THE premiums you pay for life insurance depend on a number of factors - age, sex and the state of your health. If any close relative has suffered or died early from cancer or heart disease or a number of other serious conditions you may find that premiums are `loaded' or the application refused altogether.
Most people accept, with varying degrees of approval, that this kind of underwriting discrimination, based as it is on existing medical statistics and evidence and a certain amount of guessing, is fair. But how could the insurance industry price its underwriting contracts in a future where individuals have access to their genetic blueprint (or their children's) and know the odds of their developing a life threatening illness? Would it eventually force the industry itself to resort to a genetic screening-out of certain clients? How fair would that be?
Colm Fagan is an actuary and head of a company called Life Strategies which advises Irish and international insurance companies and other financial institutions about the ways they should be developing their businesses. In a recent speech to the Chartered Association of Certified Accountants he suggested that because of the advances made by genetic testing, the time may be coming when "the discrimination involved in the underwriting process will become a live topical issue".
He quotes a survey from the American Council of Life Insurance which showed that a minority of respondents believe it is unfair that someone with cancer or heart disease should have to pay a higher life insurance premium, even though that disease carries a high mortality risk. Yet the same respondents accepted that it was fair that non-smokers should pay cheaper premiums.
"What this survey concluded," says Mr Fagan, "is that respondents are more willing to accept the use of risk classifications for factors over which they have some control than for factors which are beyond their control.
"Over 4,500 medical conditions are now known to be transmitted genetically, and the number is increasing all the time. People are starting to realise its importance in their lives. We do not have to undergo a genetic test to have a good idea of what we carry in our genes. We can simply talk to our parents, our brothers and sisters, our cousins and see what medical conditions run in our families. Either way, can arm ourselves with the knowledge that will enable us to beat the odds set by the insurance companies.
"Insurers would much prefer if genetic tests had never been invented. They would just love it if life and death were a pure lottery, a game of chance. Then they would be could willingly take part in the game, knowing that they had a reasonable chance of making money. What worries them is that other players in the game know more than they do and will bet against them in that knowledge. Genetic testing confers that power on people," says Mr Fagan.
