurance upon slight provocation, there are few indeed, of those that think their health impaired, that will do so. ”

“ But, independently of the expenses which eat up the premiums, it may be feared that in an anxious search after business, the examining physician may not be so rigid in his report as those of the older established companies; the lives admitted by the directors, therefore, not being so good as they should be for the ultimate safety of the office. It has been added, in support of this, that in some of these companies the mortality has been 40 per cent. more than it should have been, had proper care been taken. But are we not very ignorant of the laws which govern disease? ”

“ By the zealous labours of the Health Committee, and the liberal application of the pecuniary resources placed at its command by the Act of 1875, the death rate has been reduced from 24.8 per 1,000 in 1874 to 19.1 in 1885, although the mean density of the population has increased in the same period 20 per cent. ”

“ Dependents left without a breadwinner will be exposed to sore distress if life insurance payments are extracted slowly and painfully, after costly contests in the courts. Health and accident insurance will often be the sources from which the sick and the disabled are to meet their weekly bills. Fire insurance moneys, if withheld, may leave the business man or the householder without an office or a home. ”

“ The tables of mortality known as the Northampton were the chief basis on which the various life assurance companies founded their premiums; and, by a singular error, the state adopted the same basis on which to grant annuities for life; but as the most intelligent men of the day were employed in calculating and constructing tables, the Government was scarcely to blame, particularly as they sought no profit, entering into the undertaking solely from a consideration of its advantages to the community. ”

“ Assuming that the general rate of mortality is precisely known, any deviation from it occurring in a special group of insured lives, as the result of some influence peculiar to that group, is called the effect of selection. If insurance were offered on equal terms to all, the feeble and dying would apply in disproportionate numbers, and the mortality would be excessive. ”

“ And lastly, let us provide in our constitution for its revision at stated periods. What these periods should be, nature herself indicates. By the European tables of mortality, of the adults living at any one moment of time, a majority will be dead in about nineteen years. ”

“ It is necessarily influenced by the progress of civilization, improved methods of sanitation, increased knowledge of the best methods of treating diseases, and other causes, but the collected statistics are now so numerous that the actuaries of life assurance offices have been able to prepare tables of mortality from which the cost of life premiums and the price of annuities are calculated. ”