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. 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 policies are risk-rated (underwritten) and include life insurance, disability insurance, income protection, mortgage insurance, and travel insurance. As noted above, this does not apply to private health insurance.

Life and travel insurance companies are allowed to use this genetic test information because of an underlying principle for these types of insurance. Under Commonwealth legislation, an applicant for risk-rated insurance (i.e. for a policy 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 requirement to disclose does not apply to new information that becomes available after a policy has commenced.

A person’s personal medical history or family history may be sufficient for an insurance company to charge a higher premium for such insurance, change the terms of cover or to decline an application. The result of a genetic tests may have no impact on this decision.

On the other hand, if a person has no medical or family history which would influence their risk assessment but a genetic test indicates a high risk of developing a disease, this result 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 and offer a policy at the standard rate.

The Financial Services Council represents life insurers and other financial service providers in Australia. It has Standards regarding the use of family history and genetic tests in providing these insurance services. Note that travel insurance is not covered by these Standards.

In October 2018, the Financial Services Council announced that from July 2019 life insurers would not require applicants to provide genetic test information for certain categories of life insurance. This represents a significant and voluntary change by the insurance industry.

We cannot provided detailed advice regarding a particular policy or patient, We recommend that concerns be discussed with the doctor requesting the investigation or an insurance broker. You can also find further information at the NSW Centre for Genetics Education.

Please note that these considerations do not apply to private health insurance in Australia.