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Updated: Oct 11, 2025

An R-Based Landscape Validation of a Competing Risk Model
Published on: September 16, 2022
Genetic risk scores in life insurance underwriting
Richard Karlsson Linnér1, Philipp D Koellinger2
1School of Business and Economics, Vrije Universiteit Amsterdam, De Boelelaan 1105, Amsterdam 1081HV, the Netherlands; Department of Economics, Leiden University, Steenschuur 25, Leiden 2531ES, the Netherlands.
Abstract:
Genetic tests that predict the lifetime risk of common medical conditions are fast becoming more accurate and affordable. The life insurance industry is interested in using predictive genetic tests in the underwriting process, but more research is needed to establish whether this nascent form of genetic testing can refine the process over conventional underwriting factors. Here, we perform Cox regression of survival on a battery of genetic risk scores for common medical conditions and mortality risks in the Health and Retirement Study, without returning results to participants. Adjusted for covariates in a relevant insurance scenario, the scores could improve mortality risk classification by identifying 2.6 years shorter median lifespan in the highest decile of total genetic liability. We conclude that existing genetic risk scores can already improve life insurance underwriting, which stresses the urgency of policymakers to balance competing interests between stakeholders as this technology develops.
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