Consultation Launch

As most of you will be aware, the Association of British Insurers (ABI) has been reviewing their statement of Best Practice for HIV and Insurance. The present guidelines were written in 1994, and last revised in 1997.

Pinkfinance.com has played a major role in the shaping of the new guidelines under which gay men will be underwritten for Life Assurance. Our editor, Chris Morgan, has been working closely with the ABI working party on HIV and the Terence Higgins Trust, to ensure that gay men are treated with respect during the drafting of this document.

The draft statement of Best Practice is now ready to be offered for consultation and everybody's views on this new document would be appreciated either by email to editor@pinkfinance.com or directly to the Association of British Insurers.

Pink Finance has been involved in all the areas of the statement of Best Practice; however, our main areas of concern are listed below, along with our specific suggestion for future practice.

Our Proposals

Questions relating to Lifestyle, Sexual Habits, Monogamous Relationships, Length of Relationships, Past HIV Tests, Occupation (Hairdresser, Cabin Crew, Ballet Dancer, etc) and Co-Habitation, are all highly intrusive, and a breach of human rights; and should be removed. 

Speculative questioning of a person's GP on non-clinical issues, such as sexuality, is inappropriate and out of line with the current British Medical Association (BMA) guidelines and should be brought into line.

Personal questioning of gay men, on policies such as Income Protection, Critical Illness Cover and Long Term Care Insurance, should be removed, as the majority of these policies do not cover HIV risk.

The introduction of a new respectful and relevant question to all groups, declaring 'Safe Sexual Behavior', as HIV risk is rising amongst groups outside of the gay community at an accelerated rate. 

Best Practice - September 2003 & Key Consulation Questions

Most of the above proposals have been accepted into the new guidelines and it's now important that the gay community play a leading part in the consultation process.

The following Pink Finance points have been included in the document and your views should be made to the Association of British insurers in all these areas. We urge the gay community to air their views on the subject and to take this rare opportunity to be heard by the Life Assurance Industry at the highest level. Please note that as these are extracts from the consultation document, the question numbering is not sequential. 

Underwriting Approach

2.3 (Principle 1)

An individual's general occupation is no guide to their HIV risk. For example, being a cabin crewmember, ballet dancer or hairdresser cannot of itself justify an HIV rating.

Collection of Information

2.4 (Principle 2)

Only ask for information that is relevant. Insurers will not request information which is unnecessary or irrelevant to the risk of being insured, such as speculative questions that rely on inference and assumption on the apart of the underwriter. For example, co-purchasing arrangements. 

Question 1: Are the principles the right ones and do you have any comments on them?

Communication with the Applicants GP

3.1 & 3.2

Care should be exercised when communicating with an applicant's GP. Prior explicit written permission must be obtained from the applicant before writing to the doctor with any information or questions that could directly or indirectly reveal the sexuality of the applicant to the GP. In particular, information arising from the applicant's answers to questions about belonging to certain HIV risk groups (SHOULD NOT) be passed on to the GP.

Equally, insurers must not ask the applicant's GP to speculate on whether the applicant is at higher than normal risk of infection from HIV, nor should they request an opinion on a non-clinical issue. 

Question 2: Do you agree passing information to an applicant's GP should not be allowed unless the applicant has given explicit consent?

Asking About the Applicants HIV Status and Risk

3.5

Since publication of the first version of the ABI Statement of Practice on Underwriting Life Insurance for HIV in July 1994, insurers have not asked whether an applicant has undergone counselling about HIV, or had taken an HIV test. Instead, insurers have been expected only to ask whether the applicant had tested positive for HIV, or was awaiting the results of an HIV test.

Question 3: Do you agree with the wording of the question that appears on the applications form to to begin the process of establishing risk of HIV infection. If not, please suggest alternatives and give your reasons. 

Underwriting Evidence and Exclusions

A.6

If the exclusion means that questions about a person's risk of HIV infection are irrelevant, those questions should NOT be asked. This is particularly likely to be the case for income protection and long term care insurance, because it should usually be relatively simple to establish whether or not HIV/AIDS is the cause of the claim. Insurers may still ask for details of positive HIV tests, as to do otherwise would be to offer an unfair contract to those already affected.

Question 14: Do you agree that where HIV/AIDS exclusions are applied to income protection or long-term care insurance questions relating to the risk of HIV infection should not be asked, for example, Question 15? 

Supplementary Questionnaire, Covering Letter or Leaflet - Recommended Test

B.3

'We are currently considering your application for insurance. Before we reach a decision, we require some additional information. We are among a number of insurance companies which ask for more information from applicants, so that we can protect our overall risk profile. [We have chosen to ask you because statistically, you fall within a recognised high-risk grouping for contracting HIV. - delete if not appropriate]

Any information given in your answers will be treated confidentially. We would be grateful if you would complete the questionnaire (following questions) and return it (them) in the envelope provided. If you prefer, you can answer the questionnaire (following questions) separately, and send your answers in a sealed envelope, marked for the attention of the Chief Medical Officer at our company.

Answering 'Yes' to any of the questions may lead to you being charged a higher premium, or to your application being turned down (this will be in proportion to your perceived higher risk of HIV). We may also ask you for additional medical information before taking our decision'. 

Question 16: Do you have any comments on the wording of the covering letter to the supplementary questionnaire?

B4

Whether companies choose to ask for additional information in their application forms, or in a supplementary form, to determine whether the applicant is at higher risk of HIV infection, the recommended wordings for the questions normally included are set out below.

An insurer may not, however, feel obliged to ask all of the questions below.

Question 1:Do you belong, or have you ever belonged, to any of the following groups?

a. Gay Men No/Yes
b. Bisexual Men (having partners of both sexes) No/Yes
c. Intravenous Drug Users No/Yes

Question 2: Have you ever undergone any surgical procedure outside the UK, or been a recipient of blood products outside the UK? No/Yes

If YES, please provide us with the date(s), the country or countries and the reason(s) for each procedure and transfusion undergone.

Question 3: Have you ever stayed in any of the following countries [X] for more than [4 weeks] in the last [5 years] (companies may choose to use this more specific wording than the one in paragraph 3.4)? No/Yes

Question 17: Do you have any comments on the wording of the 'Standard Supplementary Questions? 

B.5

The supplementary questionnaire should not be referred to as the 'lifestyle' questionnaire, as this can cause offence. The term 'supplementary questionnaire' should be used.

Additional Supplementary Question

B.6

Insurance companies should take care to ensure that any further questions they ask are relevant and verifiable, for example, they should not ask supplementary questions relating to: -

• Numbers of sexual partners.
• Length of relationships.
• Monogamy.
• HIV tests and sexually transmitted diseases beyond that set out in the main text.
  

Question 18: Do you agree that insurers should not ask the supplementary questions listed in Annex B6? 

B.7

The introduction of a new respectful and relevant supplementary question, declaring 'Safe Sexual Behavior', applicable to all risk groups, not solely gay men.

Question 19: Is the supplementary question in Annex B7 appropriate to help determine levels of risk in some risk groups? Can you suggest others and at which risk groups would they apply to? 

Conclusion

Pink Finance believes that the improvements to the guidelines reflect the levels of respect that the Life Assurance Industry should show the gay community. Instead of basing decisions on speculative and intrusive questioning, they will now be required to use relevant information to HIV risk in a respectful manner.

The Pinkfinance Life Assurance Campaign has now given the gay community the opportunity to be heard. We urge you all to play your part in the consultation exercise by expressing your feelings about the levels of discrimination shown by Life Assurance Companies. 

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