Providing a policy with such conditions may
constitute direct discrimination against people over
60. TIPL would need to rely on the data exemption
under the ADA to ensure it was lawful. As this
discrimination is based upon actuarial or statistical
data indicating that health risks increase with
age, the key question is whether the age cut-off is
reasonable having regard to the matter of the data
and other relevant factors.
Summary
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Relevant factors would include the nature and
purpose of the product, medical opinions, the
customer’s circumstances, other professional
opinions, actuarial advice or opinions, practice
of others in the insurance industry, commercial
judgement, and the relative number of customers
under and over 60.
Further, TIPL may also consider the impact of
increasing the age cut-off on the premium and
the effect on younger customers. If the increase
in the required cross-subsidised premium was so
significant as to make this product unattractive and
uncompetitive compared to an age-rated product,
then this may help to justify the threshold selected.
For example, if the increase in the required
premium was only 5% to increase the age limit
to 65, this may be more acceptable (and hence
should be more actively considered by TIPL) than
an increase in the required premium of 50% to
increase the limit to 75.
As the customer’s circumstances may be a relevant
factor, imposing conditions on the insurance may
be seen as less reasonable for customers over 60
who are in excellent health. However, on balance,
it may still be considered reasonable to impose
such conditions given the circumstances in which
the product is being sold, particularly if there are
alternative products available in the marketplace
which may be able to meet the needs of the older
individuals.
Where data is limited, some
approaches to price setting may
be more discriminatory, and at
greater risk of constituting unlawful
discrimination. Insurers should
consider the potential options
available to them, and whether a more
discriminatory option is justified, if less
discriminatory options are available.
•
If including a cut-off based on a
customer’s age, the level of age
threshold is again a matter of
judgement for the insurer. Similar
considerations may apply to other
protected attributes in other
situations. An insurer should carefully
consider all relevant factors, including
the availability and impact of a less
discriminatory option on the whole
population, in order to justify the
threshold selected.
5.3 Case Study: Life Insurance
When data is added to a model, it frequently affects
the fitted estimates of effects from other factors in
that model. This may include protected factors an
insurer is intending to rely on under an insurance
exemption. This case examines this issue, and any
resulting obligations on insurers to use (or not use)
any available data.
Guidance Resource: Artificial intelligence and discrimination in insurance pricing and underwriting • 2022 • 35