Genetic testing & insurance

Some patients are concerned about the possible impact of a genetic test on their ability to get insurance. Although we briefly discuss the matter here, we recommend that specific concerns be raised with an insurance broker.

Private health insurance

In Australia, a person’s current or future health does not affect their ability to get private health insurance in the long term. The result of a genetic test has no impact on eligibility for health insurance, or the cost of premiums. A current illness or diagnosis may limit cover for a short period at the commencement of a policy, but not over the long term.

Other types of insurance

The eligibility for, and cost of, some other types of insurance are calculated according to the present and past health of the applicant. The assessment of future health may be based on a person’s personal health history, family history and any genetic information known to the applicant, including the results of any genetic tests. These types of insurance include life insurance, disability insurance, income protection, mortgage insurance, and travel insurance (this does NOT apply to private health insurance).

A person’s personal medical history or family history may be sufficient for an insurance company to charge a higher premium for such insurance, or to decline an application; the result of a genetic test may have no impact on this decision. On the other hand, if a genetic test indicates that a person is at high risk of developing a disease in the future, this could provide the sole basis for the insurance company’s decision. If a genetic test shows that a person is not at risk of the family’s disorder, the insurance company may ignore the applicant’s family history.

Insurance companies are allowed to use this genetic test information because of an underlying principle for this type of insurance. Under Commonwealth legislation, an applicant for insurance (other than health insurance) and the company providing that insurance must have the same information about the person being insured at the time of the application. The failure to share potentially significant information may be regarded as a breach of contract and result in an insurance policy being cancelled. This does not apply to new information that becomes available after a policy has commenced.

The Financial Services Council represents insurers and other financial service providers in Australia. It has guidelines regarding genetic testing for its members. In mid-2019, the Council introduced a new policy regarding genetic tests and life insurance. Under this policy, an insurer will not ask about or use the result of a genetic test request for policies which fall below specified values. We cannot provide detailed advice regarding a particular policy or patient, and recommend that concerns be discussed with the doctor requesting the investigation, an insurance broker, or with the Financial Services Council on (02) 9299 3022. You can also download further information here: Centre for Genetics Education (NSW Health) life insurance and genetic testing.

As noted above, these considerations do not apply to private health insurance in Australia. 

 >Download the Financial Services Council key facts (June 2019)