Insurance underwriting in the genetic era

BACKGROUND The field of genetics is experiencing exponential growth, with a corresponding recognition that most medical information, screening and diagnostic tests, and disease processes have a genetic component. However, these scientific advances have been accompanied by fears that insurers might misuse genetic information to the detriment of the general public. METHODS This article addresses the principal issues regarding insurers' use of genetic information from the perspective of the insurance industry. Alzheimer's disease is used to exemplify problems that would occur if insurers did not consider genetic information that was known to applicants. RESULTS Prohibiting use of genetic information would make it difficult to sell individually underwritten coverage at an affordable premium because insurers could not use most of the risk parameters that correlate with likelihood of claim. CONCLUSIONS It appears that the use of genetic factors in risk classification will eventually become accepted practice. Insurers and the medical community must be proactive in seeking solutions to difficulties that can be envisioned in the future. Cancer 1997; 80:587-99. © 1997 American Cancer Society.