The ability of poz men to obtain life insurance and the lingering effects of viatical settlement payouts......

[ellentonboy]

I was hoping to get feed back from BZ members if they have noticed an increased policing of poz men when it comes to insurance companies issuing life insurance policies.

Full transparency here - back in the mid 90s up until 2002 I was one of the fortunate individuals who benefited from early payouts on life insurance policies.  These policies, or the majority of them, were through employers and were part of my benefits package.   In the initial case I sold mine back to the Federal government and was paid handsomely, the others were from at least two other future employers, one being United Health Care.  For the record, at no time time did I misrepresent my health status in obtaining these policies.  As mentioned, they came along with my salary and health benefits.  When I left the Federal government, the FEGLI policy I had was paid at 96 percent of twice my annual salary.  To this day, I am obligated to give my location, cell phone and doctor information to a third party who watches over policies that were sold in this particular fashion.  I sold the other policies to a third party, and those companies are long gone, many due to fraud complaints.  Again, I was honest with these companies, they had my labs and doctor's "notes" that are taken at the time you see your physician.

Here is my question.  2002 was a long time ago, and from 1996 to 2002 the percentage of the face value I was paid by these third party companies decreased dramatically.  The easiest policies to sell were those that guys had from their employers.  At times, though it may sound goulish, I was actually given bonuses if I referred an individual to one of these companies and his policy sold.    That happened maybe three times.   Those gentleman are still alive today, and at the time, they appreciated the information I provided on how to go about selling your policy.  So no harm, no foul.  However, certain companies, most based in Florida, shut down or the Federal government shut them down.  They were misrepresenting the health of their clients to investors so there was fraud involved.  I can tell you when I sold my policies I had a viral load of over 1 million and less than 50 T cells, and I also had KS.  I was an example of someone who an investor would take a look at, as my life expectancy was indeed, questionable.   Sorry to tell the investors, I am still alive and kicking and it 2022, and they have been paying my premiums ever since.  Who would have thought, based on my medical records at this time??

So here is my question, what next?  I don't want to be a burden on anyone, but all that money that I received during the time period mentioned, is gone.  I went through a lot of cash, new car, vacations, etc.   What I am finding, and I know the question "In the past three years, have you tested positive for exposure to HIV, been diagnosed with AIDS or ARC or have you seen a physician regarding this illness", blah, blah.  I think anyone who has looked at an application for life insurance knows that question and it has been there for years.  I mean years guys.

The only insurance company I am aware of that does NOT ask that question is Colonial Penn.   Their premiums are high and they payouts are low.  But you are guaranteed a policy no matter what.  

Now here is the $64,000 question.  Recently it came to my attention that someone I know applied for life insurance, and that question was on the application.  He indicated no.  He received a letter back from the insurance company denying his application.  So BZ members, how is his health status getting to an insurance company?  I called people involved with Ryan White case management, as well as my own insurance company and Medicare.  I even contacted several pharmacies.  I was assured that not one of these groups would release any health information to a life insurance company.

Anyone have ideas as to how someone's HIV status got to say, Globe Life Insurance.  I thought HIPPA would prevent the sharing or sale of any of that information.

Okay, I know insurance is a dry, boring subject. But money is not and if anyone KNOWS how an insurance company would get this information I would appreciate it.  Please no speculation, if someone works in that industry, how can they find out an applicant takes HIV medication or has been treated for the illness?

Thanks guys for your time.

[hntnhole]

I have no idea - sorry. 

Even sorrier that you've been through the grist mill so thoroughly.  Glad you made it out the other side.  Every guy is needed.

[BootmanLA]

I can't speak to your friend's experience. But I do know that for life insurance applications (particularly for whole life, and for large coverage amounts), many companies require a physical exam, which may include an HIV test. As part of getting that test, invariably you sign a waiver agreeing to release the results to the potential insurer.

Your friend may (or may not) have had such an exam. He may have, and not realized that (a) the exam included an HIV test and (b) he had given permission for those results to be shared with the insurance company. Maybe he figured he could bluff his way through, thinking his health info was secure under HIPAA, not realizing he'd waived that protection for this specific exam.

It's hard to say without additional information.

[analluv27]

From what I understand more life insurance companies are extending policies to HIV positive individuals due to medical science extending the lives of said individuals. A lot of policies are high since life insurance companies consider HIV as a high risk but the payout I think differs from company to company. 
I currently have life insurance through my job the premium is low but the payout is decent 

[TravelGuy1956]

Where I live,  the medical center switched to a system called "Epic"  No matter where I go,  what doctor I see,  all my medical info is there ahead of me.  Freaks me out.   Also,  my Medicare insurance broker told me my HIV status might escalate each year as I re-apply because of my status. 

[TravelGuy1956]

Edit:  My insurance rates might escalate,  not my HIV status.

[BannedWord]

I'm pretty certain that I know the actual reason. Insurance companies keep a record of all claims and payouts, and they can share that information with other carriers or in a central database. For instance, I had a couple of Homeowners Claims (one due to hurricane) and other people have had accidents. The insurance companies certainly know about those when they underwrite your policy and the result is that they either write the policy, deny the policy, or write it at a much higher premium due to the risk.

In your case, they probably have your information from having sold that policy and the reasons, and it made its way into an underwriting database. A lot of companies lost a ton of money on Viatical settlements because people began outliving the expected payouts (remember to thank Greg Louganis, kids). Anyhow, the information is out there for any and all payouts on insurance, and though I don't know the life side of the business in that case, the property/casualty side of the insurance business keeps that information and considers it in underwriting decisions for a varied number of years. It would make sense that the life side of the business would do this as well. You'd only ever expect a death payout once per person.

[ellentonboy]

17 hours ago, BootmanLA said:

I can't speak to your friend's experience. But I do know that for life insurance applications (particularly for whole life, and for large coverage amounts), many companies require a physical exam, which may include an HIV test. As part of getting that test, invariably you sign a waiver agreeing to release the results to the potential insurer.

Your friend may (or may not) have had such an exam. He may have, and not realized that (a) the exam included an HIV test and (b) he had given permission for those results to be shared with the insurance company. Maybe he figured he could bluff his way through, thinking his health info was secure under HIPAA, not realizing he'd waived that protection for this specific exam.

It's hard to say without additional information.

In this particular instance there was no physical exam required.  It was a simple yes or no on the HIV question.  That's why there is the lingering question as to what information was shared and how an insurance company could deem someone unfit or uninsurable if they A. never examined the individual, or B.  The individual never signed a release to give any medical or background information out to an insurance company.  I know the coverage amount never exceeded $100,000 but it was for whole life.  After two years of onetime payments the period of "contestability" expires and the policy can then be sold to a third party.  We have actually thought of finding another insurance company so if rejected again, we can contact the company who provided the information that deemed the individual unsuitable for coverage.   That's the real question here - what information was shared and by whom.  

Thanks for your response I appreciate it.

[ErosWired]

37 minutes ago, TheSRQDude said:

A lot of companies lost a ton of money on Viatical settlements

I’m always a bit bemused when insurance companies speak of losing money in business because I have always failed to see how the insurance business is distinct from gambling; the insurers are gambling that the insureds’ luck will hold, the insured are gambling that it won’t. And since the insurers write the policies, the deck is stacked in favor of the house.

[ellentonboy]

57 minutes ago, TheSRQDude said:

I'm pretty certain that I know the actual reason. Insurance companies keep a record of all claims and payouts, and they can share that information with other carriers or in a central database. For instance, I had a couple of Homeowners Claims (one due to hurricane) and other people have had accidents. The insurance companies certainly know about those when they underwrite your policy and the result is that they either write the policy, deny the policy, or write it at a much higher premium due to the risk.

In your case, they probably have your information from having sold that policy and the reasons, and it made its way into an underwriting database. A lot of companies lost a ton of money on Viatical settlements because people began outliving the expected payouts (remember to thank Greg Louganis, kids). Anyhow, the information is out there for any and all payouts on insurance, and though I don't know the life side of the business in that case, the property/casualty side of the insurance business keeps that information and considers it in underwriting decisions for a varied number of years. It would make sense that the life side of the business would do this as well. You'd only ever expect a death payout once per person.

I have to admit when I posted this I thought your answer was probably the most logical and correct. I called every doctor's office, social services agency, even Social Security and the Office of Personnel Management and was assured  over and over that none of my medical records would be released to an insurance company.   In fact, they assured me there were safe guards in place to prevent such things from happening.  Those policies, and to be honest I can think of eight that I sold, were from some major companies like Met Life, for example.  I can't imagine they were  not recording  the  sales of  these policies.  It's just been a long time and I remember the last policy I sold was a small one, $10,000 and I had purchased that independently.  There was no problem unloading that.    The policy prior to that was through an employer who I specifically targeted because I knew they offered life insurance, I was hired and once the benefits kicked in, I resigned and was able to convert it to a whole life.  The employer wasn't happy I abruptly  left and even the personnel director asked me why she had a request regarding information on an "accelerated death benefit" sitting on her desk with my name on it.  Well, sorry lady, I played dumb and said I was offered more money to go elsewhere.  That policy paid out well, so it was worth the mediocre salary for 90 days when I got that wire transfer from the vatical settlement company after the policy was sold.  I wasn't obligated to tell them I was ill and to be honest, I did my job and they offered it in their benefits package.   The fact I checked off "2X my annual salary" did not raise any red flags.  Now had I wanted 5 times my salary I would have had to submit to a medical exam and it would have been a cold day in hell before I agreed to anything like that.  What I should have known is that eventually the gravy train was going to come to an end and eventually purchasing and selling individual policies would become a thing of the past.  I suppose reality is setting in.   I believe my only option is to find another job that offers life insurance and suffer through working for a third of what I am used to making just for a cash payout after 90 days.

Thank you for taking the time to respond, I believe you gave me the answer I probably didn't want to hear.  However, it's probably the right one!

[ellentonboy]

18 hours ago, analluv27 said:

From what I understand more life insurance companies are extending policies to HIV positive individuals due to medical science extending the lives of said individuals. A lot of policies are high since life insurance companies consider HIV as a high risk but the payout I think differs from company to company. 
I currently have life insurance through my job the premium is low but the payout is decent 

Yes I know of at least two companies that will issue policies to poz men, but the rates are high and the payouts upon death are low.  Like you mentioned your employer offering you a decent payout should you pass away while employed.  I am finding employers who have a large number of employees usually offer the most generous policies, with low deductions from your paycheck and a larger amount of coverage.

[BannedWord]

10 minutes ago, ErosWired said:

I’m always a bit bemused when insurance companies speak of losing money in business because I have always failed to see how the insurance business is distinct from gambling; the insurers are gambling that the insureds’ luck will hold, the insured are gambling that it won’t. And since the insurers write the policies, the deck is stacked in favor of the house.

Oh boy. Please excuse this going a 'little' off track, but I think this might be helpful. Insurance companies generally don't make money on your policy. They make their money by shrewdly investing that money to get the investment income. In the early 90's, it wasn't uncommon for insurers to invest the premium dollars and get well over a 15% return if they were doing their job even minimally.. One company I worked for had an expense ratio of 103% -- meaning for every $1.00 of premium collected, they were paying out $1.03 between liabilities, payouts, and the overheard of policy servicing and claims payment/litigation. So if you say how can they survive paying out more than they collect, it's their investments that fills the deficit.

The job of the insurance company is to maximize profits for their shareholders or mutual owners. To do this, they employ legal teams to litigate claims and pay as little as possible or challenge how much they pay for something like a bumper repair. Don't even mention liability payouts. Many times, they end up paying anyway (I had a suit against a company who insisted they'd rather pay attorneys than me, they eventually paid both and much more to the attorneys). 

There are a couple of pertinent stories also about why they choose to select certain people and refuse others. Let's use Florida. We have hurricanes. If a big one hits, it could wipe out an insurer who insured too many houses in the state that would be affected. Florida has a state-run company as a result to make sure all Florida homeowners can get coverage. But why else don't you over-insure or get over-exposed? Look up the story of AIG -- they provided insurance against most of the credit default swaps before the 2008 housing crash and no one inside looked closely at what they were doing. 

Hope that begins to answer. The deck always need to be stacked in favor of the house in that business as the level of loss can be devastating if you calculate that risk wrong. AIG is an example of doing it wrong and what can happen: $185 billion in bailouts, and all of us paid for that.

[ellentonboy]

2 hours ago, TravelGuy1956 said:

Edit:  My insurance rates might escalate,  not my HIV status.

I have to agree with you.  I am not happy, at all, that my medical information is stored up in "the cloud" so to speak.  How often do we hear of "clouds" being hacked?  Quite a bit.  What I find bewildering, is why does the optometrist at Lens Crafters need to know my HIV status.  It seems a bit invasive.  They want all this background medical information to write a script for contact lenses or reading glasses.  You hand some clip board to a young woman, who you have never seen and will never see again, and she starts entering all this information into a computer.  It has got to the point that I am hesitant to give out that information.

I am sorry to hear your rates might escalate, it seems the premiums are going up, but so are the deductibles and copays, if those apply to you.  At times, I hear what people who have great jobs and what they pay bi-weekly or weekly for health insurance and it blows my mind.  For an American, if you are lucky to find a great infectious disease specialist who will take you Medicare and your secondary Medicaid insurance, you would be wise not to change doctors.  The secondary insurance part is becoming more expensive and less likely to have decent specialists.  Good luck!

[BannedWord]

30 minutes ago, ellentonboy said:

I have to admit when I posted this I thought your answer was probably the most logical and correct...

Thank you for taking the time to respond, I believe you gave me the answer I probably didn't want to hear.  However, it's probably the right one!

Anytime. You can tell me a lot more about certain things 😉 and all I can do is explain what I know about others.  Tons of things I know I can learn from you about your experiences.

Think of how insurance companies work in the simplest possible manner: Your auto policy. If you have an accident, generally your rates increase because they infer you're an accident-prone driver, regardless of you being at fault. If you don't like that, you shop for a new policy and...oh, the new insurance company knows you had an accident? How'd they know that? They share data. No surprise there. There are petabytes of information about each one of us. And...oh, we expanded that willingly on platforms like Facebook by telling them what we watch, what we like, what we buy, who we support politically, what music we prefer, even how we'll respond to certain stories and the results are a gold mine to companies who want that data or media companies that want to capitalize on that.

No. That's not being paranoid or conspiracy theorist.

[ErosWired]

@TheSRQDude - I wouldn’t begin to question your first-hand experience of the industry, as it is obviously not my field. But nothing that you have told us here contradicts the underlying fact that the entire industry is dependent upon the vagaries of luck on both the micro level (car wrecks) and the macro level (hurricanes). They may not make their profit from the individual payout, but their ability to invest is similarly keyed to the vagaries of fortune, or there would be no reason for a variation in premium dependent on risk.

Regardless of the nuts and bolts, the business of the insurance industry is risk, and risk, by definition, is a gamble. So it is small wonder, touching on the OP’s concern, that insurance companies will take any measure available to hedge that risk - if there is an opportunity to do so, one would be naïve to assume that they have not.