A woman in her late thirties has a mother and an aunt who both had breast cancer. Her GP suggests testing for the BRCA mutations. The clinical case is straightforward: knowing would allow surveillance, and possibly preventive surgery.
There is a question she may not think to ask before she books the test, and which almost nobody raises with her.
Where New Zealand stands
In this country, life and health insurers may lawfully take predictive genetic test results into account when deciding whether to offer cover, on what terms, and at what price. New Zealand has no legislative protection against this, and is widely described as the last country in the OECD without one.
The consequence is that a negative result can matter as much as a positive one, because the obligation to disclose that a test was taken does not depend on the answer being unwelcome.
Where Australia has gone
Australia operated a partial industry moratorium from 2019, under which insurers could not require disclosure of genetic test results below certain cover thresholds. That partial approach is being replaced by legislation banning the use of genetic test results in life insurance underwriting, with effect from October 2026.
Where the argument here has reached
The New Zealand government holds a regulation-making power that would allow it to restrict insurers' use of genetic test results. The power exists. It has not been used.
Advocacy groups have pressed for explicit protections in the insurance law reforms, and clinicians have reported patients declining clinically indicated testing because of the insurance consequences. That is the genuinely troubling part of the current position: a policy setting that discourages people from finding out something their doctor believes they should know.
The practical point
This is not an argument against testing. Testing saves lives and no insurance consideration outweighs a clinical one.
It is an argument about order.
Cover arranged before a predictive test is underwritten on what is known at that time. Once a result exists, it exists, and it is disclosable on any future application. The sequence does not run backwards.
So if a predictive test is being contemplated, because of family history, because a relative has been diagnosed, because a clinician has raised it, the insurance conversation belongs before the pathology. Not instead of the test. Before it.
Family history is already disclosable and already underwritten, and that is normal. What changes with a test result is specificity, and specificity is what underwriters price.
What may change
New Zealand tends to follow Australia on questions like this, with a lag, and the regulation-making power is sitting ready. It would be reasonable to expect movement within a few years. It would be unreasonable to plan a family's protection around the hope of it.
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Australian legislative position and New Zealand regulation-making power as reported in Australian and New Zealand insurance trade press, 2024 to 2026. Anyone weighing a predictive test should take both clinical and advice input before proceeding.