As discoveries within the field of genetics grow exponentially, the field's importance to insurance medicine continues to grow. In this Inside RGA interview, RGA Consultant Geneticist Dr. Sajel L. Kana, MD, FAAP, FACMG, describes her commitment to genetics and how she sees its role evolving for our industry.
In my genetics practice, I see a variety of patients –
prenatal,
fetal, pediatric, adult, and cancer-related. What I enjoy about
this field the most is that genetics is not only applicable to all aspects of medicine,
but also to many other disciplines, including life and health
insurance. I was initially drawn to the field during my pediatrics residency. I
found myself gravitating towards the most complex cases, looking for answers
and explanations for families who were burdened by unexplained and often
unexpected medical issues. The ability to make diagnoses and clarify the
outlook of some known conditions has been one of the most rewarding aspects of
my role in clinical genetics, which I have brought with me to insurance
medicine.
The rapid and substantial advances in genetic research and technology have made getting genetic testing increasingly common for individuals who wish to discover more about as well as understand their potential health risks. In terms of life and health insurance, a genetics consultant can help industry professionals grasp the implications of certain genetic variations on an applicant’s current and future health. It can also educate them, as they generally do not have a background in genetics, which will help them make more informed decisions. Genetics consultants can also provide education about the growing number of known genetic variations and mutations, how these can influence an individual's predisposition to certain genetic conditions, and the significant impact many of these variations/mutations can have on morbidity and mortality.
As genetic testing becomes more commonplace, opportunities will emerge for insurance companies to develop new products or services.
A genetics consultant can assist in the development of such products, providing the necessary expertise to ensure they are scientifically and ethically sound as well as beneficial to customers.
The responsible use of genetic information by health professionals and insurers is crucial to avoid unfair discrimination and ensure fair practices. This can be done through the development of and adherence to guidelines and policies to govern and ensure ethical and transparent use of genetic information. It is also prudent to obtain informed consent for the use of genetic information, and that the use of genetic information is limited to what is necessary for the decision-making process. Health professionals and insurance company underwriting, claims, and medical professionals should receive education and training about genetics, ethical issues, and legal regulations, to help ensure they understand the complexities of genetic information and are better equipped to use it responsibly. Some countries already have laws in place to prevent certain types of genetic discrimination: in the U.S, for example, the Genetic Information Nondiscrimination Act (GINA) specifically prohibits use of genetic information in health insurance. Given the rapid advancements in genetics and genomics, policies and practices related to the use of genetic information should be regularly reviewed and updated as necessary to reflect new knowledge and ethical considerations.
My responsibilities in this role include providing education
internally as well as representing RGA on the subject of genetics. I have
already been able to provide a more in-depth understanding of the genetic risks
that impact the health and lifespans of individuals seeking insurance coverage.
Going forward, I envision myself continuing to provide education and guidance
regarding genetic testing and genetic disorders and also providing insights
into the potential long-term genetics-related health risks within the insured
population.
I anticipate my role will also evolve to include discussions with regulatory bodies or industry groups about the use of genetic information in the insurance space, as the ethical and regulatory landscape around the use of genetic information continues to mature.
As the industry’s understanding of genetics deepens and broadens, we are likely to see innovative products developed and offered by insurance companies around the world.
The growth of genomics and
of personalized medicine could result in a more nuanced understanding of individual
risk. Geneticists will be instrumental in translating these developments into
practical applications for the insurance industry.
I would consider the future of genetic information use to be
full of potential for our industry and its customers, but it also faces ethical
and practical challenges. The key for our industry will be to balance the
advantages brought forth by the use of genetic information (such as more
accurate risk assessment and the potential for more personalized policies) with
the appetite to leverage it for consumer benefit while also respecting privacy
concerns.
The increased understanding and use of genetic information will drive a shift towards more personalized medicine and targeted testing. This predictive capacity could allow us to implement preventative strategies early, potentially delaying or preventing the onset of diseases. While genetics can provide valuable insights into an individual's health, it is only one piece of the puzzle. Genetic factors and other important determinants of health, such as lifestyle and environment, play a role in determining risk. As genetic testing becomes more commonplace, we will find that there are more genetic variables in calculating risk related to morbidity and mortality.
