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Genetics and insurance in the UK Dr Mark BaleDeputy Director of Scientific Development and Bioethics Department of Health UK 精品文档 UK background National Insurance systems account for majority of healthcare insurance, small private health insurance market Large private life and health insurance market Life insurance (often mortgage linked) Critical illness Income protection Based on mutuality requires a proposers accurate disclosure of relevant information and a fair actuarial assessment. Insurance contracts on this basis are said to reflect the utmost good faith (uberrima fides) Debate of ‘fairness’ prompted by AIDS/HIV testing in mid-1980’s Human Genome Project and ELSI debate extended this to genetic information Insurers expected disclosure; clinicians and patients experienced over-emphasis on predictive nature of genetic tests Parliament and advisory groups recognised need for independent scrutiny of material relevance of genetic test results 精品文档 Historical context Mid-1990 debate about disclosure of genetic test results 1999 Genetics and Insurance Committee Industry-backed Code of Practice 2000 GAIC approved HD for life insurance 2001 Parliamentary debates and recommendations from HGC 2001 5-year Moratorium announced, with stronger GAIC 2005 extended Moratorium plus Concordat 2007 Government consultation on Single Equality Bill 2008 Operational review of concordat 精品文档 Genetics and Insurance Committee Independent committee, chaired by Prof. David Johns, including genetics experts, insurers and patient representatives. Evaluates specific proposals from insurers to use genetic tests for particular types of insurance; Reports to Ministers on compliance by the industry with the recommendations of GAIC; Provides independent wide ranging oversight of how insurers are using genetic tests, including compliance with the concordat and moratorium Considers complaints from insurance applicants about the way an insurance company has dealt with their application. 精
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