The way the NAICOM directive came, anyone would conclude that the insurance industry in Nigeria survived on human blood and should be protected from the ravages of HIV virus.  Already, some underwriters are giving the matter that kind of interpretation.  Omotosho made his position clearer: "In financial underwriting, you have to watch out for so many things.  For example, if somebody is a clerk and he approaches you for a life insurance of N20 million; knowing his status, you would naturally become suspicious.  Maybe the man is planning to commit suicide.  In this hard times, he may want to offer himself as a sacrificial lamb just to save his family.  He may decided to take out a life insurance, borrow money from friends to pay premium for three months and then find a neat way of taking his own life.  What we are talking about is the same thing.  A person down with AIDS is a case of imminent death.  If somebody is infected, we reject them outright." The session with Omotosho opened a window to organised discrimination championed by a corporate union.  Until now, such discriminatory policies were carefully hidden in the closet with people diagnosed with HIV/AIDS systematically eased out of jobs, schools, rented accommodations and lately, places of worship. In what one rights activist described as retrogression, the controversial position of the insurance body is seen by many as a setback in the country's quest to keep abreast with the rest of the world on the HIV/AIDS issue.

To measure the rigidity of the NAICOM position, Saturday Sun visited another insurance house.  At Oasis Insurance Plc, Ikorodu Road Lagos, Muyiwa Mustapha justified the directive saying: "Insurance does not cover deliberate acts, only accidents or unforeseen events.  The fate of people living with AIDS is already known; that is why there is no insurance cover for them in Nigeria." Suggesting that life or health cover for people living with HIV/AIDS (PLWHA) is a sure way to insolvency, Mustapha agreed with the position of Omotosho who said that the insurance cover would be repudiated if it is discovered that the policy-holder  concealed their HIV status at the point of entry.  He agreed that PLWHAs have a better deal in some African countries but argued that in Kenya for example, the cover could be for a period not more than five years or in the alternative, is granted to include all health conditions except HIV/AIDS. Reacting to the positions of the two underwriters, Ebojie Arebam-Okojie, of Human and Environmental Liberties Project (HELP), told Saturday Sun that the NAICOM directive was capable of taking Nigeria back in time.   "This is a new manifestation of stigma and discrimination.  I say this because the insolvency fears is something some Third World countries have since overcome.  It is a matter of being creative with your solution mechanism to be able to move ahead with the rest of the world. I can mention a number of models begging to be adopted.  If they have worked in countries like Zimbabwe and South Africa, why not Nigeria?  In these places, the Insurance industries have managed to re-invent themselves, not as adversaries, but key partners in addressing the HIV/AIDS question."

The creative approach that Arebam-Okojie spoke about is already being enjoyed by PLWHAs in South Africa. Capital Alliance, an insurance company, produced South Africa's first insurance product that allows employers to take out insurance against the risk of their employees contracting HIV/AIDS. LifeAid by Capital Alliance provides employees who contract the virus with a monthly cash benefit for life, increasing each year in line with inflation.  It requires monthly contribution from the employer. The benefit begins at one of two levels, depending on what the employer can afford and the immunity level of the claimant.  The beneficiaries are expected to use the money for their treatment.  LifeAid works to extend and improve the quality of lives of HIV positive workers.  It has been figured out that improved health will also improve their productivity and extend their careers, reducing absenteeism and recruitment and training costs.  Also improved staff morale is expected to reflect in profitability. The iinsurance company believes the benefits of LifeAids in reducing AIDS-related productivity loses will more than compensate the cost of coverage to them.  The company is providing the product in partnership with the Southern African HIV Clinicians' Society, a network of 2,000 doctors with advanced training in HIV/AIDS care.  

The society is responsible for counseling and testing policyholders and will also provide claimant information directly to Capital Alliance, to protect workplace confidentiality. After a dramatic reduction in the cost of ARV drugs over the past few years, Ebojie Arebam-Okojie is of the opinion that HIV/AIDS can now be treated at a cost not much higher than other chronic conditions.  He queried the situation where patients with cancer are able to obtain life insurance yet HIV-positive patients are not, even when studies have shown that the latter can live a normal, healthier and longerlife. Confronted with these realities, Omotosho stuck to his guns saying, South Africa's robust economy allows it to experiment with new insurance schemes.  "What you may not know is that insurance industry is still at its infancy in Nigeria.  Africa as a whole contributes just one percent to the world premium income.  Out of that one per cent, South Africa has 87 per cent.  Both Kenya and Zimbabwe are ahead of Nigeria." Finally adopting what was to him an open mind, Omotosho presented three conditions under which PLWHAs could obtain cover in Nigeria: "Insurance is about numbers. If we have them (PLWHAS) in large number, say 1,000 of them, we can give them cover because not all will die at the same time.  We may even make good money out of it.  

The second condition is that there must be a ceiling for the sum assured or benefit payable at death. "Where negative people can take cover for say N100 million, a positive person would not get more than N5 million; of course the premium cannot be the same. The third is that such category of policy-holders cannot have more than a five-year cover.  We underwrite diabetes patient and they can live for 20-30 years." Given the uncompromising posture of Nigeria's underwriters, Arebam-Okojie is particularly sad that basic information about HIV/AIDS are still outside the reach of those who should have it, such as insurance practitioners.  He found it worrisome that some decision and policy makers still do not know the difference between HIV and AIDS or that with early testing and adequate treatment, HIV positive people can live as long as any HIV negative person. Regretting that in Nigeria, the National Health Insurance Scheme (NHIS) specifically excludes HIV/AIDS on the basis that cost of treatment would bankrupt the scheme, Arebam-Okojie pointed to another scheme, outside the South African model, that Nigerian underwriters could adopt.  He said that in Thailand, companies agreeing to implement at least three HIV/AIDS workplace policies receive a reduction of 5 to 10 percent off their group life insurance premiums from the country's largest insurance provider, American International Assurance (AIA). Companies agreeing to participate are offered assistance to enhance their activities, including providing educational leaflets, videos, a mobile exhibition, condom, peer education training, counseling and referrals to support groups for HIV positive employees.  There is no testing of job applicants for HIV, no testing of employees and no dismissal on the basis of their HIV status.