Kathryn: Generally people are going to find is that there probably aren’t as many stumbling blocks that they think that there could be with either serious illnesses – well serious illnesses, you know, the ones that are considered most severe by an insurer, or even lighter ones that people may just think, “come on, maybe I don’t need to declare that.” But when it actually comes to it, then you go through the applications, they may not realize that they’ve had something that needs be talked about when it’s been so mild, but you do need to. It may still end up that you get normal in terms of cover but it is always something that’s worthwhile explaining to the insurer on the application.
Alan: Yes, I mean we’ve got many different types of – I guess mental health conditions in essentially such a wide range of conditions anywhere ranging from mild anxiety to panic disorders to depression, whether it’s just one-off or sort of long term, going right to things like bipolar and post-traumatic stress disorder and schizophrenia even, you know. Everything is sort of encompassed by that term mental health condition or disorder. And you know, when people are coming in and applying for the life insurance, it is a question that they will be asked. And everyone is treat differently. Every single condition is treat differently. It is based on the severity of that individual condition, it’s based on the medication that somebody might be taking. It might be based on any events or any time off work that somebody’s taken in relation to that. And ultimately, as Catherine said, people might not always think this, but you can still get the same prices anybody would do if it is on the milder sort of side of the scale. Yes, if it is on the more severe scale or things like post-traumatic or bipolar for example, you are much more likely to see a higher price, but a price for life insurance might go up from 10 pounds to 20 pounds, or 30 pounds to 50 pounds. Quite often, it is not astronomically different but obviously it is all based on individual person and each individual condition.
Kathryn: I think as well as well, it’s not a nice subject to touch upon as well, but even in extreme circumstances of mental health such as suicide, even if you do have a history of suicide, depending on the times, depending on how many occasions, how much treatment and sort of secondary conditions you may have, there is still cover out there that you can have. So even if you think, “I’ve got such a severe medical history. There is absolutely no chance I can get some life insurance,” in all fairness, there is probably going to be something out there for you. It may not be with a standard insurer, it may be with someone who is much more specialist, but a lot of the time, once you’ve passed a certain amount of time, maybe even a year or a couple of years, you can start looking at the mainstream people and start looking at prices that are much more sensible than going off and getting absolutely ridiculous quotes, which some people do.
Alan: I think what a lot of people don’t always realize as well is that especially, and I’m just talking about life insurance here, it typically doesn’t have any exclusions on the policies. Obviously I’m not saying that for absolutely every plan on the market, but most of your mainstream insurers will exclude suicide for the first twelve months of the policy, but after that, they actually do cover that, so people with a history of maybe having had a self-harm or suicide attempt earlier in life, they can be covered and obviously hopefully that’s well in the past and hopefully not something that would ever happen again, but insurers obviously do take that risk onboard and say “we will cover this,” because ultimately, it’s the person’s family who passes away who needs to have the money from the policy and benefit. So it would be wrong for them to penalize that. And likewise, they don’t exclude any other conditions with most of the big providers.
Kathryn: Yeah, I think another thing as well is to put out there is the fact that we’re not just sort of like saying this. We also do have personal experience. Myself, I’ve had a generalized anxiety disorder for ten years now, and when I first came down with it, I also had two quite severe cases of acrophobia. And obviously it was something especially we were considering to get life insurance after being in the business, we make sure we have life insurance. We want to make sure that everyone is protected, so when we wanted to put together my life insurance, we gave them obviously the history and everything and the fact that obviously for a number of years, I’ve not been under any treatment. Obviously, I saw a psychologist when I was very ill. I was on some medication. The medication has obviously reduced. I’m not seeing anybody for it. I’m getting on with my life absolutely fine, happy for quite a while. And when my life insurance went through, literally a couple of months ago, it came back rated, and it almost pretty much doubled in price. And we challenged it. We went back to the insurer and said, “Hang on a minute! This isn’t fair. Obviously look at how much she has come along – how much better she is – and really she is in a completely normal life now, so this seems pretty unfair for something that was really something like five to ten years ago for the bulk of what was the issue.” And they came back, “Actually, you know what, you’re right.” And they’ve given me the normal terms for it now.
Host: They’re giving the same prices as anyone else now?
Kathryn: The same prices as anyone else, and that was for something which was obviously generalized anxiety disorder and acrophobia, which combined, was not as severe as some mental illnesses, but still a pretty hefty sort of –
Alan: Severe enough for you at the time. But yeah, I think it shows that actually you can challenge decisions. Don’t be afraid to – if you do have a decision that you actually think is unfair, don’t be afraid to challenge it. Even if they don’t overturn it then, they may be willing to review it a little bit further down the line.
Kathryn: And you sometimes get that in a few years’ time, if things are still okay, it could be worthwhile going back and reviewing and seeing if it’s worth giving a more reasonable price.
Alan: Absolutely.
Host: That’s the sort of thing that needs a bit of knowledge. You’re not going to be able to do that on a web form.
Kathryn: No, you’ll need to speak to someone about that. I mean we would always suggest that obviously if you do have any kind of medical history, it is worthwhile to – yes speak to ourselves- but if you don’t want to talk to us, just use an insurance adviser. Make sure you have an accredited insurance adviser.
Host: So the crux of what you’re saying is actually that insurers are going to treat different conditions differently.
Alan: Yeah, absolutely, and it’s so strange to see. That’s obviously why we do what we do, because every insurer is so different. So use bipolar I suppose as an example. We’ve placed quite a lot of clients who have suffered with this condition, and more often than not, it’s something where it’s been diagnosed for some time, and actually now it’s been very well controlled with medication usually. And actually, you will get some companies who just, as soon as you mention the words, “bipolar”, they will say, “No, we will not cover.” And especially when it comes to the likes of critical illness and income protection even, and it is just straight up we don’t cover that condition. But then you’ve got other insurers who will just hike up the price a small amount and cover it. The income protection, if they will consider it, are likely to exclude it, which is understandable since it is already and adds a risk, but yeah, every insurance company is so different, and not just related to mental illness. That comes down to every health condition as well and alter it very differently.
Kathryn: I think that’s the benefit of using insurance advisers. This is what we do day in and day out. We know which company is going to be the best for which conditions, and even if a couple of companies may cover the same condition, that’s fantastic, they may cover it at different rates. So you know, somebody could put on a 100% loading, somebody may put on a 200% loading, so it’s always worthwhile using someone who knows what they are doing – somebody that can get you the best terms.
Alan: But just to sort of I guess take out from what Catherine just said, the reason to stop people doing that directly themselves – it’s a bit more time-consuming. Some people might not want to speak to an adviser. I think using an online form is, as you said, you cannot capture that kind of information, but you can speak to insurers directly a lot of the time so somebody wants to contact half a dozen of them, there is nothing to stop you doing that as well.
Host: So if we did that, what sort of questions are we going to get asked? What sort of questions are the insurers going to ask us based on these conditions?
Alan: So usually, it will step from what the condition is, and so they will ask first of all what the name of the condition is. It is important to give them the actual name, so you couldn’t get away with calling posttraumatic stress disorder stress for example, because they would want to know that it was posttraumatic. They would want to know a little bit about the reasoning behind it, quite often, so usually you will find they will ask if it was due to a life event, i.e. a bereavement, something that happened at work. And they will usually ask what type of medication you take, so things like Citalopram or Sertraline or Fluoxetine or Prozac, I think it used to be known, are classed as maintenance drugs. Antidepressants are generally they are fine with them, but then if there are heavier duty medications then that’s when we start to – the prices do creep up potentially. They will ask about things like self-harm and suicide attempts, and that will be the case for –
Kathryn: That’s the standard for every application. That’s not particularly because you have a mental health condition.
Alan: They will ask that and they will obviously assess that. They will ask for time off work as well, so some insurers will say if you’ve had six months off work recently, it’s obviously been a little more severe, and they will treat accordingly. The best thing to do is just be completely honest, you know? Be honest with them, and if the price does go up a little bit, be prepared to review it a little bit further down the line, because if you go back to them, you may get a better price.
Kathryn: It is possible that they may ask to see you apart from the GP. Now that is again completely standard. It happens more times than not – a lot of times life insurance. A lot of the times it’s actually a lot better if they do because then at least you know that when they are writing your application, they have exactly all the information. There is no case of, “Oh you’ve missed something here,” or “You’ve missed a medication that you use all the time since the last episode.” They will have absolutely everything from the doctor, so when they underwrite it, they know everything about you. The only thing is obviously going back to what Allan was saying before obviously, people can do this direct, and if you would like to do it direct, fine, that’s one approach but what you may find as well is that obviously it is a lot more time-consuming than using an insurance adviser because if you go to an insurance adviser such as ourselves, we’ll go through all these questions, get everything we want – that’s it. You leave it with us and we get back to you. If you go to insurers on your own, you’re going to go through the exact same questions again and again 5-6 times and it is going to take a lot more time and effort, and it’s going to be self-destroying, so probably better not to do it!
Alan: I think one of the things I was going to say as well just with relation to the questions that you do get asked on this – it’s really strange because, and I say this to a lot of the clients, when you say you’ve suffered with stress, they ask you more questions than if you say you’ve had a heart attack. It’s one of these strange ones, and I think it’s because a lot of the time you say you’ve had a heart attack, it’s a heart attack. There is one – yes there are different severities, it could attack different vessels etc, but a heart attack is a heart attack, whereas when you say something about mental health, they need to find out how severe it was, what type – it’s almost a little bit of a flowchart, actually.
Kathryn: It’s so complex. There are so many secondary conditions because obviously it is tied with arthritis, people obviously got cancer. Stress comes as part of a lot of conditions.
Alan: It can quite often be closely linked to a lot of different conditions, yeah.
Host: So when you go through all these questions and you’ve given answers to all these in-depth questions about your situation, what impact does that have on your application?
Alan: So for your life insurance, it very well could be that you will get – if it’s mild and no significant amount of time of work, no recent sort of self-harm or anything like that, then there is a chance that actually much like you would with Catherine’s, it goes through what we call standard terms which means prices are the same as anybody else. If there have been stronger medications recently, I guess more severe episodes, there is a chance that the price may go up a little bit, but that might be something that could be reviewed a little bit further down the line. If it is something that is very severe, I suppose if I use the example of self-harm or something like that, because obviously it does happen, then you are likely to see that the insurers will actually will want to wait a little bit. So if somebody had an incident of self-harm or suicide attempt within the last month, insurers are probably going to say well let’s wait a year. Let’s make sure that you can get yourself back on track again. And once those twelve months are gone, it might be that that point, they charge you a higher price, but they might turn around and say, “Well actually we’ll only charge you this higher price for three or four years, and then as long as there isn’t another of the same episode or such, then we will bring the price back down again.” So there’s lots of potential outcomes for it and in sort of the very severe cases that we’ve seen before, or where there have been multiple attempts or recent attempts or where maybe there has been a combination of alcohol or drug problems as well, then we do end up approaching some specialist insurers, and they will usually put in exclusions, and they may say, “Actually we may not cover for things like suicide and maybe alcohol-related conditions” for example, but they are usually a last attempt sort of thing.
Host: We’ve been talking about life insurance, but I mean how might other forms of insurance be affected by these types of mental health conditions?
Alan: Yeah, there’s a few that we primarily work in, so critical illness insurance, which trend quite similarly to life insurance. They will ask similar sorts of questions and work in a similar way. It might be that the price is slightly higher, and it’s not – typically, critical illness isn’t quite as harsh I guess as life insurance because the chances of developing something like cancer or having a heart attack because of having stress is maybe seen as a slightly lower risk to the insurers. There are certain circumstances where they might put exclusion on, so if they’ve got a condition on their critical illness policy that says for example if you become totally disabled, they may put an exclusion on that, much like income protection for example. An income protection policy basically pays a monthly income if somebody cannot work due to ill health. That is very common with income protection that they will exclude rather than put the prices up, which can be a positive for some people, it can be a negative for others, obviously because if you do want to be covered for those conditions, it’s not always possible. Usually they say with income protection if you’ve been under treatment or if you’ve been having issues for the last 3-4 years, chances are it won’t be included on the policy. One of the interesting things that I would say with income protection is that a lot of people think that actually insurance companies look for a way not to pay most of the time, or look for a reason not to cover, and one of the things actually with life insurance – with critical illness insurance actually – the claims rates are extremely high, and because it’s very very bad press if they don’t pay, so they want to pay as much as they can. But for income protection there are a few providers now who are saying if somebody has a bout of say depression or stress and it’s been reactive in recent one-off, for example, in relation to a bereavement or even a life event where actually they will cover without that exclusion as long as you are symptom-free at the moment. So again, it’s not to be it is going to be an absolute definite that they will not cover it, because there are certainly circumstances where they can. And if they do it exclude it, don’t be afraid to try again a couple of years down the line and see if they would reconsider adding that in because a lot of them will.
Host: What about things like private medical insurance as well? I mean that seems very relevant here because we’re obviously talking about medical conditions that people have got.
Alan: Yeah, so private medical insurance is usually done on sort of an underwriting basis where they exclude your medical history that has happened in maybe the last 2, 3 or 5 years. So they say if you’ve had a condition that you’ve had treatment for in the last five years, for example, they will not cover. However, a lot of them have got what we called a moratorium on it which says if you have got symptomfree of that condition for two years, or treatment years, they will consider – sorry, not consider, but they will re-include it under the policy. And there are a couple of different ones on that as well where if it’s one company for example who will cover you if you’ve been treated for it as long as you go a couple of years and help any sort of major symptoms. So again, it’s likely to be excluded at the start but the longer you go without anything for it, the more chances it has for being covered again in the future. And I think the other the thing with private medical insurance as well is that actually acute sort of conditions can often be covered with it, so maybe with this sort of exclusion in relation to what you’ve got, if somebody who suffers something that is completely different and an acute version, then they will consider covering those.
Host: So from what you’re saying, it sounds like actually having a current mental health condition, a past mental health condition shouldn’t necessarily be a barrier to getting insurance?
Kathryn: No, not at all.
Alan: Definitely not.
Kathryn: Going back to myself as an example as well, the life insurance I applied for did have for mine is called a serious illness coverage, which is a version of the critical illness in a sense. And that also was standard terms when I put the application through. So it is possible. Obviously it is dependent upon the condition and there’s something about obviously time since last events in a sense, and obviously if you put your application through and in between the time of it being accepted and going live, you then have an episode of panic disorder or something. You’ve been absolutely fine for three years, you put your application through and then in between, two weeks before it goes live, you suddenly have a major setback and rush to the doctor’s. You must inform the insurer before the policy actually starts because any time anything that happens before that start date could potentially invalidate the cover.
Alan: Actually I think the last big thing that was in the news a couple of years ago about an insurer not paying was due to something very similar to that. It’s better not to go into too much detail but it was a big story in the news at the time where someone had tried to make a claim for one condition but they had something happen, but they had a test for something in between, and that led to the claim not being paid up. So it’s always important to remember just to make full disclosure, to tell obviously of any changes that do happen. But people certainly should not be afraid of getting cover or applying for cover or researching cover if they’ve had any sort of mental illness. I think there’s as much need there potentially as anybody else with it. There’s no reason they shouldn’t be having the cover. There’s much more understanding I think these days as to where they have been in the past while it is still an invisible condition most of the time, where people don’t see most people having touched by mental illness in some way – whether themselves, a partner or a family member. People do understand it a lot more now than maybe they have in the past.
Host: So it might be slightly more complicated than applying for a policy normally, but help is out there, and if people need help, they can get in touch with you guys.
Kathryn: Yeah, definitely.
Alan: Absolutely, and it’s a great bunch and actually some of the people in the office, as we’ve already said with Catherine, have suffered with things themselves, so we’re up and we’re always happy to have a conversation, and everyone’s very friendly.
Host: Got the in-house experience?
Kathryn: Oh yeah!
Host: Great. As always, good to see you. It’s been an enlightening conversation as always and we’ll see you next time.
Kathryn: Thank you for having us.
Alan: Thank you.
1 in 4 people will experience a mental health problem this year. They will range from the mild to the severe and many cases will involve intervention from the medical profession. When someone has been diagnosed with a mental health condition how will this affect their ability to get insurance?
