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Document Details :

Title: The Impact of Multifactorial Genetic Disorders on Critical Illness Insurance
Subtitle: A Simulation Study Based on UK Biobank
Author(s): MACDONALD, Angus , PRITCHARD, Delme , TAPADAR, Pradip
Journal: ASTIN Bulletin
Volume: 36    Issue: 2   Date: 2006   
Pages: 311-346
DOI: 10.2143/AST.36.2.2017924

Abstract :
The UK Biobank project is a proposed large-scale investigation of the combined
effects of genotype and environmental exposures on the risk of common
diseases. It is intended to recruit 500,000 subjects aged 40-69, to obtain medical
histories and blood samples at outset, and to follow them up for at least
10 years. This will have a major impact on our knowledge of multifactorial
genetic disorders, rather than the rare but severe single-gene disorders that have
been studied to date.What use may insurance companies make of this knowledge,
particularly if genetic tests can identify persons at different risk? We describe
here a simulation study of the UK Biobank project. We specify a simple hypothetical
model of genetic and environmental influences on the risk of heart attack.
A single simulation of UK Biobank consists of 500,000 life histories over
10 years; we suppose that case-control studies are carried out to estimate agespecific
odds ratios, and that an actuary uses these odds ratios to parameterise
a model of critical illness insurance. From a large number of such simulations
we obtain sampling distributions of premium rates in different strata defined
by genotype and environmental exposure. We conclude that the ability of such
a study reliably to discriminate between different underwriting classes is limited,
and depends on large numbers of cases being analysed.