The Association of British Insurers (ABI) is preparing to launch a consultation on the line of questioning used for those considered to be at a higher risk of contracting HIV and Hepatitis B or C. What changes, if any, would be welcomed by the life assurance industry?
Market views
Kevin Carr, Lifesearch
There are two main issues here: travel abroad and sexuality.
Clients who have worked or travelled outside of mainland Europe or the US, such as certain parts of Africa or Asia, for example, for more than two months will often be asked to undergo a HIV test and medical screening as incidence in these countries can be high. However, this is to be expected. Lifesearch's clients are notified at the outset and I am comfortable with the current questioning and underwriting process employed.
With regards to sexuality, in particular homosexuality, the position needs clarification.
Most providers ask a lifestyle question on their application form along the lines of 'do you belong, or have you ever belonged to one of the following groups: homosexual, bisexual, intravenous drug user, or are you a sexual partner of anyone in these groups?' If the answer is 'yes', then clients are then required to undergo a medical screening and an HIV test and the insurer may also write to their GP. As long as all the results are clean, most providers will not ask anything further and will not alter the original premium.
However, currently some providers go further, which is where the problem lies. Some insurance companies will write to the client asking further questions about their sexual history and will often then increase the premium by a minimum of 50% as a result.
I feel this is bordering on being an infringement of human rights and, in my opinion, the ABI's guidelines should outlaw this practice.
Nick Kirwan, Scottish Provident
The industry has been working with external bodies such as the British Medical Association (BMA) with regards to this consultation, and we should take this as an opportunity to improve our medical questions with our ever-increasing medical knowledge about conditions like HIV and Hepatitis B and C. Of course, this is an issue that affects most types of life and health insurance policies.
The key will be to ensure we get the balance right between the interests of policyholders and those at greater risk from these conditions. On one side, there is the need to avoid unnecessary questions about people's lifestyles when they apply for insurance cover. On the other, we need to retain our ability to underwrite health risks effectively to protect the interest of policyholders. If we do not get this balance right, there are several potential consequences that will be bad for customers.
Less effective underwriting is likely to result in increases in premiums for everyone to allow for any expected increase in claims. Either way, we would not be serving customers well if premiums were forced to rise, or policies offered more restrictive cover. That is why this consultation and these negotiations are extremely important.
Chris Morgan, Compass IFA
The ABI has been reviewing its statement of best practice for HIV and insurance. The present guidelines were written in 1994, and last revised in 1997.
I have been working closely with the ABI working party on HIV and the Terence Higgins Trust, to ensure gay men are treated with respect during the drafting of this document. The main areas of concern are questions relating to lifestyle, sexual habits, monogamous relationships, length of relationships, previous HIV tests, occupation and co-habitation. These are all highly intrusive questions and should be removed.
Speculative questioning of a person's GP on non-clinical issues, such as sexuality, is inapp-ropriate and out of line with the current BMA guidelines. It should be brought into line.
The introduction of a new respectful and relevant supplementary question to all groups, declaring 'safe sexual behaviour' would be welcomed as HIV risk is rising at an accelerated rate among groups outside of the gay community.
Helen Collins, Liverpool Victoria
Consistency and sympathy is the answer. If we could all have a consistent approach, then everyone would know their case is considered on an individual basis. Even with consistency, there is room for innovation.
There are many changes afoot in the life insurance world and mostly as a result of improving mortality, advancing diagnostic techniques and the realisation people are, in general, living longer.
There are also many different lifestyles in the world today and all of them could be classified as unique in their own way. Hepatitis may be an easier condition to determine the level of risk as the main enquiry is the level of damage sustained to the liver, and from this the life expectancy is determined.
Discussions are under way between the ABI and the Terrence Higgins Trust and we wait with interest to hear the outcome of this consultation. Meanwhile, we would like to stress whatever an applicant's lifestyle or origin, we endeavour to treat everyone equally and sympathetically – there are certainly no preconceived ideas of what a particular lifestyle may bring.
