Evidence-based underwriting in the molecular age: the politics of reinsurance companies towards the genetics issue

Abstract

One of the most contentious topics in public policy debates on genetics has been the use of genetic information by private insurance companies. Confronted with legislation prohibiting the use of genetics in private insurance, the insurance industry has been prompted to deal proactively with the issue. One central feature of this change in tactics is the investment in “evidence-based underwriting”, currently promoted by transnational reinsurance companies. This strategy should contribute to de-politicizing the genetics issue in insurance. Drawing on fieldwork in reinsurance companies and in the broader field of insurance, this article analyzes how reinsurance companies deal with this strategy of evidence-based underwriting and whether it has delivered on its promises. Making use of the theoretical work of Barry and others on the politics of calculation in transnational technical zones, we show how the explicit goal of evidence-based underwriting by reinsurance companies helps to reveal uncertainty in life underwriting, which in turn stimulates new contestation and discussion over the issue of genetics and, more generally, the life underwriting process. In fact, it seems that the turn towards evidence-based underwriting standards has provoked new sources of politicization. While the intentions of evidence-based underwriting strategies are to de-politicize the genetics issue, the effects of this politics of calculation may appear to be political (again).