The long-term outlook of people living with HIV has been improving for years and last month it was revealed that a child in South Africa had been “virtually cured” of the disease.
Research published earlier this year revealed that young people receiving the latest HIV drugs now have a “near-normal” life expectancy.
Yet despite such profound changes in the health of people with the conditions, one in four say they have been refused a financial product or quoted an unaffordable insurance premium in the past five years.
The survey, carried out by the National AIDS Trust (NAT), shows that some insurance products such income protection and critical illness cover remain completely unavailable to people living with HIV.
It’s a problem that experts warn extends far beyond those living with the virus.
NAT chief executive Deborah Gold says that with a normal life expectancy, people living with a diagnosis have as much of a right to long-term financial security as anyone else.
She argues that it is neither necessary nor appropriate to charge exclusionary premiums or exclude them altogether. But the survey, which was carried out as part of a report into financial exclusion of the HIV community, found that many people living with HIV are simply not aware of the increased range of insurance products available to them.
On top of that, negative experiences have led three in five to avoid applying for financial products because of their HIV status. Self-exclusion is a real issue due to fears of refusal, higher costs and stigma.
“We applaud the insurance sector for the significant steps taken to eradicate discriminatory practices and improve access for people living with HIV, but we have found that many people are still not aware of these changes or struggle to find HIV-inclusive products,” she says. “It’s therefore vital that insurance providers and HIV organisations work together to better communicate the availability of financial products to people living with HIV.”
While enormous, important steps have been made – particularly since the early 2000s as before then people with an HIV diagnosis sometimes struggled to find even basics like car insurance and mortgage lending – the NAT says that some injustice persists.
Ms Gold explains: “We’re especially concerned that critical illness cover policies will only pay claims for HIV when acquired through an occupational injury or assault. HIV is singled out as the only condition where mode of transmission is relevant to the success of a claim. This differential treatment is stigmatising and unnecessary.”
Critical of the cover
While HIV is a special case thanks to the prejudice those living with it face on top of the medical challenges, some IFAs have expressed concern that other long-term conditions face unfair exclusion from some insurers.
Medical advances across a range of conditions have made them more survivable and even more possible for patients to live normal lives alongside their treatment.
Lena Patel, a financial planner at ISJ Independent Financial Planning, says: “Whilst many people make full recoveries from serious and life changing illnesses, many insurance companies have not changed their views on pre-existing medical conditions and their underwriting processes.
“This puts people who have suffered a serious illness at a disadvantage, with many conditions still excluded from a new policy, even if the illness occurred many years ago. If the applicant is accepted [then] premiums can be very expensive and exclusions are common.”
Cathy Beaumont, mortgage & protection adviser at London Money, says: “I still find a frustrating degree of resistance from many insurers. Diabetes is a good example. Medical advances make it easier for people to manage the condition on a day to day basis, indeed our Prime Minister is a sufferer, yet the attitude of many insurers doesn’t seem to have caught up.”
However, she does not believe that sufferers are necessarily discriminated against unfairly or unjustly, just that it’s “a shame every insurer doesn’t treat each application on an individual basis. For example, one insurer takes a blanket approach to diabetes, imposing a standard increase to the premium charged, without considering the applicant’s individual circumstances.”
Yet Ms Patel argues that the extra hoops applicants with a long-term condition must pass through could be considered unfair. “For example, I have seen people be charged for the provision of medical reports, which can be expensive, particularly if multiple reports are needed. Cover is often declined too, leaving people out of pocket and with no protection in place.”
While there’s scope to accuse some insurers of not moving fast enough to provide products that reflect improved medical outcomes, progress is being made.
Ms Patel adds: “Things are improving slowly. Some insurers are very good at looking at each case individually and moving away from a one-size fits all approach. Insurers such as Vitality encourage fitness and provide discounts based on activity, which is a small step in the right direction.”
And Ms Beaumont says that insurers already do a lot to re-evaluate products on a regular basis. “Critical illness cover is a good example,” she says. “It has changed dramatically with some providers moving with the times and offering innovative products to mirror the way we now treat and, in some cases live with, serious illnesses.”
Yet among communities living with long-term condition there is often a feeling that the premiums and products on offer do not reflect their improved outlooks. Paul Fleming, a community representative, says: “HIV medication has progressed incredibly in the past 20 years but society hasn’t kept up. I am fit, healthy and HIV positive – it isn’t a contradiction. Yet financial services have been slow to wake up to that fact.”