Genetic test results cannot be used for insurance.
Would you like to have an uncomplicated genetic test so that you can know your chances of developing lung cancer at the age of 50? If this test result will be used in your insurance underwriting, will you agree? I’m afraid it depends on the result.
Genetic testing, which sounds like a high-tech means, is actually not far from people. Many insurance companies have tried to "buy insurance to send genetic testing". However, there are two sides to everything. Perhaps, because you carry a highly pathogenic gene of a disease, you will pay special attention to or buy a health insurance. But perhaps, the results of genetic tests will affect the rate at which you buy insurance — — Even if you carry a highly diseased gene, it will not break out for a lifetime.
This week, the China Insurance Regulatory Commission revised the management measures for health insurance, and is in the period of soliciting opinions. It is mentioned for the first time that when an insurance company sells health insurance products, it is not allowed to illegally collect and obtain genetic information and genetic testing data of the insured except family medical history; Nor may the applicant be required to provide it. An insurance company shall not take genetic information and genetic testing data other than the family medical history of the insured as underwriting conditions.
Buying insurance and testing genes is a double-edged sword.
As we all know, suffering from diseases has a considerable relationship with the genes carried by human beings. In the past, genetic testing was regarded as a great technology, far from ordinary people. Now, you only need your saliva or a very small amount of blood to detect more than 50 diseases, including cancer, cardiovascular disease, Alzheimer’s disease and other gene-related diseases stipulated by the official critical illness insurance. The cost is only about 5,000 to 20,000 yuan. Even if you only look at a certain disease, the price of genetic testing can be achieved within 1,000 yuan.
In the era of big data, genetic testing is of unusual significance to insurance companies. Many insurance companies have cooperated with testing institutions to reduce the original expensive expenses so that ordinary people can also do genetic testing. This kind of "buy insurance and send genetic testing" product has been controversial since it entered the market. Among them, it involves not only ethics and privacy, but also policies and regulations.
For insurance companies, obtaining the genetic information related to the insured’s disease will make the level of risk controllable. For the insured, on the one hand, they want to know their genetic status, so as to judge whether to buy an insurance; On the other hand, they are worried that if the insurance company obtains its own genetic information, it will be refused insurance or raise the premium.
Genetic testing is a gray area.
You only need to scrape the epidermis on your mouth to know your risk probability of breast cancer in the future. This kind of "buy insurance and send genetic testing" is an innovative insurance, and it is also the initial stage of cooperation between insurance institutions and genetic testing institutions. The greater significance behind it is that genes containing a lot of body information are the most coveted big data in the insurance industry as a whole, and insurance companies can make more accurate risk pricing based on this database.
The person in charge of a large domestic life insurance company explained the genetic testing as follows: genetic testing can be used as the starting point of health management, and can provide targeted follow-up health management services according to the test results of customers. The results of genetic testing determine what kind of health services will be provided to customers in the future, and at the same time, a huge amount of health data can be obtained. At the same time, more accurate pricing can also be completed. However, to a certain extent, this is the adverse choice of insurance companies, and the principle of good faith has always been mutual.
The person in charge of this life insurance company told the reporter that a related case was reported abroad. A woman bought long-term care insurance after she found that the genetic test for the risk of Alzheimer’s disease was positive. Previously, the insurance company had tested her memory three times, and no abnormality was found in the genetic test.
If you are forced to test your genes, your concerns about the insured are more obvious. In addition to refusing insurance, privacy also has to be worried.
The new regulations prohibit the use of genetic testing for insurance.
China has always been in a vague area for genetic testing to be used in insurance. The new health insurance regulations in the consultation period explicitly mention for the first time: insurance companies selling health insurance products shall not illegally collect and obtain genetic information and genetic testing data of the insured except family medical history; Nor may the applicant be required to provide it. An insurance company shall not take genetic information and genetic testing data other than the family medical history of the insured as underwriting conditions.
Xia Ruxue, deputy general manager of the actuarial and big data department of Ping An Health Insurance, said that this move can completely block some companies or products from illegally collecting and obtaining the genetic information and genetic testing materials of the insured except family medical history in the name of genetic testing, or using genetic testing as a gimmick. "If the new regulations are officially promulgated, the related genetic testing insurance products on the market may undergo a wave of compliance adjustment".
The reporter learned that in many countries, whether genetic testing can be used for insurance has been controversial for many years. In order to minimize the negative impact of genetic testing technology on insurance, many countries have passed corresponding laws to guide it. Some countries prohibit the use of genetic testing results to some extent, some do not intervene, and some have a discussion period for several years before the laws are really passed, thus protecting both the insured and the insured, and safeguarding the interests of insurance companies.
What changes will the new health insurance regulations bring?
■ Long-term health insurance rates may be adjusted.
"Insurance companies can float the short-term health insurance rate, and the range does not exceed 30% of the benchmark rate; The insurance company may stipulate in the insurance products that the rate of long-term health insurance products shall be adjusted, and clearly indicate the trigger conditions for the rate adjustment. " This provision in the Opinion Draft means that it is possible to adjust the rate of long-term health insurance in the future.
The so-called long-term health insurance mainly refers to two products: one is health insurance with an insurance period of more than one year, and the other is health insurance with a guarantee renewal clause, although the insurance period does not exceed one year.
Guaranteed renewal clause refers to a contract in which the applicant applies for renewal of insurance before the expiration of the previous insurance period, and the insurance company must continue to underwrite according to the original clause and the agreed rate. To put it simply, the insurance company promises that the insured will underwrite according to the original terms and agreed rates every time he renews his insurance.
At present, the long-term health insurance rate is unchanged. In terms of critical illness insurance, consumers have bought a long-term critical illness insurance, and the premium paid every year is the same. According to the new regulations, if the rate of long-term health insurance can be adjusted, it means that the annual premium paid by consumers may be different, and it may rise in the future.
■ Information sharing between insurance companies and medical institutions
One of the highlights of the exposure draft is to increase the content of cooperation between health management services and medical insurance, encourage insurance companies to combine health insurance products with health management services, provide health risk assessment and intervention, and provide services such as disease prevention, health examination, health consultation, health maintenance, chronic disease management and health care, so as to reduce health risks and disease losses.
However, the exposure draft makes it clear that "health insurance products provide health management services, and their shared costs shall not exceed 20% of the net insurance premium". Services exceeding the above limits shall be priced separately, not included in the insurance premium, and the price of health management services shall be clearly stated in the contract.
According to the exposure draft, under the premise of fully protecting customer privacy and data security, insurance companies are encouraged to realize information interconnection and data sharing with medical institutions and basic medical insurance departments. In this regard, some professionals pointed out that breaking data barriers is an urgent task for insurance companies to cooperate in medical insurance business. With the subsequent information interconnection and data sharing, medical insurance and commercial insurance cooperation may have more to do.
Our reporter Fu Yang