The Risk of Anti-Selection in Protection Business from Advances in Statistical Genetics

RGA’s Global Research and Data Analytics team has produced a series of webcasts to explore the following topics:

• The tremendous growth in direct-to-consumer genetic testing and the potential for genetic anti-selection in protection insurance: View webcast
• The latest research on genetic predisposition to disease and polygenic risk scores: View webcast
• A groundbreaking research study by RGA and King’s College London investigating the importance of genetic information to predict morbidity and mortality outcomes: View webcast 
• How advances in genomic medicine and affordable direct-to-consumer genetic testing might increase anti-selection in the protection industry: View webcast 

Executive Summary:

During the past decade, significant progression in genetics research has allowed scientists and clinicians to explore the human genome in incredible detail. When coupled with the ever-decreasing cost of DNA sequencing, the era of genomic medicine can now be considered truly underway. Genomics has the potential to transform all aspects of medicine, including prevention of disease manifestation, accurate diagnosis and prognosis of disease, pharmacogenomics, and motivating lifestyle changes to improve health. This will almost certainly lead to improvements in mortality and longevity, which will be positive for the life insurance industry and for society as a whole.

One area of focus in this series of webcasts is the growing risk of genetic anti-selection, in part due to the huge surge in direct-to-consumer genetic testing. With results from a groundbreaking research collaboration between RGA and King’s College London, we demonstrate that knowledge of common genetic variants, not the rare high-penetrance gene mutations studied in insurance to date (e.g. BRCA, Huntington’s), provides powerful risk information that is largely additive to normal underwriting risk factors. This means that traditional underwriting measures do not capture the complete morbidity and mortality risk of applicants, and are unlikely to guard against the increasing possibility of anti-selection.

We conclude that advances in the use of genetics to predict morbidity and mortality outcomes remains an emerging risk issue for the insurance industry; the industry must continue to monitor and contribute to research on both the scientific advances and consumer behaviours that underlie the potential impact.