The use of genetic tests by the individual life insurance industry in South Africa
The life insurance industry’s ability to access genetic test results has raised public concern regarding loss of privacy and discrimination. The insurer requires access to genetic test results to reduce the impact of individuals changing their insurance purchasing behaviour based on a predictive genetic test result, of which the insurer is unaware (anti-selection). In South Africa, industry guidelines have been established to reduce the risk of genetic discrimination whilst enabling insurance companies’ access to this information for appropriate assessment of insurance risk. This study was the first to investigate the use of genetic tests by the life insurance industry of South Africa and their compliance with the guidelines, in order to identify behaviour that could result in genetic discrimination or unexpected risk exposure for the insurer. A structured interview process was conducted with 13 companies (8 insurance companies and 5 reinsurance companies), representing the individual life insurance industry. The interview guide was structured in a manner to gain insight into the companies’ approach to using genetic information, including genetic test results, in defining the policy terms of an individual’s life insurance contract. This study found that the companies’ responses to genetic information, particularly genetic test results, were demonstrated to be aligned with the regulatory guidelines. Irregularities in their processes were noted and these could lead to discrimination or increased risk exposure for the insurance company. These resulted from inconsistencies noted in the companies’ understanding of the genetic disease mechanisms of a medical condition, which is used to interpret the genetic information to assign risk. In conclusion, this study identified the need for a consistent approach to the interpretation of genetic information which would reduce the risk of genetic discrimination. This may be established through the support of specialist genetic services.
MSc (Med)Genetic Counselling, Faculty of Health Sciences, University of the Witwatersrand, 2009
life insurance, genetics