Insurance processes can compound issues of mental health

Amanda Lyons

9/04/2018 3:22:51 PM

New research shows that insurance companies’ assessment processes can have an adverse effect on patients’ mental health.

Problems with insurance processes for people experiencing issues of mental health have been found to include refusal of coverage, broad exclusions, excessive premiums, and problems claiming.
Problems with insurance processes for people experiencing issues of mental health have been found to include refusal of coverage, broad exclusions, excessive premiums, and problems claiming.

Research conducted by beyondblue on ‘insurance discrimination’ and mental health in Australia, which is due for release later this year, has found the claims process can itself exacerbate people’s problems.
‘Of the people surveyed who had experienced a mental health condition and had claimed on their total and permanent disability policy, 50% reported the insurance claims process had a negative impact on their mental health,’ GP and Associate Professor Grant Blashki, who is lead clinical advisor for mental health education and advocacy organisation beyondblue, told newsGP.
Despite efforts by a number of campaigns and organisations to destigmatise mental health in Australia, the health insurance industry remains an important area in which stigma appears to persist.
‘Common issues include refusal of coverage; blanket or broad exclusions on claims relating to all mental health conditions, even if unrelated to someone’s specific condition; excessive premiums; and problems with claiming,’ Associate Professor Blashki said.
Associate Professor Blashki believes any discrimination from insurance companies can serve to reinforce wider negative perceptions of people experiencing mental health issues, with concerning consequences.
‘It creates a ripple effect of reinforcing self and community stigma,’ he said. ‘When mental health conditions are stigmatised, people are less likely to seek help and it can reduce their capacity to participate in society.’
The applications and claims process can also be uncomfortable for GPs, as insurance companies may request medical information in a way that GPs feel is not in their patients’ best interests.
‘Having to provide information to life insurers can be a major dilemma for any doctor,’ Dr Edwin Kruys, RACGP Immediate Past Vice President, told newsGP.
‘Having said that, GPs are always “in the middle”. In a way, you could say that’s our job and our duty to advocate on our patients’ behalf, especially for people living with mental health conditions.’
beyondblue has found that one of the major issues for people experiencing issues of mental health who are trying to set up or claim on policies is the use of an outdated ‘one-size-fits-all’ approach by the insurance industry.
‘It appears that industry practices make insufficient distinction between different mental health conditions, overestimate their severity, or underestimate the possibility of recovery,’ Associate Professor Blashki said.
In order to help provide a fairer balance for patients with mental health issues disorders, beyondblue and the RACGP advocated for patients during the Parliamentary Joint Committee on Corporations and Financial Services inquiry into the life insurance industry in late 2017. A number of the organisations’ recommendations have been suggested for adoption, including preventing insurance companies being able to access patients’ full medical records.
‘I was very pleased to hear the Committee has adopted the RACGP recommendation that life insurers cannot have access to complete medical records, and should be asking for a targeted report by the treating doctor instead. If implemented, this will be a big win for patients and doctors,’ Dr Kruys, who represented the RACGP during the inquiry, said.
‘Importantly, it will help ensure that people feel they can talk to their family doctor without fear that everything they share may one day end up on the desk of an insurance company. It should also have a positive effect on the doctor–patient relationship and ease some of the ethical burden placed on GPs when providing information to insurers.’
Associate Professor Blashki would also like to see the insurance industry base future assessments on solid evidence and acknowledge that not all mental health conditions are the same, as well as provide further training for its staff.
‘beyondblue recognises that insurance companies need to make a profit to maintain commercial viability, but that this should not be at the expense of people living with mental health conditions. A fairer balance is required,’ he said.
The RACGP provides a resource for GPs writing medical reports for insurance companies, which includes information on what to include, how to format the report and how to set fees.

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