Early last year, South African life insurers finally acknowledged the strides in AIDS treatment when the industry body, Life Offices' Association, said these companies would begin paying death and disability claims to HIV/AIDS infected customers.



Before this development, those carriers who offered life cover for HIV positive clients did so with reduced payoffs and premiums sometimes nine times higher than those for healthy persons.

With about 5.4 million of South Africa's 47 million people infected by the disease, this decision opened up new possibilities for this population segment. Without the ability to purchase life cover, many could not get home loans, business loans or provide for their families in the event of their deaths for any cause.

Contributing to this turn in the industry is the growing success of AIDS/HIV treatment. Many recognize that AIDS/HIV is a disease of extremes instead of averages. Those who monitor their health and get treatment do well. Those who do not die quickly.

For this reason, the new AIDS/HIV life cover policies are structured to require policy holders to receive and maintain antiretroviral treatments. With this requirement met, AIDS/HIV is considered a chronic, treatable disease like diabetes and many other chronic diseases, and is therefore insurable.

Premiums for AIDS/HIV life cover policy remain higher, but are no longer prohibitive. Age, gender, smoking habits and additional medical history are other variables that affect premiums for these policies. Eligibility depends on the applicant's age, ability to work and lead an active life, medical condition and manner in which the individual contracted the virus. Those who were infected through sexual contact or an accidental needle stick are considered a lower risk than intravenous drug users. Blood tests are performed to ensure an acceptable level of the virus in the applicant's bloodstream.

AllLife was a groundbreaker in the affordable AIDS/HIV life insurance market. Clients commit to treatment once their CD4 count (a measurement of the strength of the immune system) falls below 200. The company monitors and encourage adherence. Those who default lose their cover.

The company targets a pool of about 2 million HIV-positive South Africans earning a minimum monthly salary of R2,500. Their client base includes a range from domestic workers to company executives. Most receive medical aid to pay for their ARV treatment.

Products include Term Life insurance with varying durations of cover and fixed premiums, Whole Life "standard" insurance providing level cover as long as premiums are paid, and Home Loan Protection insurance providing cover for the outstanding balance of the individual's home loan.

Average cover is R450,000, but policies can be taken out for a maximum of R3million. Premiums average R300 per R100,000 per month. High risk policy premiums can go up to R700.

After watching its average life expectancy drop to 51 since 1991, the South African government launched a new AIDS plan with the goal of cutting new infections by 50 percent and bringing treatment and support to at least 80 percent of HIV-positive people by 2011.

With this change in its insurance industry, South Africa became one of only two countries worldwide where HIV-positive people could purchase life insurance. Some companies offering policies for this cover include AllLife, AtRisk, Old Mutual, Sanlam and Metropolitan.