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Anti-Selection & Genetic Testing in Insurance: An Interdisciplinary Perspective

Published online by Cambridge University Press:  04 March 2022

Abstract

Anti-selection occurs when information asymmetry exists between insurers and applicants. When an applicant knows they are at high risk of loss, but the insurer does not, the applicant may try to use this knowledge differential to secure insurance at a lower premium that does not match risk.

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Independent Articles
Copyright
© 2022 The Author(s)

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References

Rothstein, M., “Time to End the Use of Genetic Test Results in Life Insurance Underwriting,” Journal of Law, Medicine & Ethics 46, no. 3 (2018): 794801, at 797.CrossRefGoogle ScholarPubMed
Berry, R., “The Human Genome Project and the End of Insurance,” University of Florida Journal of Law and Public Policy 7, no. 2 (1996): 205-56, at 205; R. Strohmenger and A. Wambach, “Adverse Selection and Categorical Discrimination in the Health Insurance Markets: The Effects of Genetic Tests,” Journal of Health Economics 19 (200): 197-218.Google ScholarPubMed
Akerlof, G., “The Market for ‘Lemons’: Quality Uncertainty and the Market Mechanism,” Quarterly Journal of Economics 84, no. 3 (1970): 488500, at 84.CrossRefGoogle Scholar
Hendren, N., “Private Information and Insurance Rejections,” Econometrica 81, no. 5 (2013): 17131762.Google ScholarPubMed
Cutler, D.M. and Reber, S.J., “Paying for Health Insurance: The Trade-Off between Competition and Adverse Selection,” The Quarterly Journal of Economics 113, no. 2 (1998): 433466.CrossRefGoogle Scholar
Durnin, M. and Hoy, M., “Third Party Sharing of Genetic Information,” in Hostiuc, S., ed., Clinical Ethics at the Crossroads of Genetic and Reproductive Technologies (Academic Press, 2018): at 385406.Google Scholar
Roy, D. and Dorak, M. Tevfik, Environmental Factors, Genes, and Development of Human Cancers (New York: Springer, 2010): 1520.CrossRefGoogle Scholar
Otlowski, M., Taylor, S., and Bombard, Y., “Genetic Discrimination: International Perspectives,” Annual Review of Genomics and Human Genetics 13 (2012): 433454, available at <https://www.annualreviews.org/doi/full/10.1146/annurev-genom-090711-163800?url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub%3Dpubmed> (last visited November 2, 2021).CrossRefGoogle ScholarPubMed
Nill, A., Laczniak, G., and Thistle, P., “The Use of Genetic Testing Information in the Insurance Industry: An Ethical and Societal Analysis of Public Policy Options,” Journal of Business Ethics 156, no. 1 (2019): 105121.CrossRefGoogle Scholar
Joly, Y., Baker, M., and Huynh, M., “Genetic Discrimination in Private Insurance: Global Perspectives,” New Genetics and Society 29, no. 4 (2010): 351368; A. Wauters and I. Van Hoyweghen, “Concerns about Genetic Discrimination after Regulation: A Qualitative Study of the Situation Regarding BRCA and Huntington’s Disease in Belgium,” Laws 7 (2018): 17; Otlowski et al., supra note 8.CrossRefGoogle Scholar
Dep’t of Health & Social Care, “Concordat and Moratorium on Genetics and Insurance,” Her Majesty’s Government and Association of British Insurers,” UK 2004, available at <https://www.abi.org.uk/globalassets/sitecore/files/documents/publications/public/2014/genetics/concordat-and-moratorium-on-genetics-and-insurance.pdf> (last visited November 2, 2021).+(last+visited+November+2,+2021).>Google Scholar
Otlowski et al., supra note 8.Google Scholar
Stirton, R., “Insurance, Genetic Information and the Future of Industry Self-Regulation in the UK,” Law, Innovation and Technology 4, no. 2 (2012): 212-237 at 212.CrossRefGoogle Scholar
Daykin, C.D. et al., “Genetics and Insurance–Some Social Policy Issues,” British Actuarial Journal 9, no. 4 (2003): 787830, at 815.CrossRefGoogle Scholar
Tiller, J., Otlowski, M., and Lacaze, P., “Should Australia Ban the Use of Genetic Test Results in Life Insurance?Frontiers in Public Health 5 (2017): 330, available at <https://www.frontiersin.org/articles/10.3389/fpubh.2017.00330/full> (last visited November 2, 2021).CrossRefGoogle ScholarPubMed
Financial Services Council, FSC Standard No. 11: Moratorium on Genetic Tests in Life Insurance, June 21, 2019, available at <https://www.fsc.org.au/resources-category/standard/1779-standard-11-moratorium-on-genetic-tests-in-life-insurance/file> (last visited November 2, 2021).+(last+visited+November+2,+2021).>Google Scholar
Financial Services Council, “Genetic Tests and Applying for Life Insurance – Key Facts,” available at <https://www.fsc.org.au/resources-category/publication/1785-moratorium-key-facts/file> (last visited November 2, 2021).+(last+visited+November+2,+2021).>Google Scholar
Genetic Non-Discrimination Act, S.C. 2017, C 3, available at <https://laws-lois.justice.gc.ca/PDF/G-2.5.pdf> (last visited November 2, 2021).+(last+visited+November+2,+2021).>Google Scholar
Lombardo, M., “The Impact of Genetic Testing on Life Insurance Mortality,” Society of Actuaries, 2018, available at <https://www.soa.org/globalassets/assets/files/resources/research-report/2018/2018-impact-genetic-testing-report.pdf> (last visited November 2, 2021).+(last+visited+November+2,+2021).>Google Scholar
Canadian Coal. for Genetic Fairness v. Attorney Gen. of Can., 2020 SCC 17 (Can.), available at <https://decisions.scc-csc.ca/scc-csc/scc-csc/en/item/18417/index.do> (last visited November 2, 2021).+(last+visited+November+2,+2021).>Google Scholar
Prince, A. and Waterstone, M., “The Genetic Information Nondiscrimination Act (GINA) of 2008,” in Quinn, G., Paor, A. De, Blanck, P., eds., Genetic Discrimination: Transatlantic Perspectives on the Case for a European-level Response (New York: Routledge, 2015): at 114.Google Scholar
Roberts, J., “The Genetic Information Non Discrimination Act as an Antidiscrimination Law,” Notre Dame Law Review 86, no. 2 (2011): 597648, at 597; S. Baruch and K. Hudson, “Civilian and Military Genetics: Nondiscrimination Policy in a Post- GINA World,” American Journal of Human Genetics 83, no. 4 (2008): 435-444, at 435.Google Scholar
Wolf, L., Brown, E., Kerr, R., Razick, G., Tanner, G., Duvall, B., Jones, S., Brackney, J., and Posada, T., “The Web of Legal Protections for Participants in Genomic Research,” Health Matrix 29 (2019): 1112.Google ScholarPubMed
Golinghorst, D. and Prince, A., “A survey of U. S. State Insurance Commissioners Concerning Genetic Testing and Life Insurance: Redux at 27,” Journal of Genetic Counseling 29 (2020): 928935.CrossRefGoogle ScholarPubMed
Lewis, A., Green, R., and Prince, A., “Long-Awaited Progress in Addressing Genetic Discrimination in the United States,” Genetics in Medicine (2020): 13.CrossRefGoogle Scholar
Disability Act 2005 (Act No. 14 Part 4/2005) (Ir.), available at < http://www.irishstatutebook.ie/eli/2005/act/14/section/41/enacted/en/html#part4> (last visited November 2, 2021).+(last+visited+November+2,+2021).>Google Scholar
Disability Act 2005 (Act No. 14 § 42/2005)(Ir.), available at <http://www.irishstatutebook.ie/eli/2005/act/14/section/42/enacted/en/html> (last visited November 1, 2021).+(last+visited+November+1,+2021).>Google Scholar
de Paor, A., “Direct to Consumer Genetic Testing – Law and Policy Concerns in Ireland,” Irish Journal of Medical Science 189, no. 3 (2018): 575584, at 579.CrossRefGoogle Scholar
de Paor, A., “The Irish Legislative Response to Genetic Discrimination – An Analysis of Part 4 of the Disability Act 2005: Time for Reform?Dublin University Law Journal 38 (2015): 129156, at 141–142.Google Scholar
Id., at 144.Google Scholar
Regulation (EU) 2016/679 of the European Parliament and of the Council of 27 April 2016 on the Protection of Natural Persons with Regard to the Processing of Personal Data and on the Free Movement of such Data, and Repealing Directive 95/46/EC, 2016 O.J. (L 119) 1.Google Scholar
de Paor, supra note 30.Google Scholar
Avraham, R., Logue, K., and Schwarcz, D., “Towards a Universal Framework for Insurance Anti-Discrimination Laws,” Connecticut Insurance Law Journal 21 (2014): 152, at 8; M. Hoy and M. Ruse, “Regulating Genetic Information in Insurance Markets,” Risk Management and Insurance Review 8, no. 2 (2007): 211-237, at 214.Google Scholar
Association of British Insurers and Department of Health and Social Care, Her Majesty’s Government, Guidance: Code on genetic testing and insurance (October 23, 2018), available at <https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/751230/code-on-genetic-testing-and-insurance.pdf> (last visited November 2, 2021).+(last+visited+November+2,+2021).>Google Scholar
Macdonald, A., “Genetics and Insurance: What Have We Learned So Far?Scandinavian Actuarial Journal (2003): 324348.CrossRefGoogle Scholar
Falconer, D.S., ed., Introduction to Quantitative Genetics (Pearson Education Limited, 1996).Google Scholar
Hacariz, O., Kleinow, T., and Macdonald, A., “Genetics, Insurance and Hypertrophic Cardiomyopathy,” Scandinavian Actuarial Journal (2020): 128.Google Scholar
Macdonald, A. and Yu, F., “The Impact of Genetics on Insurance: Conclusions from the ‘Bottom-up’ Modelling Programme,” ASTIN Bulletin 41 (2011): 343376.Google Scholar
Howard, R., Report to Canadian Institute of Actuaries Research Committee, Genetic Testing Model: If Underwriters Had No Access to Known Results, Document 214082 (July 10, 2014), available at <http://cia-ica.ca/docs/default-source/2014/214082e.pdf> (last visited November 2, 2021).+(last+visited+November+2,+2021).>Google Scholar
Crocker, K. and Snow, A., “The Efficiency of Competitive Equilibria in Insurance Markets with Asymmetric Information,” Journal of Public Economics 26, no. 2 (1985): 207219.CrossRefGoogle Scholar
Rothschild, C., “The Efficiency of Categorical Discrimination in Insurance Markets,” Journal of Risk and Insurance 78, no. 2 (2011): 267285.CrossRefGoogle Scholar
Hoy, M. and Durnin, M., “The Potential Economic Impact of a Ban on the Use of Genetic Information for Life and Health Insurance,” Office of the Privacy Commissioner of Canada (2012).Google Scholar
Hoy, M., “Categorizing Risk in the Insurance Industry,” Quarterly Journal of Economics 97, no. 2 (1982): 321336; M. Hoy, “Risk Classification and Social Welfare,” The Geneva Papers on Risk and Insurance – Issues and Practice 31 (2006): 245-269.CrossRefGoogle Scholar
Thomas, G., “Book Review: Loss Coverage,” The Actuary, November, 29, 2017, at 5, available at <https://onlinelibrary.wiley.com/doi/full/10.1111/jori.12262> (last visited November 2, 2021).+(last+visited+November+2,+2021).>Google Scholar
Doherty, N. and Thistle, P., “Adverse Selection with Endogenous Information in Insurance Markets,” Journal of Public Economics 63, no. 1 (1996): 83102.CrossRefGoogle Scholar
Dionne, G. and Rothschild, C., “Economic Effects of Risk Classification Bans,” Geneva Risk and Insurance Review 39 (2014): 184221; Strohmenger and Wambach, supra note 2.Google Scholar
Hoel, M., Iversen, T., Nilssen, T., and Vislie, J., “Genetic Testing in Competitive Insurance Markets with Repulsion From Chance: A Welfare Analysis,” Journal of Health Economics 25, no. 5 (2006): 847860.CrossRefGoogle Scholar
Doherty, N. and Posey, L., “On the Value of a Checkup: Adverse Selection, Moral Hazard and the Value of Information,” Journal of Risk and Insurance 65, no. 2 (1998): 189211; F. Barigozzi and D. Henriet, “Genetic Information: Comparing Alternative Regulatory Approaches When Prevention Matters,” Journal of Public Economic Theory 13, no. 1 (2011): 23-46; R. Peter, A. Richter, and P. Thistle, “Endogenous Information, Adverse Selection, and Prevention: Implications for Genetic Testing Policy,” Journal of Health Economics 55 (2017): 95-107.CrossRefGoogle Scholar
Posey, L. and Thistle, P., “Genetic Testing and Genetic Discrimination: Public Policy When Insurance Becomes ‘Too Expensive,’Journal of Health Economics 77 (2021): 102441.CrossRefGoogle ScholarPubMed
Hoy, M. and Polborn, M., “The Value of Genetic Information in the Life Insurance Market,” Journal of Public Economics 78, no. 3 (2000): 235252.CrossRefGoogle Scholar
Polborn, M., Hoy, M., and Sadanand, A., “Advantageous Effects of Regulatory Adverse Selection in the Life Insurance Market,” Economic Journal 116, no. 508 (2006): 327354.CrossRefGoogle Scholar
Subramanian, K., Lemare, J., Hershey, J., Pauly, M., Armstrong, K., and Asch, D., “Estimating Adverse Selection Costs from Genetic Testing for Breast and Ovarian Cancer: The Case of Life Insurance,” Journal of Risk and Insurance 66, no. 4 (1999): 531550, available at <https://www.jstor.org/stable/253862?casa_token=01CdUvEx9f4AAAAA:1g8cDicHN9PXZvHJ3jaHXoSvANrSwW7C9y2bZZv-0uuHh1HUC21-iVP8U3S2BeK_kAjuQdBYa3oGJf6hMV8SwgSXpecqYCiw9hhkporrHCLdd-0PD1U5&seq=1#metadata_info_tab_contents> (last visited November 3, 2021).CrossRefGoogle Scholar
Hoy, M. and Witt, J., “Welfare Effects of Banning Genetic Information in the Life Insurance Market: The Case of BRCA 1/2 Genes,” Journal of Risk and Insurance 74, no. 3 (2007): 523546.CrossRefGoogle Scholar
Viswanathan, K., Lemaire, J., Withers, K., Armstrong, K., Baumritter, A., Hershey, J., Pauly, M., and Asch, D., “Adverse Selection in Term Life Insurance Purchasing Due to the BRCA 1/2 Genetic Test and Elastic Demand,” Journal of Risk and Insurance 74, no. 1 (2007): 6586.CrossRefGoogle Scholar
Howard, supra note 40.Google Scholar
Lombardo, supra note 20.Google Scholar
Armstrong, K., Weber, B., FitzGerald, G., Hershey, J., Pauly, M., Lemaire, J., Subramanian, K., and Asch, D., “Life Insurance and Breast Cancer Risk Assessment: Adverse Selection, Genetic Testing Decisions, and Discrimination,” American Journal of Medical Genetics 120A, no. 3 (2003): 359364, available at <https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajmg.a.20025> (last visited November 3, 2021).CrossRefGoogle ScholarPubMed
Zick, C., Smith, K., Mayer, R., and Botkin, J., “Genetic Testing, Adverse Selection, and the Demand for Life Insurance,” American Journal of Medical Genetics 93, no. 1 (2000): 2939, available at <https://doi.org/10.1002/1096-8628(20000703)93:1<29::AID-AJMG6>3.0.CO;2-K> (last visited November 3, 2021).3.0.CO;2-K>CrossRefGoogle ScholarPubMed
Oster, E., Shoulson, I., Quaid, K., and Dorsey, E., “Genetic Adverse Selection: Evidence from Long-Term Care Insurance and Huntington Disease,” Journal of Public Economics 94, no. 11-12 (2010): 10411050, available at <https://www.sciencedirect.com/science/article/abs/pii/S0047272710000745> (last visited November 3, 2021).CrossRefGoogle Scholar
Zick, C.D., Mathews, C.J., Roberts, J.S., Cook-Deegan, R., Pokorski, R.J., and Green, R.C., “Genetic Testing for Alzheimer’s Disease and its Impact on Insurance Purchasing Behavior,” Health Affairs 24, no. 2 (2005): 483490.CrossRefGoogle ScholarPubMed
Van Oostrom, I. et al., “The Common Sense Model of Self-Regulation and Psychological Adjustment to Predictive Genetic Testing: A Prospective Study,” Psycho-Oncology 16, no. 12 (2007): 11211129.CrossRefGoogle ScholarPubMed
Id.; McClelland, M., Feldhof, J., Morrison, F., Gestsdottir, S., Cameron, C. et al., “Self-Regulation,” in Halfon, N., Forrest, C., Lerner, R., and Faustman, E., eds., Handbook of Life Course Health Development (New York: Springer, 2018): 275298; C. Cameron et al., “Self-Regulation Principles Underlying Risk Perception and Decision Making within the Context of Genomic Testing,” Social and Personal Psychology Compass (2017).CrossRefGoogle Scholar
McClelland et al., supra note 67, at 275-298; Golman, R., Hagmann, D., and Loewenstein, G., “Information Avoidance,” Journal of Economic Literature 55, no. 1 (2017): 96135.CrossRefGoogle Scholar
McClelland et al., supra note 67, at 275-298; Heck, P. R. and Meyer, M.N., “Information Avoidance in Genetic Health: Perceptions, Norms, and Preferences,” Social Cognition 37 (2019): 266293; D. O. Case, J. E. Andrews, J. D.Johnson, and S. L. Allard, “Avoiding Versus Seeking: The Relationship of Information Seeking to Avoidance, Blunting, Coping, Dissonance, and Related Concepts,” Journal of the Medical Library Association, no. 93 (2005): 353.CrossRefGoogle Scholar
Taber, J. M., Klein, W.M., Ferrer, R.A., Lewis, K.L., Harris, P.R., Shepperd, J.A., and Biesecker, L.G., “Information Avoidance Tendencies, Threat Management Resources, and Interest in Genetic Sequencing Feedback,” Annals of Behavioral Medicine 49 (2015): 616621.CrossRefGoogle ScholarPubMed
Caplin, A. and Leahy, J., “The Supply of Information by a Concerned Expert,” Economic Journal 114, no. 497 (2004): 487505; B. Kőszegi, “Health Anxiety and Patient Behavior,” Journal of Health Economics 22, no. 6 (2003): 1073-1084; A. Caplin and K. Eliaz, “Aids Policy and Psychology: A Mechanism-Design Approach,” RAND Journal of Economics 34, no. 4 (2003): 631-646.CrossRefGoogle Scholar
Hoy, M., Peter, R., and Richter, A., “Take-Up for Genetic Tests and Ambiguity,” Journal of Risk and Uncertainty 48 (2014): 111133.CrossRefGoogle Scholar
Meiser, B. and Dunn, S., “Psychological Impact of Genetic Testing for Huntington’s Disease: An Update of the Literature,” Journal of Neurology, Neurosurgery and Psychiatry 69, no. 5 (2000): 574578.CrossRefGoogle ScholarPubMed
Oster, E., Shoulson, I., and Dorsey, E., “Optimal Expectations and Limited Medical Testing: Evidence from Huntington Disease,” American Economic Review 103, no. 2 (2013): 804830.CrossRefGoogle Scholar
Schwartz, M.D., et al., “Randomized Noninferiority Trial of Telephone Versus In-Person Genetic Counseling for Hereditary Breast and Ovarian Cancer,” Journal of Clinical Oncology 32, no. 7 (2014): 618626.CrossRefGoogle ScholarPubMed
Desai, S. and Jena, A., “Do Celebrity Endorsements Matter? Observational Study of BRCA Gene Testing and Mastectomy Rates After Angelina Jolie’s New York Times Editorial,” British Medical Journal 355, note 6357 (2016): 14.Google ScholarPubMed
Fagerlin, A., Zikmund-Fisher, B., and Ubel, P., “Helping Patients Decide: Ten Steps to Better Risk Communication,” Journal of the National Cancer Institute 103 (2011): 14361443.CrossRefGoogle ScholarPubMed
Davis, K., Roter, D., Schmidlen, T., Scheinfeldt, L., and Klein, W., “Testing a Best Practices Risk Result Format to Communicate Genetic Risks,” Patient Education & Counseling no. 103 (2020): 18.Google Scholar
Oster et al., supra note 62.Google Scholar
Otlowski, M., Stranger, M., and Taylor, S., “Practices and Attitudes of Australian Employers in Relation to the Use of Genetic Information: Report on a National Study,” Comparative Labor Law and Policy Journal 31, no. 4 (2010): 637691, at 638; A. de Paor and N. Lowndes, “Tracing the History, Evolution and Future of Genetic Science and Technology,” in G. Quinn, A. de Paor and P. Blanck, eds., Genetic Discrimination: Transatlantic Perspectives on the Case for a European Level Legal Response (London: Routledge, 2014): 11-35; Roy and Tevfik Dorak, supra note 7; C. Diver and J. Maslow Cohen, “Genophobia: What Is Wrong with Genetic Discrimination?” University of Pennsylvania 149, no. 5 (2001): 1439-1482, at 1440, 1451.Google Scholar
de Paor, A. and O’Mahony, C., “The Need to Protect Employees with Genetic Predisposition to Mental Illness? The UN Convention on the Rights of Persons with Disabilities and the Case for Regulation,” Industrial Law Journal 45, no. 4 (2016): 525555.CrossRefGoogle Scholar
Lervasi, K., “Life Insurance Cost: What’s the Average Cost of Life Insurance?” Finder, available at <https://www.finder.com/average-cost-of-life-insurance#learn> (last visited November 3, 2021).+(last+visited+November+3,+2021).>Google Scholar
The Price of Life Insurance (in Canada), Ratehub, available at <https://www.ratehub.ca/insurance/life/cost-of-life-insurance> (last visited November 3, 2021).+(last+visited+November+3,+2021).>Google Scholar
Laycock, R., “How Much Is Life Insurance?” Finder AU, available at <https://www.finder.com.au/weekly-cost-life-insurance> (last visited November 3, 2021).+(last+visited+November+3,+2021).>Google Scholar
US – 22% of families have no savings. T. Knutson, “Nielsen: Even Many High Earners Live Paycheck to Paycheck,” Financial Advisor, August 6, 2015, available at <https://www.fa-mag.com/news/nielsen--even-many-high-earners-live-paycheck-to-paycheck-22704.html?mod=article_inline> (last visited November 3, 2021); Canada – 53%: “BDO Canada Affordability Index 2019,” available at <https://debtsolutions.bdo.ca/our-people/bdo-in-the-news/bdo-canada-affordability-index-2019/>; Australia – 40%: “Household Financial Comfort Dragged Down by Residential Property Price Falls and Weakening Labour Market,” Members Equity Bank Limited, August 12, 2019, available at <https://www.mebank.com.au/news/household-financial-comfort-dragged-down/> (last visited November 3, 2021); UK – 31%: “Almost One Third of British Workers Live Paycheck to Paycheck, CareerBuilder.co.uk Survey Finds,” CareerBuilder UK, October 8, 2015, available at <https://hiring.careerbuilder.co.uk/news/almost-one-third-of-british-workers-live-paycheck-to-paycheck-careerbuilder.co.uk-survey-finds> (last visited November 3, 2021).+(last+visited+November+3,+2021);+Canada+–+53%:+“BDO+Canada+Affordability+Index+2019,”+available+at+;+Australia+–+40%:+“Household+Financial+Comfort+Dragged+Down+by+Residential+Property+Price+Falls+and+Weakening+Labour+Market,”+Members+Equity+Bank+Limited,+August+12,+2019,+available+at++(last+visited+November+3,+2021);+UK+–+31%:+“Almost+One+Third+of+British+Workers+Live+Paycheck+to+Paycheck,+CareerBuilder.co.uk+Survey+Finds,”+CareerBuilder+UK,+October+8,+2015,+available+at++(last+visited+November+3,+2021).>Google Scholar
Bruzelius, E., Scarpa, J., Zhao, Y., Basu, S., Faghmous, J., and Baum, A., “Huntington’s Disease in the United States: Variation by Demographic and Socioeconomic Factors,” Movement Disorders 34 (2019): 858865.CrossRefGoogle ScholarPubMed
LIMRA, “Facts from LIMRA: Life Insurance Awareness Month, September 2014,” 2014, available at <https://www.limra.com/siteassets/newsroom/fact-tank/fact-sheets/limras-facts-about-life-2014> (last visited November 3, 2021).+(last+visited+November+3,+2021).>Google Scholar
OECD, Improving Financial Education and Awareness on Insurance and Private Pensions (Paris: OECD Publishing 2008): at 40, available at <https://www-oecd-ilibrary-org.proxy.lib.uiowa.edu/docserver/9789264046399-en.pdf?expires=1588022075&id=id&accname=ocid177074&checksum=22070F15E7CB14DC171FF379F044DFDE> (access restricted).+(access+restricted).>Google Scholar
Gottlieb, D., “Prospect Theory, Life Insurance, and Annuities,” Working Paper No. 44, Department of Busisness & Public Policy, Univeristy of PennSylvania, 2012, available at < https://cpb-us-w2.wpmucdn.com/sites.wustl.edu/dist/c/547/files/2016/11/PT-Life-Insurance-and-Annuities-2g3rcto.pdf> (last visited November 3, 2021).+(last+visited+November+3,+2021).>Google Scholar
Bernheim, B., Forni, L., Gokhale, J., and Kotlikoff, L., “The Mismatch between Life Insurance and Financial Vulnerabilities: Evidence from the Health and Retirement Survey,” American Economic Review 93, no. 1 (2003): 354365.CrossRefGoogle Scholar
Balasubramanian, R., Chester, A., and Milinkovich, N., “Rewriting the Rules: Digital and AI-powered Underwriting in Life Insurance,” McKinsey & Company, July 31, 2020, available at <https://www.mckinsey.com/industries/financial-services/our-insights/rewriting-the-rules-digital-and-ai-powered-underwriting-in-life-insurance#> (last visited November 3, 2021).+(last+visited+November+3,+2021).>Google Scholar
Lusardi, A. and Mitchell, O., “Financial Literacy around the World: An Overview,” Journal of Pension Economics and Finance 10 (2011): 497508.CrossRefGoogle ScholarPubMed
Brinkman, R., Dubé, M., Rouleau, G., and Orr, A., “Human Monogenic Disorders — A Source of Novel Drug Targets,” Nature Reviews Genetics 7, no. 4 (2006): 249260.CrossRefGoogle ScholarPubMed
Gutierrez, M. and Macdonald, A., “Huntington’s Disease, Critical Illness Insurance and Life Insurance,” Scandinavian Actuarial Journal (2004): 279313.Google Scholar
Joly, Y., Dupras, C., Pinkesz, M., Tovino, S., and Rothstein, M., “Looking Beyond GINA: Policy Approaches to Address Genetic Discrimination,” Annual Review GINA: Policy Approaches to Address Genetic Discrimination 21 (2020): 491507.Google ScholarPubMed
Association of British Insurers and Department of Health and Social Care, Her Majesty’s Government, supra note 35.Google Scholar
Genetic Non-Discrimination Act, supra note 18.Google Scholar
Lane, M., Ngueng, I., and Joly, Y., “Genetics and Personal Insurance: The Perspectives of Canadian Cancer Genetic Counselors,” Journal of Genetic Counseling 24 (2015): 10221036.CrossRefGoogle ScholarPubMed
Rupe, S., “Half of Consumers Think Life Insurance Not Relevant: AALU Survey,” Insurance News Net, November 6, 2019, available at <https://insurancenewsnet.com/innarticle/half-of-consumers-think-life-insurance-not-relevant-aalu-survey#.XqdL32hKg2x> (last visited November 3, 2021)+(last+visited+November+3,+2021)>Google Scholar
Howard, supra note 40.Google Scholar
Canadian Institute of Actuaries, Statement on Genetic Testing and Insurance, Document 214073 (June 2014), available at <https://www.cia-ica.ca/docs/default-source/2014/214073e.pdf> (last visited November 3, 2021).+(last+visited+November+3,+2021).>Google Scholar
Sheridan, M., “The STOLI Worm: A Practitioner’s Guide to Managing Life Settlements and Micro Longevity Risk,” (2019); Braun, A. and Xu, J., “Fair Value Measurement in the Life Settlement Market,Journal of Fixed Income 29 (2020): 100123.Google Scholar
Haçariz, O., Kleinow, T., Macdonald, A., Tapadar, P., and Thomas, R., “Will Genetic Test Results Be Monetized in Life Insurance?Risk Management and Insurance Review 23 (2020): 379399.CrossRefGoogle Scholar
See Doherty, N. and Singer, H., “The Benefits of a Secondary Market for Life Insurance Policies,” Real Property, Probate and Trust Journal 38 (2003): 449478; Sheridan, supra note 103.Google Scholar
Durant, J. et al., “Public Understanding of the New Genetics,” in Marteau, T. and Richards, M., eds., The Troubled Helix: Social and Psychological Implications of the New Human Genetics (Cambridge: Cambridge University Press 1996): at 235248; D. Allain, S. Friedman, and L. Senter, “Consumer Awareness and Attitudes about Insurance Discrimination Post Enactment of the Genetic Information Nondiscrimination Act,” Familial Cancer 11, no. 4 (2012): 637- 644.CrossRefGoogle Scholar
Kung, J. and Wu, C.T., “Leveling the Playing Field: Closing the Gap in Public Awareness of Genetics between the Well Served and Underserved,” Hastings Center Report 46, no. 5 (2016): 1720.CrossRefGoogle ScholarPubMed
de Paor, A., Genetics, Disability and the Law – Towards a European Union Legal Framework (Cambridge: Cambridge University Press, 2017): at 289.CrossRefGoogle Scholar
U.N.E.S.C.O., International Declaration on Human Genetic Data, at Article 24 (Oct. 16, 2003); U.N.E.S.C.O., Universal Declaration on Bioethics and Human Rights, at Article 25 (Oct. 19, 2005); U.N. Convention on the Rights of Persons with Disabilities, Article 8, U.N. Doc. A/RES/61/106 (Dec. 13, 2006).Google Scholar
Joly, Y. et al., “Establishing the Genetic Discrimination Observatory,” Nature Genetics 52 (2020): 466468.CrossRefGoogle ScholarPubMed
de Paor, supra note 109, at 289.Google Scholar
Prince, A., “Comprehensive Protection of Genetic Information One Size Privacy of Property Models May Not Fit All,” Brooklyn Law Review 79, no. 1 (2013): 175228.Google Scholar