Life insurance companies are increasingly denying claims by arguing that the insured failed to disclose a genetic predisposition to certain medical conditions. Families are stunned because the insured never had a diagnosis, never received treatment, and often never knew the genetic information existed. Insurers use this tactic to rescind policies after death by claiming the insured hid hereditary risks that would have changed the underwriting decision.
These denials are legally questionable and medically flawed. A genetic predisposition is not a medical condition. It is not a diagnosis. It is not a certainty of future illness. Yet insurers treat it as if the insured intentionally concealed a serious disease.
This guide explains how insurers use unreported genetic predispositions to deny claims, why these denials often fail, and how beneficiaries can challenge them.
What Insurers Mean by Genetic Predisposition
A genetic predisposition is a hereditary trait that may increase the likelihood of developing a condition. It is not proof that the insured ever had the condition or ever would have developed it.
Insurers may point to predispositions for:
• Heart disease • Diabetes • Cancer • Alzheimer’s • Blood clotting disorders • Autoimmune conditions • Neurological disorders
Insurers often discover these predispositions through medical records, family history notes, or genetic testing results that were never intended for underwriting.
How Insurers Use Genetic Predispositions to Deny Claims
When a claim is filed, insurers search for any reference to hereditary risk. They may argue that the insured:
• Failed to disclose a family history of a condition • Failed to disclose genetic testing results • Failed to disclose participation in a genetic study • Failed to disclose a known hereditary risk • Misrepresented their medical history by omitting genetic information
These denials often rely on assumptions rather than facts. Insurers treat a predisposition as if it were an active medical condition, even when the insured had no symptoms or diagnosis.
Why These Denials Are Often Improper
A genetic predisposition is not a medical condition that must be disclosed unless the application specifically asks for it. Most applications do not. Insurers cannot deny a claim based on information they never requested.
Here are the most common reasons these denials fail.
The application did not ask about genetic information
Most life insurance applications ask about diagnoses, treatment, symptoms, or medical advice. They do not ask about genetic markers or predispositions. If the insurer did not ask, the insured could not have misrepresented anything.
The insured did not know about the predisposition
Many people learn about genetic risks only after death when insurers dig through medical records. Insurers cannot deny a claim based on information the insured never knew.
A predisposition is not a diagnosis
A genetic marker does not mean the insured had the condition. Insurers must prove that the insured had a diagnosable illness at the time of application. A predisposition does not meet that standard.
The cause of death was unrelated
If the insured died from an accident, infection, or unrelated illness, the genetic predisposition is irrelevant.
Underwriting guidelines rarely treat predispositions as disqualifying
Most insurers do not deny coverage based solely on hereditary risk. If the insurer would have issued the policy anyway, the denial cannot stand.
How Insurers Build These Denials
Insurers often rely on:
• Family history notes in medical records • Genetic counseling summaries • Lab reports from unrelated testing • Research study participation • DNA testing ordered for other conditions • Physician comments about hereditary risk
They take these references out of context and claim the insured should have disclosed them.
How Beneficiaries Can Challenge These Denials
These denials are highly challengeable because they rely on assumptions, vague application questions, and information the insured often never knew.
Beneficiaries should take the following steps.
Request the complete claim file
The claim file will show what the insurer relied on and what evidence it ignored.
Obtain the full medical records
Insurers often rely on partial records or misinterpret genetic notes.
Compare the alleged nondisclosure to the application questions
If the insurer never asked about genetic predispositions, the denial is invalid.
Review underwriting guidelines
If the insurer would have issued the policy even with full disclosure, the denial cannot stand.
Challenge the relevance to the cause of death
If the death was unrelated, the insurer’s argument weakens significantly.
When the Denial Becomes Bad Faith
A denial may cross into bad faith when the insurer:
• Treats a predisposition as a diagnosis • Uses genetic information the insured never knew • Applies underwriting rules retroactively • Ignores evidence that contradicts its position • Misinterprets genetic counseling notes
These behaviors can support a claim for additional damages.
Why Families Should Not Give Up
Genetic predispositions are not medical conditions and do not justify denying a valid life insurance claim. Insurers use these arguments because they sound scientific and intimidating, but they often collapse under legal scrutiny. Families should not accept a denial based on hereditary risk without a thorough review.