# life assurance and STD testing



## query (16 Sep 2004)

i am looking for life assurance and notice that on many application forms that you are asked whether you have ever been tested for any sexually transmitted disease.
are you automatically loaded if you answer yes to this question? even if you had no positive tests?
and if you have tested positive for a non life threatening STD will this have a serious impact on the cost of life cover?


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## potblack (16 Sep 2004)

*Life Assurance*

IMHO you would not be automatically loaded. I think like all medical questions it would be assessed and only if found to be a high insurable risk that you may be loaded.
I am not a Doctor so I cannot say if an STD is classified as a high insurable risk however I personally don't think it would be.

The effects of non-disclosure is dangerous. They will possibly write to a Doctor and if they find out you have omitted items on the proposal they could reject the application. If at a later stage, you were diagnosed of, lets say, pelvic cancer, and you have not disclosed an STD and the insurance company found out about it, they could reject the claim, even though it may not be related.

When it comes to a life policy, honesty is the best policy.


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## Elcato (17 Sep 2004)

*Re: Life Assurance*

Quite often your GP will advise you to get a HIV or STD test done independently as he will be obliged to put in on your record if you go through him. This is advised for precisely this reason. Agree with previous poster regarding disclosure so if you had the test done through your GP you will have no choice but to reveal. If, through an indepedent private clinic, you have got a negative result I don't see why you need to reveal this.


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## MissRibena (17 Sep 2004)

*Re: Life Assurance*

I spoke to my doctor about this the last time I had a proper check-up.  She was aware of the situation re Life Assurance etc. and offered to ensure the (negative) results were not put on my file.  If they were positive, it wouldn't really make much odds as then there would clearly be something tangible to declare.

I don't think it's fair for the companies to ask the question.  It would be fair to ask (say) whether you had a test that returned abnormalities.  My GP was against the question too - she felt strongly that generally people who initiated tests were far less likely to have something wrong than people who come forward with symptoms and _then_ have a test.

Anyway, if she offered to do this for me, then maybe it is unofficial procedure among GPs even if it is not 100% legit.

Rebecca


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## rainyday (18 Sep 2004)

*Re: Life Assurance*

While it may be unpalatable, it seems fair enough to me that an insurance company may want to apply different charges to individuals who have had STD testing (which has almost certainly got to indicate some level of indulgence in risky behavours) compared to inviduals who have never had STD testing. If you really don't like this question, find another insurance company.


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## veron01 (20 Sep 2004)

*Re: Life Assurance*

".....who have had STD testing (which has almost certainly got to indicate some level of indulgence in risky behavours)"

Why does it? 

I don't agree that it means that people who have been tested have indulged in anymore risky behaviour than those foolish people who have never had an STD test.

Mightn't it be some of the people who have never been tested are infecting others out there?

I think it is unfair for insurance companies to load more charges on an individual who has been tested as I feel that that person is being more careful than people who never get checked out.


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## ajapale (20 Sep 2004)

*Re: Life Assurance*

Hi Veron,



> I think it is *unfair* for insurance companies


.

Unfortunatley, insurance companies exist to make money and not (neccessarily) to be fair.

Are insurance companies entilted to ask you whether you have had genetic testing?

ajapale


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## veron01 (20 Sep 2004)

*Re: Life Assurance*

Ajapale

I understand what you are saying and although I agree, I was annoyed that some people assume that if you are tested you are indulging in risky behaviour. 

I think that this is backward thinking and that people should always get themselves checked out. 

Its the notion that insurance companies would load a person even if the tests were negative, that I think is crazy.


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## rainyday (20 Sep 2004)

*Re: Life Assurance*

Hi Veron - Read my post carefully. I didn't say that someone who had a test was more likely to be involved in risky behavours than someone who did not have a test. I said that having a test is an indicator of some level of participation in risky behaviours - Do you disagree with this point?


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## veron01 (20 Sep 2004)

*Re: Life Assurance*

"I said that having a test is an indicator of some level of participation in risky behaviors. Do you disagree with this point?"

Hi Rainday,

I do disagree. I don't think that all people who have had a test are more likely to think that they have a chance of getting an STD. 

I feel it should be common practice that anyone who is sexually active should be tested, whatever their indulgences are. 

That is why I think that it is not right if insurance companies preload an application on the grounds of STD testing. 

Do you not agree with this?


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## ajapale (20 Sep 2004)

*Proxy (Poxy) Measures for Life Assurance*

hi rainy and veron,

In certain US states it is compulsory to undergo syphills blood tests before you can get a marriage licence.

Im inclined to agree with veron, if you go for an STD test it could be a singn that you are engaging in risky activty but also it could be a sign that you are a hypocondriac or worse still an american?

I dont like the used of thes proxy (poxy!) measures. Why not simply ask " have you ever been treated for STD's?".

ajapale


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## rainyday (20 Sep 2004)

*Re: Proxy (Poxy) Measures for Life Assurance*



> I do disagree. I don't think that all people who have had a test are more likely to think that they have a chance of getting an STD.


That's not the question I asked. I didn't ask anything about what the person thinks about their chances of getting an STD. Please don't twist my words.

What I asked was "having a test is an indicator of some level of participation in risky behaviours - Do you disagree with this point?". Please explain why anyone would volunteer for an STD test if they had NEVER indulged in risky behavours? [& I don't think the ajapale American hypochondriac example is a very realistic answer]


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## ajapale (20 Sep 2004)

*Re: Proxy (Poxy) Measures for Life Assurance*

Hi rainy,  still not convinced...

In many countries pregnant women undergo compulsory std testing.

I suppose pregnancy could also be used as a proxy measure. After all it shows a propensity for "risky behaviour".



> "having a test is an indicator of some level of participation in risky behaviours "


 I disagree with your statement...having a test is indicates having a test no more no less and it is wrong for insurance companies to draw inference from it.

ajapale


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## rainyday (20 Sep 2004)

*Re: Proxy (Poxy) Measures for Life Assurance*



> In many countries pregnant women undergo compulsory std testing.


Let's just stick to Ireland, shall we?


> having a test is indicates having a test no more no less



What percentage of those people who have volunteered for STD tests have NOT had unsafe sex, do you reckon?


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## ajapale (20 Sep 2004)

*Medical/Lifestyle Questions and Underwriting Standards*

*Medical/Lifestyle Questions and Underwriting Standards*

Hi rainy,

Do you think it is ok for life assurance companies to ask applicants questions concerning whether they have sought  STD counseling from health care professionals?

Having got the answer to those questions is it ok for them to make adverse underwriting decision based on the answers?

ajapale

The following British joint Publication (Medical Information and Insurance - The Joint Guidelines from the British Medical Association and the Association of British Insurers) is interesting:




> Sexually Transmitted Infection (STI)
> 6.1 Both the ABI and the BMA are aware that people may be discouraged from seeing their GPs about STIs because of the possibility that information about such infection will be revealed to other parties.
> 6.2 The guidelines indicate that the ABI and the BMA believe where there is an isolated incident of an STI (or even multiple episodes of non-serious STIs) with no long-term health implications, insurers should not request, and doctors should not reveal, any such information. Other incidents of STIs may have significance from an underwriting point of view and should be revealed as long as the patient's consent covers this.


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## rainyday (20 Sep 2004)

*Re: Medical/Lifestyle Questions and Underwriting Standards*

Hi Ajapale - Does this mean that you're not going to answer my question (What percentage of those people who have volunteered for STD tests have NOT had unsafe sex, do you reckon?)

To answer yours;



> Do you think it is ok for life assurance companies to ask applicants questions concerning whether they have sought STD counseling from health care professionals?



Yes, absolutely. If they don't, the end result is that those who have NEVER indulged in risky behaviour and NEVER had an STD test are going to have to pay the same rates as those bold boys & girls who have screwed around. Let's zip forward in time 10 years down the road when you are running Ajapale Insurance Inc - Will you be happy to offer insurance at the same rates to those who have had STD tests and those who have not had STD tests?

STD tests - Penalty points for clubbers!


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## ajapale (21 Sep 2004)

*Re: Medical/Lifestyle Questions and Underwriting Standards*

Hi Rainy,



> What percentage of those people who have volunteered for STD tests have NOT had unsafe sex, do you reckon?


 I dont know.... 75%?.



> Will you be happy to offer insurance at the same rates to those who have had STD tests and those who have not had STD tests?


If I were a Life Assurance Company Executive (and I'm not) I would behave a manner that would maximise my shareholders return consistent with ethical, regulatory and social responsibilities.

No, I wouldnt ask whether people had *tested* for STD's (or Genetic factors). I would ask whether they had ever been treated for a list of diseases and conditions which have a direct bearing on the provision of Life Assurance.

Asking questions relating to testing and seeking professional help is wrong. Making adverse underwriting decisions based on these questions is wrong. Why? because it may lead people not to seek medical help for conditons which if left untreated can have a devastating effect on peoples lives.

ajapale


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## zag (21 Sep 2004)

*Re: Medical/Lifestyle Questions and Underwriting Standards*

Rainyday - there is a flaw in your original line of thinking.

"While it may be unpalatable, it seems fair enough to me that an insurance company may want to apply different charges to individuals who have had STD testing (which has almost certainly got to indicate some level of indulgence in risky behavours) compared to inviduals who have never had STD testing"

The flaw is that having a test *is not* an indicator of someone who has indulged in risky behaviour.  It can be an indicator of someone who has been exposed to risk, but that is a different matter, especially if the test comes back negative.

If having sex is a risky activity then something like 80% of adults had better get ready for an insurance loading.

The person who is tested may only ever have had one partner and may at all times have practised safe sex.  Their  partner, however, may have had different habits.  Getting a test in this case is only logical and sensible, and does not indicate someone who indulges in risky behaviours.  Unless having sex is a risky behaviour in which case a more suitable question would be "Have you ever had sex (with someone else) ?"

I don't know if the question is also on the relevant application form, but they should really have a question (with a positive loading) along the lines of "Do you attend a doctor for early diagnostics and tests to ensure your health is maintained and catch serious conditions before they develop into costly conditions requiring us to pay out on your policy, or do you sit around, drink lots of beer and wait until you can't make it to the fridge before seeking emergency medical assistance  ?"

z


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## rainyday (21 Sep 2004)

*Re: Medical/Lifestyle Questions and Underwriting Standards*



> I dont know.... 75%?.


That's where we disagree - I'd reckon it is 0%. I can't foresee any reasonable circumstance where someone who had never induldged in unsafe sex practices would volunteer for an STD test. I'd be interested to hear your explanation for why this 75% of people volunteered for their STD tests.

I guess that when you do set up Ajapale Insurance Inc, you can run it as you see fit. If I were running RainyDay Insurance Inc and the subsequent claims where coming out of my pocket, I wouldn't see anything wrong with asking this question. In the great capitalist free market system, you would of course be free to choose other insurance companies whose policies suit you better if you see fit (but perhaps my policies will be cheaper if I get to cherry-pick the lowest risk customers)


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## ajapale (21 Sep 2004)

*Re: Medical/Lifestyle Questions and Underwriting Standards*

Sorry rainy , I misunderstood the double negative in your question I meant to guess 25%.

That 25% would be comprised of people who ask for a test because their partner is at risk, people who imagine they are at risk and certain medical and emergency personel who may have been exposed to risk.

I'm a bit puzzled here, rainy, are you suggesting that Life Assurance companies operate without any sense of ethical or social responsibility? Can they ask any question under the sun? and base their underwriting decisions on the response? Should they be allowed ask about race, sexual orientation, religion, colour of eyes, membership of travelling community, political affiliation, income etc. Im sure I could sit down with an acutuary and get more than a casual association with life expectancy on many or most of them. I could make money on it ...but it would still be *wrong*.

ajapale


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## veron01 (21 Sep 2004)

*Re: Medical/Lifestyle Questions and Underwriting Standards*

"Please explain why anyone would volunteer for an STD test if they had NEVER indulged in risky behavours?"

Because Rainday if you read up on STD's, you might be very shocked to read how people can be infected with various STD's even when someone is practising "safe sex". 

I know it shocked the hell out of me...

That is why I have to disagree that all people who get tested are on some level involved in some sort of risky behaviour. 

Sex full stop is risky behaviour.


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## ajapale (21 Sep 2004)

*Medical Lifestyle Questions and Underwriting Standards*

There are some life assurance companies who will look favourably on those who can provide evidence of regular medical compliance:

[broken link removed] 



> Evidence of medical compliance, regular health care and especially preventative health care screenings (mammograms, blood pressure checks, colon and prostate cancer screening) should be viewed favorably.



and..



> optimistic attitudes, lack of depressive symptoms, evidence of intact and active social networks are all favorable prognostic factors that have been connected with longevity




ajapale


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## CDM01 (22 Sep 2004)

*STD testing & Insurance companies*

All sexual contact carries a degree of risk

However Insurance companies are not discriminating against people who have had a STD test. Their rates are based on risk, with the level of risk being established by the past history of their clients.

Driving your car one mile per year has an associataed risk. It’s unlikely that you will have an accident, but it could happen. The more sexual partners you have, the higher the risk of catching a std as you don’t who is a carrier, as symptoms may not show for months or even years.

Using car insurance as an example, it wouldn’t be fair that the premium for a driver who has had two accidents in the last 5 years should pay the same as somebody who hasn’t had any. 

The driver may not have an accident for another 40 years, but based on the data available to the insurance company this driver is more likely to have an accident.

Likewise it is known that people who have been tested for a STD have a higher probability of catching a STD in the future – On average they will have had more sexual partners and engage in more ‘risky’ sexual behaviour. 

Due to the accosiated health problems of STD’s, the insurance company is more likely to incur additional costs in the future. Therefore the insurance company will charge the person who has been tested for a STD extra over and above the person who has not, as on average they will make higher claims


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## ajapale (22 Sep 2004)

*Re: STD testing & Insurance companies*



> All sexual contact carries a degree of risk



All human activity carries a degree of risk



> However Insurance companies are not discriminating against people who have had a STD test.



They are if they make unfavourable underwriting decisions based on the response to the question "have you ever tested for STD's?" Surely a better question for every one is "have you ever diagnosed or treated for an STD?"



> Using car insurance as an example



Should the insurance companies ask "how many times have you brought you car to see a mechanic?" rather than the more sensible "how many claims have you made?"



> Likewise it is known that people who have been tested for a STD have a higher probability of catching a STD in the future


This may be true, but a better indicator is the actual incidence of STD.



> Due to the accosiated health problems of STD’s, the insurance company is more likely to incur additional costs in the future.


I think the original question related to Life Assurance companies. What extra costs do Life Assurance incur as a result of STD's?


ajapale


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## CDM01 (22 Sep 2004)

*Re: Life Assurance*

Quote: AJAPALE
They are if they make unfavourable underwriting decisions based on the response to the question "have you ever tested for STD's?" Surely a better question for every one is "have you ever diagnosed or treated for an STD?"


CDM01 - They’re not discriminating against people who have been tested for std’s. 

Insurance is based on assessing the risk. The higher the risk, the higher the cost – people who have been tested for STD are more likely to get a std and the related health problems that could potentially be fatal. Seems simple enough to understand.


Quote: AJAPALE

This may be true, but a better indicator is the actual incidence of STD.

CDM01 - The fact remains that the people who have been tested have a higher actual incidence of std than the general public.


Quote: AJAPALE

I think the original question related to Life Assurance companies. What extra costs do Life Assurance incur as a result of STD's?

CDM01 - Genital warts for example can increase the probability of cancer in women. If that cancer takes a woman’s death there would be a cost to the insurance company

________________________


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## ajapale (23 Sep 2004)

*Are there any questions LA Cos should not be allowed ask?*

Hi CDM01,

For clarity I have reproduced the standard questions asked here:



> *1*
> Have you smoked cigarettes in the last 12 months?
> 
> *2*
> ...



OK CDM01, If I were to accept all your points ie ...
LA companies dont discriminate, 
LA companies manage risk and carry out thier business accordingly, 
there is a good correlation between std testing and motality.................
............Are there any questions LA companies should not be allowed ask?


ajaplae


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## CDM01 (23 Sep 2004)

*Re: Are there any questions LA Cos should not be allowed ask*

Yeah, Your quite right.....

There does have to be a limit on how far a private company can infringe on your privacy.


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## ajapale (23 Sep 2004)

*Re: Are there any questions LA Cos should not be allowed ask*

Great! a sort of concencus is reached.

I think the discussion was very useful in that it highlighted the delicate balance between an Assurance Companies right to persue its legimate business of managing risk for profit and their obligations with respect to social responsibilty, regulation and treating customers in a fair and equatible fashion.

ajapale


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## ajapale (28 Feb 2007)

This question has been raised again here.


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