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• In Australia, premiums for private health insurance are not based on risk assessment according to the individual's present or past health or their family history
• Premiums for life insurance products which include cover for life, disability, trauma, business and bank loans are calculated according to present and past health of the applicant and any genetic information including their family history or any genetic test result (underwritten)
• Insurance policies offered by Life Insurance companies in Australia are 'guaranteed renewable': an individual only has to apply for the cover once and is not subject to providing any other health or genetic information for the period of cover
• The Investment and Financial Services Association Ltd (IFSA) http://www.ifsa.com.au has a policy on genetic testing and life insurance that states that no applicant will be required to undergo a predictive genetic test
• Under law, an application for a life insurance product is required to disclose any health or genetic information known to the applicant
• Costs of insurance, and the ability to obtain insurance cover, may vary between different companies depending on health risk. Applicants may wish to make applications to a range of companies at the same time; an insurance broker or agent may be helpful in this process
• It is important to involve the family doctor, specialist or geneticist if necessary in negotiations with the insurance company and document your screening and prevention strategies, where applicable
• Where an individual has received their predictive genetic test result before securing insurance cover, they are required to make the results of any genetic test available
• Where a relative has had a predictive genetic test and the test result is known, disclosure of this information is required but not any other personally identifying information like a relative's name
• An insurance policy may be secured before having genetic testing
• Where a blood sample for a predictive genetic test has been taken and the sample has not yet been analysed by the laboratory, it is unclear how this would impact on the insurance application
• Where the laboratory has analysed the sample and a result is pending; the insurance company may delay the application until the result is available
• Research Projects: Disclosure of participation in a genetics research project is not required except in those projects where a personal result has been given
• Dealing with insurance companies:
  • Genetic counselling may be supportive and informative
  • Ensure any information provided by brokers or agents is in writing from the insurer
  • The complaint system provided by the insurance company or any other official process may be helpful to some

An individual may wish to investigate their insurance options before considering predictive genetic testing. Securing a policy may take several weeks or more.

Some companies may ask whether advice and/or counselling has been sought about health or future health. In answer to this question, if genetic counselling had been attended to discuss risks based on a family medical history (but where a sample was not taken for a predictive genetic test), informing of attendance is required.

What is known about the health of parents, brothers and sisters ie. first-degree relatives should be provided to a potential insurer.

Sometimes genetic counselling can clarify that an individual's family history does not indicate that they are at potentially high risk for a certain condition, and this can be helpful when applying for insurance.

(a) A test sample has not yet been analysed by the laboratory:

As with all types of medical treatment, anyone may withdraw their consent for a procedure at any time. It is possible to withdraw consent to a sample being analysed at any time prior to the laboratory starting the process.

In this situation, disclosure is still required to a potential insurer, about the fact that a sample was provided for a predictive genetic test but that the individual had withdrawn from the testing process without a result.

It is unclear how this will impact on an insurance application. Insurance companies are bound, under IFSA's genetic testing policy, to respect an applicant's right 'not to know' their predictive genetic test result (see No 6. Dealing with insurance companies).

Sometimes an individual will give a sample for analysis to be done in the future. This is called 'DNA banking'. If a person provides a sample for DNA banking they have not yet undergone a genetic test.

(b) A laboratory has analysed a sample and a result is pending:

Providing a sample for testing and laboratory analysis assumes that a predictive genetic test has been undertaken.

Disclosure of undertaking such a test is required by a potential insurer.

In this situation an insurance company may await a result before proceeding with the application.

(c) The laboratory has analysed the sample but an individual has chosen not to have their result:

There may be a number of reasons why someone may choose not to have their predictive genetic test result. For example, an individual may have a test only for the benefit of other family members but does not wish to know their own result.

• Obligations to disclose to the insurance company that a test had been undertaken is not clear
• The insurance companies are bound, under IFSA's genetic testing policy, to respect an individual's right 'not to know' their predictive genetic test result (see #6 Dealing with insurance companies)

The insurance company will require that the results of any genetic test be made available.

When applying for insurance, it is required to disclose any health information that is known, about oneself, their parents, brothers and sisters. This is relevant to an assessment of their risk.

• This would include past and present health problems and predictive genetic test results but would not include providing personally identifying information like a relative's name.
• The insurer may also request written consent from the applicant to access their medical records from their doctor
• If there is information about a relative's genetic test result in an individual's medical record, their doctor may be obliged to disclose the test result information
• In the written consent it is possible to request that a doctor does not disclose any personally identifying information about relatives

An insurance company may be a member of IFSA and may therefore be bound by the IFSA policy.

• If the company is not a member of IFSA, enquire about their policy regarding genetic testing
• If advised by an agent/broker that an insurance offer may be declined, deferred, offered at non-standard rates or impacted on the basis of a particular genetic test result:
  • The applicant should check that this advice is received from the company’s underwriter in writing and a copy requested
  • A genetics specialist may be able to explain the reasons for a decision, and if necessary may discuss the decision with the company’s Chief Underwriter or Chief Medical Officer
  • If there are difficulties with an insurance company over an application or renewal, it is possible to follow the Internal Disputes Resolution process that each company has documented in their product disclosure brochure; this is the brochure that contains the application form

Other Genetics Fact Sheets referred to in this Fact Sheet: 21, 36, 44, 45, 47, 48, 49, 50, 51, , 54, 55