Are you part of the genetic underclass?
By Nic Cicutti, MSN Money special correspondent
Last updated March 25 2004
How your genes can affect your wealth
The onward march of modern medicine is a wonderful thing. We – well, doctors, actually – now have the capacity to transplant almost any body part bar the brain. Every day, new cures are found for existing illnesses. We can diagnose diseases more rapidly and even, in some cases, predict the likelihood of them happening.
Tests can be carried out to tell us whether our genes carry the potential for fatal diseases. At present, only a few illnesses, such as Huntingdon’s Chorea, can be confidently attributed on a genetic basis. But many doctors believe that genetic testing will allow us to predict the likelihood of contracting increasing numbers of diseases.
Why good medicine can be bad for you
Yet, the very successes of medicine also create the danger of something else: a “genetic underclass”, unable to get insurance or other financial products because companies say the risks are too great.
In turn, experts are already beginning to worry that people who might benefit from certain tests, if only because they could lead to a swifter diagnosis and treatment, will refuse to take them. They fear being excluded from financial products that are essential to protect themselves or their families, like critical illness cover or term assurance.
Insurance and risk
For insurers, the argument is all about risk.
Essentially, the argument goes as follows:
Insurance involves assessing and charging for the likelihood of something happening to one or more groups of people. For example, a 17-year-old pays more for his car insurance than a 50-year-old bank manager.
This also applies when you take out various types of cover that involve an assessment of a person’s health and likely longevity. Insurers will ask you questions on your application form, and may, if you agree, write to your doctor for more information relating to your answers.
Therefore, it follows that genetic test results are a type of medical information insurers are entitled to ask you about – and make decisions on the back of.
What kind of insurance is affected?
Genetic testing is irrelevant for some types of cover:
Motor insurance
Household insurance
But it may matter to other types of insurance:
Life cover
Health insurance
What is classed as a genetic test?
Over the past few years, scientists have identified genes that can cause some rare conditions.
These conditions are generally caused by a change in a single gene. For some of these conditions, doctors can now test your DNA (‘your genetic code’) to see if you have inherited normal or faulty copies of the gene from your parents.
A genetic test is a medical test of part of your genetic code. The code is stored in each of the cells in your body. Each cell contains 23 pairs of chromosomes, and the genetic code is written on these chromosomes as ‘genes’, made up of molecules of the chemical DNA.
It’s not all in your genes
Diseases are more likely to be caused by the interaction of several different genes, along with environmental effects (such as smoking or diet), and the interpretation of tests for these genes will be more difficult.
Sometimes your doctor may ask you if you want to have a genetic test to confirm that you have a condition, after you have started to show signs suggestive of the illness. This is called a diagnostic genetic test.
If a particular disease runs in your family, your doctor may offer you a genetic test before you show any symptoms. This is called a predictive genetic test. This test will tell whether you have inherited the faulty gene linked to that disease.
If the test result is normal (negative), then you haven’t inherited the faulty gene. If the test result is adverse (positive), then you have got the faulty gene and you may go on to develop the disease.
For some conditions, an adverse genetic test result means you are almost certain to develop the disease.
For others, an adverse result means only that you may be more likely to develop the disease. This is because other factors, such as your diet, lifestyle and environment, interact with your genes to determine what happens to you.
What kind of test?
There are two types of genetic test:
“cytogenetic”, measuring the structure of the chromosomes;
“molecular”, a test that detects abnormal patterns in the DNA of specific genes.
Not all doom and gloom
If that were the end of the story, we’d all be getting extremely worried. After all, what happens to your next home purchase if you can’t get life cover? The temptation for many would be to do without the test, even a the cost of damaging their long-term health.
Happily, things are not so bad - for now. Here is why:
You do not always need to disclose any genetic test result.
Under the terms of a five-year moratorium agreed by the insurance industry in October 2001, you can apply for a total of up to £500,000 of life cover, and £300,000 of certain types of health insurance without having to tell the insurer the results of any predictive genetic test you have previously taken.
An insurance company cannot ask you to take a genetic test.
The Code of Practice on Genetic Testing form the Association of British Insurers states that “applicants must not be asked to undergo a genetic test in order to obtain insurance.”
You only need to tell the insurer about tests approved by the government’s Genetics and Insurance Committee (GAIC).
So far, only Huntingdon’s Diseases has a test specifically approved by GAIC.
Volunteering for a research study that includes genetic testing will not affect future applications for insurance.
Insurers don’t want to know about the results of genetic tests taken as part of a research study. They are only interested in the results of genetic tests taken as part of your medical care, and then, only if the test has been approved by GAIC.
You do not have to tell your insurer if you take a genetic test after having bought insurance.
Once your insurance policy has started, you do not need to tell the insurer about the results of any genetic test you take later on for as long as that policy stays in force.
You do not have to tell an insurer if one of your relatives has taken a genetic test.
The Code forbids insurers from using the genetic test result of a relative when looking at an application from you, and vice versa. But if the insurer asks, you will need to tell them about any illnesses that run in your family. You must give the insurer any information about current or previous illnesses you or your family members have had if it is requested on the application form
This “deal” lasts until November 200l. What happens afterwards?
The moratorium was introduced to provide a breathing space, during which the industry, the Government, and other interested groups can discuss and agree on a sensible long term solution. These discussions are ongoing, and the outcome is not clear as yet.
Where can you get more information from?
There are three main websites that I can point you to that have interesting information:
Genetics and Insurance Committee (GAIC)
Genetic Interest Group
GiG is an umbrella group that represent the interests of all those affected by, or at risk of, genetic disorders.
Association of British Insurers
Finally...
I swear this is a true story: almost exactly a year ago, I started to get a severe pain in my right lung and also in my back, at about the same height. For days the pain would not go away and I was paralysed by indecision: should I go and do something about it?
I thought it was lung cancer and, in my stupidity, refused to see a doctor because I told myself that I wanted to obtain as much life and critical insurance cover as I could beforehand.
After all, I reasoned, if the disease has not yet been diagnosed, the insurer would not be able to turn down any claim from me on the grounds that this was a pre-existing illness.
In the end, I realised I was a complete idiot. I didn’t bother with any extra insurance and simply went to the doctor – who promptly diagnosed the problem as a mild case of shingles, painful but definitely not terminal. In fact, it disappeared within three weeks.
The moral of the story is two-fold:
1. If you need cover against any eventuality, don’t waste time. Just do it now.
2. If you think you have or are likely to have a physical problem that might be detected or cured by some form of genetic exam, forget about insurance and take the test. Now.
More articles by Nic Cicutti:
20 ways to save money now
Get paid for not working
How to buy that dream home abroad
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Please note that articles on MSN Money do not constitute regulated financial advice, which recommends a course of action based upon the specifics of your personal circumstances. The articles are intended to provide general personal financial information. We urge you to consult an Independent Financial Adviser (IFA) before making any important decisions about your finances. Call 0800 085 3250 for details of IFAs in your local area or click here to search online. Any statement regarding financial services products and tax liability is based on legislation and tax practices as at 1 January 2004, which is, of course, subject to change.The value of any tax benefits or reliefs depends upon the individual circumstances of the investor.When investment performance is mentioned you should remember that past performance is no guarantee of future performance. Where products have an underlying investment content, in many cases the value of the investment can fall as well as rise. For with-profit based investments, there is no guarantee as to the level of bonuses that will be declared, if any. Where mortgages or secured loans are explained do remember that your home is at risk if you do not keep up repayments on a mortgage or other loan secured on it. All mortgages are subject to underwriting, status and are not available to people under the age of 18.
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