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Mental health and insurance

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Mental health conditions might not be as easy to pin down as physical health conditions, but insurers are increasingly recognising the need to provide cover and support to people suffering with mental ill health. 

One in four of us in the UK will be affected by a mental health problem in any given year, and of these, around four million will also struggle with their financial wellbeing. We are therefore aware of the importance and value of insurance in protecting you when life doesn’t go to plan.  

The insurance industry continues to demonstrate increasing commitment to aiding people suffering from mental ill health. In 2017, Mental Health was the most common cause of claim on income protection policies in the UK. The ABI continues to engage with charities and the health and protection industry to promote greater access to insurance for people with mental health conditions and has repeatedly emphasised its commitment to aiding people suffering from mental ill health.    

There is no difference in any of the insurance decision making processes for mental health to those for physical health. The process by which decisions are made and guidelines are written is consistent for every medical condition whether physical or mental health (or, as is often the case, a combination of the two.) 

If you are considering buying an insurance product and have a mental health condition here are some things you might like to consider: 

Why have insurance to cover mental health care?

When it comes to protecting and supporting individuals who have been diagnosed with a mental health condition, protection and health insurers not only pay claims, but they also provide additional support. Support services come at no extra costs and start from the day the cover begins. It’s always there to help you, which means you can feel confident that help is always at hand.  

  • Preventative measures

Many insurers provide specialist mental health service support, which enables employees of company schemes or individual policy holders to receive rapid access to assessment, often within 48 hours. Policy holders will often have a dedicated case manager assigned to them to take them through the whole process. This can include a tailored treatment plan and access to a wide range of specialists including psychologists, counsellors and psychiatrists. 

  • Accessing support services 

Most insurers have dedicated Employee Assistance Programmes which provide access to support services 24 hours a day. These can offer support on a range of topics which may trigger stress or anxiety, such as finances, relationships and legal issues, as well as dedicated mental health counsellors. These services can be accessed through dedicated helplines as well as through interactive online services. 

  • Rehabilitation services 

Rehabilitation services are at the heart of most protection insurance products. Many insurers offer access to rehabilitation teams who help manage an employee’s or individual policy holder's sickness absence. They often offer access to counselling and a wide range of other services, including assistance with HR issues and legal assistance. Many income protection policies have specific mental health pathways for people to get the tailored assistance they need.  

Before you buy

There are lots of different types of insurance that provide cover for a wide range of situations. Many people find that buying insurance provides financial security and peace of mind, which can help them on the road to recovery when the unexpected happens. 

  • Types of insurance 

There are many different types of insurance that you might like to consider buying that can provide financial peace of mind. They include: 

  1. Private Medical Insurance enables faster access to treatment by enabling a speedy diagnosis and reduced waiting times. It also helps to pay for some, or all, of the treatment that you need. This can help you get back on our feet (and back to work) faster. 

  1. Income Protection Insurance will pay a tax-free monthly income while you are unable to work due to illness, injury and / or suffer a reduction in salary for a prolonged period. This insurance covers mental health issues and provides key support services. 

  1. Travel insurance covers the cost of any medical treatment you may need in an emergency when travelling abroad. You can also obtain travel insurance which covers the cost of your holiday if you are unable to travel and need to cancel your holiday due to illness.  

  1. Life Insurance is a type of policy that can be potentially affected by disclosure of mental health conditions. Find out more about the importance of disclosure below.  

  • The importance of disclosure

For many insurance products, disclosing pre-existing mental health conditions is very importance. A pre-existing medical condition is any condition you have at the time you apply for insurance. Some insurance policies do not cover pre-existing conditions – this means that they will not pay out on a claim related to a pre-existing condition, sometimes this can include mental health problems. If you have been denied cover of a pre-existing mental health condition, you can find a list of specialist advisers here.  

Insurers need to know about existing conditions as it allows them to understand the type of mental health condition, and the associated risk based on scientific evidence. Mental Health conditions can have a direct impact on a sufferer’s risk of premature death or disability and there are also links to greater risk of abuse of medication, drugs or alcohol, which increases the risk of a serious accident. 

"Mental health" for most insurers will include all aspects such as stress, post-natal depression, ADHD, eating disorders, addictions, ME, fatigue, as well as depression and anxiety. Individuals will typically be asked to provide their diagnosis, symptoms and treatment. 

Regardless of your age or health status, you will need to provide information on your mental health and whether you have been diagnosed with or treated for a mental health condition. Some insurers want clients to disclose all mental health episodes regardless of when they occurred. 

It is important that you disclose complete and accurate information because it affects the risk assessment, the premiums charged and the terms and conditions of their insurance policy. It’s a legal requirement that you answer honestly, and failure to do so may result in your policy being void.  

Information you might need

Some insurance policies may or may not cover pre-existing medical conditions depending on the severity of the condition. If you’re having trouble finding a policy due to a pre-existing mental health condition, you can find a specialist adviser here who will be able to help you find the cover you need.  

If you have been diagnosed, or have received treatment for a mental health condition, the insurer may want to know the following: 

  • Date of diagnosis 

  • Method of treatment  

  • Past methods of treatment 

  • Doctor’s details 

  • Symptoms and dates of last symptoms 

  • Details of any previous hospitalisations  

  • Specifics of time taken off work because of the condition 
     

Some underwriters may split a question about your medical history into two asking: 

1) "have you ever had” for the more serious incidents such as in-patient treatment or suicide attempts; and 

2) Just ask about the last five years for other mental health issues, meaning if episodes happened before then, they may not need to be disclosed at all. 

Challenges you might face

  • Advisers and insurers are used to dealing with medical conditions, both physical and mental, so there’s no need to feel embarrassed about your medical history. As with all insurance applications, when you’re applying for insurance it’s vital you’re open and honest. A tiny percentage of insurance claims are declined each year, but the main reason is due to issues of non-disclosure at the application stage, for example omitting to say you are taking medication. 

  • You could be assessed as a 'high risk' customer which means that the insurance provider believes that you are more likely to claim, and as a result, may be charged a higher premium, or have a specific exclusion added to your policy.  

  • You may be declined insurance if you try to apply for insurance directly online and disclose that you have experienced a mental health condition or have an existing mental health condition. We therefore recommend you speak to a specialist adviser who will be able to support your specific needs. 

  • If your policy does not cover a specific mental health condition because of a recent history of mental illness,  yet you go on to be symptom-free for a few years, it’s worth reviewing your policy in the future as cover could be accepted at standard terms, which could save you money. Your adviser will be able to advise when will be the best time to do this. 

Getting help

  • Who can I speak to? 

There are a lot of things you can do to make sure you get the right cover that you need.  

Some companies provide cover specifically for people with pre-existing medical conditions, including mental health conditionsIn order to gain support that is specific to your needs, you may want to look into getting an insurance quote from a specialist provider. 

Click here for specialist advisors that mental health charity MIND has signposted to. 

Mental health support is of growing importance for UK businesses. Employers increasingly provide support which may include giving employees access to counselling services such as ‘Employee Assistance Programmes (EAP’), GP services, on-site medical support and health tracking apps. EAP services are confidential and can be accessed free without disclosure required to your line manager. You may also be able to access occupational health support through your line manager or HR service.  

  • Questions to ask before buying a policy: 

  1. Does my plan cover mental health out-patient therapies or consultant sessions, and how many per year does my insurance cover?  
    This could include out-patient cognitive behavioural therapy (CBT) or counselling plan. 

  2. At what rate will my sessions be covered? Is there a cost limit per therapy session? 

  3. Is approval required from my GP to access consultant or out-patient therapies? 

  4. Do I need any pre-approval from the insurance company before I see a mental health professional? 

  5. Can I get a list of providers in my area?  

  6. Can I meet with more than one provider for a consultation or second opinion and still have it paid for?   

  7. Do I pay the provider or does the insurance company pay them?  

  8. Are psychiatric medications covered under my plan?  

  9. Does my policy cover substance abuse services? Inpatient mental health services? Psychiatry? ADHD evaluations? 

  10. Does my policy also include self-help and guided online therapy? 

  11. How many days do I receive for in-patient / day-case mental health treatment per year?  

  12. Does my insurance policy come with a counselling support service or specialist support services?  
    Examples include Employee Assistance Programs (EAP) for employer-based insurance products, or individual support from foundations such as RedArc – an organisation that includes a team of highly trained and experienced Personal Nurse Advisers who provide practice advice and emotional support.  

  • Sources of info / useful links: 

  • Complaints 

If you're unhappy about the way your claim has been handled or the way your insurer has treated you, you have the right to complain. Find out how to begin the complaints process.