Why are insurers still discriminating against HIV/Aids?
Clauses in insurance company life and trauma policies bar people with HIV and Aids from cover, or refuse to pay out if HIV is acquired through sexual contact or drug use. Nikki Mandow reports.
Israel Folau’s attempts to see homosexual people in hell have raised hackles. Surely in this era of rainbow ticks and LGBT pride, there is no room for this sort of discrimination?
Not so. Not in the insurance sector at least. Flying more under the radar than Folau’s inflammatory statements are clauses in insurance company life and trauma policies which bar people with HIV and Aids from cover, or refuse to pay out if HIV is acquired through sexual contact or drug use.
The company will not pay out on a life policy if a customer’s death “occurs as a direct or indirect result of HIV or Aids”. This is the only health condition in AA’s list of exclusions, a list that includes dying while working with explosives, being in extreme risk countries, participating in a criminal act, or death by suicide within 13 months of taking out a life policy.
NZ AIDS Foundation CEO Jason Myers says the clause is discriminatory and there’s no justification for the AA’s policy.
“This is an outdated view from the 1980s and 90s when people with HIV were a risk to insurers because they were going to die. These days HIV is a long-term manageable condition alongside all the other long-term manageable conditions out there.
“They are not excluding people with diabetes eating too many cakes.”
A 2017 study published in medical journal The Lancet showed improvements in treatment mean young people on the latest HIV drugs now have near-normal life expectancy.
A 20-year-old infected with HIV after 2008 and on long-term antiretroviral therapy could be expected to live to 78, the study showed.
AA Life General Manager Mark Savage says his company tries to make the sign-up process quick and easy for customers - but that has a trade-off.
“There is a much shorter list of screening questions, and there is also no requirement to undergo a medical examination or blood test to be eligible for cover.
“But this does mean that we need to exclude conditions or lifestyle factors that our underwriting process will not give us enough information about.”
Myers says the AA’s rationale doesn’t make sense and just serves to stigmatise people with HIV.
Heart disease, lung cancer, diabetes and stroke are among the diseases most likely to kill New Zealanders, yet they are not excluded. Aids-related deaths aren’t common.
“I know many people living with HIV. Their biggest challenge on a daily basis is stigma and discrimination. All these attitudes are based on the memory, which is that HIV means Aids and Aids means death,” Myers says.
He says he knows people who have been affected by discrimination around life insurance, but they don’t want their stories told for fear of the reaction of people around them.
AA Life, which labels itself “New Zealand’s most trusted life insurance brand”, is the only New Zealand insurance company Newsroom can find which still has this outright exclusion.
But a raft of companies, including some of our biggest insurers, put conditions on their trauma and crisis policies. Trauma insurance is when people get a lump sum payment if they are diagnosed with a specified illness.
“Nobody acquires HIV intentionally, and this feeds into a narrative of ‘good HIV’ and ‘bad HIV’, where the ‘bad HIV’ is sexually acquired and perceived to be not accidental."
Clauses in many trauma policies, including from AIA, AMP, Asteron, Fidelity, OnePath, Partners and Sovereign, specify the company will pay out only if HIV is contracted through “accident”, but not if it comes from sexual contact or drug use.
Accident might include violence, work-related incidents, or medical misadventure.
A clause in OnePath’s trauma policy is typical:
“Notification and proof that the infection is medically acquired will be required from a recognised health authority. HIV infection transmitted by any other means including sexual activity or intravenous drug use is specifically excluded.”
Myers says the “accidental” clause is hugely problematic.
“Nobody acquires HIV intentionally, and this feeds into a narrative of ‘good HIV’ and ‘bad HIV’, where the ‘bad HIV’ is sexually acquired and perceived to be not accidental.
“This is stigmatising for all people living with HIV.”
Sovereign’s chief officer, product, Len Elikhis, says most companies no longer have a blanket exclusion for HIV and “customers who acquire HIV [sexually or through intravenous drug use] are still eligible to claim under other trauma benefits in connection with their HIV”.
"The challenge from the AIDS Foundation is a good one and should prompt the industry to consider whether narrowing coverage under the HIV trauma benefit is appropriate."
But he says Newsroom canvassing the issue should raise questions for the industry.
“Having said that, the challenge from the AIDS Foundation is a good one and should prompt the industry to consider whether narrowing coverage under the HIV trauma benefit is appropriate. We intend to review this for our policies.”
It may seem discriminatory, but there’s little legal remedy. Life insurance companies are exempt from anti-discrimination rules in the Human Rights Act, and most HIV-positive people fear media spotlight if they complain.
Insurance companies are also exempt from unfair contract term provisions in the Fair Trading Act, although the latter is being reviewed by the government, with submissions to the review of insurance contract law due to close on Friday.
Myers says the AIDS Foundation didn’t know about MBIE’s insurance contract law review, but would look at making a submission.
He says the organisation doesn’t have enough resources to go after the insurance companies, preferring to concentrate on issues such as making it easier for people with HIV to move to New Zealand.
The foundation did have a meeting recently with Southern Cross, however, about getting rid of HIV exclusions in its health insurance policies.
“It was a case of presenting to senior managers and opening their eyes to the fact these exclusions are outdated and people with HIV/Aids don’t present any increased risk. Most people living with HIV will live long, healthy lives and many will die of something totally unrelated to HIV. That's the quality of the medication.”
Myers says the meeting was prompted by a Southern Cross staff member; however a spokeswoman for the company says it didn't make any changes to the HIV clauses in its health policies as a result of the NZAF discussions. Separately though the travel insurance division has removed HIV exclusions, she says.
Mark Savage said the AA had not received criticism or complaints on this issue, apart from one “in recent days” - possibly from Newsroom. However Newsroom is aware of queries about the policy dating back as far as 2014.
Savage said AA and its underwriting partner Asteron Life “regularly reviews all AA Life products, to assess market needs”.