As genetic testing becomes a cheaper and more powerful medical tool, experts are concerned about how the insurance industry treats it.

The Centre for Genomics and Society at the University of North Carolina has compared how life insurers are allowed to use genetic information in the UK, Canada, and Australia, and found that the British system appears to be the fairest.

In Australia, private life insurers are permitted to use genetic test results when setting insurance rates and deciding whether or not to accept an application. Although they are only allowed to use test results based on actuarial or statistical data, they are free to use their own judgements as to which tests meet these requirements.

In Canada, while life insurers are currently allowed to use genetic test results, the Parliament recently passed legislation that would prohibit them from doing so when drawing up insurance contracts. But in Canada insurance regulation comes under the jurisdiction of the provinces, so there is some doubt as to whether this ban is constitutional. The legislation is currently under judicial review.

Of the three countries studied, the United Kingdom had the most comprehensive protection against insurer use of genetic information.

Life insurers in the UK have agreed to a moratorium on the use of predictive genetic test results for life insurance policies below £500,000. Above this figure, insurers are allowed to use genetic tests sanctioned by a government advisory committee, but to date only Huntington’s Disease testing has been permitted.

“The two-tiered UK system is seen by many both within and outside of the country as being an effective way of balancing individual and insurer concerns—on the one hand about genetic discrimination and on the other about the economic viability of the industry. And the flexible nature of the moratorium, which is not permanent legislation, helps insurers feel comfortable that they will be able to react to advances in genomic research if necessary,” says researcher Anya Prince.

Insurers in Australia and Canada appear to believe that losing access to genetic test results would have a drastic effect on their industry, and could threaten financial collapse, according to interviews conducted as part of the study.  

Unsurprisingly, people in those countries were much more likely to fear discrimination as a result of genetic testing than those interviewed in the UK.

A major question remains; Are genetic test results actually relevant to insurance underwriting?

“While genetic testing may promise to reduce risk, it is important to keep in mind that most genetic information can be affected by so many other factors. These include the environment, the likelihood of developing symptoms if someone has a genetic mutation (called the penetrance), the variation in signs and symptoms that can occur among people with the same condition, and how easy it is to minimise risks in individuals,” Ms Prince said.

“Where there are tests for highly penetrant conditions, it is relatively easy to predict outcomes, but these conditions affect only a very small percentage of the population. It is therefore unsurprising that there is active debate about how loss of access to genetic test results would really affect the economic viability of the insurance industry.”