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Mystery callers expose insurers' approach to mental health cover

Author
NZ Herald,
Publish Date
Thu, 14 Apr 2022, 12:24pm
(Photo / Getty Images)
(Photo / Getty Images)

Mystery callers expose insurers' approach to mental health cover

Author
NZ Herald,
Publish Date
Thu, 14 Apr 2022, 12:24pm

A mystery shopping exercise has revealed "systemic issues" in the way insurers treat people with mental illness, Consumer says. 

The advocacy group tested 14 insurance companies by getting three shoppers to call each company to get cover for health, life and income protection insurance. 

They found those seeking advice or help for their mental health could be regarded as "high-risk claimants" resulting in cover being excluded - a move which Consumer considered unfair. 

Cherie Lacey, Consumer New Zealand lead investigative writer, said although exclusions and stand-down periods were standard and legal insurance practice, how they applied to mental health needed to change. 

"Many New Zealanders are unaware that what they disclose at the GP's office could have ramifications for them when it comes to insurance cover. 

"This is problematic because people should be free to discuss mental health concerns without fear of repercussions." 
 
Lacey said poor mental health was a widespread issue in New Zealand with one in five people experiencing challenges with it every year. 

"There's a disconnect between how the public views mental health and how insurance companies factor that into their policies." 

Lacey said all of its shoppers were offered insurance but most were told they would need to complete extra paperwork for an underwriter to assess whether any exclusion or stand-down period would apply. 

To make an assessment on a policy, insurers may obtain a customer's full medical history to determine the risk level of a potential claim. Medical history extends beyond diagnosis and the prescription of medicine; it also includes consultation notes from a GP, so insurers can be privy to what is discussed in the doctor's office. 

Lacey said it took issue with insurers making decisions based on medical notes without getting clarity on diagnosis or understanding the circumstances in which someone received mental health support. 

It also found there wasn't a consistent approach taken by the insurers with some adding exclusions or limiting cover while others accepted the customer as is. 

"Confusion reigned when talking to the insurance companies," Lacey said. 

"Upon follow-up, several told us that the initial advice the financial adviser gave was incorrect. Some provided mental health cover, while others couldn't give a clear answer on whether there would be cover without a full underwriting assessment." 

She said the investigation highlighted the problems with the insurance industry and how they approach mental health. 

"We believe mental health exclusions point to a systemic failure in the insurance market, which could amount to discrimination on the grounds of mental health." 

"We think the industry has a lot of catching up to do in terms of their definitions of mental health and consistency in their approach and communication of mental health exclusions." 

WHERE TO GET HELP: 
• Lifeline: 0800 543 354 (available 24/7) 
• Suicide Crisis Helpline: 0508 828 865 (0508 TAUTOKO) (available 24/7) 
• Youthline: 0800 376 633 or text 234 (available 24/7) 
• Kidsline: 0800 543 754 (available 24/7) 
• Whatsup: 0800 942 8787 (12pm to 11pm) 
• Depression helpline: 0800 111 757 or text 4202 (available 24/7) 
• Anxiety helpline: 0800 269 4389 (0800 ANXIETY) (available 24/7) 
• Rainbow Youth: (09) 376 4155 
If it is an emergency and you feel like you or someone else is at risk, call 111. 

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