IC, insurance companies OK coverage for HIV-infected individuals

The Insurance Commission (IC) has partnered with insurance industry stakeholders to come out with underwriting guidelines for people suspected or are positive for human immunodeficiency virus (HIV). (Photo: Insurance Commission website)

MANILA—The Insurance Commission (IC) has partnered with insurance industry stakeholders to come out with underwriting guidelines for people suspected or are positive for human immunodeficiency virus (HIV).

In a statement, Insurance Commissioner Dennis B. Funa said “the guidelines determine the parameters to be considered for life insurance risk classifications and other underwriting purposes in cases of life insurance applications of persons with actual, perceived or suspected to be with HIV.”

He explained that this measure will help insurance companies offer full underwritten life insurance to persons suspected to have or inflicted with HIV.

“The issue on HIV requires a comprehensive approach in prevention, treatment and impact alleviation. Despite free anti-retro viral treatment, the lack of life insurance cover for persons with HIV continues to be a source of economic strain to them and their families. Thus, there is a need to provide insurance protection to these individuals,” he said.

Under the guidelines “special underwriting standards would be applied into the existing life insurance policies.”

Insurance firms may require applicants to voluntarily undergo HIV testing, pursuant to Article III of the AIDS Prevention and Control Act of 1998.

IC said “determination on whether or not HIV testing is necessary depends on certain parameters such as the age, occupation or lifestyle of the applicant.”

Applicants who are tested positive “would be reported to the Medical Information Database (MID) as long as the applicant agrees in compliance with the provisions of the Data Privacy Act of 2012.”

IC explained that MID “is a database of all medical information gathered by life insurance companies, as part of due diligence in their risk assessment process, from declarations made on company forms, those secured from medical examinations conducted on the insured applicant or policyholder or those sourced from records of medical service providers from which the insured applicant or policyholder may have sought.”

HIV-inflicted persons or those suspected to carry the virus may be given insurance coverage if they are undergoing proper medical treatment, if the applicant has a favorable risk profile and if the results of the medical examinations required by insurance companies are within normal limits.

IC explained that people who have just discovered their infection cannot be accommodated for insurance coverage “for a period of not more than one-year from the start of continuous Anti-Retro Viral Treatment (ART).”

“The one-year period is necessary for the purpose of evaluation of compliance with and efficacy of the ART,” it said. “Applications of persons with HIV presented with co-morbidities, medical conditions or other risk factors, on the other hand, may be postponed or denied by an insurance company due to the presence of such co-morbidities, medical conditions or other risk factors,” it said.

These guidelines were formulated along with the Home Office Life Underwriters Associations of the Philippines, the Philippine Society of Insurance Medicine, and the Philippine Life Insurance Associations-Medical Information Database.

IC said “under the Philippine AIDS Prevention and Control Act of 1998, life insurance should not shun away a person on the basis of his/her actual, perceived or suspected HIV status, as long as the person does not conceal or misrepresent.”

Citing Department of Health (DOH) data, the number of persons newly diagnosed with HIV per day has risen from a person a day in 2008 to 22 per day in 2015.

“In September 2015 alone, there were 692 reported cases. A total of 1,309 deaths were reported from January 1984 to September 2015,” it added.