Health and life insurance issues

Health and life insurance issues

General practitioners (GPs) are well placed to advise patients to consider the implications around health and life insurance for themselves and their families before embarking on genetic testing.

Private health insurance is community-rated (ie based on population risk), and does not take into account genetic information, but will take into account any existing condition.

However, individuals applying for a new life insurance product (eg cover for death, disability, income protection) are required by law to disclose ‘every matter known to the applicant, or could reasonably be expected to be known, that is relevant to the insurer’s decision’. This includes the results of any genetic tests.

While some insurance companies will ask for more specific details than others, applicants must disclose all known genetic information about themselves that would be relevant to the assessment of their risk, over and above the questions asked. This includes information about any health condition(s) that were diagnosed in first-degree relatives (ie parents, children, brothers, sisters) and the age at which they were diagnosed. It does not include any other information, including their genetic test result(s), if known to you, their name or date of birth.

This information may have a range of consequences, depending on the condition involved and whether the genetic test was positive, uninformative or negative.

If an application for health and/or life insurance is held or taken out before a genetic condition is diagnosed, or before a risk is identified through a predictive genetic test, the applicant does not have to disclose this new information. Life insurance cover is guaranteed renewable and, so as long as the premiums are paid, that cover will apply.

The Financial Services Council has implemented a moratorium on the disclosure of genetic test results in life insurance product applications at a level below $500,000 for death and total and permanent disability, $200,000 for trauma, and $4000 a month for income protection. This commenced in July 2019.