How would you feel about letting your insurance company track your sleep, your diet, the number of steps your take each day and your heartbeat?
This is the dilemma confronting thousands of customers in the United States following the announcement by John Hancock, one of the country's largest life insurance companies, that it will only provide "interactive" policies – that is, it plans to track customers’ fitness and health data through wearable devices and smartphones. Existing customers will also be transferred onto the new policies beginning in 2019.
John Hancock's CEO Marianne Hanson has framed the move as an effort by the company to improve the health and wellbeing of their customers, saying "We fundamentally believe life insurers should care about how long and well their customers live. With this decision, we are proud to become the only U.S. life insurance company to fully embrace behavioral-based wellness and leave the old way of doing business behind.”
Customers who do not participate in such programs could be made to pay higher premiums.
The announcement has sparked concern from some experts, however, who say real-time tracking of consumers' health data by insurers could have a negative impact on customers’ health, and could lead to discrimination and violations of consumer privacy.
"Insurers are creating what we call a perverse incentive where the unintended consequences could be that people cannot afford the higher insurance premium if they choose not to sign up to an add-on program such as a fitness tracker," says Dr Victoria Palmer, a Fellow in Applied Ethics at the University of Melbourne's Network Society Institute.
People may well be coerced into adopting an exercise regime that is unsuitable for them, but the insurance company may insist without fully understanding the implications of their ‘advice’ or terms and conditions of insurance," says Dr Bernard Robertson-Dunn, chair of the health committee of the Australian Privacy Foundation.
MLC acknowledges that it already tracks more personal health data than it needs to for its steps-based reward program.
In Australia, many insurance companies already offer their customers incentives and rewards programs in return for access to their health and fitness data. For example, NAB’s life insurance subsidiary MLC Limited gives customers 5% lower premiums in return for walking 37,500 steps per week. This raises the question of whether the program should be considered a reward for those who participate – or a penalty for those who don’t.
The controversy over the Australian Government’s new My Health Record program has highlighted the complexities around who should have access to health data. Under the legislation, insurance companies will not be allowed to access My Health Record data. However, the industry has made it very clear that they want access to the data. NIB Chief Executive Mark Fitzgibbon has said that he hopes NIB’s 1.5 million customers will give the insurance company access to their MyHealthRecord by 2020.
Combining a customer’s My Health Record – a lifelong medical record – with real-time monitoring would provide insurance companies with an incredibly detailed and intimate picture of an individual’s health and wellbeing. MLC acknowledges that it already tracks more personal health data than it needs to for its steps-based reward program.
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On its website MLC states that "Only steps are monitored for the purposes of meeting the 5% discount. However, MLC Life Insurance will collect all information available from the fitness tracker for internal statistical analysis." MLC says that this includes monitoring your heartrate and sleeping patterns. Given the phrasing “all information available”, however, it is also possible that they could be collecting real-time location data and a variety of other indicators.
"Many consumers do not know what data is being collected and where it is being shared from a range of fitness trackers or other wearables they use," says Dr Palmer.
"It’s become public knowledge more recently that companies may be sending data to marketing firms or other third party organisations and people are becoming more aware. So the idea is being presented as a public good but it’s really serving private interests."
MLC’s Privacy Policy allows it to share customer data with a host of third parties including data brokers, advertisers, lawyers, superannuation funds and other financial services, reinsurers, claims assessors, investigators, researchers, social media sites, telemarketers and more. The company’s Terms and Conditions also say it is “collaborating” with digital analytics company InfoCentric, which will have direct access to customer health data.
Mr Fitzgibbon has argued that insurers need this level of access to personal data to "make the world a better place” through better prevention and management of health issues.
While access to better data for medical professionals may indeed improve health outcomes, however, it is less clear that it would lead to better consumer outcomes in the hands of insurers.
"Insurance companies should have an arm’s length relationship with their policyholders, otherwise there is the risk of them having a conflict of interest - the welfare of the insured versus the profit of the company,” Dr Robertson-Dunn says.
“As with all health advice - go and see your GP. They are the people to advise you and monitor your progress, good or bad.”
