State RegulationsMA specificDifficulty 2/5
A Massachusetts insurer raises the premium on an accident and health policy after learning that the applicant carries a genetic marker for a disease, although the applicant has no symptoms and no diagnosis. Under the genetic-test provisions of M.G.L. c. 175 for accident and health coverage, what is the result?
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Answer & full 3-part explanation (select an option above, or peek)
Why C is correct
M.G.L. c. 175, §§ 108H and 108I prohibit discrimination in accident and health insurance on the basis of genetic-test results or genetic information. A latent genetic marker is not a diagnosis, and conditioning the premium on it is exactly the discrimination the statutes forbid; the Massachusetts Division of Insurance enforces the ban alongside the life-side protection of M.G.L. c. 175, § 120E. The applicant's consent does not authorize discriminatory use of the information, and the wrong occurs at underwriting, not only after symptoms appear.
Why the other options are wrong
- A) General health classification is lawful, but M.G.L. c. 175, §§ 108H and 108I carve genetic-test information out of permissible underwriting factors.
- B) Consent to the test does not permit discriminatory use of its result; the prohibition in M.G.L. c. 175, §§ 108H and 108I applies regardless of consent.
- D) The violation under M.G.L. c. 175, §§ 108H and 108I occurs when genetic information is used to rate or limit coverage, not when disease later develops.
Memory hook
Marker without diagnosis still can't be priced — genetics never set the premium.