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Abstract

In Australia, the USA and many Asian countries the life insurance industry is self-regulated. Individuals must disclosegenetic test results known to them in applications for new or updated policies including cover for critical care, incomeprotection and death. There is limited information regarding how underwriting decisions are made for policies with suchdisclosures. The Australian Financial Services Council (FSC) provided de-identified data collected on applications withgenetic test result disclosure from its life insurance member companies 2010–2013 to enable repetition of an independentexamination undertaken of applications 1999-2003: age; gender; genetic condition; testing result; decision-maker; andinsurance cover. Data was classified as to test result alone or additional other factors relevant to risk and decision. Wherenecessary, the FSC facilitated clarification by insurers. 345/548 applications related to adult-onset conditions. The genetictest result solely influenced the decision in 165/345 applications: positive (n = 23), negative (n = 139) and pending (n = 3).Detailed analyses of the decisions in each of these result categories are presented with specific details of 11 test cases.Policies with standard decisions were provided for all negative test results with evidence of reassessment of previous nonstandarddecisions and 20/23 positive results with recognition of risk reduction strategies. Disclosure of positive results forbreast/ovarian cancer, Lynch syndrome and hereditary spastic paraplegia, and three pending results, generated non-standarddecisions. The examination demonstrates some progress in addressing concerns in regard to utilisation of genetic testinformation but the self-regulatory system in Australia only goes some way in meeting internationally recommended bestpractice.

Item Type:	Article
Authors/Creators:	Barlow-Stewart, K and Liepins, M and Doble, A and Otlowski, M
Keywords:	genetic testing, genetic discrimination, life insurance
Journal or Publication Title:	European Journal of Human Genetics
Publisher:	Nature Publishing Group
ISSN:	1018-4813
DOI / ID Number:	https://doi.org/10.1038/s41431-018-0198-z
Copyright Information:	Copyright 2018 The Authors. Licensed under Creative Commons Attribution 4.0 International (CC BY 4.0) https://creativecommons.org/licenses/by/4.0/
Related URLs:	Google Scholar: Otlowski, M UTAS Profile: Otlowski, M
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