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  • Could my genetic makeup prevent me from buying life insurance?
  • March 1, 2011
  • genes and life insuranceBy

    If your grandfather was an alcoholic, does that mean that you’re destined to be one as well? What about your mother and aunt who have both been diagnosed with breast cancer?

    Your genetic makeup determines more than the color of your eyes and skin, they present a detailed map that illustrates familial traits, ticks, and sometimes, your odds of being stricken by a serious illness.

    Following several key court cases beginning in early 2000, genetic testing was used to make unfounded assessments of genetic risks for those seeking employment or insurance.

    States that strictly prohibit the use of genetic information for risk selection and classification by life insurers:
    Arizona: Requires “actuarial” justification to use genetic information in life insurance and informed consent to use genetic information.

    California: Requires informed consent to use genetic information. Note: In California, an insurer can only require a person to undergo a genetic test if the life insurer explicitly pays for the cost.

    Florida: No insurance company shall refuse to issue, fail to deliver, or charge a higher rate solely because a person has a sickle-cell trait.

    Maine: Requires Informed consent and allows actuarial justification.

    Maryland: Allows actuarial justification.

    Massachusetts: Allows actuarial justification. Forbids insurance companies from requiring a genetic test.

    Minnesota: Requires informed consent and allows actuarial justification.

    Montana: Allows actuarial justification.

    New Jersey: Allows actuarial justification and requires informed consent.

    New Mexico: Allows actuarial justification and requires informed consent. Must notify applicant that genetic test may be used.

    New York: Requires informed consent.

    North Carolina: Restricts discrimination based on genetic information in life insurance, but only applies to sickle-cell trait, thalassemia-minor trait, hemoglobin C trait and Tay-Sachs trait.

    Oregon: Allows actuarial justification and requires informed consent.

    Vermont: Restricts discrimination based on genetic information in life insurance.

    Notes: An actuary has to “justify” the reason for requiring a policyholder to provide genetic test results. Informed consent is when a potential policyholder must agree to take a genetic test through a written informed consent form, it must include a description of the test, the reason, potential uses, and other limitations, it must also provide the meaning of its results, and the express right to confidential treatment of the results. The written informed consent form must also inform the individual that they should consider consulting with a genetic counselor prior to taking the test and must state whether the insurer will pay for the consultation. The form must also be approved by the state’s insurance commissioner prior to its use.

    Source: The National Conference of State Legislatures

    “We are incredibly vulnerable when it comes to our DNA,” said Dr. Deborah Peel, a practicing physician, boarded psychologist and founder and chair of the non-profit consumer health privacy advocacy organization, “I don’t think we realize that when we walk around a room we shed DNA everywhere. This information can be lifted from a glass of water or a soda can. If you can lift off enough microscopic material you can find out a great deal about that person’s genetics.”

    Some fear that as genetic testing becomes a routine practice in medical treatment, insurers will find ways to use the information to deny, limit or cancel insurance. Others fear that the possibility of discriminatory practices concerning genetic tests will bring advancements in human genetics to a grinding halt.

    Nowadays, consumers and advocacy groups alike are looking for tighter regulation when it comes to who can access their medical records.

    In May of 2008, former President Bush signed the Genetic Information Nondiscrimination Act of 2007-2008 (GINA) to protect Americans from being discriminated against by heath insurers and employers because of their DNA. The United States Department of Health and Human Services, issued a March 2009 guide that tackles GINA in detail. According to the guide, “When making determinations required under 45 CFR 46.111 (a), GINA’s provisions prohibiting discrimination in health coverage based on genetic information does not extend to life insurance. disability insurance, or long-term care insurance. GINA’s provisions prohibiting discrimination by employers based on genetic information generally do not apply to employers with fewer than 15 employees.”

    “I find GINA a bit disconcerting,” said Linda McCabe, author and Adjunct Associate Professor of Human Genetics and Pediatrics at the David Geffen School of Medicine at UCLA. “On the one hand it is a very limited step toward providing some protections for individuals who are asymptomatic and would like to have genetic testing done. I’m very concerned that anyone who actually has a disorder or develops a disorder will not be protected. GINA does not protect you if you have symptoms.”

    Even after GINA was passed, the American College of Medical Genetics reported receiving a high number of phone calls from physicians about whether patients can pay for genetic testing out of pocket, worried that such information may be used against them by insurers.

    A February 2008 survey by the Genetics and Public Policy Center in Washington D.C., showed that an overwhelming majority of the 1,199 Americans surveyed support genetic testing for research and advancements in health care, but a whopping 92 percent were concerned about genetic tests being used to profile their health. While a large majority trusted their doctor’s handling of genetic test results (86 percent), only 16 percent trusted employers who have access to this data. An even lower percentage trusted their insurers with the same information.

    Ninety three percent felt genetic testing shouldn’t be used to make decisions to deny or limit insurance coverage or decisions related to hiring and promotion in the workplace.

    Of late, the topic has been addressed in regard to health insurers, but very little has been mentioned about what this information could mean to someone applying for life insurance — particularly in the individual market.

    Life insurance is of special concern because underwriters assess mortality risk to determine how to rate or deny a policy to those who have a pre-existing medical condition.

    Pages: 1 2 3 4

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