An investigation by ESG Clarity’s sister title International Adviser has discovered a number of insurance providers in the UK are discriminating against clients because of a specific health condition
The investigation found many insurance companies offering life and/or critical illness cover are refusing applications from people who have human immune deficiency virus, better known as HIV.
This is despite the Association of British Insurers (ABI) creating a consumer guide about life insurance for people with HIV in 2016.
It said: “Life insurance has been available to people living with HIV since 2009. As with many pre-existing medical conditions, you may not be eligible for some products and may have to pay higher premiums as you are a risk for the insurer.
“However, there are a number of products offered by insurers that cover pre-existing medical conditions and, like other insurance products, the policy and price differs between insurers.”
Similarly, in 2018, the ABI worked with LGBT+ inclusive insurance firm Emerald Life to create the Guide to Minimum Standards for Critical Illness Cover as a result of recent medical developments.
The guide says: “Medical advances mean that many conditions will be picked up more frequently at earlier stages where they are less severe. This clearly has implications for the type of condition that critical illness insurance aims to cover and for the way in which conditions are defined.
“For instance, conditions which were considered life-threatening or extremely severe 10 years ago, may now be diagnosed early and, with appropriate treatment, have a good prognosis. The severity of some conditions has changed to the point that they can no longer be considered ‘critical’ in terms of their life expectancy.”
In its guide, the ABI stated: “HIV is a key example of this. According to the National Aids Trust (NAT), ‘the outlook for someone living with HIV in the UK today is relatively positive. HIV treatment outcomes in the UK are excellent: 96% of people diagnosed with HIV are on treatment and 94% of those on treatment are virally suppressed.
“Many people living with HIV report that their condition has little impact on their working life, and those diagnosed early and adherent to treatment have a normal life expectancy’.”
Following an “extensive” consultation, the ABI published its guide in May 2018, giving member firms until 1 February 2019 to update the wording of their policies.
But annex A of the guide outlined a series of changes, one of which was the deletion of the definition of HIV.
Instead, the ABI added that “firms may adopt the wording they consider appropriate to describe any cover they offer for this condition.”
IA contacted all 19 ABI member firms that offer either life or critical illness insurance.
Just seven replied, and of those, only two, namely Scottish Widows and Royal London, said they don’t have any HIV-related restrictions.
Scottish Widows said it assesses life insurance applications individually, and that “IFAs are encouraged to call our underwriters before submitting an application for a customer with a pre-existing medical condition, including HIV, so that we can discuss their individual circumstances”.
“Information will be requested from the doctor of customers with pre-existing conditions regarding their medical condition.”
Royal London said that the word ‘HIV’ does not feature in any of its policies. “Our protection policies make no mention of a customer’s HIV status. There are no limitations or exclusions in relation to claims from customers who are HIV positive.”
Another provider, Cigna, which only offers group products, said there is no HIV exclusion from its life cover. The firm does not offer critical illness cover in the UK.
Unable to provide cover
Of the remaining four firms, all have varying restrictions for either type of product.
Vitality said HIV+ people can take out life insurance, but the company will not provide serious illness or income protection cover to them.
Aviva and Zurich have similar limitations. Life insurance is available, although it may be subject to higher premiums or restricted terms, but they don’t offer critical illness cover to people with HIV.
It is the opposite, however, for Canada Life.
The firm said: “If a client had tested HIV positive, this would need to be disclosed and we would be unable to consider cover.”
There are a few exceptions, however, and these are true for both Zurich and Canada Life.
If a client becomes infected through a blood transfusion, physical assault or work-related accident, they can be given cover – either critical illness from Canada Life or life insurance from Zurich.
Any other means of transmission would immediately rule out a potential customer.
Turning away minorities
Those mostly affected by HIV in the UK are gay and bisexual men; according to the latest Public Health England (PHE) figures, in 2018 there were 4,453 HIV diagnoses; 225 Aids at HIV diagnoses; and 473 HIV/Aids–related deaths in the UK.
Just over half (50.5%) of HIV cases in 2018 were as a result of ‘sex between men’.
Separately, 850 men and 1,090 women were infected through heterosexual contact in the same year, whereas 110 caught HIV through drug use and 140 through other ways.
As the figures show, HIV predominantly affects gay and bisexual men, who also have a longstanding legacy of discrimination when dealing with the financial services industry.
In 2019, co-founder of LGBT+ financial advisory firm Attitude Financial Services and publisher of gay magazine Attitude, Darren Styles, revealed to IA that, in 1996, he was asked to bring an HIV-negative test result if he wanted to take out a pension.
“The first time [my business partner and I] went to buy a pension, it was October 1996, we’d done very well and at that point each of us had £25,000 ($31,509, €27,540) to invest as a lump sum.
“So, we sat opposite a financial adviser, but he wasn’t aware of my personal life because, at that point, it wasn’t something you would talk about openly.”
While everything went smoothly for Style’s business partner, who got the “red carpet treatment”, it was not the same for him; Styles had to disclose his sexuality.
“The temperature dropped by a few degrees, he stops filling in the form and says: ‘Ah, well, you see, the thing is, before we can do any of this for you and look at any life cover, you’re going to have to have an Aids test; and, unless that comes back clear, I’m afraid you can’t progress any further with this’,” he revealed.
What the law says
To understand the legality of the issue, IA spoke with Karen Holden, managing director of A City Law Firm, a law practice that has often worked on LGBT+ issues.
She said: “The majority of life insurance contracts in the UK do not have exclusions for any medical conditions, including HIV, if diagnosed after the cover has started, and you will continue to be covered.
“Insurance providers are not allowed to have blanket or general policies of refusing to provide insurance or only providing insurance on certain terms to people living with HIV.”
As it stands, insurance providers in the UK are breaching the Equality Act 2010; and, as a result, unlawfully discriminating against potential clients.
“The Equality Act 2010 applies in England, Wales and Scotland, and gives protection to those with a ‘protected characteristic’ in relation to employment, education, access to goods, facilities and services as well as in buying or renting land or property,” Holden added.
“The general position is that insurers cannot discriminate based on protected characteristics listed under the Equality Act 2010, and HIV is one of such characteristics.
“As such, insurers need to have a process and policy that considers all applications in the same way.
“Insurers are therefore unlikely to turn away clients who make an application for life and/or critical illness cover because of their HIV status.”
But IA’s investigation found otherwise.
Rosalie Hayes, senior policy & campaigns officer at National Aids Trust, told IA: “Although access to insurance for people living with HIV has improved dramatically in the last decade, it is disturbing that discriminatory blanket restrictions for HIV persist among certain insurers.
“We believe these bans are unlawful and fail to acknowledge the significant advances in HIV medicine resulting in normal life expectancy for people living with HIV.
“National Aids Trust will continue to challenge these discriminatory practices in our advocacy with the insurance industry. We encourage people living with HIV to always consult a specialist broker to support them in finding suitable cover.”
No additional hoops
Dawn Gale, managing director at Attitude Financial Services, told IA it is not fair to put people with HIV in such as difficult position.
“At the end of the day HIV is an illness, it is a medical condition and it should be treated like any other medical condition. So, the facts should be collected, and an underwriting decision made. There should be no blanket rejections or exclusions.
“It should be considered exactly the same way as any other illnesses. Now, that doesn’t mean that everybody who is HIV positive can get life and critical illness cover, because it will be wholly dependent on their individual circumstances.
“What we have to look at is how many hoops we make people jump through to achieve the outcome. And I think that the key message is that nobody can ever say ‘you will always get life cover, you will always get critical illness cover’.
“But what we need to try and do, as an industry, is make it not so embarrassing, not so invasive, the underwriting should be as it is for the other conditions. It’s just about answering some questions, getting some medical evidence when the decision is made. But there shouldn’t be additional hoops put in place,” she added.
Matter of assessment
A spokesperson for the Association of British Insurers told International Adviser: “Life insurance and protection cover, such as critical illness, is available to people who are HIV positive to reflect medical advances in treating the condition, and much improved life expectancy for most who are diagnosed.
“Assessing the risk will, for an insurer, be a detailed process with a number of factors needing to be taken into account, including date of diagnosis, treatment, and any other relevant medical conditions.
“This is why it is important that anyone who is HIV positive when seeking life insurance and protection cover gets independent financial advice so that their particular financial needs can be assessed, and they can be directed to those providers best placed to offer cover.”