ANC deputy secretary general Cheryl Carolus applied for life insurance — and discovered how HIV sufferers are
The experience of buying our first home has been turned, for my husband and I, into a face-to-face confrontation with the irresponsible and discriminatory way in which the insurance industry continues to deal with HIV and Aids.
It started with the bank’s recommendation that we take out life insurance in favour of each other now that we share a home loan. It made sense, so we went off to see Old Mutual. And here is where the problems began: if we wanted life insurance, we had to have HIV tests. Worse yet, the tests had to be sent straight to their in- house doctor before we or our doctor could see them.
If our tests were negative, the company would grant us insurance and we would sail off into a happy, secure, home-owning future. But if either of us turned out to be positive, the information would be forwarded to our doctor, and we would be shut out, for ever, from the possibility of life insurance.
Notwithstanding the discriminatory nature of this practice, there is the fact that it is a clear breach of medical ethics — of the primacy of doctor/patient relationship — for the insurer to insist that it must see the results first. Surely it is my right to go off and be tested by myself, and then to make the decision as to whether I wish the insurance company to see the
As I thought about the possibility of a positive test result, I had a tangible understanding, for the first time, of what it must be like to be HIV positive in this society; of just how cruel and inhumane it is to deny HIV positive people access to insurance and all the security it represents, when they are the ones who need it most.
I question the sense of requiring people to test HIV negative before granting them access to insurance — there is a window period of up to six months after infection in which you can test negative even if you are positive. And even if you are negative at the moment you get your insurance, there is no guarantee you are going to stay that way.
But I do understand that the insurance industry needs to protect its viability if it is going to continue providing services, and so I do have some sympathy for the bind it is in. All the same, I do not understand why a person with HIV cannot be insured against accidental death. If I am diabetic, I will be covered against all death save that which is directly related to my diabetes. Why can it not be exactly the same for people with HIV? Why should I and my family be discriminated against if I am run over by a bus, or stabbed?
And so the first thing I would like to see the insurance companies do, to bring them in line with our new, non-discriminatory society, is grant insurance to people with HIV even if they feel they have to exclude death due to HIV-related illness. That is the bare minimum; after that, I would like to see them explore options of how they can provide full cover to people with HIV — perhaps with higher premiums and lower payouts, perhaps also with state assistance.
The second thing I would insist that they do is beef up their confidentiality and counselling facilities. If they are going to test every applicant, they have to provide pre-test counselling. At Old Mutual, our “pre- test” counselling session consisted of reading eight brief paragraphs typed up on our application form. That is a sorry and unacceptable substitute for proper counselling, which involves one-on-one interaction and opens up the possibility of an ongoing relationship if the test is positive. I know this will cost the insurance companies a fair bit more, but they can’t have their cake and eat it.
And then, if a prospective client does test positive, it must be up to the insurance company itself to provide — or at the very least pay for — post-test counselling. Currently, state Aids centres have to absorb, at their own cost, those who have undergone the trauma of testing HIV positive while applying for insurance. Why should the taxpayer have to pay for the consequences of a discriminatory practice by a private
It is in the field of confidentiality that I take the greatest exception to the way we were handled. I came home one day to find, on my answering machine, a message from the broker’s secretary that said: “I am just phoning to check whether you have had your HIV test already.” What if there were other people in the room with me? I phoned back to complain to her boss, but before she put me through, she asked me, loudly, “Is it about your HIV test?” I could hear other voices in the background.
I do not blame her: she clearly had never been trained, by her company, on the importance of confidentiality. Given her slapdash approach to the issue, how could I feel confident that, in the event that I was HIV positive, the information would not be carelessly broadcast around the office — or my home?
Perhaps most offensive is a clause in the application in which we are asked to sign away our rights by indemnifying the company and all its employees “against any claim of whatever nature which may be made against them as a result of or arising out of such a test”. In other words, if my confidentiality is broken, I will have no legal recourse against the company. This makes a mockery of all the company’s promises of
I am convinced that all the above practices are not only discriminatory, but unconstitutional, and that a fair case could be made against the insurance industry at the Constitutional Court. I would like to suggest to the industry that it does three things as a matter of urgency: that it stops testing until it has trained its staff properly in confidentiality and put into place proper pre- and post-test counselling facilities; that it respects the primacy of the doctor/patient relationship; that it begins to look at constructive alternatives for those who do test HIV positive.
People with HIV are responsible and productive members of our society. If they are not treated fairly and decently, without discrimination, the whole premise of our new democratic society is brought into disrepute.