Insurance Discrimination in the UK – Life Insurance and Genetic Risk

Abstract

Life Insurers in the UK have operated within a moratorium on the use of predictive genetic test results since 2001. Prior to this, controversy surrounded the use and interpretation of genetic tests by insurers and led to pressure for legislation to prevent discrimination. The original moratorium applied for five years until November 2006; in March 2005 an extension to the moratorium was announced for a further five years until November 2011. The article explains the events which led to the moratorium, the difficulties of underwriting genetic test results and monitoring the activities of insurers during the moratorium. Research of adverse selection and discrimination is discussed, with reference to the UK, Europe and United States.

Keywords: Insurance; predictive genetic tests; discrimination; adverse selection; moratorium

References

Aktan‐Collan K, Haukkala A and Kaariainen H (2001) Life and health insurance behaviour of individuals having undergone a predictive genetic testing programme for hereditary non‐polyposis colorectal cancer. Community Genetics 4: 219–224. Karger, Basel.

Association of British Insurers (2002) Code of Practice on Genetic Testing. www.abi.org

Association of British Insurers (2007) Code of Practice on Genetic Testing. Compliance Report and Data Analysis for 2005. Requested from ABI. www.abi.org

Bonn D (2000) Genetic testing and insurance: fears unfounded? Lancet 355: 1526.

Brackenridge RDC, Croxson RS and Mackenzie R (2006) Brackenridge's Medical Selection of Life Risks, 5th edn. Basingstoke, Hants: Palgrave Macmillan.

Ford D, Easton DF and Stratton M (1998) Genetic heterogeneity and penetrance analysis of the BRCA1 and BRCA2 genes in breast cancer families. The Breast Cancer Linkage Consortium. American Journal of Human Genetics 62(3): 676–689.

Geer KP, Ropka ME, Cohn WF et al. (2001) Factors influencing patients’ decisions to decline cancer genetic counselling services. Journal of Genetic Counselling 10(1): 25–40.

Hall MA and Rich SS (2000) Laws restricting health insurers’ use of genetic information: impact on genetic discrimination. American Journal of Human Genetics 66: 293–307.

HM Government (2001). Fifth Report of the House of Commons Science and Technology Committee. 26 March 2001. http://www.publications.parliament.uk/pa/cm200001/cmstech/174/17402.htm

HM Government and Association of British Insurers (2005) Concordat and Moratorium on Genetics and Insurance. March 2005. Department of Health http://www.abi.org.uk/Bookshop/default.asp#Genetics

Human Genetics Commission (2001) The use of genetic information in insurance: interim recommendations of the Human Genetics Commission http://www.hgc.gov.uk

Lapham EV, Kozma C and Weiss JO (1996) Genetic discrimination: perspectives of consumers. Science 274(5287): 621–624, American Academy for Advancement of Science.

Low L, King S and Wilkie T (1998) Genetic discrimination in life insurance: empirical evidence from a cross sectional survey of genetic support groups in the United Kingdom. British Medical Journal 317: 1632–1635. Accessed online at http://www.bmj.com

Macdonald AS (2004) Genetics and insurance. In: Teugels JL and Sundt B (eds) Encyclopedia of Actuarial Science, pp. 769–778. Chichester: John Wiley & Sons.

Morrison PJ, Steel CM, Vasen HFA et al. (1999) Insurance implications for individuals with a high risk of breast and ovarian cancer in Europe. Disease Markers 15: 159–165.

Needs J (2006) Insurance Experiences of People at Genetic Risk. Unpublished MSc dissertation, Cardiff University, School of Social Sciences, Wales, UK.

Watson M, Foster C, Eeles R et al. (2004) Psychosocial impact of breast/ovarian (BRCA1/2) cancer‐predictive genetic testing in a UK multi‐centre clinical cohort. British Journal of Cancer 91(10): 1787–1794. Nature Publishing.

Zick CD, Smith KR, Mayer RB and Botkin JR (2000) Genetic testing, adverse selection, and the demand for life insurance. American Journal of Medical Genetics 93: 29–39.

Further Reading

Daykin CD, Akers DA and MacDonald AS et al. (2003) Genetics and Insurance – Some Social Policy Issues. Presentation to the Institute of Actuaries, 24 February 2003. http://www.ingentaconnect.com/content/fia/baj/2003/00000009/00000004/art00004

Harper PS (1997) Genetic testing and insurance. In: Harper PS and Clarke AJ (eds) Genetics, Society and Clinical Practice. Oxford: BIOS.

Human Genetics Commission (2000) Report to the Human Genetics Commission on Public Attitudes to the Uses of Human Genetic Information. http://www.hgc.gov.uk/Client/document.asp?DocId=41&CAtegoryId=8

Mittra J (2006) Genetic exceptionalism’ and precautionary politics: regulating for uncertainty in Britain's genetics and insurance policy process. Science 33(8): 585–600.

Morrison PJ (2005) Insurance, unfair discrimination, and genetic testing. The Lancet 366(9489): 877–880.

Rothstein MA (2004) Genetics and Life Insurance – Medical Underwriting and Social Policy. Cambridge, Mass., and London: MIT Press.

Sulston J (2004) Genetics and insurance – should we legislate? Genomics Network 1: 12 ESRC Genomics Network.

Van Hoyweghen I, Horstman K and Schepers R (2005) Genetics is not the issue: insurers on genetics and life insurance. New Genetics and Society 24(1): 79–98.

Contact Editor close
Submit a note to the editor about this article by filling in the form below.

* Required Field

How to Cite close
Needs, Jacqueline(Sep 2007) Insurance Discrimination in the UK – Life Insurance and Genetic Risk. In: eLS. John Wiley & Sons Ltd, Chichester. http://www.els.net [doi: 10.1002/9780470015902.a0020658]