Alcohol Consumption Resource Hub
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Alcohol Consumption
RGA's comprehensive guide for reviewing the updated underwriting guidelines for alcohol consumption.
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Welcome
The latest updates to RGA’s Global Underwriting Manual are now available.
This quarter, the resource hub features updated underwriting guidelines for alcohol consumption. The hazards associated with drinking alcohol have been systematically evaluated through extensive research. Alcohol consumption is associated with an increased risk of several disorders, including alcohol dependence, liver cirrhosis, and other non-communicable diseases and mental health conditions. It has been well-established that elevated levels of alcohol use is correlated with increasing levels of morbidity and mortality. The revised guidelines provide enhanced risk stratification for accurate risk assessment.
We have also added a new Learning Gateway section to our resource hub, expanding access to our educational offerings. You can now easily explore 12 comprehensive modules on alcohol and substance abuse, providing cutting-edge insights and best practices for underwriting these complex risks.
RGA is committed to providing you with the tools needed to make informed and effective underwriting decisions. Please reach out if we can provide further resources to support your team’s success.
New Update
For more information on these updates, log in to the Global Underwriting Manual.
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©2025 RGA, All rights reserved. RGA has made all reasonable efforts to ensure that the information provided in this publication is accurate at the time of inclusion and accepts no liability for any inaccuracies or omissions. Links to external websites are provided for informational purposes only. RGA bears no responsibility for the accuracy, legality, or content of external websites.
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Meet our expert
Dr. Reema Nathwani Jani
Associate Director, Global Underwriting Philosophy Design
Rebecca Abayakoon
Executive Director, Global Underwriting Manuals, Research, and Development
CONTACT US: For further information or to connect with your regional contact, email GUMHelp@rgare.com.
Rebecca Abayakoon
Head of Global Underwriting Philosophy Design
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As Executive Director, Global Underwriting Manuals, Research and Development, Rebecca Abayakoon is responsible for leading the research team that advances RGA’s competitive position through strategic content development in the underwriting manual. Prior to joining RGA in 2010, Rebecca worked with several companies, including SCOR Global Life and XL Re Ltd. With more than 20 years of underwriting development expertise with manuals, Rebecca has global experience working with audits, in-depth research, and complex cases. Rebecca received her Bachelor of Commerce degree in commercial law and management from Victoria University of Wellington, New Zealand. She is a member of the Fellow Academy of Life Underwriting and is a recognized Certified Insurance Professional by the Australian and New Zealand Institute of Insurance and Finance.
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Rebecca Abayakoon
Executive Director, Global Underwriting Manuals, Research, and Development
Akhilesh Pandey is Associate Director of Underwriting Research and Manual Development and a member of RGA’s Global Underwriting team. Akhilesh develops and publishes research-based underwriting guidelines for RGA's Global Underwriting Manual for Mortality and Morbidity benefits. Akhilesh also writes and shares internal and external communication materials related to the manual and provides training to RGA offices on various medical and non-medical underwriting topics. Akhilesh earned his FALU and FLMI designations in 2022 and 2023, respectively, and holds a Bachelor of Pharmacy from NCRD Sterling Institute of Pharmacy in Mumba
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Akhilesh Pandey
Associate Director - Global Underwriting, Manual Research
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Anemia is a deficiency of red blood cells or of hemoglobin that affects up to one-quarter of the world’s population. While anemia is a common impairment, it is often asymptomatic and may go undetected. A basic knowledge of physiology, along with consistent analysis of blood test results, can identify the type of anemia and can aid in determining whether there is a mortality risk. In this presentation, Dr. Duckett explains the root causes of anemia and how four key CBC indices can be useful in its identification.
Presentation time: 14:51 mins
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Underwriting Anemia
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Sushama Singh
Chief Manager - Research and Manual Development
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As Chief Manager, Sushama Singh spearheads underwriting research and the content development of RGA's Global Underwriting Manual. She holds degrees in Medicine and Law from Mumbai University and an ALMI designation by LOMA. With 18 years of underwriting experience, Sushama has expertise in handling high-net-worth cases, product development, reinsurance treaty discussions, underwriting manual governance and interpreting treadmill tests (TMT) and ECGs.
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Sushama Singh
Chief Manager - Research and Manual Development
Global Underwriting Hub Q2
This module of our explore series offers an overview of the components and functionality of blood in the human body.
explore courses are designed for entry level and junior underwriting staff (0-5 years experience)
Estimated Completion Time: 25-35 minutes
explore:
The Blood
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Participants in this course will gain a thorough understanding of how to:
Explain the utility of blood tests in the underwriting context
Identify the blood tests commonly used in mandatory and discretionary underwriting
Recognize the purpose of blood tests often seen in clinical medical records
Identify the types of abnormalities that are commonly detected using blood tests and the broad implications of each
accelerate courses are designed for senior underwriting staff (7+ years experience). Estimated Completion Time: 100-120 minutes
accelerate:
Blood Tests
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As Associate Director, Dr. Reema Nathwani Jani focuses on underwriting research and the development of the Global Underwriting Manual. With a medical degree and a master's in Psychotherapy, she brings over a decade of direct insurance underwriting experience, including high-value cases, product development, claims consultation, and tele-underwriting initiatives. She is actively engaged with the broader industry, frequently sharing her insights and expertise at various industry events.
Review the updated underwriting guidelines for alcohol consumption.
Substance use issues often arise alongside mental health conditions, complicating disability claims. To understand more about this challenging intersection, we spoke with RGA’s Dr. Georgiana Wilwerth. During this interview, we explore the clinical and practical considerations around co-occurring mental illness and substance use disorders to provide guidance for claims assessors on how best to approach this complicated issue.
Mental Health Claims: The Impact of Alcohol and Substance Use
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This module has been created to support claims assessors in their management of mental health claims when problematic substance use has been identified. The material will aid an understanding of how substance use disorders can complicate mental health conditions, negatively impact recovery, and interfere with claims management.
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The Link BetweenSubstance Misuse and Mental Health
This module has been created to support claims assessors in both identifying and managing substance misuse in a mental health disability claim setting.
Mental Health Claims: Managing the Impact of Substance Misuse
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CONTACT US: For further information or to connect with your regional contact, email Learning@rgare.com.
Diana Myers
Executive Director, Global Underwriting Education
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Miriam de Jonge
Head of Global Underwriting Education
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Sushama Singh
Chief Manager - Research and Manual Development
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Meet the Learning Gateway team
Diana Myers is the Executive Director, Global Underwriting Education at RGA. After a brief stint in merchandising, she found her true calling in training and instructional design, and for more than 30 years, she has developed courses on everything from managerial soft skills to understanding genetics in insurance. Diana has been with RGA for more than 12 years. An eLearning designer and developer, she focuses on adult learning principles as she strives to create courses that respect each learner’s experience.
Diana served as the chair of the St. Louis Articulate Storyline Special Interest Group for more than five years and is a regular contributor on Articulate’s e-Learning Heroes community. She is a Wisconsin native and a graduate of the University of Wisconsin.
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Diana Myers
Executive Director, Global Underwriting Education
As Chief Manager, Sushama Singh spearheads underwriting research and the content development of RGA's Global Underwriting Manual. She holds degrees in Medicine and Law from Mumbai University and an ALMI designation by LOMA. With 18 years of underwriting experience, Sushama has expertise in handling high-net-worth cases, product development, reinsurance treaty discussions, underwriting manual governance and interpreting treadmill tests (TMT) and ECGs.
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Sushama Singh
Chief Manager - Research and Manual Development
Miriam’s career spanned 20 years with the Australian life insurance market in a variety of underwriting and claims roles with both direct carriers and reinsurers. She began her career at RGA in the Australia office as Technical Underwriting Manager before joining the International Division to support RGA’s Asia Pacific region and to develop an underwriting training platform (which became the industry-leading Learning Gateway).
Among other certifications, Miriam holds a Bachelor of Commerce (accounting) with honors, from Deakin University, Warrnambool. She is a founding Senior Associate of the Australian Underwriting Claims Association (ALUCA), and a Fellow of the Academy of Life Underwriting (FALU). She has been an active member of various underwriting and training-related industry associations throughout her career.
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Miriam de Jonge
Head of Global Underwriting Education
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Alcohol Consumption and Liver Disease
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The Spectrum of Substance Misuse and Addiction
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Developments in Liver Testing
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GGT Beyond the Liver
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Liver Disorders
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explore course
The Liver
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Liver Function Tests: What to Look for and Why
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Pearls on Underwriting Liver Disease
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Liver Diseases in Life Insurance
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Let’s Process Liver Function Tests
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Substance Use Disorder
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Alcohol and Marijuana – Impact on Life Claims
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John Cardus
Vice President, Head of Underwriting Manual Development
Global Underwriting Manual
Learning Gateway features 12 comprehensive modules specifically focused on alcohol and substance abuse, providing in-depth knowledge on these critical topics. Beyond these specialized modules, we invite you to sign into our RGA Central portal and click the Learning Gateway tile to explore our extensive library of over 375 resources tailored specifically for underwriters and claims assessors. These resources cover a wide range of topics and are designed to enhance your professional knowledge, improve decision-making skills, and keep you updated on industry trends.
Explore all of our resource hubs
Learning Gateway
RGA recognizes the insurance industry’s opportunity to drive improvements in mental health inclusion, delivery, and support. Review our 2023 Global Mental Health Survey that reveals the urgent need for collective industry action – one that champions advocacy, education, and research.
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Advancing Mental Health in Insurance
This hub empowering underwriters with cutting-edge knowledge. RGA's comprehensive guide for underwriting NETs has been updated. Explore the latest advancements in NET management and their impact on insurance practices.
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Neuroendocrine Tumors (NETs)
Understand the comprehensive guidance for underwriting anemia. RGA's comprehensive guide for underwriting anemia has been updated. Explore the latest advancements in anemia's impact on insurance practices.
Anemia
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Learn to navigate the complexities of underwriting coronary artery disease. Review RGA’s updated guide for underwriting coronary artery disease. Learn about key changes including new screening modalities, ratings, risk factors, and guidance on decline criteria.
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Coronary Artery Disease
Review the latest asthma underwriting guidelines that feature updated information for accurate risk assessment. Also review, the updated guidelines for Hodgkin lymphoma. This includes expanded rating tables, risk classification guidance, and insights on etiology, signs and symptoms, and treatment toxicity.
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Asthma and Hodgkin Lymphoma
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Rebecca Abayakoon
Head of Global Underwriting Philosophy Design
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© 2025 RGA, All rights reserved. RGA has made all reasonable efforts to ensure that the information provided in this publication is accurate at the time of inclusion and accepts no liability for any inaccuracies or omissions. Links to external websites are provided for informational purposes only. RGA bears no responsibility for the accuracy, legality, or content of external websites.
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