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Health, Lifestyle and Disability Transitions of Self-Employed Workers: Evidence from Dutch Insurance Data

We apply mixed proportional hazards models to a Dutch insurer's portfolio of income insurance contracts and show that physical and mental ill-health and bad lifestyle habits generally have adverse effects on self-employed workers' disability outcomes. Yet our main result is that accurate assessment of the relation between health, lifestyle and disability outcomes requires a subgroup analysis that distinguishes several groups of policyholders (such as smokers and non-smokers, overweight and normal-weight self-employed, and men and women). Our study can contribute to more effective underwriting criteria and the development of risk-based insurance premiums, among others.