Frazer Institute, The University of Queensland, Dermatology Research Centre, Brisbane, Queensland, Australia.
Victorian Clinical Genetics Services, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
Twin Res Hum Genet. 2023 Apr;26(2):184-187. doi: 10.1017/thg.2023.11. Epub 2023 May 25.
The expansion of genetic and genomic testing in clinical practice and research, and the growing market for direct-to-consumer genomic testing has led to increased awareness about the impact of this form of testing on insurance. Genetic or genomic information can be requested by providers of mutually rated insurance products, who may then use it when setting premiums or determining eligibility for cover under a particular product. Australian insurers are subject to relevant legislation and an industry led standard that was updated in 2019 to introduce a moratorium on the use of genetic test results in life insurance underwriting for policies <AU$500K. The Human Genetics Society of Australasia has updated its position statement on genetic testing and life insurance to account for these changes and to increase the scope of the statement to include a wider range of personally-rated insurance products, such as life, critical care, and income protection products. Recommendations include that: providers of professional education involving genetics should include ethical, legal, and social aspects of insurance discrimination in their curricula; the Australian Government take a more active role in regulating use of genetic information in personal insurance; that information obtained in the course of a research project be excluded; insurers seek expert advice when making underwriting decisions regarding genetic testing; and engagement between the insurance industry, regulators, and the genetics profession be improved.
遗传和基因组检测在临床实践和研究中的扩展，以及直接面向消费者的基因组检测市场的增长，使人们越来越意识到这种检测形式对保险的影响。相互评级保险产品的提供者可以要求提供遗传或基因组信息，然后在设定保费或确定特定产品的承保资格时使用这些信息。澳大利亚的保险公司受相关立法和行业主导标准的约束，该标准于 2019 年更新，对 50 万澳元以下的人寿保险承保中使用遗传检测结果引入了暂停使用的规定。澳大利亚人类遗传学学会更新了其关于遗传检测和人寿保险的立场声明，以说明这些变化，并扩大声明的范围，包括更广泛的个人评级保险产品，如人寿、重症监护和收入保障产品。建议包括：涉及遗传学的专业教育提供者应在其课程中纳入保险歧视的伦理、法律和社会方面；澳大利亚政府在个人保险中使用遗传信息方面发挥更积极的作用；排除在研究项目过程中获得的信息；保险公司在做出关于遗传检测的承保决策时寻求专家意见；并改善保险行业、监管机构和遗传学专业之间的合作。
