Genetic testing: what can insurers ask for?

Experts estimate that about five to ten percent of all cancers can be traced back to inherited genetic changes, also known as germline mutations. If a genetic test reveals an increased risk of developing cancer, those affected must learn to deal with this knowledge. Physicians provide support by providing information and advice on preventive medical measures. In addition, those affected often worry that they will no longer receive life insurance after such a genetic test or that they will be fired by their health insurance company. This fear is only partially justified.

Private insurance wants to assess the risks

When entering into an insurance contract, private insurance companies, such as life, healthcare, health or disability insurance, naturally want to know what risk the business means to them. Specifically: How high is the risk to the insurance company that the policyholder will develop cancer or another serious illness? How likely is it that the policyholder will be unable to work or need care? A genetic test for hereditary cancer risk can help with such predictions.

Insurance companies cannot request genetic testing.

However, insurance companies are expressly prohibited from requesting a genetic test before or after the conclusion of an insurance contract (§ 18 Act on Genetic Diagnosis).

Ultimately, everyone can decide for themselves if they want to have a genetic test for germline mutations and thus find out something about their risk of developing cancer, for example. In the medical field, everyone has the so-called right not to know: This means that no one has to take such a test to find out about certain predispositions to a disease.

Questions about permitted genetic testing?

The legal situation is different if the result of a genetic test is already available when an insurance contract is concluded. Then those affected must inform the insurer of the result at the request of some insurers. The following insurance companies are affected:

  • life insurance
  • disability insurance
  • disability insurance or
  • Nursing Pension Insurance.

However, the obligation to communicate the result of a genetic test only applies to these insurance companies if

  • a service of more than 300,000 EUR or
  • An annual pension of more than 30,000 euros is agreed.

According to this, for example, the insurance company will not be able to request genetic tests for life insurance policies up to 300,000 euros. In private health insurance, the issue of genetic testing is always prohibited, regardless of the sum insured

Post-contract genetic testing

If a genetic test is carried out after the conclusion of the contract, the result does not have to be communicated to the insurance company. As a general rule, an insurance contract that has already been concluded cannot be terminated due to a genetic predisposition to a disease that is determined after the conclusion of the contract. Of course, this also applies to private health insurance, because they are taken out for subsequent illnesses.

Obligation to report illnesses remains

Regardless of whether or not the result of a genetic test must be communicated to the private insurance company, questions about existing or past illnesses must be answered truthfully (§§ 19 to 22 Insurance Contract Law).

Genetic tests for people with compulsory health insurance

The result of a genetic test is irrelevant to statutory insurance (social insurance) such as statutory health insurance companies or the German pension insurance association. There are no health checks for social security. If the legal requirements are met, membership is independent of existing or past illnesses or the result of a genetic test.

krebsinformationsdienst.med: Service for specialized groups

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