Firms Can’t Demand Antibody Check : Insurers Require New AIDS Test to Skirt Law

Life and health insurance industry officials said Friday that insurers increasingly are requiring T-cell blood tests of those attempting to purchase policies for large amounts--thus getting around a California law that bars insurance companies from requiring the most common AIDS antibody tests.

The T-cell tests are priced more than four times higher than the AIDS antibodies tests and are regarded as far less reliable, the industry representatives conceded. Yet, they said, the companies--wary of paying out huge benefits to AIDS victims--have no choice.

Many of the life insurance companies in particular, the spokesmen said, have become alarmed at indications that many people who have been told they tested positive for the presence of the AIDS virus are buying policies that may cost the companies large sums later, if the buyers develop and die of AIDS.

So, beyond a certain threshold, which may be $250,000 or $500,000, or some other figure depending on the company, Californians seeking to buy policies are being told they cannot do so unless they agree to take a T-cell test.

Some Can’t Get Policies

Those testing positive in the company-ordered tests are generally not sold insurance.

Karen Clifford, a spokeswoman for the Health Insurance Assn. of America and an industry expert on AIDS testing questions, said Friday that once it had become evident that California would keep its ban on insurance company use of the most common tests, then use of the T-cell tests became inevitable.

Last November, Lewis Keller, president of the Assn. of California Life Insurance Companies, disclosed that the state’s insurers were drafting legislation that would allow them to use three standard AIDS antibodies tests that together cost only about $8.75.

But, a spokesman for the association said Friday, the trade and lobbying organization decided not to actually have the legislation introduced once it realized the outlook for its passage was not bright.

‘Colossal Fight’ Threatened

Assemblyman Art Agnos (D-San Francisco), who had sponsored the ban on use of the tests in 1985, had declared the insurers would “have one colossal fight on their hands” if they sought its repeal.

Both types of AIDS blood tests require analysis of a small blood sample.

But most medical experts consider the T-cell tests less accurate than the antibodies tests, which are generally regarded as being 99% reliable.

The T-cell tests measure the concentration of a type of white blood cell called the “T-4 lymphocyte.” The number of these cells may be decreased in individuals infected with the AIDS virus, but other unrelated factors may also be responsible for a decrease.

For instance, as Clifford pointed out Friday, mononucleosis or even a bad cold can result in a decrease in the white blood cells. So, she said, there is a “severe false positivity” problem in using the $40 T-cell tests as indicators of the presence of the AIDS virus.

Firms May Be Jeopardized

As the life and health insurers’ concern increases that the projected spread of AIDS in the next several years could jeopardize their solvency, and the pressures for insurance-related testing grow, there has been some lessening of resistance among traditional test critics to a carefully controlled use of the tests for some insurance purposes.

For instance, Jeffrey Levi of the National Gay and Lesbian Task Force said in an interview Friday that “there is not much argument that someone buying a lot of life insurance shouldn’t be tested.”

At present, he remarked, when tests are banned in a few states or are being refused in other states by prospective insurance buyers, many companies are refusing to sell big life insurance policies anyway to those people.

So, he went on, “We need to be looking at more creative solutions.”

Meanwhile, the insurance industry has been stressing that its AIDS-related costs are skyrocketing.

Internal Study

The New York Life Insurance Co. this week released an internal study saying the industry is being hurt financially by those who test positively for AIDS antibodies who are taking out life insurance policies once they become aware of a high likelihood they will contract the disease.

The company announcement said the trend is evidenced by “a marked increase in the dollar amounts of death claims for AIDS victims and an inordinate percentage of claims on policies in force for less than two years.” It added: “The analysis also indicates that these trends are accelerating.”

New York Life said that in the 18-month period ending February, 1987, the company had claims on 110 clients totaling $7.1 million for AIDS-related deaths. Of these claims, half originated in New York or California and 90% were males. About one-third of those claims were on policies that had been in force for less than two years, and those policies accounted for more than half of the total dollar amount, or $3.6 million.