基因信息在保险核保中的应用及其限度

基因信息可应用于保险核保的理论基础在于保险的风险分类理论与保险法的对价平衡原则。政策、伦理、道德、技术等方面的反对意见并不足以否定基因信息应用于保险核保的正当性,因为商业保险不应承担社会保障职能;基因信息相比一般医疗信息不具有特殊性;保险承保的本来就是具有不确定性的风险,基因检测的准确性也在逐步提高。是故,应当允许基因信息应用于保险核保,但为防止基因信息的滥用,还须通过规范的方式明确基因信息的应用限度:明晰保险人获取基因信息的方式;设定保险人使用基因信息的条件;规定保险人对于依据基因信息作出不利被保险人决定之理由的披露义务;强化基因咨询师的咨询与建议职责;完善对被保险人的救济机制及其具体运作规范。

The Application and Limitation of Genetic Information in Insurance Underwriting

The rationale of genetic information applied in insurance underwriting is the risk classification theory of insurance and the equivalence principle of insurance law.Political,ethical,moral,and technological objections cannot deny the justifiability of application of genetic information in insurance underwriting,because commercial insurance shall not bear the function of social welfare,and compared to general medical information,genetic information does not have extraordinary differences,meanwhile the risks insurance covers are inherently uncertain,and the accuracy of genetic testing is also gradually improving.Accordingly,genetic information shall be permitted to use in underwriting,but to prevent the abuse of genetic information,the limitations in application of genetic information shall be clarified through legislation:Firstly,clarify ways that insurers acquire genetic information.Secondly,set conditions for the insurers to use genetic information.Thirdly,stipulate insurers’duty of disclosure for the reasons of the decisions unfavorable to the insured that they made on the basis of genetic information.Fourthly,strengthen the counseling and suggesting duty of genetic counselors.Lastly,improve the insured’s remedy mechanism and its specific operational regulations.