Abstract for presentation at 11th International Congress of Human Genetics

Australian life and disability insurance underwriters are allowed to use genetic test results disclosed by applicants. Since 2001, these ‘genetic’ applications have been collected by the Investment and Financial Services Association. Members of the Genetic Reference Group of the Institute of Actuaries of Australia (chairman GW) have access to anonymised files in the 4-year period to 30 November 2004. We studied the 667 genetic tests reported and the use of individual data by underwriters. Data for each disease were analysed for the proportion of mutation positive results along with the decisions by underwriters. A high proportion of haemochromatosis results reported, 454 applications, reflected recent screening programmes in Australia. Other main conditions reported were factor V Leiden or prothombin gene mutations (42), Huntington’s disease (41), cystic fibrosis (24), breast cancer (22), colorectal cancer (13) and familial adenomatous polyposis (9). Other conditions were reported less than 10 times. For the autosomal dominant conditions with later onset (Huntington’s disease, hereditary breast cancer, FAP and colorectal cancer) people with test results, negative for deleterious mutations, were offered standard rates unless other medical factors influencing insurance were present. Mutation positive individuals were offered standard terms, were declined insurance or were offered cover at increased cost or for shorter periods, reflecting the degree of genetic risk. Other factors, not related to the mutation, often influenced the terms offered.
This is the largest study of genetic tests and insurance to be published to date. Applications reporting genetic tests form a small part of insurance business in Australia. These data can inform policies for genetic test usage so that help is provided to people at increased risk whilst keeping insurance commercially viable and without increased premiums for the large majority of insured persons.