Taking actuarial fairness seriously: what is required for the ethical use of genetics in insurance?

Whether life insurers should be able to consider genetic information during underwriting is a long-standing debate often characterized by strong opinions on both sides. Insurers push for full access to applicants' genetic information, and consumer advocates often call for a ban on insurer use of the information. Both sides employ concepts of fairness and discrimination in supporting their position. This article considers the concept of actuarial fairness, where individuals are expected to pay for the risks they bring to an insurance pool. Currently, law and policy adopting this standard most often take a deferential approach, allowing insurers to utilize genetic information with wide latitude. This article takes seriously a middle-ground approach, broadly labeled as actuarial utility. Building from prior literature examining this issue, this article proposes a framework US policy can adopt to assist in the assessment of the actuarial utility of genetic information with a particular focus on emerging genetic technologies.