Fair play for children
Need for change
Tom is 18 years old, about to leave school and unlike most of his friends who don't have a clue what they want to do, he has wanted to join the Garda Siochana since he was a child. He fulfils the educational requirements and is physically fit, exercising regularly. However, he will not even be considered for selection.
Mary has been driving a car for the last 15 years. She is a conscientious driver and has never been involved in a car accident. However, she has to reapply for her driving licence every three years. She also suspects her motor insurance has been unfairly loaded in the past.
Michael and his partner are about to buy their first home together. With rising house prices, the monthly repayments will be tough but they will manage. As life assurance is a requirement for a mortgage, Michael calls a number of insurance companies for a quote. He suspects his quote may be slightly higher than usual, however he is shocked to receive a quote 300% higher than his partner's.
Tom, Mary and Michael have type 1 diabetes and unfortunately in Ireland today, these are not unique scenarios. Despite the huge advances that have been made in both our understanding and treatment of diabetes, the issue of discrimination remains a significant problem.
Much of this can be put down to the fact that many policies relating to diabetes, such as those in the workplace, are decades old, dating back to a time when the idea of disposable pre-filled insulin pens had not even been considered. Certain policies, such as blanket bans on certain jobs, have simply not kept pace with the huge developments in diabetes management.
In the field of insurance an entirely different type of discrimination exists. While not as blatant as a blanket ban, the issue of 'loading' is a more subtle form of discrimination as different rules apply to different types of insurance and to different companies.
Loading is a charge that the insurer adds to the net premium, to produce the gross premium actually paid by the policy owner. What this means is that an insurer takes a basic premium that it wishes to charge for a certain level of cover. The insurer then adds an amount, a loading, which is designed to cover the operating expenses of the company, to compensate for the loss of income when policies lapse.
It can be a contentious issue - young, male drivers for example face huge motor insurance premiums due to loading, regardless of how good their driving record is.
People with diabetes are also subject to loading when it comes to insurance. An example of this is within the area of specified illness cover. This type of policy ensures that, should you suffer any one of a range of illnesses, you will receive a tax-free lump sum at a time when you need it most - during your recovery. While different insurers will include different illnesses as part of their policy, most will cover illnesses such as heart attack, cancer, stroke, multiple sclerosis, motor neurone disease, severe burns and benign brain tumours.
As diabetes is linked to a higher risk of heart problems and this is included in specified illness policies, loading inevitably occurs. This practice is discriminatory, according to Eamonn Griffin, an insurance broker with ERM Financial Services. 'There are certain illnesses that have no relation to diabetes, such as cancer. And in fact, the highest number of claims we get from people with diabetes with specified illness cover is for cancer and not heart-related problems'.
This is why insurance companies should consider offering a separate plan for people with diabetes, rather than offering them the same policy as non-diabetics, but at a far higher price, Mr Griffin says.
He set about this task on behalf of the Diabetes Federation of Ireland, eventually finding success with Irish Life, which now offers Federation members a group specified illness and life cover plan.
'We approached a number of insurers to develop a plan for people with diabetes. However going by the prices they suggested, it was clear that they were not interested', he says.
However life assurance, which is money paid to your beneficiary when you die, is a whole different ball game because group plans are not available. Each person applying is assessed individually; therefore in the case of a person with diabetes, loading nearly always takes place.
The process whereby an insurer assesses what premiums an applicant should pay is called underwriting. If you apply for life assurance, you will be asked a series of detailed questions about your health. In the case of a person with diabetes, a report from your GP will also be required; a report from a specialist clinic may also be needed.
Each assurance company has a chief medical officer, who is a doctor, to ensure that they interpret any medical information correctly. According to Mr Griffin, loading on life policies for people with type 1 diabetes is typically 150%-300%, which is a significant increase, especially if your diabetes is well controlled.
The Federation has had some success in tackling the issue of loading. For several years now, it has been at the forefront of a campaign to stop loading in the area of motor insurance. A recent report of the Motor Insurance Advisory Board recommended: 'That insurers undertake to desist from applying policy terms, limitations or loadings that may be encountered by policyholders with disability issues relating to drivers or passengers unless there is evidence of additional risk'. The Irish Insurance Federation has implemented the recommendation.
This means that a motor insurance company cannot load a person simply because they have diabetes, unless additional risk can be proved. However the issue of 'additional risk' remains a sticky one.
Loading without proof of 'additional risk' is blatant discrimination and anyone who feels they have been subject to unfair loading should contact the Federation.
The Federation is also attempting to reverse the blanket bans on entry into certain professions. It has identified a number of organisations, including the Garda Siochana and the Armed Forces and has asked them for clarification of their current policies in relation to people with diabetes, as well as their intentions for the future.
If a doctor has diabetes, they can still carry out full duties, including operating on patients. Why therefore can a person with diabetes not patrol the streets as a Garda?
Fair play for children
The issue of discrimination does not only affect adults. Children may come up against it in school. Perhaps they are not fully encouraged to take part in sporting activities for instance. Maybe there is some concern over state examinations, if the child requires insulin during an exam for example.
It is essential that parents and guardians explain the situation to the necessary people - to the principal and teachers. After all the school may have genuinely little or no experience or knowledge of diabetes.
However according to the Department of Education, this is a serious issue and must be tackled. If a parent is genuinely concerned that their child is being discriminated against, they should in the first instance contact the principal. Following that, they should approach the school's board of management.
'If a parent is not happy with the response of the principal, ideally the situation should be tackled appropriately by the board of management. The principal is usually the secretary of the board however there are also a number of other people, including parents, who have been elected', the spokesperson explained.
If a parent is still unhappy with the situation, the department itself should be contacted. However in the case of post-primary schools, the department is limited in what it can do because these are privately owned, therefore the board of management is in the best position to deal with the issue.
Need for change
The bottom line is that a number of policies have not changed in line with developments in the control and treatment of diabetes. From blanket bans on certain types of jobs to 'loading' on insurance premiums, having diabetes can undoubtedly limit your activities, despite the fact that a person with the condition probably knows more about a healthy lifestyle than the average Joe on the street.
If you feel you have suffered discrimination as a result of diabetes, please contact the Diabetes Federation of Ireland helpline: 1850 909 909, to help gather information for its campaign.
Issue March 03