Many countries ban insurers from using genetic test results in underwriting. One study [Howard, R. C. W. (2014). Report to CIA research committee: Genetic testing model: If the underwriters had no access to known results. Canadian Institute of Actuaries (CIA).] stated that such a ban in Canada would expose life insurers to adverse selection, causing premiums to increase by 12%. More than a quarter of this cost was attributable to a single disorder, Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC). We model ARVC in a life insurance market, following the methodology of [Haçarız, O., Kleinow, T. & Macdonald, A. S. (2021). Genetics, insurance and hypertrophic cardiomyopathy. Scandinavian Actuarial Journal 2021, 54–81.], including ‘cascade’ genetic testing (CGT), so the rôle of family history in underwriting is modelled explicitly. We review (in the Appendix) the published epidemiology of ARVC, in particular the existence of an effective treatment, which we also include in our model. Our results are consistent with those of [Macdonald, A. S. & Yu, F. (2011). The impact of genetic information on the insurance industry: Conclusions from the ‘bottom-up’ modelling programme. Astin Bulletin 41(02), 343–376.] and [Haçarız, O., Kleinow, T. & Macdonald, A. S. (2021). Genetics, insurance and hypertrophic cardiomyopathy. Scandinavian Actuarial Journal 2021, 54–81.], namely, that in realistic scenarios premium increases would be negligible. We also consider the possibility of life settlement companies ‘gaming’ insurers by learning of adverse genetic test results, and conclude that to profit from purchasing policies from affected individuals, they would have to predict the future trajectory of the epidemiology of ARVC better than the epidemiologists themselves.

许多国家禁止保险公司在承保中使用基因检测结果。一项研究 [霍华德，RCW (2014)。向 CIA 研究委员会报告：基因检测模型：如果承销商无法获得已知结果。加拿大精算师协会 (CIA)。] 表示，加拿大的此类禁令将使人寿保险公司面临逆向选择，导致保费增加 12%。超过四分之一的成本归因于单一疾病，即致心律失常性右心室心肌病 (ARVC)。我们遵循 [Haçarız, O., Kleinow, T. & Macdonald, AS (2021) 的方法，对人寿保险市场中的 ARVC 进行建模。遗传学、保险和肥厚型心肌病。斯堪的纳维亚精算杂志2021, 54–81.]，包括“级联”基因检测 (CGT)，因此明确模拟了家族史在承保中的作用。我们回顾（在附录中）已发表的 ARVC 流行病学，特别是有效治疗方法的存在，我们也将其包括在我们的模型中。我们的结果与 [Macdonald, AS & Yu, F. (2011) 的结果一致。遗传信息对保险业的影响：“自下而上”建模计划的结论。Astin Bulletin 41 (02), 343–376.] 和 [Haçarız, O., Kleinow, T. & Macdonald, AS (2021)。遗传学、保险和肥厚型心肌病。斯堪的纳维亚精算杂志2021, 54–81.]，也就是说，在现实情况下，保费增加可以忽略不计。我们还考虑了寿险公司通过了解不利的基因检测结果来“博弈”保险公司的可能性，并得出结论，要从受影响个人的购买保单中获利，他们必须比流行病学家更好地预测 ARVC 流行病学的未来轨迹他们自己。