Transcript Predictive testing and Insurance Law

PREDICTIVE TESTING
AND INSURANCE LAW
PREDICTIVE TESTING AND
INSURANCE LAW
Summary:
①
Predictive Tests
②
Insured Perspective
③
Insurers perspective
④
Legislation
PREDICTIVE TESTS
PREDICTIVE TESTS
Predictive genetic testing is the use of a genetic
test in an asymptomatic person to predict future
risk of disease.
The results of predictive and presymptomatic
testing can provide information about a person’s
risk of developing a specific disorder and help with
making decisions about medical care.
PREDICTIVE TESTS
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It was this ability to
prognosis,
PREDICTING
FUTURE RISKS and
diseases that aroused
the interest of
insurance companies
This kind of
information would
enable (insurers) to
evaluate more
effectively the insured
INSURED PERSPECTIVE
INSURED PERSPECTIVE
National Institute of Health (USA) made a
study about the reaction of people to the
possibility of the insurance companies have
access to their genetic data.
PEOPLE’S CONCERNS –
CONCLUSIONS

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Biggest concern: possibility of discrimination
considering that if Insurance companies had
access to this kind of information, they would
increase exponentially the premiums or even
exclude some people
Those who knew that probably would suffer from
a serious disease or ill, would buy all types of
insurances.
Almost everyone opposed to this be a compulsory
require to access insurance
DISCRIMINATION

Hypothesis:
Possibility of having someone healthy excluded of
insurance based on the results of a predictive
test.
Being that this
illness may not even
come to manifest
itself as it is a mere
probability
INSURED PERSPECTIVE
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Rise the question:
Can the insurance companies submit their
candidates to such tests?
INSURED PERSPECTIVE
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“ The main issue is in respecting the right of not
knowing. In this field of predictive genetic
testing, those types of information's can generate
greater emotional and psychological instability.”
– LUÍS ARCHER
The right of not-knowing should prevail over the
interest of the insurers.
INSURED PERSPECTIVE

And those who have taken predictive genetic
tests?
principle of good
faith and the duty
of information
all individuals who
have taken this
tests should reveal
the results to their
insures
INSURED PERSPECTIVE
TWO
CONSEQUENCES:
1. Discrimination based on the different
treatment of two clients with the same
genetic problem
2. Many people don't do it because they are
afraid of insures reaction
INSURED PERSPECTIVE

According to Prof Guilherme de Oliveira:
“ it's certain that the duty of information is essential
to the risk management, but it's also true that the
personal data given by the candidates to insurers is
already a VIOLATION OF THE PRINCIPLE OF
PRIVATE INTIMACY, and those information must
be reduced to the essential.”
INSURED PERSPECTIVE

The impact of predictive genetic results:
Genetic disease is
a condition that no
one can fight
against
Distressing for
the carrier of the
genetic disorder
and for his
family
PROTECTION OF PRIVACY AND
CONFIDENTIALITY IS FUNDAMENTAL
AND MUST BE KEPT AWAY FROM THIRD
PARTIES
INSURED PERSPECTIVE

Here discrimination is based on genetic
caracteristics and unlike the others this is not
visible to the “naked eye”
INSURERS PERSPECTIVE
INSURERS PERSPECTIVE
Insurance

“Economic product”
Consumers


Protect their own
economic future
Ensure the future of
those who depend on
him
INSURERS PERSPECTIVE
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Risk Evaluation
1.
Evaluate a number of factors (smoker, poor diet)
2.
That could influence and decrease average life
expectancy
Through this they calculate the premium
INSURERS PERSPECTIVE
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The more information
Insurers have about their
candidates
More precise and fair
the Premium will be!
INSURERS PERSPECTIVE
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Predictive genetic tests are extremely useful: fair
premiums and adequate to the insured’s reality
Insurers need to calculate properly the risks of
any candidate or else the prices will increase to
compensate all the unfair indemnities paid to
the less healthy
INSURERS PERSPECTIVE
THAT’S WHY DISCRIMINATION IS WHEN
TWO PEOPLE EQUAL ARE TREATED
DIFFERENTLY, OR IN OTHER WORDS,
WHEN TWO INSURED HAVE DIFFERENT
RISKS AND PAY THE SAME PRIZE.
INSURERS PERSPECTIVE

Use of predictive genetic tests to avoid “adverse
selection”
Adverse Selection
If individuals discover
that they are very likely
to suffer from a serious
disease, they might
purchase a Great deal of
insurance
LEGISLATION
LEGISLATION
Portugal

Law 12/2005
“Insurers cannot ask for predictive genetic tests
or use any type of genetic data to deny insurance
or establish higher premiums”
LEGISLATION
UNESCO
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Universal declaration of human genome and the
human rights (1997)
Article 6: “No one shall be subjected to
discrimination based on genetic characteristics that
is intended to infringe or has the effect of infringing
human rights, fundamental freedoms and human
dignity.”
Include genetics in the traditional concept of
DISCRIMINATION
LEGISLATION
Council of Europe

Convention on human rights and biomedicine (1997)
Article 12: Predictive genetic tests
Limits the use of genetic data to health or scientific
research. Insurers CANNOT USE THIS TYPE OF
DATA
LEGISLATION
Council of Europe

Convention on human rights and biomedicine (1997)
Article 12: Predictive genetic tests
“Tests which are predictive of genetic diseases or which
serve either to identify the subject as a carrier of a gene
responsible for a disease or to detect a genetic
predisposition or susceptibility to a disease may be
performed only for health purposes or for scientific
research linked to health purposes, and subject to
appropriate genetic counselling”.
LEGISLATION
WHO (World Health Organization)
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PROPOSED
GUIDELINES on ethical
issues in medical genetic on
genetic services (1998)
LEGISLATION
WHO (World Health Organization)
“ employers, insures, schools, government
agencies or other institutional third parties
SHOULD NOT BE GIVEN access to predictive
test results WITHOUT THE INDIVIDUAL’S
CONSENT in order to avoid discrimination”.
Consent must be VOLUNTARY
LEGISLATION
USA
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GINA – GENETIC INFORMATION NON
DISCRIMINATION ACT – TITLE 1
Since 2008
LEGISLATION
UK
Lasts
until
2014
“Moratorium”
PACT
INSURERS
ASSOCIATION (ABI)
GOVERNMENT
LEGISLATION
UK
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Main principles of the “MORATORIUM”:
1.
Applicants will not be asked to, nor be part under any
pressure to, undergo a predictive test in order to obtain
insurance.
2.
Insures may only take into account results of these predictive
genetic tests, that GAIC´s body (Genetic and insurance
Committee) as decided are technically, clinically, and
actuarially relevant.
3.
There must be no increase in the premiums or worsening in
the terms an Insurer offers, arising from such test, unless
GAIC as decided that an adverse predictive genetic result is
technically, clinically, and actuarially relevant for insurance
purpose.
LEGISLATION
UK

Exception:
if EXCEED 500000 pounds in
case of death
if EXCEED 300000 pounds in
case of critical disease
GAIC
AUTHORIZATI
ON