Insurer tells grieving woman not to seek mental health treatment for two years or void cover


Updated

October 31, 2018 07:26:34

Tania Wenn has lived through the trauma of losing someone to suicide. Her former husband and father of her children, Barry, died in 2015.

Key points:

  • Insurer tells grieving women any mental health treatment would exclude her from cover
  • Mental health groups are alarmed Australians are being discouraged from seeking treatment
  • As more Australians ask for help, there are calls for mental health exclusions to be lifted from insurance policies

“I was an absolute mess, an absolute mess,” she said.

“I still have a dark day about it. It’s something that you never get over.”

To cope with Barry’s death, Ms Wenn spoke to a counsellor and took medication for a brief period of time.

Soon after, she took out a life insurance policy. Ms Wenn was now the sole carer of her children and she wanted to get her finances in order and to insure against any loss of income or her own death to make sure, if anything happened, her children would be looked after.

The insurance company told her the policy would exclude cover for a broad range of mental health-related conditions, such as stress and anxiety.

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Ms Wenn is a lawyer and believed the policy was unfair, so she argued the point.

The insurer told her it would review her policy in two years, on the condition she had no further mental health-related symptoms or treatment for them within that time.

“They just said that if I seek any form of assistance, whether it be counselling, psychological assistance, medication, anything that’s on my record for the next two years, then I won’t be covered for that,” Ms Wenn said.

“I was ropeable, absolutely ropeable. I thought, ‘If I fall into a dark hole and I actually need help, you’re almost encouraging me to take the option that I wouldn’t want to take and put more risk to my kids’.

“Because [if] I put my hand up and say, ‘I want help’, I should be praised for that and in the long run it’s going to assist my longevity of my life.”

Mental health groups are alarmed by what they say is the insurance industry’s move to discourage people from seeking treatment so they can have policy exclusions lifted.

“I think the idea that you would set a time limit on whether or not someone experiences a relapse in their mental health, is a really challenging one,” SANE Australia deputy chief Michelle Blanchard said.

“The nature of mental illness is that it is often episodic, and really for people to recover and be well and be healthy, having a sort of arbitrary deadline that then determines whether or not they can receive a policy can actually be quite detrimental.”

We are learning to ask for help, but insurers aren’t listening

Mental health is the number one reason Australians are going to the GP and Medicare data reveals just how much of a change that is.

Data modelled by the ABC shows a 30 per cent increase in the number of GP appointments for the preparations of mental health plans over the past four years.

Dr Blanchard said the data raised questions about how out of step the life insurance industry was with society.

“When you see the number of people presenting to their GP to get a mental health plan increasing, that reflects that community awareness and understanding is growing,” she said.

SANE Australia’s position is that it is time the insurance industry got in line with community sentiment and removed blanket exclusions for mental health.

“We feel very strongly that those exclusions need to be removed across the board because everybody’s experience of living with a mental illness is different,” Dr Blanchard said.

Accessing support should be seen ‘as an asset not a deficit’

Dr Blanchard said insurers should look at the context around somebody’s application and what might have happened in their life before excluding them from coverage.

“When someone acquires an insurance policy — whether that’s something that sits alongside super or whether it’s something they seek out themselves — some questions [should be] there that build an understanding of that person’s experiences over time,” she said.

“So rather than asking simply, ‘Have you ever seen a mental health professional?’, [They should be] giving people the opportunity to say why that was, whether it was around relationship counselling, or grief counselling, or a complex mental illness.”

Dr Blanchard said there was an opportunity for insurers to learn a lot more about policy holders before taking a one-size, exclude-all approach to mental health and that it was about, “building up a profile of that person’s experiences over their lifetime”.

“It would be great to see insurers taking into account the things that people are doing to stay well and stay healthy and to see accessing treatment and support as an asset rather than a deficit,” she said.

“I think though there is a challenge in that we know the current mental health system doesn’t meet the needs of people living with complex mental illness.

“So we are living in a catch 22, in that we want people accessing that help and support, but for some people in some communities that health and support isn’t available, so we need to bear that in mind as well.”

The industry insists changes are coming

The Financial Services Council (FSC) represents the life insurance industry and insists its members are making changes.

Nick Kirwan from the FSC said the industry’s code of practice was being revised and would serve consumers better.

Need advice?

If you already have life insurance, you can check your list of exclusions to see how treatment for mental health affects your cover. If you need to advice, you can try:

“The new code will make it clear that you do need to take account for the individual circumstances and you do need to look at the underlying cause if that’s known,” he said.

He denied many insurers excluded people from cover if they had undergone mental health treatment.

“I don’t accept that that’s the case, but there are some times when insurers are unable to do that,” Mr Kirwan said.

“Different insurers have different appetites for risk and will offer different terms. So do shop around and if you’re not sure, an adviser will be able to help so don’t accept the first thing that’s offered to you.”

For Tania, her fight was with insurer BT Financial Group.

The company said if a customer had a pre-existing condition when they applied for cover, “exclusions may apply to the policy”.

“Exclusions can help to improve the accessibility of insurance to more customers who have a mental illness, who would otherwise not be covered,” BT said in a statement.

“If a customer’s circumstances change, we endeavour to reassess the customer’s situation, existing policies and any exclusions to ensure the policy is reflective of the customer’s current circumstance.”

The company said it worked with industry to understand the market’s changing needs.

Dr Blanchard from SANE Australia said the new code of practice had “limitations”.

“What we’re hearing from people living with complex mental health concerns is that they are still facing discriminatory behaviour and practices when they’re applying for insurance or looking to claim against their insurance policy,” she said.

“We would like to see stronger oversight to ensure that these discriminatory practices cease once and for all.”

Topics:

insurance,

industry,

business-economics-and-finance,

health,

mental-health,

health-policy,

health-insurance,

australia

First posted

October 31, 2018 06:12:13



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