EXAMINATION. The early mortality tables were constructed on the basis of the mor tality of the general population. In the absence of restrietions it is obvious that insurance com panies would suffer from an unfavorable selec tion of risks. The unhealthy and the weak would seek the benefits of insurance, while the strong and healthy would make comparatively little use of it. ITIlder such conditions the mortality of the members of an insurance company eonld not safe ly be inferred from the mortality of the general population. To avoid such unfavorable selection, insurance companies endeavor to limit their operations to persons of average expectation of life, and to bar out those below the average. In the beginning, therefore, insured lives are a selected class, and might be expected to show a death-rate considerably below the average for the general population. It is commonly claimed, however, that through the tendency of the strong er to surrender their insurance readily and of the weaker to keep theirs up as long as possible, the entire benefit of the original selection is lost within five or six years.
The original selection of risks was made chiefly on the results of the medical examination, which the company aims to have conducted with great thoroughness and caution. The medical ex aminer is required to ascertain from the appli cant personally all needed facts relating to family and personal history, as well as to present physi cal condition and evidences of past disease, and also to judge of the risk. Among the facts to be
elicited are the following: age and oecupation of the applicant, residence, and all previous places of residence, as well as facts concerning expected removal to a new locality; whether or not he has been rejected or postponed because of illness or risk: use of liquors and of tobacco: service in army or navy, or rejection by recruiting officer; height and weight; race and sex; presence of hernia, or results of accident or injury: heredi tary influences, as inferred from age and condition of health of pa rents and of four grandparents, if still alive or at time of death, with cause of death in each case; similar facts regarding brothers and sisters; existence of pulmonary tuberculosis or insanity in any part of family: all diseases from which applicant has suffered, with date. duration, severity, and result in each ease, as well as name of attending physician: present condition of physical health and evidence of tendencies toward disease. Moral hazard must be considered as well as physical condition. From this informa tion the examiner is asked to judge of the risk, as if personally insuring the applicant, for a par tial guide for the medical director.