How family medical history is used

What gets asked

Applications typically ask about first-degree relatives: your parents and your siblings. Grandparents, aunts, uncles and cousins are usually outside the question, because the genetic and behavioural link is weaker.

The conditions asked about most often are heart disease, stroke, certain cancers, diabetes, kidney disease and specific hereditary disorders such as Huntington’s disease or polycystic kidney disease.

For each, the insurer wants to know what the condition was, at what age it was diagnosed, and, if the relative has died, at what age and of what.

Why age matters more than the condition

This is the part that makes family history questions make sense.

A father who had a heart attack at 82 tells an underwriter almost nothing. Cardiovascular disease is common in the eighties, and it is a feature of ageing rather than a signal about you.

A father who had a heart attack at 48 is a different piece of information. Disease appearing that early suggests something inherited or a shared pattern rather than ordinary ageing, and it changes the picture.

This is why most application questions are framed around a threshold, commonly diagnosis or death before age 60 or 65. Below the threshold, the answer carries weight. Above it, usually not.

Number matters too. One parent with early heart disease is noted. Both parents and a sibling is a pattern.

How much it actually affects things

Less than people fear, and the effect is usually at the margins.

The most common consequence is on access to preferred rates. Preferred classes require unusually good measurements across the board, and a strong family history of early cardiovascular disease or certain cancers can be enough to keep an applicant at standard rates rather than preferred. Standard rates are ordinary pricing, not a penalty.

A rating driven by family history alone is uncommon and generally requires a strong pattern: multiple close relatives with early onset of the same serious condition.

Your own health carries far more weight. Someone with a difficult family history whose own measurements are good is usually assessed on their own measurements. Family history is a tiebreaker, not the main event.

Certain specific hereditary conditions are treated differently and more seriously, because the inheritance pattern is well established and predictable. Those are individual cases rather than a general rule.

Genetic testing

Canada has a clear rule here, and it is worth knowing.

Under the federal Genetic Non-Discrimination Act, it is prohibited to require someone to undergo a genetic test, or to disclose the results of an existing genetic test, as a condition of providing goods or services, which includes entering into a contract of insurance.

So an insurer cannot require you to take a genetic test, and cannot require you to hand over results of a test you have already had.

Note the boundary. This concerns genetic test results. Ordinary questions about your family’s medical history, and about conditions you have actually been diagnosed with, remain part of the application. If a genetic result led to a diagnosis or to treatment, that diagnosis and treatment are part of your own medical history.

If you have specific concerns about how a genetic result interacts with an application, that is a question for a lawyer or a genetic counsellor rather than for an insurance page.

If you do not know

An honest “not known” is an acceptable answer, and it is a common one.

People are adopted, lose contact with a parent, or come from families where causes of death were never discussed or recorded. Insurers deal with this regularly and it does not by itself cause a problem.

What is not acceptable is guessing, or answering no because you do not want to look into it. If a parent died and you genuinely do not know the cause, say that.

What to do with a difficult family history

Nothing about it changes on the application, and two things are worth knowing.

Insurers weigh family history differently from one another, so it is one of the factors where where you apply can change the answer.

And your own numbers are what matter most. An underwriter looking at a strong family history alongside your own good measurements and consistent follow-up is looking at evidence that the pattern has not shown up in you. That evidence is the most useful thing in the file.

Anything you want to do about your own health in light of family history is a conversation for your doctor, and it is a good reason to have it.