Published 24 May 2024 | 13 min read

Genetic testing has emerged as a powerful healthcare tool, offering insights regarding individuals’ predispositions for a variety of diseases and conditions. We ask experts for their insights into the potential benefits, ethical considerations, and practical implications of genetic testing for life insurance.

As the healthcare landscape evolves, life insurance companies are increasingly considering the integration of genetic risk data to tailor their services to help drive a healthier and longer lifespan for all of their policyholders.

This subject was the focus of a recent webinar moderated by Cindy Hallberlin, Chief Ethics and Compliance officer with the Digital Health Institute for Transformation (DHIT), and featuring thought leaders Sir Peter Donnelly, CEO and Co-founder of Genomics PLC; Marc Giguere, President and CEO of Munich Re Life US; and Sears Merritt, Head of Enterprise Technology and Experience with MassMutual.

Hallberlin and the panel provided expert insights and perspective into the potential benefits, ethical considerations, and practical implications of this evolving trend.


Potential Benefits

Donnelly opened the session by making the case for genetic testing, tracing its transformation from focusing almost exclusively on rare conditions to providing insights about the common diseases responsible for most of the sickness and mortality across the globe.

“Until a few years ago, if I knew the entire DNA sequence of someone who is healthy, I'd learn something medically actionable in only about two percent of cases. That's because for most of its history, genetics in medicine has focused on very rare diseases caused by a single letter change in our DNA. Those diseases are typically very serious, but, thankfully, they're rare individually and collectively. And that's why it only impacts about two percent of people if we look at people who are currently healthy,” he said. “There's been a dramatic change over the last few years. It's now the case that if I have DNA information on someone who's healthy, I learn something medically actionable in about 70 percent of cases. The change from two percent to 70 percent is because we now know how to measure the genetic component of risk for all common diseases – for heart disease, diabetes, common cancers, breast cancer, prostate cancer, colon cancer, and so on.”

“There's been a dramatic change over the last few years. It's now the case that if I have DNA information on someone who's healthy, I learn something medically actionable in about 70 percent of cases."

There are millions of different positions in our DNA code that individually affect our risk for common diseases like cancer or heart disease. Donnelly noted that when this data is combined with algorithms, it can provide people with much more personalized and tailored health advice than the generic health advice they’re used to.

This opportunity is at the core of Genomics’ partnership with MassMutual. Policyholders are offered the opportunity of a genetic test. If they consent to a test and the order is approved by a physician, Genomics sends a saliva kit to their home and the policyholder returns the sample back to a lab via the mail. After the sample is processed, Genomics uses the genetic data to create a personalized report for the policyholder containing specific advice based on their risk of disease.

“It's a complete transformation in the way we can tailor prevention programs, both in terms of what we do as individuals and how we interact with our healthcare system,” said Donnelly. “We focus only on diseases where there are things you can do if you're at high risk, where there are either individual actions, your lifestyle, your diet, and in most cases, things you can do in connection with your healthcare system that will either act to prevent disease or reduce your risk or to catch it early.”

Sears said MassMutual’s motivation for such a partnership is simple.

“We want our policyholders to live as long as possible and have an exceptional health span so that they can have a happy, healthy, rewarding life,” he said. ”That's really what motivated us to begin exploring this space in the first place and begin to forge relationships with folks like Peter and Marc.”

Giguere from Munich Re echoed Sears’ sentiments and says that such partnerships can spur a true paradigm shift in the relationships between insurance companies, regulators, and policyholders.

“I’ve been in the industry a long time, and they used to say that the only times a life insurance company talks to you is when they issue the policy and when somebody dies. That's not true anymore,” he said. “Life insurance companies are a heavily regulated group, and we need to make sure that regulators understand that all we're trying to do is help people live better lives. I think more and more companies are looking into that, looking for ways that they can provide that and be educators for their policyholders.”


Privacy Considerations

Halfway through the conversation, the focus shifted to what Hallberlin called “the elephant in the room,” as she asked the panel to outline what they’re doing to prevent critical breaches in data privacy.

Donnelly explained that “maintaining the trust of the individuals we work with and whose data we have and being completely transparent about how we use that data” is “absolutely central” to Genomics’ mission as a company. He said it was great to learn that the vast majority of the individuals who’d been through the process had confidence that their data had been handled securely.

“We put a lot of effort into data protection, into having the right quality standards, and into cybersecurity protection,” he said. “We pass HIPAA and GDPR, which is a very high European standard for data. We're very transparent with individuals about what their data will and won't be used for before they sign up.”

While Sears noted that policyholders’ trust is absolutely central to the whole program, MassMutual doesn’t actually want or even need to access policyholders’ data in order to provide value to them.

“We never see any of this information,” he said. “All we want to do is make it available to our policyowners (so) they're more likely to take action, and they're more likely to figure out ways in which they can use it to increase their health span and longevity. That's the impact that we are trying to create.”

Despite Sears’ assertion that MassMutual doesn’t want or need policyholders’ genetic data – and Donnelly’s earlier comments that genetic testing is about helping people who already have life insurance policies, not deciding whether or not to insure new customers and what to charge them – Giguere noted that we are fast approaching a time when genetic testing will become so commonplace that, when a policyholder gets a concerning test result and consults their doctor about it, that information will then be part of their medical record, and, by extension, accessible by their insurance company. Giguere says that ongoing discussion and adaptation will be needed to define where privacy starts and where it ends.


Practical Implications

Later in the conversation, Hallberlin prompted the panelists to offer their perspectives of the benefits of genetic risk testing, as well as what they think they’ll look like five years from now.

Donnelly said he is incredibly excited about the positive impact these kinds of approaches can have. He then alluded to the rapid pace of progress in this area by recounting an entertaining exchange he had with a senior medical professional in the United States who lamented the current way health systems handle prevention.

“They measure risk all the time to work out who to put into screening programs, who to put into prevention programs. They do that in really clunky ways currently for many diseases. It’s just age. When you get to a certain age, screening starts,” he said. “And when he was thinking about this possibility, he looked at me and said, ‘Oh my God, we're going to look back at what we're doing now as doing medicine with leeches because we will have the possibility of actually doing personalized or precision medicine.’”

Giguere noted that in just the past two years, there has already been an impressive increase in the amount of information available for scoring patients’ risk for disease.

“We used to completely depend on people telling us their information. Maybe they forget to tell us about something,” he explained. “Now there is so much information out there that we can remind them and we can actually show that the combination, if you take this information from this provider and another test you did, if you put them together, that's not additive. It's multiplicative.”

Giguere then described what he’d like to see five years from now.

“I want people to say, ‘It's amazing how the life insurance industry brought all of this to the general population.’ Not the healthcare industry, which you would think would be an obvious pick. Maybe the employers, but the life insurance industry is making this accessible and then it will become commonplace in our health system and employer benefits.”

Sears expressed excitement not only for the future of genetic testing, but for the partnership with Genomics.

“I am very excited to continue the journey that we have started with Genomics. We've got some big ambitions for what we believe we can do together and the impact that that is going to have on our policyholders.”