Genetic testing and insurance

How new changes will make it easier for people with inherited gene mutations to obtain insurance 

If you have a strong family history of breast cancer or were diagnosed at a young age, you may have been recommended genetic testing to determine whether you carry an inherited gene mutation, such as the BRCA1 or BRCA2 gene mutations.

While genetic testing provides useful information and can help you make decisions about how to reduce your risk of breast cancer, there are implications for you and your family members. Until this year, an adverse genetic test (i.e. showing you carry a gene mutation) might affect not only your ability to obtain life insurance, but also that of your family members. However, changes are being introduced to make it easier for at-risk family members to obtain insurance.

The Beacon spoke to Dr Michael Gattas, Clinical Geneticist at Brisbane Genetics, about these changes.

What has been the issue around insurance until now?

Being able to get life insurance is one of the real hesitations people have about genetic testing. They come to see us for genetic advice and when we tell them about the implications for insurance for themselves, their children and other relatives, they decide not to do it.

When you apply for insurance, insurers generally ask about your family’s medical history. You have an obligation to tell them what you know. So if someone in your family had a diagnosis of breast cancer at a young age, you have to tell them that. If someone carries a BRCA gene defect, you have to tell them that.

Even though you might not have been tested yourself, the fact that someone in your family has a BRCA gene mutation puts you at higher risk of breast cancer than the general population. Insurers use genetic testing information as part of their assessment to determine your risk of developing medical conditions. What you do for a living (your occupational risk) also affects your risk rating. So they have quite sophisticated ways of calculating whether you’re an average risk person or not. If you are at higher risk of developing a medical condition such as cancer, their response has generally been to either knock back your application, put an exclusion on your policy (for example they won’t cover you for cancer), load your policy so you pay more for the policy than the average person, or cap the policy, meaning they’ll limit the payout. Of course, you don’t have to give them your medical information, but then they probably won’t insure you at all.

So what is changing?

The Financial Services Council is introducing a five-year moratorium on using genetic test results as part of the risk assessment for life insurance and income protection insurance. This means that, from 1 July this year until 30 June 2024, a person will be able to apply for life insurance and/or income protection insurance without having to disclose their family’s genetic testing results. The policies will be capped at $500,000 for life insurance and $4,000 per month for income protection.

So this is really good news for families where a family member has had an adverse genetic test. It means that children and other family members who may not have been able to obtain insurance because of their family history will now be able to apply for an insurance policy that will cover them for breast cancer.

Unfortunately, it is not going to help people who have been diagnosed with breast cancer.

It is important to note that this moratorium is for five years only. It will be reviewed in 2022 and may be extended, but it may not. This is a voluntary code of conduct and is not legislated by government, so it can be changed.

While there is no guarantee that you will be able to take out a new policy after 2024, if you take out a policy in the next five years you will keep that policy for as long as you continue to pay the premiums. Insurance companies won’t renege on policies that are in place.

What if I already have life insurance and am thinking about genetic testing?

People often worry that their existing policies will be void if they have genetic testing. That has never been true. If you already have a policy and have been paying your premiums, getting an adverse genetic test result makes no difference to your policy at all – and you do not have to pass the results on to your insurer.

Will genetic testing affect my private health insurance?

Another common misunderstanding is that your private health insurance may be affected by genetic testing results – this is also not true. Genetic testing makes no difference to your private health insurance policy.

More information 

Issue 84
Autumn 2019