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Q&A Insurance
Q & A - Insurance Issues & Genetic Testing
A/Professor Kristine Barlow-Stewart, Director, Centre for Genetics Education, NSW health and Clinical A/Prof, Northern Clinical School, Sydney Medical School University of Sydney.
Will having a predictive genetic test for breast and ovarian cancer affect my health insurance?
No. Private health insurance is available to anyone, regardless of their health, if they are willing to pay the premiums. Those premiums are the same for all Australians and are not risk-rated i.e. underwritten. In other words, they are not determined by any risk factor you may have such as predicted by your genetic makeup. Health insurance is described as being community rated.
Will having a predictive genetic test for breast and ovarian cancer affect my current life insurance policy?
No. If the policy that you already have covers you in the event of death, inability to work (Income protection), the onset of certain illnesses (trauma or crisis insurance) or setting up a business, is provided by a life insurance company, it is ‘guaranteed renewable’. In other words, as long as you keep paying the premiums, you are covered regardless of any information you may have obtained after taking out the policy – such as the result of a genetic test. The premiums would have been assessed on the level of risk at the time of taking out the policy. That risk may have been impacted by your current health, lifestyle and your family history of cancer which you would have had to disclose at the time of your application. Your family history may mean that your premiums are higher than the standard rate for someone your age and sex, or may have other conditions attached to the policy.
So if the result shows you have inherited the faulty gene that predisposes you to breast and ovarian cancer, you don’t have to tell the insurance company. However, if you haven’t inherited the family faulty gene, the risk associated with your family history of cancer is no longer relevant so you should contact the insurer to discuss having your premiums re-assessed.
What if I don’t have cancer but have had a predictive genetic test for breast and ovarian cancer that shows I have inherited the faulty gene and I want to take out life insurance?
You will have to disclose that information along with your family history and any other relevant health or lifestyle information. Every insurance company will assess your risk differently so you should make applications to different companies.
What if I disclosed in my application for life insurance that the result of my predictive genetic test for breast and ovarian cancer shows I have inherited the faulty gene, and I think that the insurance company has not treated my application fairly?
Each insurance company has a system in place (the Internal Disputes Resolution process) to handle complaints. Details of this process will be in their product disclosure brochure. However, it is important to find out on what basis the decision has been made so request the reason from the insurer. If the adverse assessment of your risk was based on your family history and genetic test result (i.e. no other lifestyle or health risks were relevant), you should discuss your concerns with your genetics specialist who may be able to explain to you the reasons for the decision, and if necessary can discuss the decision with the company’s Chief Underwriter or Chief medical officer.
What if my insurance is an annually renewable sickness and accident policy?
This type of insurance is not ‘guaranteed renewable’ so every year when you renew it is like taking out a new policy and you will have to disclose any new information you have about your lifestyle or health, including the result of any genetic test you have had.
Since taking out my original life insurance policy, I have had predictive genetic testing for breast and ovarian cancer that shows I have the faulty gene (but I do not have cancer) and now I want to change the policy (e.g. increase the amount covered, add extra insurance such as income protection).
You will have to disclose any new information about your lifestyle or health which will include the result of the genetic test.
What if I don’t have cancer but one of my close relatives (e.g. parent, sibling) has had a predictive genetic test for breast and ovarian cancer that shows they have the faulty gene and I want to take out life insurance?
You will have to disclose that information along with your family history and any other relevant health or lifestyle information in your application.
What if I want to apply for life insurance, I do not have cancer but have had a predictive genetic test for breast and ovarian cancer through a research study and I will never know whether or not I have inherited the faulty gene?
As you will not know anything that is relevant to your future health from your participation in the research study, you do not have to tell the insurer about your genetic test in your application.
What if I want to apply for life insurance, I do not have cancer but have had a predictive genetic test for breast and ovarian cancer through a research study that will tell me whether or not I have inherited the faulty gene?
As you will learn information that is relevant to your future health from your participation in the research study, you will have to tell the insurer about your genetic test in your application.
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