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The life insurance outlook for HIV-positive gay men

Scientific studies on the subject of gay morbidity and mortality have been intertwined with vociferous political influence from the outset. Either pro-gay or pro-traditional family institutions led most of the studies, the results of which are highly criticized by the other.

No study is universally acknowledged to have resolved the question, and ultimately, life insurers want hard numbers when they decide who will be offered policies and how to price them.

No life insurance company asks about a person's sexual orientation on policy applications.

When one applies for a life insurance policy, the insurer will perform routine blood tests to identify any problems that will reduce life expectancy and, therefore, affect one's premium.

Kim McKeown, spokesperson for the Society of Actuaries, notes that no life insurance company asks about a person's sexual orientation on policy applications. "There are discrimination issues about trying to use that kind of information for life insurance pricing," she says. Thus there is no insurance actuarial data on whether gay men as a group have a reduced average life expectancy due to HIV/AIDS.

However, a diagnosis of HIV/AIDS will bring a swift life insurance rejection, no matter how well the patient is living with the disease.

Insure.com polled 35 leading life insurance companies and found that, as part of normal underwriting practices, life insurers will automatically decline any applicant who turns out to be HIV-positive. However, this blanket denial is notable given the growing body of knowledge that shows there are tens of thousands of gay men who have been HIV-positive and healthy for two decades now since AIDS burst on the national scene in the 1980s.

Senior market reporter Phil Young of Insure.com has, over the course of 10 years, examined hundreds of different life insurance applications and company acceptance guidelines. Young states, "While it's true that the life insurers do not ever ask about sexual preference, it's also true that every one of them will decline any applicant that proves to be HIV-positive. So, with their actions but not their words, life insurance companies are making a bold statement that anybody who is HIV-positive need not apply."

The Centers for Disease Control (CDC) states in a June 2007 report, "HIV/AIDS Among Men Who Have Sex with Men," that men who have sex with men (MSM) accounted for 71 percent of adult and adolescent males diagnosed with HIV/AIDS in 2005, thus rendering them ineligible for life insurance coverage at any price. Five to 7 percent of adult and adolescent men identify themselves as MSM, according to the report, so obviously MSM have a much higher risk of contracting the disease — they are anywhere from 32.5 to 46.5 times more likely than other men to be diagnosed. But insurance companies check for the disease, not the behavior.

"Insurers haven't had enough experience to know how long HIV applicants are going to make it. If they created something now it would be so costly that no one would want to buy it."
Kevin Coughlin, Target Insurance Services

Life insurance pricing is all about assessing "risk," but so far no life insurance company has taken the leap to collecting information on MSM and judging them to be engaging in "risky behavior." Information on individual MSM behavior wouldn't be verifiable, anyway.

AIDS/HIV has been able to drop out as a leading cause of death for older age groups but not yet for the younger generations. The CDC says in a June 2008 "National Vital Statistics Report" that HIV is still a serious public health concern: "In 2006, there were 12,045 estimated deaths from HIV disease. The preliminary age-adjusted death rate for this cause declined significantly by 4.8 percent between 2005 and 2006. Following a period of increase between 1987 and 1994, HIV disease mortality reached a plateau in 1995. Subsequently, the rate for this disease decreased an average of 33.0 percent per year from 1995 to 1998, and 3.3 percent per year from 1999 to 2005."

"For all races combined, in 2006," says the CDC, "HIV disease was the 8th leading cause of death for the age group 15–24 years, an increase in rank from 11th place in 2005, and the 6th leading cause of death for the age group 25–44 years. Between 2005 and 2006, HIV disease exited the list of 10 leading causes of death for the age group 45–64 years."

Kevin Coughlin of Target Insurance Services Inc., a brokerage that helps agents find life insurance for high-risk applicants, says it could take decades for insurers to have enough data on any condition with treatments that rapidly advance in order to offer policies to patients. "Insurers haven't had enough experience to know how long HIV applicants are going to make it," explains Coughlin. "If they created something now it would be so costly that no one would want to buy it."

HIV "isn't a death sentence," says Coughlin. "But you have to go a lot further to be insurable."

Until there's a long history of living healthily with HIV, insurance companies are sure to continue their current practices.

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