Abstract：The current legislative model that completely prohibits insurers from using genetic information for underwriting is controversial. From the perspective of balancing interests, the basic standpoint of total regulation in protecting the personal interests of the insured deserves recognition. However, the total regulation does not sufficiently consider the principle of consideration balance in the insurance law and the operational mechanism of insurance, nor does it meet the requirements of the principle of proportionality. There is a need for moderate adjustments. The strict restricted mode that prohibits the use of genetic information underwriting by insurers as a principle but allows exceptions for insurers to use genetic information for underwriting within limited scope is a more suitable solution. The reasons are as follows. Firstly, the strict restricted mode does not deny the basic stance of prohibiting the use of genetic information in principle. Secondly, genetic information presents a diverse characteristics in accurately assessing risks. Allowing insurers to collect genetic information with more accurate predictive capabilities within a limited scope can resolve the controversy over the accuracy of genetic information risk predictions and enable insurers to accurately assess risks. Thirdly, collecting genetic information within the restricted scope will not result in the proliferation of adverse selection. Fourthly, the risks of compromising the insured’s personal interests arising from the use of genetic information within the restricted scope can be controlled. Fifthly, allowing the use of genetic information within the restricted scope aligns with the functional positioning of commercial insurance complementing social insurance in China. This can not only balance the consideration balance principle in insurance and the operational mechanisms of insurance, but also achieve the balance of interests among all parties, i-n line with the principle of proportionality. However, allowing insurers to use partial genetic information for underwriting may result in the risk of consideration imbalance, genetic discrimination, difficulties for vulnerable groups in obtaining insurance protection, and potential risks of privacy and personal information leakage. These risks can be controlled through reasonable institutional design. Firstly, insurers should be required to collect genetic information that meets the scientific reliability standard and has a direct relevance to risk assessment. Moreover refining insurer’s inquiry specifications and improving the duty of utmost good faith disclosure system can help control the risks of consideration imbalance. Secondly, genetic discrimination and difficulties for vulnerable groups in obtaining insurance protection can be controlled by limiting the types of insurance where insurers have the authority to access to genetic information, setting threshold amounts for insurer’s access to genetic information, prohibiting the insurers from actively requesting genetic testing from the insured as a condition for underwriting, and enhancing pre-approval procedures by insurance regulatory authorities. Lastly, controlling risks of individual privacy and sensitive information leakage by insurers during the use of genetic information can be achieved through refining the insurer’s disclosure obligations, limiting the insured’s consent to “separate consent only”, imposing confidentiality obligations on insurers after obtaining genetic testing results and clarifying the insured’s rights to rectify and delete genetic information.
吴涵昱. 论基因信息在保险核保中的使用及限制[J]. 浙江大学学报(人文社会科学版), 2023, 53(12): 87-105.
Wu Hanyu. The Use and Restrictions of Genetic Information in Insurance Underwriting. JOURNAL OF ZHEJIANG UNIVERSITY, 2023, 53(12): 87-105.
1 Viola de Azevedo Cunha M.， “Data protection and insurance： the limits on the collection and use of personal data on insurance contracts in EU law，” Global Jurist， Vol. 10， No. 1 （2010）， pp. 1-27. 2 武亦文： 《基因信息在保险核保中的应用及其限度》，《北方法学》2020年第1期，第102-117页。 3 Cushing T. H.， “Should there be genetic testing in insurance risk classification，” Defense Counsel Journal， Vol. 60， No. 2 （1993）， pp. 249-263. 4 美］C.丹尼斯、［英］R.加拉格尔： 《人类基因组：我们的DNA》，林侠、李彦、张秀清等译，北京：科学出版社，2003年。 5 Golru S.， “Regulating the use of genetic information in the life insurance industry，” University of New South Wales Law Journal， No. 7 （2020）， pp. 1-18. 6 Radetzki M.， Radetzki M. & Juth N.， Genes and Insurance： Ethical， Legal and Economic Issues， Cambridge： Cambridge University Press， 2003. 7 Jensen P.， “Genetic privacy： the potential for genetic discrimination in insurance，” Victoria University of Wellington Law Review， Vol. 29， No. 2 （1999）， pp. 347-370. 8 Joly Y.， Dalpe G. & Gallois H. et al.， “Erring in law and in fact： the supreme court of Canada’s reference re genetic non-discrimination act，” Canadian Bar Review， Vol. 99， No. 1 （2021）， pp. 172-192. 9 Adjin-Tettey E.， “Potential for genetic discrimination in access to insurance： is there a dark side to increased availability of genetic information？” Alberta Law Review， Vol. 50， No. 3 （2013）， pp. 577-614. 10 冷传莉： 《“人格物”权利冲突的构成机理与裁判之道》，《法商研究》2021年第3期，第146-159页。 11 胡玉鸿： 《弱者权利保护基础理论研究》，北京：商务印书馆，2021年。 12 McGoodwin W. L.，“Genetic testing in life and disability insurance—a new challenge for public policy，” Brief， Vol. 28， No. 1 （1998）， pp. 25-32. 13 梁上上： 《利益衡量论》，北京：北京大学出版社，2021年。 14 Anderson M. C.， “Genetic testing in insurance underwriting： a blessing or a curse？ an examination of the tension between economics and equity in using genetic testing in risk classification，” Creighton Law Review， Vol. 25， No. 4 （1992）， pp. 1499-1536. 15 徐聪颖： 《论比例原则在知识产权损害赔偿中的适用》，《现代法学》2022年第3期，第179-193页。 16 周学峰： 《论保险法上的风险分类：合理区分V.歧视》，《比较法研究》2014年第2期，第93-108页。 17 Wortham L.， “Insurance classification： too important to be left to the actuaries，” University of Michigan Journal of Law Reform， Vol. 19， No. 2 （1986）， pp. 349-424. 18 何建志： 《基因信息与保险：社会政策与法理分析》，见《北大法律评论》编辑委员会编： 《北大法律评论》第5卷第1辑，北京：法律出版社，2003年，第1-23页。 19 康萌萌、刘素春： 《中国商业保险和社会保险耦合协调关系及时空特征研究》，《保险研究》2016年第6期，第90-100页。 20 Tarr J.， “Regulatory approaches to genetic testing in insurance，” Sydney Law Review， Vol. 24， No. 2 （2002）， pp. 189-206. 21 龙卫球： 《中华人民共和国个人信息保护法释义》，北京：中国法制出版社，2021年。 22 杜万华： 《保险案件审判指导》，北京：法律出版社，2018年。 23 王静： 《保险案件裁判精要》，北京：法律出版社，2019年。 24 朱荣荣： 《论我国基因信息不知情权的确立》，《法律科学》2021年第1期，第71-82页。
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