Insurers have used broadly defined genetic information in underwriting for life insurance. Applications for life insurance policies commonly seek information on family history, cholesterol level, hypertension, coronary heart disease, cancer, diabetes, and much other impairment that may have a genetic basis, which is inherited, acquired, or both. Many applicants are requested to undergo blood and other tests for conditions or diseases such as high cholesterol that may have a genetic component. Insurers’ right to evaluate and to underwrite on the basis of information from these tests is essential to risk classification.
The report of the NIH-DOE task force commented on the impending genetic revolution, stating a “[a] wave of new genetic information is coming. Others are making this same prediction. Although such a wave has not yet been sighted, insurers sense its presence and are concerned. Life insurers believe that this technology must be dealt with in an intelligent and rational manner.
The industry has not rushed to embrace narrowly defined, DNA-based genetic tests. In fact, insurers are approaching them very cautiously in their usual approach to technological advances. As stated, they generally refrain from requiring medical tests in underwriting until the tests have been shown to be reliable. Although no insurers are known to require genetic tests as part of the underwriting process, questions have arisen because of rapidly developing scientific advances, various legislative challenges, and inquiries such as that being conducted by the study underlying this book.
When applicants undergo such tests in clinical settings before applying for insurance coverage, it is critical that insurers have access to and the right to underwrite on the basis of test results in order to avoid adverse selection. If the number of DNA-based tests administered in clinical settings increases as anticipated, this will become increasingly important, as the results of these tests are likely to influence the timing, nature, and amount of coverage sought.
The industry is well aware that consumers have privacy concerns in relation to confidentiality and security of personal information and heightened concerns about medical information, including genetic information. Insurers believe that all personal medical information should be given the same high level of confidentiality and security protection. They believe that each consumer wants such information to be confidential and secure, regardless of whether it is characterized as genetic information. Life insurers strongly support the NAIC Insurance Information and Privacy Protection Model Act, the NAIC Model Privacy of Consumer Financial and Health Information Regulation, and the NAIC Standards for Safeguarding Customer Information Model Regulation.
By its very nature, life insurance involves personal and confidential relationships, and it is imperative for insurers to maintain consumers’ trust in these relationships.