The fundamental requirement of an insurance contract is that both the insurer and the applicant must deal in good faith and make full declaration of all material facts related to the risks being insured. An applicant withholding information so they can be assigned to a lower priced risk pool is not only cheating the insurance company, but they are also cheating other policyholders who may have to pay more premium to cover the costs of the fraud. Moreover, the OPC maintains, even if all genetic test results were 100% accurate and reliable (which is not the case), they would be helpful to insurers in only a limited number of cases. Other jurisdictions have responded in different ways. The resources on this site should not be used as a substitute for professional medical care or advice. For example, if you are in good health but were assigned to an average risk group due to family history of heart disease, genetic test results that show that you to be a better than average risk could help you get lower premiums on another policy. This will result in cross-subsidization of the high-risk policyholder by other low-risk policyholders. However, GINA does not cover life insurance, disability insurance or long-term care insurance. The vast majority of diseases are multifactorial, i.e. Regulating access to genetic information In August, 2015 the Canadian Medical Association passed the following motion: "The Canadian Medical Association urges the federal government to enact legislation prohibiting all forms of discrimination … Health insurance providers have different policies about which tests are covered, however. What kinds of direct-to-consumer genetic tests are available? However, any caution or advice that physicians may provide should be consistent with the prevailing practice guidelines.​​. An insurer that does not know about the applicant's genetic test results would issue the increased coverage, without realizing the high likelihood of an earlier claim. It is our practice to work with insurers that are members of CLHIA and follow the Industry Code recommended by CLHIA, however, we may work with other insurers in some very exceptional situations requiring specialised insurance. Assess the health rating that your insurer assigned to you. In contrast, several countries have prohibited, or introduced moratoria on, the use of genetic information by insurance companies. Can the results of direct-to-consumer genetic testing affect my ability to get insurance? Insurers often require applicants to disclose their family's health history as a means to assess risk. You may be trying to access this site from a secured browser on the server. But applicants are expected and required to disclose all test results—genetic or otherwise. It would also assign the applicant to a risk pool with lower premiums, which would be unfair to the other policyholders in the pool. This code – which constitutes a voluntary guideline for member companies – has three fundamental positions with respect to the use of genetic tests, consistant with what has already been mentioned: ​(a) Insurers will not initiate or require any applicant to undergo a genetic test as part of the process of applying for insurance. Private information, according to the OPC's privacy criteria, should only be collected if it can be shown that it is necessary for legitimate business purposes and efficient in accomplishing the task for which it is used. It maintains that there is little evidence to believe that results of genetic tests will result in significant antiselection. Will health insurance cover the costs of genetic testing? The Office of the Privacy Commissioner (OPC) of Canada disagrees with the CIA's report referenced above. It could affect a patient's eligibility for insurance or result in a significant increase in their insurance premium. Companies that offer these policies have the right to request medical information, including the results of any genetic testing, when making decisions about coverage and rates. How much does direct-to-consumer genetic testing cost, and is it covered by health insurance? The following are a few examples of how this is being applied: But employers and governments are not the only ones that use genetic information. Some of these companies request information about genetic testing as part of their application process, but others do not. English and It is possible that factors such as family history increased your premium (or rendered you uninsurable). What are the benefits and risks of direct-to-consumer genetic testing? (b) Insurers will not request genetic testing results where an applicant has undergone genetic testing for research purposes but did not receive the results. In the United Kingdom, the Association of British Insurers and the Government have agreed on a voluntary moratorium, recently extended to 2017, on the use of predictive genetic test results for life insurance policies under £500,000 or critical illness policies under £300,000.