HIV and Life Insurance: Can I get covered?

Can someone who has had a positive test for HIV still get life insurance?

If someone has tested positive for HIV, it is possible to get life insurance. Although it could be a challenge to get a comprehensive policy, there are some options available.

What to do

  • Speak to an adviser or your insurer.
    • HIV is now considered a chronic but manageable condition1 so it's worth speaking to the insurer and getting your condition assessed.
  • Get medical evidence or an assessment of your HIV status. Typically you'll need to demonstrate the following:
    • A CD4 Count that is greater than 350.
    • Your Viral Load is confirmed at less than 1000/ml copies.
    • If your condition is considered 'undetectable' you'll have a greater chance of getting life insurance.
  • Evidence of HAART (Highly Active Antiretroviral Therapy).
    • Insurers will need this to show you are proactively using treatment to decrease Viral Load and increase CD4 count.

What not to do

  • Go with an automatic acceptance policy thinking you'll be covered
    • These policies blanket exclude pre-existing conditions.
  • Not disclose your condition
    • Insurers could deny you at claim time.

Need to know

  • If you are able to get cover you might have a limited amount of cover e.g. less than 20 years of cover. You may also pay more on your premium (roughly 150% more than standard).
  • If you can't get covered try another insurer, speak to an adviser

Find cover for occupationally acquired HIV

What is HIV?

HIV

Human immunodeficiency virus (HIV) is the virus that causes acquired immunodeficiency syndrome (AIDS). HIV is contracted through contact with the bodily fluids of another infected person. People will generally contract the virus through unsafe sex, shared needles, through breast milk or within the womb. People can contract HIV and not show symptoms for many years.

Once contracted the virus can have a serious effect on your body. Once infected the virus will infect the cells that are involved in maintain the immune system. If left untreated the cells that are infected will increase and the immune system of the infected person will weaken, this leads to AIDS. People with AIDS will usually not die directly from the virus but from an infection that the immune system has failed to fight off.

In comparison to HIV, AIDs is not a condition that can simply be caught. AIDs is the result of HIV that has been left untreated and allow HIV to continue to destruct the immune system. This can lead to the person suffering life threatening infections and cancers.

While HIV contraction through the workplace is rare it can happen. If you work with the virus or around people that have the virus then you will be at a higher risk of contraction. Healthcare workers such as doctors, surgeons, nurses and dentists can face the added risk of HIV being contracted through working with patients. Most Trauma insurance policies will provide cover for occupationally acquired HIV as a specified condition. Many insurers will also offer Needlestick Injury benefit, which is available as an additional option on Life Cover and Income Cover policies to provide a lump-sum benefit for the accidental contraction HIV for people working in the medical and allied forces.

What if I develop HIV after taking out cover?

A form of life cover called Trauma Insurance provides a lump-sum benefit in the event that the insured person suffers a listed medical event and meets the eligibility criteria as defined by the insurer. When it comes to HIV cover, trauma policies may offer cover for 'occupationally acquired HIV'.

Find out if Trauma Cover is the right option for you

What is occupationally acquired HIV?

It is a sad reality that no matter how precautions we may be in our day-to-day lives, accidents can still happen. Some of these accidents can result in serious illness or injury that can cause significant emotional and financial stress. Certain occupations will be exposed to an increased level of risk than others and finding protective cover to give financial security in the event of a loss occurring is critical.

One such condition that a number of occupations have an increased risk of facing is HIV. If you work around people with HIV or with HIV then you should consider insuring yourself so you are covered if you contract the virus. Most trauma and income protection policies insurance policies will provide cover for occupationally acquired HIV, both built-in and with the additional Needlestick cover benefit.

Trauma insurance for occupationally acquired HIV

Many life insurance companies will provide cover for HIV that has been contracted as a result of an accident in their normal occupation. Some typical conditions that will be applied in order for the benefit to be paid include:

The accident:

    • HIV is acquired as the result of an accident that has occurred while the person is engaged in their normal occupation
    • HIV is acquired as the result of an accident that occurred while the person was carrying out the normal duties of their occupation
    • Seroconversion to the HIV virus occurs within 6 months of the accident occurring

Reporting the accident:

    • Any accident that has occurred that may lead to the insured claiming under this benefit must have been reported to the insured’s employer
    • Notice of the accident must be provided to the insurer within a specified time of the accident occurring
    • Proof of a negative HIV antibody test taken after the accident must be provided

Evidence required by insurer:

    • Insurer must be able to test blood samples that have been used as evidence
    • Take additional tests if required
    • A copy of the report of the accident that was made with the employer at the time the accident occurred
    • Evidence on the source of the infection

A benefit will not be paid if:

    • Infection must not be acquired by any other cause other than accident caused through the occupation
    • Precautionary measures were not taken by the insured before and after the accident has occurred

Cover for occupationally acquired HIV with needlestick injury benefit

Most life insurance policies will provide needlestick injury benefit as an additional option on Life Cover and Income Protection Insurance policies. This feature is designed specifically for people in medical and allied occupations to provide a benefit in the event that they become accidentally infected with HIV, Hepatitis B or Hepatitis C while working in their normal occupation.

How is the needlestick injury benefit paid?

  • Life cover: Under life cover, the Needlestick injury benefit is usually provided as a lump sum and must not exceed the insured lump-sum for life cover. The benefit may only be paid once for this condition.
  • Income protection: Under income protection, the insurer will generally pay a multiple of the insured monthly benefit that would be provided for income cover. As an example, Asteron will pay 50 times the monthly benefit if the insured becomes infected as a result of accidental infection.

General Conditions for the Needlestick Injury Benefit to be Paid

  • Any accident that may give rise to a claim must be reported to the insurer within a specified time period along with a negative HIV test taken within a specified period from the accident
  • Evidence of seroconversion to HIV must be provided within 6 months of the accident occurring
  • Insurer must be given access to all blood tests that have been taken independently by the insured
  • Insurer has the right to take additional tests to verify condition if required
  • Benefit will only be paid if infection was the result of an accident that occurred while the insured was carrying out the normal duties of their occupation
  • No benefit will be paid for any other disease or illness that has occurred through the course of the insureds occupation
  • In the event that the insured is also able to claim for HIV under their Trauma Insurance policy, both benefits will be paid to a combined maximum amount. As an example, AIA will pay up to a maximum of $2 million

Read the review for Zurich Needlestick Insurance

Speak to an insurer about your condition

Name Product Maximum cover Maximum Entry Age Minimum Sum Insured Guaranteed Future Insurability Expiry Age Short Description
$1,500,000
65
$100,000
Yes
99
Cover for pre-existing conditions are assessed on a case by case basis. You will need to disclose during your application and you may need to speak to someone on the phone regarding your condition.
$1,000,000
65
$100,000
No
No expiry age as long as premiums are paid
Cover for pre-existing conditions are assessed on a case by case basis. You will need to disclose during your application and you may need to speak to someone on the phone regarding your condition.
$15,000,000
69
$0
Yes
99
Cover for pre-existing conditions are assessed on a case by case basis during the application process. You may be subject to an increase in premiums or a specific exclusion.
$1,500,000
65
$3,000
No
80
Cover for pre-existing conditions are assessed on a case by case basis. You may need to speak to the underwriter over the phone. Make sure you select the 'Tailored' option on site.

Compare up to 4 providers

  1. https://www.positivelife.org.au/your-voice/hiv-and-insurance.html

Maurice Thach

An insurance researcher and writer for finder.com.au who loves finding an answer to the question "Am I covered for ________?" Maurice has also completed a Tier 1 Life Insurance and a Tier 2 General Insurance Certification under ASIC's Regulatory Guide 146. This means he can confidently provide general advice for life insurance and non-life insurance products.

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