(c) Insurers may request that existing genetic test results be made available to the insurer for the purposes of classifying risk. However, there are no specific provisions to protect against genetic discrimination. This will result in cross-subsidization of the high-risk policyholder by other low-risk policyholders. A person interested in submitting the costs of testing may wish to contact his or her insurance company beforehand to ask about coverage. Despite the stance of the OPC, the recent motion passed by the CMA, and the Industry Code adopted by the CLHIA, there are presently no laws in Canada that specifically address the use of genetic test results by insurance companies. Genetic Testing Information for Insurance Underwriting, CLHIA , 2015, available online at in How can consumers be sure a genetic test is valid and useful? Users with questions about a personal health condition should consult with a qualified healthcare professional. Now that we have discussed the basics of how insurance arrangements work, let's put it in context. English and It will be much more than what the insurers can be expected to absorb without a very substantial increase in premium rates for term insurance. The common practice in the industry is to ask for new applicants to submit results of genetic tests only if they have already gone through such tests. For these reasons, the OPC has concluded that the use of genetic test results by insurance companies is neither necessary nor efficient. It is hard to predict if an individual will fall sick or die in a given year. Under GINA, it is unlawful for health insurance companies to request or require an individual to complete a genetic test or purchase genetic information for liability purposes.¹ Health insurance companies are only permitted to request genetic results to verify the necessity of a procedure or treatment that has been billed; in that case, they are allowed to have minimal information to know … The OPC's argument is structured around two themes: discrimination and privacy. Also in August, 2015 the Canadian Life and Health Insurance Association (CLHIA) developed an Industry Code as part of its updated position on how genetic test results are used in risk selection and insurance underwriting. How does genetic testing in a research setting differ from clinical genetic testing? In broad terms, GINA prohibits employers from using genetic information for hiring or compensation purposes and insurance companies from using genetic information to make underwriting decisions with respect to health insurance. Therefore, while discussing the possibility of genetic tests with patients, physicians may want to consider the effects that the test results may have on their eligibility for insurance or insurance premiums, among other things. Please enable scripts and reload this page. Genes In Life discusses insurance coverage and reimbursement for genetic testing. Genetics Home Reference content now can be found in the "Genetics" section of MedlinePlus. 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. Learn more. As most of these privacy laws were passed before genetic testing became accessible, they do not specifically define what constitutes genetic information, nor do they provide any guidance on how such information should be protected. These rules mean that disclosure of genetic test results of any family members (e.g. As discussed above, genetic testing could have broader implications than medical diagnosis. Instead, they may opt to pay out-of-pocket for the test. According to the OPC, the insurance industry has failed to establish that genetic information is necessary and efficient for the purpose of pricing risk accurately and avoiding antiselection. for more information.). With the existing knowledge and technology, the contribution of multiple genes, relative to other factors, in causing an illness cannot be established accurately. 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 based on genetic testing. What are the benefits and risks of direct-to-consumer genetic testing? (DM 5-67)." What are the benefits of genetic testing? How is direct-to-consumer genetic testing done? In turn, this information could be used to affect decisions regarding employment and insurance. What Can I Do If I Am Told I Am Uninsurable? What are the risks and limitations of genetic testing? However, any caution or advice that physicians may provide should be consistent with the prevailing practice guidelines.​​. Obtain as much coverage as possible through your employer's group insurance plan, Obtain as much coverage as possible through your spouse's employer's group insurance plan, Convert your group policy to an individual policy, if permitted to do so, Purchase guaranteed/simplified issue insurance, Purchase a "second or last-to-die" policy, Statement on the Use of Genetic Test Results by Life and Health Insurance Companies, Office of the Privacy Commissioner of Canada, July 2014, Genetic Testing and Privacy, Privacy Commissioner of Canada, 1995, Genetic Information, the Life and Health Insurance Industry and the Protection of Personal Information: Framing the Debate, Office of the Privacy Commissioner of Canada, December 2012, The Potential Economic Impact of a Ban on the Use of Genetic Information for Life and Health Insurance, Office of the Privacy Commissioner of Canada (Michael Hoy and Maureen Durnin), March 2012, The Actuarial Relevance of Genetic Information in the Life and Health Insurance Context (Angus Macdonald, Department of Actuarial Mathematics and Statistics and the Maxwell Institute for Mathematical Sciences, Heriot-Watt University, Edinburgh, Scotland), Office of the Privacy Commissioner of Canada, July 2011, Genetic Testing Model: If Underwriters Had No Access to Known Results, Report to Canadian Institute of Actuaries Research Committee, Robert C.W. How do I choose a direct-to-consumer genetic testing company? Can a direct-to-consumer genetic test tell me whether I will develop cancer? What is noninvasive prenatal testing (NIPT) and what disorders can it screen for? Assess the health rating that your insurer assigned to you. Get tested if you feel there is value to you. The study also concluded that the rates for traditional permanent insurance would also rise but to a lesser extent than term insurance. What you will learn from the test results may allow you to make better healthcare and lifestyle choices. If yes, consider applying for new coverage and terminate the existing one after the new policy has been issued and accepted. How much does direct-to-consumer genetic testing cost, and is it covered by health insurance? Howard (FCIA, FSA), July 2014, Statement on Genetic Testing and Insurance, Canadian Institute of Actuaries, June 2014, Statement on Genetic Testing and Insurance, Canadian Institute of Actuaries, November 2000, Canadian Life and Health Insurers Limit Use of Genetic Test Results, Jacqueline Nelson, The Globe and Mail, September 25, 2014, Debate Over Use of Genetic Tests in Insurance Heats Up, Jacqueline Nelson, The Globe and Mail, November 2, 2014, Health Insurance and 'Genetic Discrimination': Are Rules Needed?, Carly Weeks, The Globe and Mail, January 1, 2012, Home DNA Tests May Affect Insurance, Employment – Marketplace Investigation Finds No Protection for Canadians Against Discrimination Based on DNA Tests, Megan Griffith-Greene, CBC News, April 2, 2015, Insurance Companies Shouldn't Seek Genetic Test Results, Says Privacy Watchdog, Steve Rennie, The Canadian Press, July 10, 2014, Study Finds Genetic Discrimination by Insurance Firms, Joseph Hall, The Toronto Star, June 9, 2009, About Genetic Discrimination, Canadian Coalition for Genetic Fairness, 2009, Genetic Testing – New Options, New Obligations,The Canadian Medical Protective Association, September 2013, Genetic Discrimination: Australian Experiences and Policies, GeneWatch, The Council for Responsible Genetics (Kristine Barlow-Stewart, Ph.D.), 2009, Genetic Discrimination and Canadian Law, Library of Parliament Background Paper, Julian Walker (Legal and Social Affairs Division, Parliamentary Information and Research Service), September 16, 2014, Summary of Provisions on Genetic Discrimination in other Jurisdictions. What are secondary findings from genetic testing? What kinds of direct-to-consumer genetic tests are available? The vast majority of diseases are multifactorial, i.e. For risk pooling to work effectively, an applicant and the insurer must have the same information about the applicant's risks in order for the applicant to be assigned to the appropriate pool and charged the appropriate premium. 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. Genetics Home Reference content now can be found in the "Genetics" section of MedlinePlus. Insurers often require applicants to disclose their family's health history as a means to assess risk.