Family medical history and life insurance
You are perfectly healthy, but your family is not. A parent who died young from cancer, a sibling with heart disease, a strong family history of diabetes. Insurers do ask about family medical history, and it can affect your premiums. This page explains exactly what matters, what does not, and how genetic testing fits into the picture.
The short answer
Insurers ask about first-degree relatives (parents and siblings) who have had cancer, heart disease, stroke, or diabetes before age 60. One relative with a condition after age 60 is usually negligible. One relative before age 60 may result in a minor loading of 25-50%. Two or more first-degree relatives with the same condition before age 60 typically results in a loading of 25-75%. Genetic testing adds complexity - the UK insurance moratorium means you generally do not have to disclose predictive genetic test results, with one exception.
What insurers ask about family history
Not all family history matters for insurance. Insurers have specific criteria for what they consider significant.
Which relatives count?
Only first-degree relatives: your biological parents and biological siblings. Grandparents, aunts, uncles, and cousins are not typically asked about. Step-parents and adoptive relatives are not relevant for genetic family history. If you are adopted and do not know your biological family history, you can state this and it will not count against you.
Which conditions matter?
The conditions insurers specifically ask about are cancer, heart disease (heart attack, angina, cardiomyopathy), stroke, and diabetes. Some insurers also ask about kidney disease, multiple sclerosis, Parkinson's disease, motor neurone disease, and Huntington's disease. Conditions like arthritis, depression, or allergies in family members are not typically asked about.
What age threshold is used?
Most insurers use age 60 as the key threshold. A first-degree relative who developed one of the listed conditions before age 60 is considered significant. A relative who developed the same condition after age 60 is generally not considered significant for underwriting, because the condition is more likely age-related than genetic.
Does it matter what type of cancer?
Yes. Some cancers have a stronger hereditary component than others. Breast cancer, ovarian cancer, bowel cancer, and prostate cancer in a first-degree relative before age 60 are the most significant. Lung cancer in a smoking relative is viewed differently from lung cancer in a non-smoker. Skin cancer (melanoma) in a relative may be noted but typically has less impact.
How family history affects your premiums
The impact depends on how many relatives are affected, at what age, and with which condition.
One relative, condition after age 60
Usually no impact
A parent who developed cancer, heart disease, or diabetes after age 60 is very common and is generally not considered significant for underwriting. Most insurers will offer standard rates. This is the most common family history scenario and should not concern you at all.
One relative, condition before age 60
Minor loading possible
A single first-degree relative who developed a significant condition before age 60 may result in a minor loading of 25-50%, depending on the condition and the relative's age at diagnosis. A parent diagnosed with bowel cancer at 45 is viewed more seriously than a parent diagnosed at 58. Some insurers may still offer standard rates even in this scenario.
Two or more relatives, same condition before age 60
Moderate loading likely
Two or more first-degree relatives with the same condition before age 60 is the most significant family history scenario. This suggests a strong genetic predisposition. Typical loadings are 25-75%, depending on the condition and ages at diagnosis. For example, a mother and sister both diagnosed with breast cancer before age 50 would typically attract a loading at the higher end of this range.
Multiple relatives, multiple conditions before age 60
Significant loading
When several first-degree relatives have developed different serious conditions at young ages, the cumulative loading can be significant. However, each condition is assessed separately. Having a parent who died of heart disease at 50 and a sibling with cancer at 45 does not compound in the same way as two relatives with the same condition. The loading is typically 50-100%.
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Get QuoteGenetic testing and life insurance
Genetic testing is an increasingly common area that causes significant confusion around insurance. The rules are actually clearer than most people think.
The UK insurance moratorium
The UK Government and the Association of British Insurers (ABI) have a voluntary agreement called the Code on Genetic Testing and Insurance. Under this agreement, insurers cannot require you to take a genetic test, and for most policies, they cannot ask you to disclose the results of predictive genetic tests you have already taken.
This means that if you have had a BRCA gene test, Lynch syndrome screening, or other predictive genetic tests, you are generally not required to disclose the results on insurance applications for policies up to certain financial limits.
The one exception: Huntington's disease
Huntington's disease is the only condition where a positive predictive genetic test result must be disclosed on life insurance applications above 500,000. For policies of 500,000 or less, the moratorium applies and you do not need to disclose. This exception exists because Huntington's is a single-gene disorder with a near-certain progression, making it uniquely relevant to insurance risk.
BRCA and other genetic results
If you have tested positive for a BRCA1 or BRCA2 gene mutation, you are not required to disclose this under the moratorium for standard policy amounts. However, you must still disclose your family medical history (which may be the reason you were tested in the first place). If you have had preventive surgery as a result of a positive genetic test (such as a preventive mastectomy or oophorectomy), you must disclose the surgery itself.
A negative genetic test result is worth disclosing voluntarily. If you have a strong family history of breast cancer but have tested BRCA-negative, this can actually help your application by indicating that you do not carry the known genetic risk factor.
The honest answer
Family history is one of those areas where people worry more than they need to. If you have one relative who developed cancer or heart disease after age 60, it is unlikely to affect your premiums at all. Even with a more significant family history - a parent with early-onset cancer, multiple relatives affected - the loadings are typically in the 25-75% range, not the catastrophic increases people fear. You are being assessed on a statistical risk, not a certainty. The main thing to understand is that family history alone, without any personal health issues, is very rarely a reason for outright decline. You will pay more, but you will get cover.
How specific family conditions are viewed
Family history of cancer
The type and age matter most. Breast cancer, bowel cancer, ovarian cancer, and prostate cancer in first-degree relatives before age 60 attract the most attention. A single occurrence may result in a minor loading; multiple occurrences of the same cancer type typically result in a moderate loading. Lung cancer in a smoking relative is often discounted as lifestyle-related rather than genetic.
Family history of heart disease
A parent or sibling who had a heart attack or was diagnosed with coronary artery disease before age 60 is significant. The younger the relative at diagnosis, the more significant the loading. One relative before age 60 typically results in a 25-50% loading. Two first-degree relatives with early heart disease may result in a 50-75% loading.
Family history of stroke
Stroke in a first-degree relative before age 60 is treated similarly to heart disease. The loading is typically in the same range. Stroke after age 60 in a relative, particularly if associated with known risk factors (atrial fibrillation, high blood pressure), is generally not significant.
Family history of diabetes
Type 2 diabetes in a parent is extremely common and typically has minimal impact on premiums, even if diagnosed before age 60. The impact is greater if multiple relatives have diabetes, particularly if you also have risk factors yourself (high BMI, pre-diabetes). Type 1 diabetes in a sibling or parent before age 60 may be noted but has less underwriting impact than cancer or heart disease family history.
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Frequently asked questions
Do I need to disclose my family history if they are not my biological relatives?
No. Family history for insurance purposes means biological relatives only. If you were adopted, or if a step-parent had cancer, this is not genetically relevant and does not need to be disclosed as family medical history. However, if you know your biological family history, you should disclose it.
Should I get a genetic test before applying for life insurance?
This is a personal decision, but from a purely insurance perspective, there is no advantage to getting a genetic test before applying. Under the moratorium, you do not need to disclose most predictive genetic test results. However, once a test reveals a condition that has already manifested (a diagnostic rather than predictive result), this must be disclosed. Consider the medical and personal benefits of testing separately from insurance implications.
My parent died of cancer at 55. How much more will I pay?
A single parent with cancer before age 60 typically results in a minor loading, often 25-50% depending on the type of cancer and exact age. On a policy that might otherwise cost 20 per month, this could mean paying 25-30 per month. The exact amount depends on the insurer, the type of cancer, and your overall profile. It is a noticeable increase but not a prohibitive one.
I have a family history of Huntington's disease. What are my options?
If you have not been tested, you do not need to disclose the family history of Huntington's beyond what the application form specifically asks about family conditions. If you have been tested and the result is negative, you can voluntarily disclose this to your advantage. If you have tested positive, the moratorium protects you for policies up to 500,000. For policies above this amount, disclosure is required. A specialist broker who understands the moratorium and Huntington's underwriting is essential.
Both my parents had heart disease. Can I still get life insurance?
Yes. Two parents with heart disease is a significant family history, but it does not prevent you from getting cover. The loading will depend on the ages at diagnosis - if both were diagnosed after 60, the impact is minimal. If both were diagnosed before 60, expect a loading of 50-75%. Cover is available from mainstream insurers in both scenarios. Your own cardiovascular health (blood pressure, cholesterol, fitness) also factors in and can mitigate the family history to some extent.
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