Insurance underwriting in the genetic era.

Genetic technology is assuming a greater role in the practice of medicine. Insurers have a vested interest because individually underwritten insurance cannot be sold without risk classification, and much of the medical information needed to classify risks will have a genetic component. This paper reviews recent genetic advances and their potential impact on life, disability income, long-term care, and critical illness insurance. Alzheimer disease is chosen to illustrate the effect of an organized effort to withhold medical information from insurance companies. Consumers will not support a private insurance mechanism with extensive cross-subsidization among policyholders and where medical information becomes inviolate simply because it is genetic. A framework for deliberations with the medical community is proposed.