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Gross ‘generalisations’ by insurers perpetuate HIV+ stigma

‘Outdated viewpoints on medical conditions just aren’t relevant anymore’

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The ever-changing nature of people’s lives has brought an array of insurance products to cater to virtually any person’s need – unless they have some specific pre-existing medical conditions.

In July 2020, an investigation by International Adviser revealed that several life and critical illness providers were turning away clients for a very specific reason. Their HIV status.

While this is not true for all insurers, still a large majority still  does not provide any type of cover, especially when it comes to critical illness, to HIV+ people.

Despite 40 years’ worth of research, medical advances and more effective treatment, the insurance industry’s standpoint has not changed that much in the past four decades.

Having HIV is still considered too much of a risk to offer cover to such clients.

According to the latest Public Health England statistics, in 2018 just over half of HIV+ cases were labelled as resulting from “sex between men”.

And if we consider the historic tensions between the financial service industry and the LGBTQ+ community and the legacy that it carries, it makes it incredibly difficult, if not impossible, for certain people to obtain cover.

But “nine time out of 10, people within the LGBTQ+ community are the one that need this protection”, Krystle Skelton, senior specialist insurance adviser at Cura Financial Services, who specialises in arranging cover for HIV+ people, told IA.

‘Just outdated’

“There are definitely some changes that need to be made,” she said.

“We’ve gone from hardly anybody [offering protection to people with HIV] with a maximum of a 10-year term and astronomical increases to premiums, to now having several insurers who impose no restriction in the term of what they’re able to offer, and the increases are minimal.”

But the problem lies with the assumptions the sector holds when it comes to HIV+ clients.

“They’re healthier than we are, and know what their immune system is doing. We don’t. They get a check-up every six to 12 months. And I couldn’t tell you the last time I went to the doctor. It’s just silly to me.”

Luckily, nowadays, the option pool for life products has largely increased, Skelton said.

But, unfortunately, “nobody, currently, will do critical illness”, and it doesn’t look like there is a reasonable explanation for this.

Skelton asked many providers why they refused to offer any type of critical illness protection, and she concluded the sector is holding on to “outdated viewpoints on medical conditions, what antiretroviral medication can cause, the impacts it can have, that just aren’t relevant anymore”.

This is because the risks that people suffering from this condition used to face – such as cardiovascular complications, kidney and liver issues – are a thing of the past that were overcome with medical research and advancements in treatments.

“So, it is just outdated,” she added.

Mismatch

These views are still present, however, and Skelton thinks they are due to the “use of a large amount of generalisation”.

She feels that when the sector talks about risks of non-compliance with medication or drug abuse among HIV+ people, they are not taking into consideration such people are very unlikely be the ones seeking protection insurance.

“It’s really unfair to penalise people who live with HIV and look after themselves, probably better than the general population. And because they’re aware of their own mortality, they don’t sit shoving cheeseburgers.”

Additionally, there is a lot of information and research about the current situation of people living with HIV, but according to insurers, it has not been proven for long enough for them to be able to make any changes.

“I do understand that, obviously; they’re putting large amounts of money forward,” Skelton added. “But I also think that not offering any cover at all is unfair.

“There is this risk factor still, but we can see that the risk is, so far, negligible.”

Blame game

There are insurers that offer some form of cover, although for a very limited time frame and with higher premiums.

“It’s not the best option, but at least it’s an option,” she said.

The problem lies in the fact that every provider has its own risk scale and, as a result, they are allowed to say: ‘We just cannot offer any cover’.

“A lot of it is to do with re-assurers, so the people who sit behind the insurance companies and mitigate their risk.

“Insurers say the re-assurers don’t want this as a risk, and the reinsurer say it’s the insurance companies that don’t want this risk.

“So, there’s this blame game backwards and forwards. And as advisers and specialists in areas when we push buttons, we never get a straight answer.

“And I don’t know how we force a straight answer and how we get them to actually answer us properly, instead of waffling and blaming each other constantly.”

Stigma and alienation

But the lack of options available to HIV+ people is only part of the issue.

“Many clients that I speak to have spoken to another company or spoken to their mortgage broker and said, ‘I’m HIV positive’ and up until that point, they’ve had a great experience, and then they just feel like a wall’s gone up,” she added.

“They feel judged against. And nine out of 10 people within the LGBT+ community are the people that need this protection.

“They are high earners, they don’t have children who cost them a fortune, so there’s money to be protected.

“We are alienating a massive area of our community and it’s ridiculous.”

And that is true for partners of HIV+ people, as well.

“There are some companies where, if a client were HIV+, and their partner was also looking for cover, but they were negative, they would ask the partner to have an HIV tests to confirm their status.

“It doesn’t particularly happen these days, but it did. And at which point I would advise against doing a joint policy and just put them with separate insurers, because it’s a huge intrusion.”

Change?

Skelton believes that it’s high time things change, but it’s very difficult to approach the subject and have something concrete come out of it.

“As advisers and as brokers we will say, ‘hang on a minute, this isn’t right, what’s going on’, but we’re one voice.

“And unless the public, or the LGBTQ+ community, go ‘I’m not happy about this’ as a whole, nothing’s going to change.

There is also a very common misconception that HIV only affects LGBTQ+ people, which couldn’t be further away from reality.

Skelton added: “A large percentage of my clients are heterosexual, obviously, as a general rule of thumb, in the HIV demographic 51% are homosexual, but the remaining 49% are heterosexual, married couples.

“The stigma needs to be removed.”

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