title: Life insurance: genomic stratification and risk classification.
abstract: With the development and increasing accessibility of new genomic tools such as next-generation sequencing, genome-wide association studies, and genomic stratification models, the debate on genetic discrimination in the context of life insurance became even more complex, requiring a review of current practices and the exploration of new scenarios. In this perspective, a multidisciplinary group of international experts representing different interests revisited the genetics and life insurance debate during a 2-day symposium 'Life insurance: breast cancer research and genetic risk prediction seminar' held in Quebec City, Canada on 24 and 25 September 2012. Having reviewed the current legal, social, and ethical issues on the use of genomic information in the context of life insurance, the Expert Group identified four main questions: (1) Have recent developments in genomics and related sciences changed the contours of the genetics and life insurance debate? (2) Are genomic results obtained in a research context relevant for life insurance underwriting? (3) Should predictive risk assessment and risk stratification models based on genomic data also be used for life insurance underwriting? (4) What positive actions could stakeholders in the debate take to alleviate concerns over the use of genomic information by life insurance underwriters? This paper presents a summary of the discussions and the specific action items recommended by the Expert Group.
authors.affiliation: Center of Genomics and Policy, McGill University, Montreal, QC, Canada.
authors.forename: Yann
authors.initials: Y
authors.lastname: Joly
authors.affiliation: PHG Foundation, Cambridge, UK.
authors.forename: Hilary
authors.initials: H
authors.lastname: Burton
authors.affiliation: Center of Genomics and Policy, McGill University, Montreal, QC, Canada.
authors.forename: Bartha Maria
authors.initials: BM
authors.lastname: Knoppers
authors.affiliation: Center of Genomics and Policy, McGill University, Montreal, QC, Canada.
authors.forename: Ida Ngueng
authors.initials: IN
authors.lastname: Feze
authors.affiliation: PHG Foundation, Cambridge, UK.
authors.forename: Tom
authors.initials: T
authors.lastname: Dent
authors.affiliation: University College London, London, UK.
authors.forename: Nora
authors.initials: N
authors.lastname: Pashayan
authors.affiliation: PHG Foundation, Cambridge, UK.
authors.forename: Susmita
authors.initials: S
authors.lastname: Chowdhury
authors.affiliation: Center of Genomics and Policy, McGill University, Montreal, QC, Canada.
authors.forename: William
authors.initials: W
authors.lastname: Foulkes
authors.affiliation: PHG Foundation, Cambridge, UK.
authors.forename: Alison
authors.initials: A
authors.lastname: Hall
authors.affiliation: Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada.
authors.forename: Pavel
authors.initials: P
authors.lastname: Hamet
authors.affiliation: Association of British Insurers, London, UK.
authors.forename: Nick
authors.initials: N
authors.lastname: Kirwan
authors.affiliation: Heriot-Watt University, Edinburgh, UK.
authors.forename: Angus
authors.initials: A
authors.lastname: Macdonald
authors.affiliation: Laval University, Quebec City, QC, Canada.
authors.forename: Jacques
authors.initials: J
authors.lastname: Simard
authors.affiliation: Maastricht University, Maastricht, The Netherlands.
authors.forename: Ine
authors.initials: I
authors.lastname: Van Hoyweghen
mesh_terms: D002170:Canada; D005820:Genetic Testing / Q000941:ethics / Q000331:legislation & jurisprudence; D055106:Genome-Wide Association Study; D023281:Genomics; D006801:Humans; D007352:Insurance, Life / Q000941:ethics / Q000331:legislation & jurisprudence; D018570:Risk Assessment / Q000331:legislation & jurisprudence