Life insurers make disability and critical illness cover available to people living with HIV

30 November 2017 Dr Maritha van der Walt, ASISA
Dr Maritha van der Walt, convenor of the Medical Underwriting Standing Committee at ASISA.

Dr Maritha van der Walt, convenor of the Medical Underwriting Standing Committee at ASISA.

Over the past two years the majority of South African life insurers expanded their range of products available to people living with the human immunodeficiency virus (HIV) to include disability and critical illness cover. South Africa was the first country to introduce life cover for people living with HIV in 2001.

Dr Maritha van der Walt, convenor of the Medical Underwriting Standing Committee of the Association for Savings and Investment South Africa (ASISA), says so much has changed in the almost 40 years since the virus that causes AIDS was identified in the early 1980s.

“Not so long ago being diagnosed with HIV was a death sentence for many. Also, early treatment programs were expensive and difficult to adhere to. Today, HIV is considered a treatable chronic disease like diabetes and many others. In fact, South Africa has the largest and one of the most affordable HIV treatment programs in the world.”

Van der Walt says vast improvements in the treatment of HIV and a better understanding of the long-term outcome of treatment programs have enabled life companies to insure HIV positive customers on the same basis as customers with other treatable chronic diseases. A chronic disease is defined as a condition that can be managed, but not cured.

She says life companies increasingly have access to reliable South African data relating to the HIV/AIDS survival rate and the way the disease responds to treatment. This has enabled life companies to start innovating products that meet the needs of people living with HIV. The cost of cover for people living with HIV has also reduced in line with the improved life expectancy due to better treament.

Van Walt says now that people living with HIV have access to a much wider choice of long-term insurance products, it is important that customers compare cost as well as terms and conditions to make sure the cover will meet their individual needs.

She recommends that customers ask the following questions before buying cover:

• Can the life cover be reduced or changed to accidental cover only? If yes, under what circumstances?
• Does the policy require ongoing testing and compliance with treatment? What are the consequences of non-compliance?
• Is the premium guaranteed and for what period? By how much can the premium increase over time?
• Is the initial premium loaded (a higher premium to factor in higher risk) and does the policy make provision for the premium to be reduced over time if the risk decreases?
• Does the policy only provide for life cover or does it include additional benefits such as critical illness and disability cover?

Other SA milestones

Van der Walt says South Africa has achieved a number of milestones in recent years aimed at ensuring the fair treatment of South Africans living with HIV.

The ASISA HIV Testing Protocol, for example, provides best practice guidelines for HIV testing for insurance purposes and has been hailed one of the best in the world. The HIV Testing Information Sheet is available in 11 languages and sets out quality standards for HIV testing and also addresses aspects such as personal pre- and post-test counselling.

Another first for the South African life industry was the introduction in July 2008 of telephonic pre-test counselling via a toll-free number for consumers who have applied for life insurance policies and require an HIV test. This service is offered in addition to written and individual pre-test counseling.

In 2012 ASISA extended this free telephonic service to post-test counselling. The aim is to reach customers who do not have access to a personal doctor. Once a client has elected in writing that he or she would like the HIV test results sent to the call centre, the call centre will provide telephonic counselling in one of South Africa’s official languages and will also arrange for follow-up tests and treatment if required. Further testing and treatment is for the customer’s own account.

Customers can also request face-to-face post-test counselling with a doctor and life companies will pay for the initial session.

“While life insurance products have become so much more accessible and affordable for people living with HIV over the past 16 years, the life industry will continue to develop products that increasingly meet the needs of people living with HIV. Life insurers will also continue to help raise awareness by facilitating pre-test as well as post-test counselling.”

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