Mental health - Everybody’s talking about it, yet… we struggle to talk about it

This blog by Justin Harper, Head of Protection Marketing at LV=, was originally published in Cover Magazine

How is the protection industry stepping up?

Openness about mental health has come on leaps and bounds over the last 18 months. We’ve seen the Royals, high profile stars from entertainment, politics, sport, and some of our own industry colleagues share their own struggles and experiences.

We’re getting familiar with the statistics too aren’t rel="noopener noreferrer" we? The most recent figures show that one in six of us are dealing with a mental health issue at any one time. This might not mean we take time off, but the strains and pressures remain. In the whirlwind world of work – and in our desire to impress and remain employable – mental health is a major issue behind presentiment, as well as absenteeism.

Yet many people see a mental health issue as an embarrassment, a negative stigma or even a ‘weakness’, which they’re reluctant to admit to. In my own family, we’ve spoken about our close relatives’ or our own experiences in hushed tones. We’ve found and find it difficult to talk about openly – it’s ‘not the done thing’ and, sadly, too often we’ve avoided the subject (and our own family members) completely and swept it under the carpet. I suspect we can all relate to that.

The Challenge for the industry 

When it comes to protection – disclosure, underwriting, product design or claims – mental health is the subject of many misconceptions, several shortcomings and some challenges. The Access to Insurance [https://a2ii.org/ ] movement is doing great work in tackling these head on – seeking greater understanding and transparency plus, importantly, stronger collaboration with expert support services and charities. 

Many consumers, and their advisers, will have reservations and misconceptions about how their mental health history will impact their access to insurance. Industry events such as the Cover Mental Health Forum can help shed some light of understanding and – in my own small way – hopefully this blog too. 

Insurance and mental health in 2019 

At LV=, we see a mental health disclosure in c10-15% of applications. With the advent of intelligent underwriting systems, it’s is often the adviser that asks the medical questions of their clients. However, this too can prove a barrier – understandably, some advisers aren’t comfortable probing into such issues. But alternatives are available. At LV=, for example, we can offer access to specially trained tele-underwriters, who can take over the application and are experienced in asking and talking to clients with empathy. 

Mental health issues can vary dramatically in terms of severity, cause, duration and treatment. For minor episodes of mild depression or bereavement, we’ll often accept applications with no loading or exclusions. For example, over 90% of LV= life insurance applicants who make a mental health disclosure, are covered and … on standard rates. 

We consider more complex mental health conditions individually. We look at the whole picture and take on board any historical triggers and how the condition is controlled and, if required, the views of the client’s GP or psychiatrist. 

Mental health is a leading reason for income protection claims, and where a client has experienced mental health problems that have led to time off work within the last 2-3 years, IP providers are more likely to apply an exclusion to reduce the underwriting risk. 

LV=, however, is the only provider currently offering automatic reviewable exclusion periods. That’s really important for cases of mental health (which represent about half of all our reviewable exclusions). If your client has a history of mental health problems, but has no further issues after taking out their LV= policy, we can remove that exclusion after 1, 2 or 3 years. 

Mental health is one of the three most common reasons for new income protection claims, but we know that mental health issues can also emerge as a secondary associated cause of claims. For example, the primary cause of a claim might be cancer, but the challenge of having and dealing with the illness can have emotional implications, meaning that insurers should be tailoring their support in a variety of ways. At LV=, in the second half of 2018, we assisted 40 claimants suffering mental health problems with treatment, advice and back-to-work support. 

What about issues that wouldn’t trigger a claim? Can insurance go further? 

We recognise that many people suffer from milder depression, negative stress and anxiety, and that they often try to muddle through. Yet these conditions can wear us down and lead to more serious longer lasting complications. At LV=, we’ve recently extended our Doctor Services offering to include psychological services. There’s no need to claim – your client simply needs to tap a few times on the LV= app on their mobile device and they can access up to five consultations with a mental health professional each year. Following a consultation, they may be recommended one of several approved consultative behavioural therapy programmes – with support for anxiety, depression, substance abuse, and insomnia or other sleep disorders. 

An appointment can be arranged in as little as two to three hours at the client’s convenience, without the need to consult with their own GP first. The technology even allows the client to turn off the camera on their device if they feel it will make the video link conversation more comfortable. 

I’m encouraged that increasingly advisers and insurers are taking practical positive steps to help people overcome moments of vulnerability and live more confident lives. But let’s remember that as a wider society and as an industry, there’s more we can do, and organisations such as Time to Change are doing amazing work to help bring an end to mental health discrimination.