DEFINITION

CD4 count: A measure of the CD4 cells in a drop of blood. CD4 cells are one of a number of types of blood cells that make up the immune system. These cells are attacked by HIV. People not infected with HIV have between 700 and 1 000 CD4 cells in a drop of blood.

The government gives antiretroviral treatment to people when their CD4 count drops to 350.

AllLife has a dispute resolution mechanism that involves the South African HIV Clinicians Society, but it has not had to use the mechanism despite offering life policies to people with HIV since 2005, Beerman says.

AllLife helps people with HIV to remain healthy by reminding them how to stay healthy, including when to go for their blood tests (at least every six months). As long as policyholders manage their health, all they must do to prove adherence is give permission upfront for AllLife to receive their medical information, he says.

Dalene Allen, underwriting manager at AltRisk, says it has never declined a claim for failure to adhere to a treatment programme since it started offering cover in 1999. A report from a treating doctor is all that is required to prove adherence, she says.

CHRONIC ILLNESS LOADING

People with HIV who take out Sanlam’s “normal” policy will have their premiums loaded, as is the case for anyone who has a chronic illness when they take out life cover.

The loading is applied on a sliding scale, depending on the stage of the disease, whether or not the policyholder is managing the disease well and/or has any complications, Coetzer says, and it is therefore “more secure and less of a hassle”.

Allen says AltRisk’s premiums are most favourable for people who are members of a medical scheme and therefore have ready access to the antiretrovirals and the specialised healthcare they require.

Sanlam may decline to cover some people with HIV, just as it may decline cover to some people with other chronic illnesses. Generally, those who can illustrate that they approach their disease management responsibly will qualify, Coetzer says.

Those declined will still be able to apply for a policy that monitors adherence to treatment.

Beerman says AllLife’s policies are likely to be available to a broader range of people, because it provides cover to individuals with a CD4 count as low as 200. The amount of life cover is also not limited.

He says people with HIV can get cover from AllLife within 45 minutes, whereas obtaining cover on a standard life policy will require submission of a CD4 count and may require a range of medical tests before you receive a quote.

Coetzer says Sanlam can offer people with HIV normal life cover because international and local research has shown that HIV is now a manageable disease if it is treated timeously and properly. Local data has enabled Sanlam to assess the risks involved, he says.

The research apparently shows that people living with HIV who follow recommended treatment protocols timeously, can have a life expectancy equal to 80 percent of that of an HIVnegative person of the same age.

Section 27, a human rights organisation, recently raised concerns that the blanket denial of cover by most insurers for those who are HIV positive was discriminatory.

Sanlam does not not offer disability cover to people with HIV. AllLife does offer disability cover, and AltRisk offers critical illness cover, impairment cover and income replacement on impairment.

The maximum assured amount on Sanlam’s normal policies for those who are HIV- positive is R5 million, while HIV- negative policyholders enjoy unlimited cover, but Coetzer says this may be reviewed in future.

AltRisk’s maximum for people with HIV is R4 million and AllLife has no maximum.