01 August 2011

Out of mind, out of insurance

Mental health discrimination and insurance: a survey of consumer experiences [PDF], a 33 page report by the Mental Health Council of Australia, considers "the experiences of Australians living with mental illness when accessing insurance products and making claims against their policies". The news isn't good and is alas unlikely to get better.

The report is founded on a survey involving the mental health, insurance and financial services sectors, aimed at improving "life insurance and income protection outcomes for Australians experiencing mental illness".

In contrast to the flippant heading of this blog post, 'mental illness' does not exclusively mean what one of my less positive colleagues refers to as "baying" (at the moon or otherwise). It might involve short term or ongoing depression. The report reinforces past claims that Australians with experience of mental illness face substantial difficulties when seeking insurance products that are otherwise readily available to people without a history of mental illness but who might, for example, be grossly obese.
Survey respondents reported significant difficulty and discrimination when applying for insurance products, particularly life insurance and income protection products, and when making claims against their policies. Mental health consumers often face higher premiums and exclusions on their policies and in many cases are refused coverage outright. Moreover, survey respondents stressed that insurance companies did not take into consideration their personal circumstances and instead made broad assumptions about their ability to maintain employment and their general level of function, and this in turn had negative implications for their application or claim.

Survey respondents revealed a lack of awareness of their rights and responsibilities in relation to insurance applications, including their duty of disclosure, or their right to appeal a decision. Moreover, the matter-of-fact nature of some sales, underwriting and/or call centre staff in obtaining information about suicide attempts and/or ideation, for instance, was viewed as humiliating, embarrassing or undignified.

Given that one in five Australians will be affected by mental illness in any twelve month period, and one in two will be affected across the span of a lifetime, it is of great concern that Australians living with mental illness are still not able to access or maintain insurance policies at the same rate as other Australians.
The authors comment that -
The results of this survey highlight the work that still needs to done in educating not only the insurance and financial sector workforce, but all Australians about the real-world experiences of mental illness, to break down the stigma and stereotypes that are so frequently applied to mental health consumers, and to minimise the disadvantage they experience as a result of misinformation and misconception. Moreover, considerable work needs to be done to increase knowledge and awareness of the insurance and financial services industries, how they work, and what products are better suited to people with mental health conditions etc., amongst Australians living with mental illness. This publication recommends that the mental health and broad ranging insurance, financial and superannuation sectors continue to work towards better understanding and addressing these gaps.
They note that -
Being proactive and seeking treatment was experienced as a disadvantage for consumers who applied for insurance. Consumers who had sought treatment experienced higher premiums and exclusions, which were viewed as unfair.
and that
Participants also believed that insurers encouraged self-exclusion by trying to wear people down on purpose so they would just give up; this was specifically mentioned with regard to the claims process. Not being granted insurance or having to endure lengthy claims processes and just general day-to-day dealings with insurers were often described as having a significant impact on the person’s life. This was experienced in terms of the impact on the respondent’s mental health but also, as in the aforementioned example, in terms of financial strain and stress, and the flow on effects. In this way, some respondents drew on the significant impacts of the incompatibility of mental illness and insurance that were seen to perpetuate a cycle of exclusion. Many respondents mentioned their gratitude at being given a voice on this issue, suggesting that they had been excluded from having a voice about this in the past.