More assurers now treating people with HIV like those with other chronic diseases

Tips for taking out cover if you are HIV+

South African life assurers are finally accepting that HIV/Aids should be treated in the same way as any other chronic illness, such as diabetes or high blood pressure.

This week, ahead of World Aids Day tomorrow, Old Mutual announced that it will accept people with HIV on both its LifePlan and Greenlight policies; Liberty announced it will allow people with HIV to take out cover against death on its Lifestyle Protector policies; and AltRisk announced it is scrapping the requirement that qualifying clients with HIV must comply with antiretroviral treatment in order to enjoy benefits on its policies.

In August, Sanlam took the lead among the large life assurers, offering “normal” cover against death of up to R5 million to HIV-positive people.

Until then, people with HIV could access only policies that required proof of ongoing adherence to treatment.

Liberty is following suit, but Old Mutual is extending not only its death cover, but also its disability and severe-illness cover to those who are HIV-positive, with only a loading for the illness, similar to the loadings that are applied for other chronic illnesses.

AltRisk was one of the first assurers to offer death, disability and severe illness cover to people with HIV, but the cover was subject to a clause that reduced the policy benefit to 10 percent of the assured amount if, at claims stage, the assurer found the policyholder had not been complying with his or her treatment.

As of next week, AltRisk will be offering new policies to people with HIV based on their compliance with an existing treatment programme and without the threat of a reduced benefit if the policyholder does not continue to comply with treatment.

AltRisk’s specialist risk consultant, Dalene Allen, says the company’s 14 years of data on HIV-positive policyholders shows that these policyholders do comply with their treatment programmes. It is therefore no longer necessary for the company to offer cover subject to compliance to There are a few things people who are HIV-positive should watch out for when taking out life cover, Dalene Allen, underwriting manager at AltRisk, says. These are:

◆ Make sure the cover is for the whole of your life, as some insurers offer cover that is only for a certain term. Initially, life cover for people with HIV was only offered on a term basis.

◆ Check whether the cover is subject to providing proof of ongoing compliance with a treatment programme.

◆ Check whether you can accelerate your cover if you become ill and your illness is terminal. This may help you to get your financial affairs in order – for example, paying off debt – before you die.

◆ Get an upfront indication of what the premium is likely to be before you go through all the trouble of the medical underwriting, as it may not suit you.

◆ Check whether you can get cover for all your needs: death, disability, severe illness and temporary disability. a treatment programme, she says.

However, AltRisk policyholders who are willing to prove adherence to treatment every two years, will enjoy a discounted premium.

A discount of anything between 25 percent and 75 percent of the loaded portion of the premium will apply and the discount will remain in place for two years. To continue to enjoy the discount, a policyholder will be required to submit proof of compliance with treatment again.

Allen says existing policyholders who are required to adhere to a treatment protocol can apply for new policies. These new policies will have reduced premiums. She says AltRisk has reduced the premiums on its cover for people with HIV three times over the past 14 years.

There are no specific limits on Old Mutual’s cover against death, disability and severe illness, and the amount of cover will be dependent on each individual’s merits.

Dr Peter Bond, the chief medical office at Old Mutual, says people with HIV will be able to take out either a LifePlan policy or a Greenlight policy. The LifePlan policy is not fully underwritten, while the Greenlight policy is underwritten.

Underwritten cover involves answering more medical questions and having certain medical tests, and, because of this, is generally cheaper than partially underwritten or nonunderwritten cover.

Bond says Old Mutual’s decision to open up its cover means that people with HIV will get far more extensive cover, including cover for severe illness and disability.

Liberty, like Sanlam, is offering cover for death to people with HIV but only up to R5 million.

The life assuer is also making its EduCator benefit available to people with HIV, to ensure that children can continue with their education even after the death of their parents.

Bond says South Africa has now had a successful HIV treatment programme for five years and the data shows that those on treatment adhere to it and their life expectancies are quite good.

He says Old Mutual will also offer cover to those who are not yet on treatment if their CD4 count (CD4 cells are blood cells in the immune system that are attacked by HIV) is above the level at which South Africans are entitled to enter the government treatment programme for HIV.

People with HIV will need only supply their latest CD4 count and a report from their treating practitioner when applying for cover with Old Mutual. In this way, they will be treated the same as someone with asthma or diabetes who is sent for tests on applying for cover and not having to be tested after being accepted for cover.

For the LifePlan product, they will only need to answer some specific questions and supply their latest CD4 count.

Old Mutual will use medical questions, reports and test results obtained when you apply for cover to determine how well you are managing your disease, and this will determine the loading that will be applied to your premiums, Bond says.

These loadings can, however, make a big difference to your premiums.

Allen says a R150 premium can buy an HIV negative 30-year-old man with a good risk profile (no chronic illnesses), cover of R2.2 million. However, a man of the same age who is HIV-positive would get only R1.1 million in cover for the same premium.

Liberty says advances in the treatment of HIV mean that people are able to live with the condition as one would with any other chronic ailment such as diabetes and they should not have to prove ongoing compliance with treatment programmes.

“At Liberty, we don’t believe it is appropriate for people to lose their cover if they can no longer adhere to their treatment regime, as their need for life cover is completely separate from their ability to adhere to a treatment regime or their body’s ability to respond positively to treatment,” Nicholas van der Nest, divisional director of risk products at Liberty, says.

“We believe a less punitive and discriminatory approach is what is needed, and we have adapted our product offering accordingly.”