Regulatory Compliance Framework Involving Information on Genetic Disorder Diagnoses for Insurance Claims
Ministry of HealthSpeakers
Summary
This question concerns how doctors should report genetic disorder diagnoses in insurance forms and the regulations preventing insurers from using such information to deny payouts. Minister for Health Ong Ye Kung stated that the Moratorium on Genetic Testing and Insurance prohibits using predictive genetic test results for underwriting, except for high-value policies. He clarified that while manifested symptoms and formal diagnoses must be disclosed as part of medical history, underlying genetic causes should not be included. Once coverage is accepted, the moratorium does not apply to claim assessments, allowing insurers to evaluate claims without secondary underwriting. Furthermore, the Ministry of Health plans to strengthen legislative protections for genetic information to provide greater public assurance.
Transcript
10 Mr Yip Hon Weng asked the Coordinating Minister for Social Policies and Minister for Health (a) when insurance forms explicitly ask doctors if a diagnosis is linked to a genetic disorder, whether the Ministry can provide guidance on how these doctors should discharge their duty of honesty, while complying with the Moratorium on Genetic Testing and Insurance; and (b) what regulations prevent insurers from relying on such disclosures to deny payouts for related genetic disorders.
Mr Ong Ye Kung: The Moratorium on Genetic Testing and Insurance prohibits insurers from requesting for or using predictive genetic test results in underwriting, with limited exceptions. Without this, we risk fragmenting the risk pool based on individuals' genetic makeup and undermining the purpose of insurance.
The Ministry of Health (MOH) has worked with the Life Insurance Association to carefully design the policy application forms to adhere to these guidelines. Information disclosed in application forms must be relevant, accurate, and not misleading. For example, once an individual has consulted a doctor for manifested symptoms or received a formal diagnosis, such medical information forms part of their medical history and may be disclosed for underwriting. But the underlying genetic causes should not be disclosed.
However, for very high-value insurance products where it can be susceptible to abuse, insurers may request additional information, including genetic test results, to ensure fairness across all policyholders.
In addition, after a policyholder has been accepted for insurance coverage, the moratorium does not apply. This allows individuals to submit relevant medical history and/or diagnosis in support of their insurance claims and the insurer to assess if the claim is covered according to policy terms and conditions. Such information is only used for claim assessment purposes and no secondary underwriting is imposed. Moving forward, MOH will strengthen legislative protections for all genetic information and genetic test results to provide greater public assurance.