The general public have a complicated relationship with genetic science.
On the one hand, it is believed to herald a new generation of children
without health problems and smart cures for existing health problems while
its darker side brings fears of mutant clones and Big Brother medical tests.
For the present, the widely reported advances in genetic testing,
including the human genome project, are not likely to have a great effect
on the majority of the population, either in relation to their healthcare
or the insurance products they are offered.
But a climate of confusion and fear has grown and the ABI has been
pressurised by the Government and the Human Genetics Commission, the
genetics watchdog, to ann-ounce a three-year moratorium on the use of
genetic tests by the insurance industry.
The ABI code prohibits insurers asking customers to take genetic tests.
Before the moratorium, insurers could ask to see the results of tests
already taken for Huntington's disease, Alzheimer's disease, certain forms
of breast and ovarian cancer and a few other less well known diseases. The
moratorium means no genetic tests may be used for any policy under
£300,000 in value, and only the test for Huntington's disease may be
used for policies over that figure.
The HGC wanted an upper limit of £500,000 but the ABI says the
present moratorium covers 98 per cent of policies and will avoid who learn
of inherited diseases taking out unusually big policies.
The Government is keen to avoid a repeat of the climate of fear and
confusion that grew around the issue of HIV testing in the 1980s and early
1990s. When the moratorium comes to an end, whatever regulation that
follows it will have to balance on the one hand the risk of people avoiding
testing because of a perceived fear of “blackening” their insurance rating
while, on the other hand, deal with the insurance industry's legitimate
fears of people taking out higher levels of cover if they learn of their
own increased risk.
Massow Rainbow Group IFA Joe Swanson says: “There is no longer such a
strong requirement for people to buy life cover so we have to persuade
people that life and critical-illness cover is a good idea. We have to take
people through the underwriting process, which can be humiliating enough as
it is. Anything that allays people's fears is a help. We welcome the
The relatively low number of people for whom genetic testing makes a
difference means the insurance industry is not set to lose money by
agreeing to the moratorium. At present, around 95 per cent of insurance
business is written on a standard basis, with 4 per cent paying higher
premiums and 1 per cent being rejected.
But with Health Secretary Alan Milburn announcing a £30m investment
to offer a free genetic screening programme to identify women with an
inherited risk of breast cancer, the insurance industry is aware the issue
many become commercially significant in the future and is keen to establish
ground rules at an early stage.
ABI deputy director general Stephen Sklaroff says: “The point of principle
under discussion is the basis for an insurance contract. The basis for any
contract is the quality of knowledge relating to it that the two parties
“In many ways, genetic information is no different to other forms of
information insurers ask for, such as height, weight and family health
Even for the limited number of conditions that insurers have been looking
to use, the tests are by no means conclusive. Only the test for
Huntington's disease has been approved by the Genetics and Insurance Committee, the body set up by the Government to review genetic tests and judge on wh
ether they were scientifically reliable enough for insurance purposes.
The GAIC standard requires tests to be “actuarially significant”, with a
50 per cent likelihood of the disease being passed. Evidence of people
being deterred from taking tests is sketchy as genetic testing is
relatively new but anecdotal evidence shows some people whose parents have
had Huntington's disease have shied away from taking a test.
The test for Alzheimer's is only of limited value as it has not passed the
GAIC standard and, in any event, only relates to Familial Early Outset
Alzheimer's disease, which accounts for only 1 per cent of all Alzheimer's
cases, which exemplifies the present state of the clinical value of the
In any event, many of the tests will only ever give evidence of a
predisposition to developing a condition and other factors, such as
lifestyle, stress levels and diet will still play an important part in
deciding people's likelihood of developing illnesses.
The industry hopes selling life, critical-illness and healthcare products
will now be more straightforward since the adoption of the moratorium. The
moratorium is designed to take the heat out of the debate at a time when
the public are wary of genetics.
People have always been wary of new technology, and the ABI hopes changes
in public awareness will mean the benefits of genetic testing will increase
the spread of insurance through society. Sklaroff says: “The more we can
price products accurately the easier it is to spread insurance through the
population. As medical science has advanced, insurance has made greater and
greater inroads into society.”