How Genetic Testing Can Influence Life Insurance Decisions
Life insurance underwriting starts with health and lifestyle information
When someone applies for life insurance, the insurer typically evaluates health-related information to decide whether to offer coverage and, if so, at what price. The goal of this process is to align the cost of the policy with the level of risk the insurer believes it is taking on. In practice, that means applicants are commonly asked to complete a health survey that covers medical history and lifestyle factors.
These application questions can include whether a person smokes and whether they take part in hobbies considered risky. Alongside these self-reported details, insurers may also consider other indicators that can influence risk, such as age and gender. Some underwriting reviews can also include information that is not strictly medical, including driving history, as part of a broader effort to understand risk.
Within that overall health-and-risk evaluation, genetic information can become relevant. Genetics can reflect the possibility of developing certain serious medical issues, and insurers may use that information in their assessment. However, genetic data is only one part of what insurers may consider, and it can potentially work in an applicant’s favor if the results and the rest of the medical picture indicate good health.
Why DNA can matter to life insurers
DNA contains information that can be associated with the potential for future medical conditions. In an underwriting context, genetic test results may be used as one more data point to statistically predict the likelihood that an applicant could develop a medical issue that might shorten life expectancy.
Depending on what a genetic test suggests, insurers may respond in several ways. The results could contribute to a higher premium for the same amount of coverage. They could lead to limits on how much coverage an insurer is willing to provide. In some cases, certain conditions may preclude someone from receiving life insurance coverage at all.
At the same time, genetic information does not automatically point in a negative direction. If a genetic profile contains no concerning findings, it may support qualification for lower premiums, particularly when the rest of the medical record and lifestyle information also reflect a healthy overall picture. In other words, genetic testing can be viewed by insurers as either a risk signal or a reassuring indicator, depending on what is found and how it fits with other underwriting factors.
How insurers may obtain genetic test information
Life insurance companies are not medical providers, and they cannot order an applicant to take a genetic test. However, insurers may still be able to access genetic test results in a few ways during the underwriting process.
Through medical records: As part of applying for life insurance, an applicant may be asked to authorize access to medical records. If a doctor previously ordered genetic testing and the results are in those records, the insurer could see them as part of the file it reviews.
Through data providers: Genetic test data may also be accessed through data providers who buy it from at-home DNA test providers.
By requesting it from the applicant: An insurer may ask an applicant to provide genetic test information during the application process.
HIPAA regulations require life insurers to obtain permission to access health information gathered by doctors. Access rules can also vary by state. Only a few states, including Florida and Illinois, prohibit life insurance companies from accessing direct-to-consumer test results without the applicant’s permission.
Genetic information is not the only factor in underwriting
Even when genetic testing is part of the underwriting picture, it is not the only consideration. Insurers may also look at existing health conditions, including diabetes and high blood pressure. Underwriting can incorporate a range of personal and behavioral factors as well, such as age, gender, hobbies, and driving record.
This broader context matters because genetic information is not necessarily a complete forecast of health outcomes. A genetic test may indicate elevated risk, but it does not automatically determine what will happen. Underwriting decisions, however, may still be influenced by how insurers interpret statistical risk and how they incorporate genetic findings into their models.
Legal protections: health insurance versus life insurance
In the United States, insurers are barred from using genetic information to determine health insurance coverage due to the Genetic Information Nondiscrimination Act (GINA) of 2008. However, that protection applies to health insurance and does not extend to other categories of insurance.
Life insurance, disability insurance, and long-term care insurance are not bound by GINA in the same way health insurance is. As a result, genetic information can play a role in life insurance underwriting, even though it cannot be used to set health insurance coverage terms.
Concerns raised about using genetic data in life insurance
A review published in January 2021 examined risks associated with using genetic information in life insurance underwriting. The review discussed how allowing insurers to use genetic test results can create downstream effects for American workers, in part through dynamics tied to risk and decision-making around insurance.
One concept discussed in this context is “adverse selection.” Adverse selection refers to the idea that people who believe they have a higher risk of death may be more likely to apply for life insurance or to seek higher coverage amounts. From an insurer’s perspective, this can increase financial risk because the pool of applicants may include a higher proportion of people who expect to need the benefit sooner.
However, adverse selection is not the only issue. Genetics does not guarantee outcomes, and using genetic information as a sole determinant may overlook important realities. For example, mutations in the BRCA1 and BRCA2 genes are associated with breast cancer risk. But denying or limiting life insurance coverage based only on a BRCA1 or BRCA2 mutation does not account for individuals who take preventive measures against developing breast cancer or who might never develop it.
Another concern is that fear of genetic discrimination may influence behavior. If people worry that genetic test results could lead to employment discrimination or affect their ability to obtain certain types of insurance, they may decide to avoid genetic testing. In addition, some may opt to forgo life insurance rather than take a genetic test, reflecting how the perceived consequences of genetic information can shape personal decisions.
Situations where genetic tests may not be considered
Not every life insurance pathway involves the same level of medical scrutiny. In many cases, insurers will not consider genetic tests, such as when a person obtains group life insurance through an employer. Group life insurance policies are typically “guaranteed issue,” meaning coverage is provided without requiring a medical exam or the disclosure of genetic test results.
It may also be possible to purchase a guaranteed issue policy independently. These policies can provide a route to coverage when a person wants to avoid medical underwriting. However, there can be trade-offs. Guaranteed issue policies may come with higher premiums or lower coverage amounts than standard life insurance policies.
Privacy and control of genetic test information
For applicants who have used direct-to-consumer DNA testing, privacy questions can be complicated. If someone uses a self-testing kit, that information might be shared with third-party commercial organizations. Some large direct-to-consumer testing companies state that they will not share individualized genetic information with insurance companies, and they may offer ways for users to delete personal information. The specific steps depend on each company’s privacy policies.
Still, privacy options can be limited when genetic testing is ordered by a doctor. If a doctor-ordered genetic test appears in a medical record, there may be little to prevent an insurer from accessing that information during underwriting, because granting access to medical records is a standard part of applying for life insurance (except in cases such as guaranteed issue policies).
Given these realities, people considering genetic testing may want to think carefully about how results are stored and where they might appear. The distinction between a direct-to-consumer test and a test ordered by a doctor can matter, particularly because medical records are commonly reviewed in underwriting.
Practical steps applicants can take
While applicants may not be able to fully control how genetic information is used in life insurance underwriting under current rules, there are steps that can help them better understand what information insurers may see and what options exist.
Understand what the application process requests: Life insurance applications typically require a health survey and may include authorization to access medical records. Knowing what you are agreeing to can help clarify what information may be reviewed.
Consider whether guaranteed issue coverage fits your needs: Group life insurance through work is commonly guaranteed issue, and some guaranteed issue policies can be purchased independently. These options can avoid medical exams and genetic test disclosures, but they may involve higher premiums or lower coverage amounts.
Review privacy policies for direct-to-consumer testing: Some companies offer methods to delete personal information, and the details are typically described in their privacy policies.
Request your underwriting file from the Medical Information Bureau (MIB): To see what medical information insurance companies may have, you can request your file from the MIB, a database of underwriting information used by insurers. It functions like a credit report but for health. You can request it once a year for free and dispute errors if you find them.
Balancing risk assessment with real-world health outcomes
Life insurers use underwriting to estimate risk, and genetic information can be part of that estimation. But genetic results do not necessarily reflect the full picture of an individual’s health trajectory. Preventive measures, ongoing medical care, and the fact that some risks never materialize can complicate how genetic findings translate into real-world outcomes.
From an applicant’s standpoint, this can create uncertainty: a genetic marker may influence premiums or eligibility even when a person is otherwise healthy or taking steps to reduce risk. At the same time, genetic information may also support favorable pricing when it aligns with a strong overall health profile.
The broader debate includes questions about fairness, privacy, and how genetic information should be treated across different insurance products. Under current law, genetic information is protected in the health insurance context, but not in life insurance, disability insurance, or long-term care insurance. Some advocates have argued for expanding protections so that genetic test results are not used in life insurance underwriting.
What to keep in mind before applying
Applying for life insurance generally involves sharing health and lifestyle information, and genetic testing can become part of that process if results are available to insurers through medical records, data providers, or direct requests. The impact can range from lower premiums to higher rates, coverage limitations, or denial, depending on the findings and the insurer’s underwriting approach.
For people who want coverage without extensive medical review, guaranteed issue policies—especially those offered through employers—may provide an alternative, though often with cost or coverage trade-offs. For those navigating underwriting, reviewing what information insurers may have on file through the MIB can help ensure accuracy and provide a clearer view of what is being considered.
Ultimately, genetic information is one factor among many in life insurance underwriting. Understanding how it may be accessed and used can help applicants make informed choices about testing, privacy, and the type of policy that best fits their financial needs.