HIV and life assurance

2013-12-01 14:00

On World Aids Day today, we look at how the life assurance industry has changed its approach to this illness. An increase in research and a reduced stigma has resulted in a revision of life assurance products available to HIV-positive clients. Neesa Moodley-Isaacs investigates

Liberty recently announced that its flagship life product, Lifestyle Protector, is now available to people living with HIV – with life cover of up to R5?million.

The company is also making its EduCator benefit available to ensure that children of people living with HIV can continue with their education even after their parents pass away.

Steven Braudo, the chief executive of Liberty Retail, says: “We know that HIV is manageable. Advances in treatment mean that people are able to live with the condition as one would with any other chronic ailment such as diabetes.

“People living with HIV can access our Lifestyle Protector product just like any other customers. No additional requirements will be asked of them.”

Altrisk, which was the first life assurance provider to offer cover for HIV-positive clients in 1999, says experience has proven that HIV is a chronic illness much like diabetes.

According to the company, “the reality is that in almost 14 years, Altrisk has only ever had two HIV claims – a trend that demonstrates that HIV has become a manageable condition like any other chronic illness”.

Altrisk says that its underwriting statistics show that clients with pre-existing conditions, such as heart disease or diabetes, for example, can have loadings that are significantly higher than many HIV-positive clients with well-managed conditions.

Comprehensive financial protection

Jaco Gouws, a marketing actuary at Old Mutual, says: “The massive resources allocated to HIV/Aids in the last 25 years mean that it’s now one of the most researched and understood conditions in the world.

“And as that understanding has evolved, so has actuarial science, which has enabled us to refine our underwriting and provide comprehensive financial protection for those living with the disease.”

Gouws points out that the great strides in understanding the condition and advances in antiretroviral (ARV) therapy have enabled life assurers to group HIV/Aids with other chronic conditions like diabetes and hypertension, which can be controlled with medication, therapies and proper lifestyle management.

“It’s also enabled us to provide more affordable cover than ever before, because we now have a better understanding of each customer’s risk,” he says.

Living with and managing HIV/Aids has become significantly less onerous and expensive as the years have passed, Gouws explains.

This is due to the simplification and increased efficiency of treatment: 10 years ago, patients had to take about 20 pills a day and the medication had unpleasant side effects.

Today, that has been reduced to just one pill a day.

Part of removing the stigma around HIV/Aids is the ability of financial services providers to protect the most valuable asset of someone living with HIV, their income. This will allow consumers to financially protect their families, businesses and retirement savings, Gouws says.

“People living with HIV now have the power to do great things with their money, just like everyone else,” Gouws adds, noting that previously separate products were offered to HIV-positive individuals.

That has changed and they are now offered a similar comprehensive range available to HIV-negative individuals.

You can apply for cover with Old Mutual without being on or having to prove that you’re on ARV treatment.

»?What cover can you expect?

Different life assurers will offer HIV-positive clients different levels of cover. Before you commit to any financial product, make sure you clearly understand the terms and conditions of the policy.

Policies may have onerous exclusions, compliance requirements and waiting periods, which will not be in your best interest and could be a serious problem when it comes to the claims stage or when you need the cover most.

You should always get advice before buying any financial product.

Gouws says: “We are all unique and have specific financial needs. It’s important to speak to an adviser about which product best suits your needs, and those of your family and business.”


Liberty does not require people living with HIV to be subjected to regular testing. Clients living with HIV will be underwritten at the application stage and, if they are accepted, will be treated in the same manner as any other clients with a health condition.

Says Nicholas van der Nest, Liberty’s divisional director of risk products: “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.”

In May 2002, the Constitutional Court ruled that Nevirapine should be available to all HIV-positive pregnant women who give birth in

any public sector facility, as well their infants. As a result of this intervention, many of these children are born HIV negative. Liberty also offers HIV-positive clients the EduCator benefit to ensure that their children, who may be HIV negative, can continue to go to school.

“We believe that offering our EduCator benefit to HIV-positive clients will meet a real need – ensuring access to a better future for children who are affected and impacted by HIV and Aids. This is important to us because we recognise the need for parents to ensure that their children are able to access an education in the event that one or both parents pass away,” notes Van der Nest.


At Altrisk, HIV-positive applications can follow one of two routes.

Scenario 1: If you are already HIV positive when applying for cover and are on antiretroviral treatment, underwriting will be based on your condition at the application stage. In this scenario, treatment adherence is not a condition for cover, but ongoing adherence may result in lower premiums.

Scenario 2: If you were diagnosed with HIV, or find out at the application stage that you are HIV positive, cover where granted will be conditional. You will be required to adhere to a treatment programme once your viral load and CD4 count reach certain levels. These measurements show if you have become, or are at risk of becoming, drug resistant and provide an overview of how the disease is progressing.

No ongoing additional reporting or submission of blood tests is required during the cover period, but at the claim stage Altrisk will request a report from the treating HIV clinician to determine compliance with a treatment programme.

In the event of non-adherence, Altrisk will still pay claims for natural-death causes not related to HIV at 100% of the cover amount.

Claims for accidental-death causes are also paid at 100% of the cover amount by Altrisk, regardless of adherence. Where there is a claim for natural causes related to HIV and the client did not adhere to their treatment regimen, Altrisk will limit the claim to 10% of the cover amount.

»?Old Mutual

Old Mutual offers two suites of products. LifePlan offers death and disability cover, but since only limited underwriting is required, cover is limited to R500?000.

The other option, Greenlight, requires full underwriting, including medical tests.

A more comprehensive range of benefits including death, disability and severe illness (an industry first) can be offered on this option, as underwriting allows for a better understanding of the person’s health. You are not limited to the amount of cover you can apply for.

Gouws says: “We are particularly proud to offer severe-illness protection. Cancer, heart disease and strokes don’t discriminate against your HIV status. You therefore need every chance to fight and recover from these diseases. HIV-positive people can now do this with severe-illness protection.”

»?Important questions

Is cover linked to a treatment regime?

When it comes to assessing an HIV-positive applicant for cover, an important consideration for the underwriter is a track record of compliance with the ARV programme, as well as the measures used to manage the condition.

Factors such as having medical aid, access to treatment, family history, lifestyle, income and education will all affect your premium.

Does your CD4 count have to be at a certain level?

CD4 is a measure of the strength of the immune system. The average CD4 count of a healthy HIV-negative person is between 400 and 1?700 per cubic millimetre of blood and this will be taken into consideration by the underwriter.

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