Hostname: page-component-848d4c4894-8bljj Total loading time: 0 Render date: 2024-06-24T12:10:51.705Z Has data issue: false hasContentIssue false
  • English
  • Français

Genetics and Insurance– Some Social Policy Issues

Published online by Cambridge University Press:  10 June 2011

C. D. Daykin ,
D. A. Akers ,
A. S. Macdonald ,
T. McGleenan ,
D. Paul  and
P. J. Turvey
C. D. Daykin
Affiliation:
Government Actuary's Department, Finlaison House, 15-17 Furnival Street, London EC4A 1AB, U.K., Tel: +44(0)20-7211-2620, Fax: +44(0)20-7211-2650, Email: chris.daykin@gad.gov.uk
Get access Rights & Permissions [Opens in a new window]

Abstract

Rapid developments in genetic science have been accompanied by confusion regarding the predictive power of DNA-based tests and in the impact of such tests on the insurance industry. The United Kingdom actuarial profession has begun to engage in the associated social policy issues and to try to throw some light on the issues through quantitative research and objective analysis. At the same time, many insurance industry actuaries have been involved in work on behalf of the insurance industry to develop a sound basis for permission to be sought to make use of the results of certain predictive genetic tests. This paper briefly outlines some of the history of the development of the debate in the U.K. and draws together some of the debates and discussions which have taken place within the Genetics Group of the Social Policy Board of the U.K. actuarial profession, as well as providing some pointers to the directions which the debate might take in the future, with some important potential consequences for the insurance industry and for actuaries.

Keywords

GeneticsInsurancePredictive Genetic TestsUnderwritingFamily History
Type
Sessional meetings: papers and abstracts of discussions
Information
British Actuarial Journal , Volume 9 , Issue 4 , 01 October 2003 , pp. 787 - 830
Copyright
Copyright © Institute and Faculty of Actuaries 2003

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

ABI (1999). Genetic testing: ABI code of practice (revised August 1999). Association of British Insurers, London.Google Scholar
Caspi, A., McClay, J., Moffitt, T.E. et al. (2002). Role of genotype in the cycle of violence in maltreated children. Science, 297, 851–4.CrossRefGoogle ScholarPubMed
Chuffart, A. (1996). Genetics: the implications for life. Paper presented at the LIA Convention, 1996.Google Scholar
CMI (1991). Continuous Mortality Investigation Reports Number 12. Institute of Actuaries and Faculty of Actuaries.Google Scholar
CMI (1999). Continuous Mortality Investigation Reports Number 17. Institute of Actuaries and Faculty of Actuaries.Google Scholar
CMI (2000). Continuous Mortality Investigation Reports Number 18. Institute of Actuaries and Faculty of Actuaries.Google Scholar
Cummins, J.D. & Tennyson, S. (1996). Moral hazard in insurance claiming: evidence from automobile insurance. Journal of Risk and Uncertainty, 12, 29–51.CrossRefGoogle Scholar
Department of Trade and Industry (1998). Government response to the Human Genetic Advisory Commission's Report on The implications of genetic testing for insurance. DTI.Google Scholar
Dinani, A., Grimshaw, D., Robjohns, N. et al. (2000). A critical review: report of the critical illness healthcare study group. Presented to the Staple Inn Actuarial Society, London, 14 March 2000.Google Scholar
Dullaway, D. & Elliott, S. (1998). Long-term care insurance: a guide to product design and pricing. Presented to the Staple Inn Actuarial Society, London, 10 March 1998.Google Scholar
Fischer, E.-P. & Berberich, K. (1999). Impact of modern genetics on insurance. Publications of the Cologne Re, No. 42.Google Scholar
Goford, J. (2003). Thinking and behaviour. Presidential address to the Institute of Actuaries. British Actuarial Journal, 9, 1–33.CrossRefGoogle Scholar
Gui, E.H. & Macdonald, A.S. (2002). A Nelson-Aalen estimate of the incidence rates of early-onset Alzheimer's disease associated with the Presenilin-1 gene. ASTIN Bulletin, 32, 1–42.CrossRefGoogle Scholar
Gutiérrez, M.C. & Macdonald, A.S. (2001). Adult polycystic kidney disease and critical illness insurance. Genetics and Insurance Research Centre, Heriot-Watt University: Research Report No. 01/4.Google Scholar
Hoem, J.M. (1988). The versatility of the Markov chain as a tool in the mathematics of life insurance. Transactions of the 23rd International Congress of Actuaries, Helsinki S, 171–202.Google Scholar
HCSTC (2001). House of Commons Science and Technology Committee, Fifth report: Genetics and insurance. HC174. T.S.O., London.Google Scholar
HGAC (1997). The implications of genetic testing for insurance. Human Genetics Advisory Commission, London.Google Scholar
HGC (2000). Whose hands on your genes? Consultation paper. Human Genetics Commission, November 2000.Google Scholar
HGC (2002). Inside information: balancing interests in the use of personal genetic data. Human Genetics Commission, May 2002.Google Scholar
Le Grys, D.J. (1997). Actuarial considerations on genetic testing. Philosophical Transactions of the Royal Society B, 352, 1057–1061, and (with discussion) British Actuarial Journal, 3, 997–1008 and 1044–1058.CrossRefGoogle ScholarPubMed
Lemaire, J., Subramanian, K., Armstrong, K. & Asch, D.A. (2000). Pricing term insurance in the presence of a family history of breast or ovarian cancer. North American Actuarial Journal, 4, 75–87.CrossRefGoogle Scholar
Macdonald, A.S. (1997). How will improved forecasts of individual lifetimes affect underwriting? Philosophical Transactions of the Royal Society B, 352, 1067–1075, and (with discussion) British Actuarial Journal, 3, 1009–1025 and 1044–1058.CrossRefGoogle ScholarPubMed
Macdonald, A.S. (1999). Modeling the impact of genetics on insurance. North American Actuarial Journal, 3:1, 83–101.CrossRefGoogle Scholar
Macdonald, A.S. (2001). Moratoria on the use of genetic tests and family history for mortgage-related life insurance. Genetics and Insurance Research Centre, Heriot-Watt University: Research Report No. 01/3.Google Scholar
Macdonald, A.S. (2003). Genetics and insurance: what have we learned so far? Scandinavian Actuarial Journal, 2003, 324–348.CrossRefGoogle Scholar
Macdonald, A.S. & Pritchard, D.J. (2000). A mathematical model of Alzheimer's disease and the APOE gene. ASTIN Bulletin, 30, 69–110.CrossRefGoogle Scholar
Macdonald, A.S. & Pritchard, D.J. (2001). Genetics, Alzheimer's disease and long-term care insurance. North American Actuarial Journal, 5:2, 54–78.CrossRefGoogle Scholar
Macdonald, A.S., Waters, H.R. & Wekwete, C.T. (2003a). The genetics of breast and ovarian cancer I: a model of family history. Scandinavian Actuarial Journal, 2003, 1–27.CrossRefGoogle Scholar
Macdonald, A.S., Waters, H.R. & Wekwete, C.T. (2003b). The genetics of breast and ovarian cancer II: a model of critical illness insurance. Scandinavian Actuarial Journal, 2003, 28–50.CrossRefGoogle Scholar
McGleenan, T. (2001). Insurance and genetic information. Association of British Insurers.Google Scholar
Pasternak, J.J. (1999). An introduction to human molecular genetics. Fitzgerald Science Press, Bethesda, Maryland.Google Scholar
Pritchard, D.J. (1997). Life assurance: financial implications of a change in insuring behaviour resulting from individuals' increased knowledge of their genetic predispositions. M.Sc. dissertation, Heriot-Watt University, Edinburgh.Google Scholar
Ross, T. (1997). The likely financial effect on individuals, industry and commerce of the use of genetic information. Philosophical Transactions of the Royal Society B, 352, 1103–1106, and (with discussion) British Actuarial Journal, 3, 1027–1034 and 1044–1058.CrossRefGoogle ScholarPubMed
Smith, C. (1998). Huntington's chorea: a mathematical model for life insurance. Swiss Re Publications, Zurich.Google Scholar
Strachan, T. & Read, A.P. (1999). Human molecular genetics, second edition. BIOS Scientific Publishers, Oxford.Google Scholar
Subramanian, K., Lemaire, J., Hershey, J.C., Pauly, M.V., Armstrong, K. & Asch, D.A. (2000). Estimating adverse selection costs from genetic testing for breast and ovarian cancer: The case of life insurance. Journal of Risk and Insurance, 66, 531–550.CrossRefGoogle Scholar
Tan, K.W. (1997). The financial impact of genetic testing on annuities. M.Sc. dissertation, Heriot-Watt University, Edinburgh.Google Scholar
Warren, V., Brett, P., Macdonald, A.S., Plumb, R.H. & Read, A.P. (1999). Genetic tests and future need for long-term care in the U.K.: report of a Work Group of the Continuing Care Conference Genetic Tests and Long-Term Care Study Group. Continuing Care Conference, London.Google Scholar
Weatherall, D.J. (2000). Science, medicine and the future. Single gene disorders or complex traits: lessons from the thalassaemias and other monogenic diseases. British Medical Journal, 321, 1117–1120.CrossRefGoogle ScholarPubMed
Wilkie, A.D. (1997). Mutuality and solidarity: assessing risks and sharing losses. Philosophical Transactions of the Royal Society B, 352, 1039–1044, and (with discussion) British Actuarial Journal, 3, 985–996 and 1044–1058.CrossRefGoogle ScholarPubMed
Wilkie, A.D. (2000). Peer review of application to GAIC for approval of the use of the predictive genetic test for Huntington's disease in respect of life insurance applications.Google Scholar
Zimmern, R. (2001). What is genetic information? Genetics Law Monitor, 1:5, 9–13.Google Scholar