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Protection Review Conference 2019: Mental health tops the agenda

Industry facing up to the elephant in the room

Kevin Carr, the chief executive office of Protection Review, reported protection markets had performed well in 2018, and that the second quarter of 2019 was up on the previous year. But, he added, not everything was rosy in the protection garden.

On the plus side, consumer confidence had improved and far fewer claims were declined but he reminded the full capacity audience at London’s Landmark Hotel that the press was not there for the industry’s benefit and while declines had reduced, there were complaints that some could not obtain cover due to their mental health issues – the theme of the first session.

He said: “We are about people and we impact their lives. Insurers have the right to insure whomsover they want but, in regard to mental health, we must adapt and evolve and accept more on fairer terms. Over a quarter are more likely to buy cover after a mental health episode but 52% believe suicide is not covered with a further 31% are not sure. Nearly one in six believes mental health questions are unfair, while a third say they are not comfortable discussing these issues. Only one in twelve says they would talk about mental health with a financial adviser while 60% says the industry is tougher at the underwriting stage on mental health compared to physical health.”

Carr added: “Many firms don’t understand suicide and don’t offer or suggest specialist help when an application is declined. Only 18% – less than one in five – think the industry is open-minded on mental health.”

Keynote speaker Helen Undy, chief executive of Money and Mental Health Policy Institute, said those with mental health issues were 3.5 times as likely to be in problem debt, and that debt collection strategies – governed by legislation over 40 years old – needs to recognise this.

She said: “Over half of mental health patients have problem debt and over 100,000 in problem debt attempt suicide. If we had the right products at the right time, we could save lives and change some worlds. We applaud the new government initiative that bans, from next year, going home from a hospital and finding debt collectors on the doorstep. Creditors should offer more time while GPs should no longer charge £50 to £100 for evidence letters.”

She added: “There is a vicious circle. If you have financial difficulty, you are more likely to have mental health issues and therefore less likely to pass underwriting. Nearly 25% of those suffering have taken over a year off so we have to tailor cover. Under 10% get insurance help while over half go without essentials and miss obligatory payments. And once you are behind, there is less chance of better.”

Undy listed some insurance problems.

She said: “We looked at travel cover and found disproportionate loading for mental health even if the episode was long ago and managed – many just don’t buy, and they are unaware of specialist options. Some think mental health is covered when it is not and although sufferers pay more, they have more exclusions – and these are especially hard to spot when you have a mental health issue.”

She added: “Mental Health is a protected characteristic in insurance, allowing discrimination, but the evidence has to be accurate. It would be possible to breach the Equalities Act and we are in discussion with the Financial Conduct Authority on this point.”

Group income replacement would be one of the best ways to square the circle, but too few have access.

She said: “We need to get to smaller employers because there is little or no disclosure with group as people don’t like to share this – often not even with family. Some end up taking on products which will not pay out. We need good industry standards for disclosure and too often insurance staff sound cold and unsympathetic. Some sufferers don’t like phones – they get panic attacks or sweat – so if you have problems here, you can miss on functions including claiming. People don’t switch when they are struggling – and don’t want to disclose again. Banking has improved – insurance is lagging.”

She added: “We must have product innovation. It can be a life saver – the good news is that it is moving up the industry agenda even if there’s still a long way to go.”

The conference heard that insurers think of suicide and self-harm – and that’s a message that does not go down well.

Mark Twigg of Cicero Consulting told how he has suffered from depression on and off since he was 15 and his father died. He said: “What you get can depend on pot luck, especially in the group market where you don’t have a choice. When I tried to claim, there were trying to assess whether it was a pre-existing condition so they could get out of paying. After loads of intrusive questions, I put the phone down. That was five years ago and the last time I spoke to an insurer. Most would do the same.

“I don’t put too much trust in industry statistics as mental health sufferers self-select out of the market. You have to look at individual requirements – the challenge is to get help where and when needed but we are letting people down. If we treated cancer patients like this, there would be an outcry. There must be a fundamental recognition of the group market but half of those suffering are not in regular employment.”

He added: “Insurers are not part of the solution – they are part of the problem. We have had three claims declined at our workplace so we effectively self-insure. We see lots of negatives but it can be put right easily. I would love to be more positive a year onwards.”

Yvonne Braun from the Association of British Insurers asked: “What can we do better? The whole point of insurance is to help people – mental health is in the top three for payments. The industry is a sleeping giant with huge potential. Talking is cheap and damaging stories harm our reputation – we know banks are doing better.”

She added: “We need to look at questions and how we interpret them. Customers don’t expect the impossible but don’t like questions about ‘suicidal thoughts’, stress and anxiety at the same time as physical health questions. We have to communicate decisions better – and help advisers. We can make a difference, rebuild trust and improve our industry. We must change.”

Justin Harper from LV= told his personal story and his connections to mental health issues. Steve Casey from Square Health said the key was accessibility to help and the need for a clear clinical pathway – but was critical of the underwriting process where decisions were often not explained.