Abstract
Under current Australian regulation, life insurance companies can require applicants to disclose all genetic test results, including results from research or direct-to-consumer tests. Life insurers can then use this genetic information in underwriting and policy decisions for mutually rated products, including life, permanent disability, and total income protection insurance. Over the past decade, many countries have implemented moratoria or legislative bans on the use of genetic information by life insurers. The Australian government, by contrast, has not reviewed regulation since 2005 when it failed to ensure implementation of recommendations made by the Australian Law Reform Commission. In that time, the Australian life insurance industry has been left to self-regulate its use of genetic information. As a result, insurance fears in Australia now are leading to deterred uptake of genetic testing by at-risk individuals and deterred participation in medical research, both of which have been documented. As the potential for genomic medicine grows, public trust and engagement are critical for successful implementation. Concerns around life insurance may become a barrier to the development of genomic health care, research, and public health initiatives in Australia, and the issue should be publicly addressed. We argue a moratorium on the use of genetic information by life insurers should be enacted while appropriate longer term policy is determined and implemented.
Highlights
Reviewed by: Roxana Moslehi, University at Albany (SUNY), United States Orestis Panagiotou, National Cancer Institute (NIH), United States
The Australian life insurance industry has been left to self-regulate its use of genetic information
We argue a moratorium on the use of genetic information by life insurers should be enacted while appropriate longer term policy is determined and implemented
Summary
A woman with an identified BRCA gene change indicating elevated risk of breast cancer, elected to have a bilateral prophylactic mastectomy to reduce her risk. The risk reduction surgery was not taken into account by her life insurer and in her application for death and critical illness cover, the insurer excluded any cancer cover and imposed a 50% premium loading for death cover [7] In another case, a man with a family history of colorectal cancer had an identified gene change confirming his increased risk. The Standard contains several clauses that could be considered to conflict with the 2005 Government recommendations, including a recently added clause requiring applicants to disclose to insurers even a consideration of genetic testing, if requested It is uncertain how insurers will use an affirmative response, but we consider even the inclusion of this request to be evidence of an erosion in consumer rights made possible by lack of regulatory oversight [18].
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