NY Financial Regulator to Probe Insurance Denials to Users of HIV Prevention Medicine
A New York financial regulator is investigating reports that some life and disability insurers are denying coverage to applicants who used medication meant to reduce the risk of HIV infection.
February 15, 2018 at 05:33 PM
3 minute read
Maria Vullo of the New York state Department of Financial Services. Photo credit: Rick Kopstein.
A New York financial regulator is probing allegations that some life and disability insurers are denying coverage to applicants who use pre-exposure prophylactic medication meant to reduce the risk of HIV infection in adults.
Department of Financial Services Superintendent Maria Vullo said Wednesday that the department, which regulates banks and insurance companies operating in the state, would investigate the insurance companies after a report by The New York Times that some gay men who had used PrEP medication—approved by the U.S. Food and Drug Administration to reduce the risk of acquiring the virus that causes AIDS—had been turned down for life and disability insurance policies across the United States.
According to the Times, health insurance companies usually cover PrEP medication, which the Centers for Disease Control and Prevention approved in 2014 guidelines for those “at substantial risk of infection.” But some life, long-term care and disability insurers have been denying policies to those who took the drugs. Some gay rights advocates and others say the charge amounts to discrimination against gay men. At least one lawsuit has been filed against an insurer for denying a gay male applicant long-term care coverage citing PrEP use, the news organization said.
In a statement announcing the investigation Wednesday, Vullo said “insurers cannot choose to deny life and disability insurance coverage based on discriminatory reasons. There is absolutely no legal justification for denying or limiting insurance coverage simply because an individual takes pre-exposure prophylaxis (PrEP), a prescription drug used for the prevention of HIV infection. This is tantamount to penalizing applicants based on sexual orientation. DFS will not tolerate discriminatory treatment in the approval or denial of life, long-term care and disability insurance policies and will hold companies that discriminate accountable.”
A spokesman for the Washington-based American Council of Life Insurers, a trade group representing the industry, said in an email Thursday afternoon that a confluence of criteria —such as height, weight and medical history — are taken into consideration when underwriting a life insurance policy. Spokesman Jack Dolan added that New York state laws and federal law “strictly govern their underwriting practices” in a highly competitive market.
“The life insurance industry is very competitive with 171 life insurers licensed to do business in New York working to serve consumers' financial needs. Establishing their own underwriting criteria in accordance with relevant New York laws is one way individual companies can differentiate themselves from their competitors. As a result, insurers might evaluate the same applicant differently and, therefore, make different decisions on issuance and pricing. Because underwriting guidelines vary by company we recommend that applicants shop around to find the best policy for them,” Dolan said in the email.
Update: This story has been updated to include response from the American Council of Life Insurers.
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