Genetics and Epigenetics in Health and Life Insurance

Al Klein April/May 2019

There are many genetic tests available today that can provide information on heredity and susceptibility to diseases. It is important to note that virtually all diseases have an environmental component to them. This means that just because one is more susceptible to a disease doesn’t mean they will get it, and if one is not susceptible to a disease, it doesn’t mean they won’t get it. Results can also provide information on medications. This is important for the insurance industry because if a drug works for a disease to which the individual is more susceptible, we should be less concerned. However, if a drug doesn’t work for a disease to which the individual is more susceptible, there might be more concern. Here, “works” means the person metabolizes the drug more quickly. For quick metabolizers, less than the normal dosage is likely needed. If the person can’t metabolize the drug, treatment can move immediately to another drug, without wasting time on one that doesn’t work.

In the United States, genetic testing is not allowed for health insurance underwriting, but it is not prohibited for life insurance underwriting. While many are afraid that insurance companies will use genetic information about an individual against them if they have access to it, I suggest the opposite is true—that insurance companies can help insureds with this information. As mentioned, a genetic test tells the diseases to which one is more or less susceptible. Health insurers want insureds to stay healthy, and life insurers want insureds to live longer. Therefore, as an industry, post-issue genetic tests can be used by the company to inform insureds how to extend healthy longevity, which is a win-win for everyone.

While genes never change, epigenetics changes over time based on one’s actions. Epigenetics is a methylation process that indicates gene expression. It provides the current state of genes and is driven by behaviors such as diet, exercise, smoking and medications. This too can be used to improve health and longevity.

Al Klein, FSA, MAAA, is a principal and consulting actuary at Milliman.

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