Select Committee on Science and Technology Minutes of Evidence



Letter to Ms Mary Francis, Director General, Association of British Insurers, from Mr Keith Bedell-Pearce, Director, Prudential plc, following the evidence session of 7 February

GENETIC TESTING AND INSURANCE

  As you know, I gave evidence last Wednesday to the Select Committee on Science and Technology, along with representatives from CGNU and CIS, on genetic testing and insurance.

  The discussion at the Committee reinforced what had already become apparent to me during the preparation for giving evidence, namely, that the insurance industry, primarily through the development and implementation of the ABI code of conduct in this area, was essentially correct in terms of a need to balance public sensitivities with underwriting prudence. However, it was also apparent that it was in danger of falling at the last hurdle because of poor communication and a failure to recognise that what might appear to be of little or no relevance from an industry point of view might be hugely important in terms of public perception, particularly where there is influence by a media that has not yet fully engaged in the technical complexities of what is involved.

  Some of the points of detail which I now think need to be addressed by the relevant Committees within the ABI are as follows:

    1.  The point of greatest concern about the current Code of Practice is the deterrent effect that these genetic tests by insurers might have on people contemplating having a test. This is particularly sensitive as one of the three conditions submitted for GAIC approval, breast cancer arising from the mutation of the BRCA1 and BRCA2 genes can be addressed to some degree by prophylactic action. No doubt other accurate and predictive tests will emerge in time, potentially affecting a higher proportion of the population and I therefore think it is extremely important that alternative insurance arrangements are put in place on a pooled basis, certainly for life cover, so that the disincentive to take a test because of uninsurability is minimised.

    2.   The Committee asked why the industry hadn't undertaken research about public opinion on genetic testing and insurance. I pointed out to the Committee that this would be a difficult research study to undertake as, on an uniformed basis, one would intuitively expect the majority of the public to be against it. Such research, however, could be carried out on at least a partially informed basis and perhaps this is something that would best be carried out under the direction and control of the GAIC, albeit funded by the insurance industry.

    3.   The use of, as yet GAIC unapproved, genetic tests (paragraphs 6 and 33 of the code refers) by some insurers was a matter which the Committee dwelt on at length. In my view, the continued use of unapproved tests is anomalous and the ABI should review its advice to members and the Code on this point. The Committee's concerns were heightened when they were told during the course of the committee meeting by one of their scientific advisers that Professor Raeburn, on whose advice the ABI was acting was also a member of the GAIC. Up to that point, I was unaware of this and whilst I rebutted allegations of impropriety made by members of the Committee, I don't think this is something where Professor Raeburn can continue to run with the hare and hunt with the hounds. Indeed, in such circumstances, I am now concerned that if the GAIC does approve the use of genetic tests in the two outstanding conditions before them, these approvals may be seen as somehow tainted.

    4.   On the broader front of communications, I believe that insurance companies, and Prudential is no exception, could do far better in communicating their position on genetic testing, particularly in relation to what is contained on material supplied with application forms. Prudential will be undertaking an immediate review of this area as part of our ongoing focus on simplification. Similarly, I would hope the industry would feel able to take a much more proactive stance on communicating how it is handling the use of genetic testing and, in doing so, remove some of the mystery and mystique that surrounds both insurance and genetic testing itself.

    5.   The Committee expressly asked the three witnesses to request that the ABI clarify the position in relation to genetic tests carried out for research purposes. The view of all three giving evidence was that these tests should be excluded from consideration of underwriting results. The only qualification that I would add is that, subject to the scientific validity of the test, insurance companies may take into account negative tests where these are volunteered by the proposer.

  No doubt the Committee will publish its own set of comments and recommendations but it would be helpful if the relevant committees of the ABI could act immediately on at least some of the points mentioned above in anticipation of the Committee's report.

12 February 2001




 
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