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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