Genetics and Insurance– Some Social Policy Issues

Abstract

Rapid developments in genetic science have been accompanied by confusion regarding the predictive power of DNA-based tests and in the impact of such tests on the insurance industry. The United Kingdom actuarial profession has begun to engage in the associated social policy issues and to try to throw some light on the issues through quantitative research and objective analysis. At the same time, many insurance industry actuaries have been involved in work on behalf of the insurance industry to develop a sound basis for permission to be sought to make use of the results of certain predictive genetic tests. This paper briefly outlines some of the history of the development of the debate in the U.K. and draws together some of the debates and discussions which have taken place within the Genetics Group of the Social Policy Board of the U.K. actuarial profession, as well as providing some pointers to the directions which the debate might take in the future, with some important potential consequences for the insurance industry and for actuaries.

Genetics and insurance in the United Kingdom 1995–2010: the rise and fall of “scientific” discrimination

“…(p. 343) Some commentators suggested that the evidence required by GAIC to approve genetic tests raised questions about the lack of equivalent evidence to support other common practices of insurers (e.g. Macdonald 2000, Daykin et al 2003. This accords with the findings of interviews with executives at two European reinsurance companies (van Hoyweghen and Horstman 2009), which noted that efforts to document a stronger evidence base for ratings, initiated with the hope of de-politicizing the issues of genetics and risk classification, have instead tended to highlight the lack of evidence for many established practices, and so opened new questions about fairness.…”

“…As an example of this, the actuaries Daykin et al (2003) expressed dissatisfaction with the inability of GAIC to progress the insurers' agenda, and referred to hypothetical future applications to GAIC as "specious statistical exercises for which data may not be available for another ten or more years." (p. 817) They suggested that a demonstration of statistical significance should not be required, and that insurers should be allowed to use genetic test results if they could demonstrate "financial vulnerability" to applicants with private knowledge of genetic test results.…”

The Impact of Multifactorial Genetic Disorders on Critical Illness Insurance: A Simulation Study Based on UK Biobank

“…We need not rehearse the debate, often heated, that has surrounded genetics and insurance in the past 10 years, except to note that it has mainly focussed on single-gene disorders. Daykin et al (2003) or Macdonald (2004) are sources. It seems plausible that awareness of genetic issues will be heightened by enrolling 500,000 people into a genetic study.…”

Physicians, genetics and life insurance

“…According to the principle of mutuality underlying insurance, an insured person will then be assigned to a group with similar risk factors. By its very nature, the process of underwriting discriminates between individuals 4 to pool them into at-risk groups. 5,6 Unbeknownst to most, 90% of life insurance applicants are insured at standard rates.…”