Insurers may not put it in their marketing literature, but it is an industry which is based on discrimination. In car, life and home insurance, providers discriminate between good and bad risk and price products accordingly.
However, the industry can take time to notice when the goal posts have moved. Take the position of those living with HIV; they have been routinely turned down for cover despite the march of retroviral drugs and treatments.
But there are signs that the industry is waking up to the reality of tens of thousands of Britons living healthy lives with HIV. Pulse Insurance, which specialises in covering people turned down by other providers, will from this week offer Harbour, a life insurance product, to those with the virus without the need for a medical or GP's report. The launch marks a milestone for an industry that has previously made it virtually impossible for anyone with HIV to get cover.
"We're pleased to see these products finally coming on to the market and we're keen on more financial products like this being made available.
"In the past, people with HIV have been seriously disadvantaged financially, so anything that can support access to core products such as life insurance and mortgages will help," says Lisa Power, the policy director at the Terrence Higgins Trust, an HIV charity.
Recently, PruProtect became the first mainstream provider to extend its existing life cover to include people living with HIV, providing up to £250,000 cover over a maximum period of 10 years. However, where Pulse differs is that it is the only provider that does not insist on a medical or doctor's report, which means cover can be put in place in a matter of days, not several months.
"A person living with HIV is entitled to be able to provide for their family and dependants without worrying about jumping through hoops or having to undergo lengthy and intrusive medical inquiries," says Paul Sandilands, the managing director of Pulse Insurance.
Consumers are warned, however, that there may still be strict criteria to meet and that costs are high.
First, with both Pulse and PruProtect, the policies are only for those who are HIV positive, not those suffering from Aids. There are also tight age restrictions; with PruProtect applicants must be between 25 and 50. Applicants also need to meet specific medical requirements.
At PruProtect, prospective customers must be receiving Haart (highly active antiretroviral therapy) in the UK and treatment must have commenced in the past five years and for at least six months. Also, applicants who contracted HIV through intravenous drug use are excluded, as well as anyone with hepatitis B or C. Then, if all the criteria are met, they require a doctor's report, a medical exam and hepatitis tests.
When PruProtect first unveiled its policy, its estimates suggested that only 7 per cent of people diagnosed with HIV would be covered under these conditions.
"One of the challenges is that we need to be fair to all our customers and carefully approach the risk management surrounding this, so there are some conditions. There is still a need for innovation but this is a small market and it will take some time for those conditions to change," says PruProtect's Deepak Jobanputra.
In order for patients to be accepted for a product of this nature, their infection must be under control. This is determined by two features: the CD4 count and the viral load. PruProtect requires both the CD4 cell count and the viral load to be "suppressed to a near undetectable level" – fortunately modern medicine, combined with early detection and appropriate treatment means that this is now achievable.
"CD4 count shows how well the body is fighting the virus and the viral load shows how much virus is in your body. With modern treatment, you can get an undetectable viral load. So for an otherwise healthy individual, there's no reason they shouldn't access life insurance," says Ms Power.
With Pulse Insurance, the age restrictions are more favourable – applicants must be aged between 18 and 64 – and it does not require the applicant to be on Haart. But they will still need to provide details on when they were diagnosed, their CD4 count and viral load plus their treatment or related illnesses.
Acceptance is purely down to the information provided, and although this may still mean that many applicants will not be accepted, crucially, they can put the entire policy in place without needing to submit or medical report or undergo a medical.
This will mean that successful applicants can get cover quickly, but it is questionable whether this is the most cost-effective way to get cover. Pulse does offer fixed monthly premiums from £15 but this is only for 18 to 24-year-olds and provides only £10,000 life cover and £10,000 accidental cover. At the other end of the scale, Pulse charges 60 to 64-year-olds up to £180 for £25,000 life cover and £200,000 accident cover.
The price of not having to undergo a medical means they are paying a catch-all premium. Policyholders can expect to pay around two to three times what a non-HIV infected person would pay. "Without a shadow of a doubt, if a client goes through a medical examination they are more likely to get a cheaper premium against a policy that doesn't require medical evidence," says Chris Morgan, from Compass Insurance Services.
Another sticking point is the level of cover. While PruProtect offers up to £250,000 life cover, the policy from Pulse, which is underwritten at Lloyds of London, offers only £25,000 life cover for a term of 10 years and £200,000 of accidental death cover.
"The amount of cover is limited and £200,000 of accidental death cover bears no real relationship to HIV. And, although £25,000 life cover is better than nothing, it's not necessarily comprehensive," says Mr Jobanputra.
Despite this, Pulse's launch should spark a wider move for the industry to offer appropriate financial products to people with HIV.
"As time goes by and more competition enters the market, it will help to normalise the whole issue. We need to get that message out that people with HIV lead a full life and also a long life," says Ms Power.