Genetics and Life Insurance

By Elaine A. Lisko, Health Law & Policy Institute

Currently, the life insurance industry is undecided on the issue of whether to use genetic information. Most insurers do not require applicants to undergo testing. Nevertheless, some insurers do seek access to previous test results as well as applicants’ medical histories, which may disclose genetic predispositions. Proposals to place a moratorium on testing have been presented to the American Council of Life Insurers, but it has thus far rejected the idea of an industry-wide moratorium because of antitrust concerns.

Life insurers’ use of genetic information is of increasing importance due to the proliferation of predictive testing for more common multi-factorial disorders and the widespread introduction of genetic testing into clinical practice. Genetic tests are expected to become faster, cheaper and more common. Because applicants for life insurance may be expected to have greater knowledge of their genetic predispositions, life insurers will have a great incentive to require access to the results of previously taken genetic tests or even to request or require applicants to undergo testing.

Notwithstanding the looming potential for use and misuse of genetic information in life insurance, current legislation does little to regulate the area. Less than one-half of the states have enacted or are considering legislation regulating life insurers’ use of genetic information, and a number of states have exempted life insurance from laws prohibiting or restricting the use of genetic information. Of those states that have taken action to regulate life insurance, no one consistent approach has been adopted:
 
State Statutory Provision Use Allowed Testing Allowed Use Restricted Testing Restricted Informed Consent Required Actuarial Fairness Required Life Insurance Exempted from General Limitations
Arizona Ariz. Rev. Stat. Ann.§20-448(D)&(E) (added in 1989) & §20-448.02(A) (added in 1997)    
X

 

X


 

X


 

X

 
California Cal. Ins. Code § 10143 (re: use) (added in 1977) & § 10148 (re: testing) (added in 1994)    
 

X


 

X


 

X


 

X

 
Colorado Colo. Rev. Stat. § 10-3-1104.7(10) (added in 1994)            

X

Georgia Ga. Code Ann. § 33-54-7 (added in 1995)            
X
 
Indiana Ind. Code § 27-8-26-1(b)(5) (added in 1997; effective Jan. 1, 1998)            
 

X

Louisiana La. Rev. Stat. Ann. § 22:1214(23) (added in 1997)            

X

Maine Me. Rev. Stat. Ann. tit. 24-A, § 2159-C(3) (added in 1997)    

 X

X

 X

 X

 
Maryland Md. Code Ann., Ins. § 27-208(a)(3) (added in 1997)    

X

   

X

 
Minnesota Minn. Stat. § 72A.139 (added in 1995; effective Jan. 1, 1996)

X
by implication

   

X

X

   
Montana Mont. Code Ann. § 33-18-206(3) & (4) (added in 1991; effective Oct. 1, 1991)    
 

X

   
 

X

 
New Hampshire N.H. Rev. Stat. Ann. § 141-H:5 (added in 1995; effective Jan. 1, 1996)            

 X

New Jersey N.J. Rev. Stat. § 17B:30-12(f) (added in 1996)    

X

X

X

X

 
New Mexico N.M. Stat. Ann. §§ 24-21-3(D) & -4(C) (added in 1998; effective May 20, 1998)    
 

X

   
 

X


 

X

New York N.Y. Ins. Law § 2612(a) (added in 1996; effective Nov. 6, 1996)      
 

X


 

X

   
Oregon Or. Rev. Stat. § 746.135 (added in 1995)    

X

X

X

 

X
by implication

Wisconsin Wis. Stat. § 631.89(3) (added in 1991; effective July 1, 1992)  

X
by implication

X

   

X

X

In summary, the extant state laws and bills that address genetics and life insurance can be categorized as follows: (1) those that require that life insurers obtain the applicants’ informed consent for genetic testing or use of genetic information; (2) those that require that life insurers use genetic information only in an actuarially justified manner; and (3) proposals to prohibit the use of genetic information altogether or for policies below a certain dollar amount. While these categories describe the legislative efforts made to address genetics and life insurance generally, a wide range of other legislation is possible and should be given serious consideration.

The proliferation of predictive genetic tests will be extremely important in prevention of numerous serious disorders and in helping individuals make important life decisions. Without thoughtful policy development, however, the predictive data can also be used in ways that are not justified by scientific data and that deny access to important opportunities to numerous individuals. Such results may cause individuals at risk for genetic illnesses to forego genetic testing and lead to extremely deleterious public health consequences.

01/25/99