Health Insurance: some exclusions are just mental!
It's 2013. There are all sorts of laws in place now to prevent discrimination on the basis of a disability; reasonable adjustments must be made in a workplace; venues have no excuse for not being accessible to you. In such a progressive (by which I really just mean "equal") society we should feel safe and confident about discussing our mental health. Right?
You'd hope so, wouldn't you? But sadly this still doesn't seem to be the case.
Getting a mortgage isn't a lot of fun. We got one recently and spent much of it on the telephone to the monotonal Emily, who, on each occasion, would inform us of yet another document we should have provided for her had our telepathic skills been up to the job. On each occasion Emily insisted petulantly that we should have known we needed each of these items without her prompting (despite having never applied for a mortgage before) and made it perfectly clear to us that we were a pair of idiots who frankly didn't deserve said mortgage. Why Emily chose to tell us about one document per phonecall rather than sending us a concise list is anybody's guess. But for some there is an even bigger hurdle: the thorny issue of insurance.
Optimists that mortgage brokers are they are keen to remind you of all the terrible things that could befall you, and their terrible resulting ripple effects. "If you were to die suddenly," I was told cheerfully "your husband would be left with the mortgage" (the mortgage clearly being the primary concerm of my husband on the untimely death of his beloved). "If you were to get cancer," he continued chirpily, beaming at my husband, "and be signed off work long term, your wife would struggle." The upshot of this, of course, was a big sales pitch: "Well, fortunately, you needn't worry about your leg falling off or falling off a cliff because I'm about to sell you some nice insurance - for just £50 a month."
Insurance, though, as anyone who has watched "Sicko" knows, is a minefield. People are paid to sit in offices and sift through the most intimate aspects of your medical history: "You want cover for arthritis, you say? Oh I'm sorry, I'm afraid that's not possible. You see, you were treated for genital warts in 1997 and failed to declare this on your original application" or "it says here at 15 you sought advice on period pain. I'm afraid this means we won't be able to pay for an artifical limb after your arm was severed off in that freak Scrabble accident."
The initial application is quite straightfoward. You go through a skin-crawling list of ailments from the frankly terrifying to the comedically icky and hope you're able to tick "no" to all of them. If you have to get "yes", things get more complicated. In the case of something like asthma, this largely entails confirming what medication you're on while the insurance chappie sucks on his teeth like a builder before he utters the immortal phrase "it's gonna cost ya." With mental health, though, it turns out it's a different thing altogether.
If you mention on one of these forms you have or may have had any hint of anything that could be carelessly shoved under the catch-all "mental health" heading everything suddenly gets serious. Proceedings grind to a halt. The man who was grinning a minute a go as he relayed all the possible ways you could meet your early demise ("What if you were hit by a bus? What if you fell off a ladder? What if you were attacked by a rabid penguin in a freak zoo-escape incident?") tells you gravely there is a "special form" you will need to complete, and that this will be despatched forthwith.
A fretful few days - and the irony of the tense wait for someone who's just declared they suffer from anxiety isn't lost on you - later the form arrives. Compiled by a pen pusher with little experience either of mental health, common sense or indeed the application of correct grammar given the redundant question mark, it blithely begins: "please outline the nature of your problem?", followed by "When did the problem start" (no question mark) and "are you still suffering from the problem?" This alone is non-sensical in the case of depression and anxiety, which are so often transient and can strike with no warning or explanation. To pin down an exact date when you decided you were depressed and then a date when it all finished, as though depression is a library book you gave back and which is therefore no longer your concern, is laughable. But it got better: the last question was "Have you ever tried to take your own life? If yes, please give dates and details."
A friend and I amused ourselves for a good ten minutes compiling an answer, to be read in the voice of Alan Bennett, along the lines of "It was a warm Tuesday in early May, 1996. I distincly remember it because I was in B&Q and found myself looking at some particularly sturdy ropes, which I thought might come in handy later that afternoon if indeed there was time, after "Emmerdale", to attach it to the light fitting in the back bedroom - the best choice as the struggle wouldn't disturb the neighbours..." etc.
But joking aside, what is the outcome if you declare you have a mental health "problem"? Presumably it is consistent and proportionate, taking into account the risk, looking at your medical history, perhaps your employment sickness record, to arrive at a sensible quote?
It would seem not. The following is a genuine "exclusion" in an insurance policy issued to someone who declared a history of "mild depression", for which they had never taken leave from work:
"No benefits of any kind will be payable in the event of any claim arising directly or indirectly from any mental or behavioural disorder (as defined by the World Health Organisation using the International Classification of Diseases (ICD10 or subsequent revision(s) thereof) including (but not exhaustively) anxiety, depression, bipolar disorder, stress, schizophrenia and schizoaffective disorders, or mental or behavioural disorder due to alcohol or substance use or misuse, or any functional somatic symptoms (also known as medically unexplained symptoms) including (but not exhaustively) chronic fatigue, chronic pain, or irritable bowel syndromes or myalgic encephalomyelitis/-pathy (ME)."
The company (who I won't name, as they are surely not alone so it would seem unfair) claim that they treat mental health the same as physical health, so if you declare a pre-existing condition you would inevitably face some exclusions. Really? Following the logic above, would you be denied cover for a stroke if you had, say, suffered from a heart attack? Or cancer if you'd had a bad back? It's worth noting my husband and his ashthma faced no exclusions at all, and my own cancer scare was brushed aside as having been "too long ago". But if you suffer from anxiety you can't be covered for schizophrenia; if you're schizophrenic they wouldn't cover you if you're unfortunate enough to get IBS; if you have depression you can't be covered for chronic pain - so woe betide any depressive foolish enough to develop, say, sciatica. And the nice caveat of "not exhaustively" renders everything else uncertain and therefore pointless - I'm sure, given the chance, most conditons could be spuriously linked to the above. There is no medical or scientific basis I can find for any of this - it seems to lump all "mental health" conditions togther in one sloppy "loony" category, and tag on some physical health conditions for good measure. At best this seems daft, at worst it's discriminatory, judgemental and extremely damaging.
Policies such as this seem to reinforce taboos that still, sadly, surround issues of mental health and, ultimately, scare people away from seeking help when they need it. They penalise the very people brave and sensible enough to say "there's something wrong here", from alcoholics to depressives.
I work in a caring profession and frequently try to encourage my clients to see doctors and counsellors for what such policies casually term their "problems". If I were to tell those clients that seeking and obtaining such help might, on the one hand, arm them with the tools (be they CBT, tablets, or whatever) to continue with their lives and work, but would also, on the other, effect their ability to get something so crucial as a mortgage years later, I'm sure every single one would think twice before going any further. They would suffer in silence. I don't even want to suggest the consequences of this - in some cases they are too frightening. Companies would do well to think about that before reinforcing a stigma for the sake of cynical penny-pinching. Shame on them.
You'd hope so, wouldn't you? But sadly this still doesn't seem to be the case.
Getting a mortgage isn't a lot of fun. We got one recently and spent much of it on the telephone to the monotonal Emily, who, on each occasion, would inform us of yet another document we should have provided for her had our telepathic skills been up to the job. On each occasion Emily insisted petulantly that we should have known we needed each of these items without her prompting (despite having never applied for a mortgage before) and made it perfectly clear to us that we were a pair of idiots who frankly didn't deserve said mortgage. Why Emily chose to tell us about one document per phonecall rather than sending us a concise list is anybody's guess. But for some there is an even bigger hurdle: the thorny issue of insurance.
Optimists that mortgage brokers are they are keen to remind you of all the terrible things that could befall you, and their terrible resulting ripple effects. "If you were to die suddenly," I was told cheerfully "your husband would be left with the mortgage" (the mortgage clearly being the primary concerm of my husband on the untimely death of his beloved). "If you were to get cancer," he continued chirpily, beaming at my husband, "and be signed off work long term, your wife would struggle." The upshot of this, of course, was a big sales pitch: "Well, fortunately, you needn't worry about your leg falling off or falling off a cliff because I'm about to sell you some nice insurance - for just £50 a month."
Insurance, though, as anyone who has watched "Sicko" knows, is a minefield. People are paid to sit in offices and sift through the most intimate aspects of your medical history: "You want cover for arthritis, you say? Oh I'm sorry, I'm afraid that's not possible. You see, you were treated for genital warts in 1997 and failed to declare this on your original application" or "it says here at 15 you sought advice on period pain. I'm afraid this means we won't be able to pay for an artifical limb after your arm was severed off in that freak Scrabble accident."
The initial application is quite straightfoward. You go through a skin-crawling list of ailments from the frankly terrifying to the comedically icky and hope you're able to tick "no" to all of them. If you have to get "yes", things get more complicated. In the case of something like asthma, this largely entails confirming what medication you're on while the insurance chappie sucks on his teeth like a builder before he utters the immortal phrase "it's gonna cost ya." With mental health, though, it turns out it's a different thing altogether.
If you mention on one of these forms you have or may have had any hint of anything that could be carelessly shoved under the catch-all "mental health" heading everything suddenly gets serious. Proceedings grind to a halt. The man who was grinning a minute a go as he relayed all the possible ways you could meet your early demise ("What if you were hit by a bus? What if you fell off a ladder? What if you were attacked by a rabid penguin in a freak zoo-escape incident?") tells you gravely there is a "special form" you will need to complete, and that this will be despatched forthwith.
A fretful few days - and the irony of the tense wait for someone who's just declared they suffer from anxiety isn't lost on you - later the form arrives. Compiled by a pen pusher with little experience either of mental health, common sense or indeed the application of correct grammar given the redundant question mark, it blithely begins: "please outline the nature of your problem?", followed by "When did the problem start" (no question mark) and "are you still suffering from the problem?" This alone is non-sensical in the case of depression and anxiety, which are so often transient and can strike with no warning or explanation. To pin down an exact date when you decided you were depressed and then a date when it all finished, as though depression is a library book you gave back and which is therefore no longer your concern, is laughable. But it got better: the last question was "Have you ever tried to take your own life? If yes, please give dates and details."
A friend and I amused ourselves for a good ten minutes compiling an answer, to be read in the voice of Alan Bennett, along the lines of "It was a warm Tuesday in early May, 1996. I distincly remember it because I was in B&Q and found myself looking at some particularly sturdy ropes, which I thought might come in handy later that afternoon if indeed there was time, after "Emmerdale", to attach it to the light fitting in the back bedroom - the best choice as the struggle wouldn't disturb the neighbours..." etc.
But joking aside, what is the outcome if you declare you have a mental health "problem"? Presumably it is consistent and proportionate, taking into account the risk, looking at your medical history, perhaps your employment sickness record, to arrive at a sensible quote?
It would seem not. The following is a genuine "exclusion" in an insurance policy issued to someone who declared a history of "mild depression", for which they had never taken leave from work:
"No benefits of any kind will be payable in the event of any claim arising directly or indirectly from any mental or behavioural disorder (as defined by the World Health Organisation using the International Classification of Diseases (ICD10 or subsequent revision(s) thereof) including (but not exhaustively) anxiety, depression, bipolar disorder, stress, schizophrenia and schizoaffective disorders, or mental or behavioural disorder due to alcohol or substance use or misuse, or any functional somatic symptoms (also known as medically unexplained symptoms) including (but not exhaustively) chronic fatigue, chronic pain, or irritable bowel syndromes or myalgic encephalomyelitis/-pathy (ME)."
The company (who I won't name, as they are surely not alone so it would seem unfair) claim that they treat mental health the same as physical health, so if you declare a pre-existing condition you would inevitably face some exclusions. Really? Following the logic above, would you be denied cover for a stroke if you had, say, suffered from a heart attack? Or cancer if you'd had a bad back? It's worth noting my husband and his ashthma faced no exclusions at all, and my own cancer scare was brushed aside as having been "too long ago". But if you suffer from anxiety you can't be covered for schizophrenia; if you're schizophrenic they wouldn't cover you if you're unfortunate enough to get IBS; if you have depression you can't be covered for chronic pain - so woe betide any depressive foolish enough to develop, say, sciatica. And the nice caveat of "not exhaustively" renders everything else uncertain and therefore pointless - I'm sure, given the chance, most conditons could be spuriously linked to the above. There is no medical or scientific basis I can find for any of this - it seems to lump all "mental health" conditions togther in one sloppy "loony" category, and tag on some physical health conditions for good measure. At best this seems daft, at worst it's discriminatory, judgemental and extremely damaging.
Policies such as this seem to reinforce taboos that still, sadly, surround issues of mental health and, ultimately, scare people away from seeking help when they need it. They penalise the very people brave and sensible enough to say "there's something wrong here", from alcoholics to depressives.
I work in a caring profession and frequently try to encourage my clients to see doctors and counsellors for what such policies casually term their "problems". If I were to tell those clients that seeking and obtaining such help might, on the one hand, arm them with the tools (be they CBT, tablets, or whatever) to continue with their lives and work, but would also, on the other, effect their ability to get something so crucial as a mortgage years later, I'm sure every single one would think twice before going any further. They would suffer in silence. I don't even want to suggest the consequences of this - in some cases they are too frightening. Companies would do well to think about that before reinforcing a stigma for the sake of cynical penny-pinching. Shame on them.
posted by RLS at 4:18 pm
1 Comments:
Apart from anything, they're factually wrong about ME- it has been officially recognised as neurological and not psychological for over a decade now.
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