Facing legal action, the insurer will now cover people taking Truvada, a drug for HIV prevention • Good Assurance


The Mutual of Omaha agreed not to refuse insurance to people who use drugs to prevent H.I.V. infection.

The insurer also settled a lawsuit filed by an unidentified homosexual in Massachusetts, who was denied long-term care insurance after admitting to taking an anti-HIV drug called Truvada.

"Consumers who seek to protect themselves from H.I.V. Transmission should not be ruled out from the purchase of insurance, "said Maura Healey, Massachusetts Attorney General, in a statement.

The company has admitted no wrongdoing in settlements and will pay an amount of $ 25,000 to the state.

Omaha Mutual became the subject of discrimination complaints after claimants, mainly gay men, were denied disability, long-term care or life insurance for the sole reason that they took Truvada to protect yourself from HIV, a practice called PrEP (in English). prophylaxis of exposure).

Centers for Disease Control and Prevention exhort men and women at risk of HIV infection. Truvada infection to take every day. Studies have shown that the drug is extremely effective at blocking the virus and that health insurers almost always cover the cost.

Some gay men said they stopped taking Truvada, risking danger, just to get insurance. Last year, after the Times reported the denials, regulators in New York also began investigating state insurers to determine if they were engaging in practices. Similar.

The agreement of the Mutual of Omaha with the Massachusetts Attorney General applied only in that State. But the company has now reviewed its valuation practices nationwide, said Andy Halpern, spokesman for the insurer.

Like other insurers, Mutual of Omaha has underwriting guidelines that are mostly exclusive and hidden from the public. Clients wishing to purchase long term care, life or disability insurance are assessed and rated.

Certain conditions, including H.I.V. infection, are enough for an insurer to refuse coverage. However, according to Bennett Klein, a lawyer with GLBTQ Legal Advocates and Defenders in Boston, Mutual of Omaha's denials in more than a dozen cases were based on the use of medication by healthy people.

Mr. Klein, who represented the homosexual man who was denied long-term care insurance, argued that this policy constituted discrimination on the basis of sexual orientation, since % of people who take Truvada are homosexual men.

The Omaha Mutual "considered them disabled, in the same way that they would exclude a person with the H.V. virus," Klein said. For the company's evaluators, the fact that a candidate took a PrEP meant that it was, by definition, high risk for H.I.V. infection.

"But they do not otherwise evaluate H.I.V. risk," Klein said. "They do not ask you if you are engaging in unsafe practices or using a condom."

Mutual of Omaha's concessions are "fantastic", said Scott Schoettes, H.I.V. Project Manager for Lambda Legal, L.G.B.T. advocacy group.

"We now need the rest of the insurance industry to align and realize that if they do not, they will face legal action," said Schoettes.