Updated 25 October 2016

Insurer to use finger-prick test for HIV

Simpler tests will mean faster policy processing says Nicky van der Nest of Liberty, which is changing its screening methods for HIV.


Trypanophobia is the extreme fear of medical procedures involving injections or hypodermic needles. It is estimated that at least 1 in 10 adults suffer from trypanophobia in some way or the other.

Liberty has just become the first insurer to revise its screening methods for HIV and Cotinine, which means clients no longer have to undergo invasive medical tests and new policies can be significantly issued faster, explains Nicky van der Nest, Divisional Director Risk Products.

As the largest South African risk insurer, Liberty’s aim is to make the underwriting process as effortless, quick and non-invasive as possible. For precisely this reason we have made some exciting changes to our medical evidence collection process, making it faster, more efficient and more convenient for clients.

While most large insurers make use of nurses to collect medical evidence, Liberty is taking the next step to tailor this collection process to suit our clients’ needs. We understand that the reality is that most clients face time pressure when it comes to providing medical evidence. There simply should no longer be any reason for potential clients to wait for long periods of time to receive an underwriting decision as a result of medical test delays.

From July, Liberty replaces blood screening for HIV and Cotinine with finger prick screening for HIV and urine screening for Cotinine respectively. These revised screening methods will mean that clients no longer have to undergo invasive medical tests and that new policies are likely to be issued significantly faster too.

Approximately 70% of our prospective clients only require an HIV or Cotinine test to effect their policies. In reality, this means that they should not be required to answer any additional medical questionnaires or undergo other non-medical tests. Traditionally, however, these clients have still been required to provide a blood sample for screening purposes. Blood samples need to be processed by a laboratory before the policy can be effected, which means that clients are more than likely to experience processing delays.

We are confident that this innovation will improve the overall experience of doing business with Liberty for our clients.

Over the past few months Liberty has conducted significant amounts of research into the viability of finger prick testing for insurance purposes through a pilot on potential applicants. The results of this pilot were very positive, indicating that the finger prick screening is at least as sensitive and specific as blood testing. There is however a marginal increased potential for unclear test results, mainly as a result of the technology used. Our study has also confirmed that false positive results pose virtually no risk within an insurance testing context.

Liberty will confirm all unclear and positive finger prick test results with a blood HIV test, conducted through a laboratory. In addition to complying with internationally accepted medical practices, this will also ensure full compliance with the ASISA HIV Protocol* for insurance HIV screening. 

The pilot study conducted on urine Cotinine testing also yielded extremely positive results. Not only was it found that clients prefer the quicker and less invasive urine testing, but also that this testing method is in fact more accurate than blood Cotinine testing. 

The revised practice will initially be available only to certain clients who elect to make use of Liberty’s Nurses on the Road. The new screening practices will be made available to approximately 20 nurses in Gauteng, KwaZulu Natal and the Western Cape. The intention is to then roll the practice out to all Liberty’s Nurses on the Road over the next few months.

We are excited to bring this level of innovation to our policy holders and truly believe that the changes will be positive to Liberty and the South African market in general.

Why life insurers have been reluctant to use the finger-pricking screening method:

Traditionally, few  life insurers have given consideration to the use of finger prick testing for the following reasons:

  • The possibility of false positive and false negative results,
  • Caution regarding the relatively newer technology used for finger prick testing, and
  • The need to comply with the ASISA HIV Protocol for insurance HIV testing practices.

*The ASISA HIV protocol prohibits insurers from declining life cover based on the result of a finger prick test. Insurers are effectively only allowed to deny cover as a result of HIV infection where such test result is confirmed by a laboratory using a blood sample.

(Press release, July 2012) 


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HIV/Aids expert

Dr Sindisiwe van Zyl qualified at the University of Pretoria before working for an HIV/AIDS NPO in Soweto for many years. She was named one of the Mail & Guardian's Top 200 Young South Africans in 2012.

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