Le Grys D J
Munich Reinsurance Company (Life), London, UK.
Philos Trans R Soc Lond B Biol Sci. 1997 Aug 29;352(1357):1057-61. doi: 10.1098/rstb.1997.0085.
In the UK the majority of life insurers employ relatively liberal underwriting standards so that people can easily gain access to life assurance cover. Up to 95% of applicants are accepted at standard terms. If genetic testing becomes widespread then the buying habits of the public may change. Proportionately more people with a predisposition to major types of disease may take life assurance cover while people with no predisposition may take proportionately less. A model is used to show the possible effect. However, the time-scales are long and the mortality of assured people is steadily improving. The change in buying habits may result in the rate of improvement slowing down. In the whole population, the improvement in mortality is likely to continue and could improve faster if widespread genetic testing results in earlier diagnosis and treatment. Life insurers would not call for genetic tests and need not see the results of previous tests except for very large sums assured. In the UK, life insurers are unlikely to change their underwriting standards, and are extremely unlikely to bring in basic premium rating systems that give discounts on the premium or penalty points according to peoples genetic profile. The implications of widespread genetic testing on medical insurance and some health insurance covers may be more extreme.
在英国，大多数人寿保险公司采用相对宽松的承保标准，以便人们能够轻松获得人寿保险。高达95%的申请人能按标准条款获得承保。如果基因检测变得普遍，那么公众的购买习惯可能会改变。相对而言，更多易患主要疾病类型的人可能会购买人寿保险，而没有患病倾向的人购买量可能会相应减少。使用一个模型来展示可能产生的影响。然而，时间跨度很长，且被保险人的死亡率在稳步改善。购买习惯的改变可能会导致改善速度放缓。在整个人口中，死亡率的改善可能会持续，如果广泛的基因检测能带来更早的诊断和治疗，改善速度可能会更快。人寿保险公司不会要求进行基因检测，除了保额非常大的情况外，也无需查看之前检测的结果。在英国，人寿保险公司不太可能改变其承保标准，极不可能引入根据人们的基因概况给予保费折扣或罚分的基本保费评级系统。广泛的基因检测对医疗保险和一些健康保险的影响可能更为极端。
