Insurance underwriting in the genetic era

Abstract

corresponding recognition that most medical information, screening and diagnostic tests, and disease processes have a genetic component. However, these scientific Cologne Life Reinsurance Company, Stamford, Connecticut.advances have been accompanied by fears that insurers might misuse genetic information to the detriment of the general public.METHODS. This article addresses the principal issues regarding insurers' use of genetic information from the perspective of the insurance industry. Alzheimer's disease is used to exemplify problems that would occur if insurers did not consider genetic information that was known to applicants. RESULTS.Prohibiting use of genetic information would make it difficult to sell individually underwritten coverage at an affordable premium because insurers could not use most of the risk parameters that correlate with likelihood of claim.CONCLUSIONS. It appears that the use of genetic factors in risk classification will eventually become accepted practice. Insurers and the medical community must be proactive in seeking solutions to difficulties that can be envisioned in the future. Iwould like to thank the American Cancer Society for providing an opportunity for me to meet with other physicians who share my desire to ensure that insurance protection remains widely available and highly affordable in the genetic era that lies ahead. To the best of my knowledge, this is the world's first cancer genetics conference with an agenda that seeks to identify and solve proactively insurance difficulties that can be envisioned ahead of time. I understand that consumers and most physicians know very little about the inner workings of the private insurance mechanism, and people wonder if obtaining coverage will become more difficult in the future. For this reason, I will confine my remarks to my most deeply held convictions as a consumer, physician, and insurance professional regarding what will probably occur and, in fact, what must occur if individually underwritten insurance is to remain a product that appeals to most people. In this regard, I must emphasize that I appear today in a personal capacity and that the opinions expressed in this paper, whether explicit or implied, are mine alone and not necessarily those of the organizations with which I am associated.Presented at the American Cancer Society Workshop on Heritable Cancer Syndromes and Focus of the DiscussionGenetic Testing, Chicago, Illinois, October 7-8, 1996. Insurance figures prominently in articles that discuss concerns engendered by advances in genetic technology. Two of the more detailed from the perspective of an insurance medical director. The goal is to foster an atmosphere of understanding and mutual respect and point

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