Family history of breast cancer and cost of life assurance: a test case comparison of current UK industry practice.

Under the current recently extended moratorium, applicants for life assurance need not disclose the results of predictive genetic tests.1 The exception is for policies exceeding certain values, when insurers may seek results of tests approved by the government's Genetics and Insurance Committee. The committee expects to receive applications for the use of adverse results from tests for the BRCA1 and BRCA2 genes. Currently, insurers may, and often do, seek family histories. Substantial epidemiological data describe the relative risks of developing breast cancer depending on family history and age.2 Preventive action for women at risk can include early enrolment on surveillance programmes and prophylactic surgery. Evidence is emerging for the benefits of the former,3 and evidence is strong for risk reduction by the latter.4 5 We surveyed 21 companies representing 100% of the reinsurance market and 68% of the life and pensions market in the United Kingdom. We asked the companies to assess a fictional proposal for a 20 year policy (paying benefit only on …