Changing minds: How can insurers make a difference on the mental health journey?

More people are seeking help for mental health conditions than ever before. It‘s a topic that cuts across different cultures and countries all over the globe and its growing prevalence, awareness – and ambiguities – make it an important discussion for insurers. How can we better understand the drivers behind mental illness? Do we fully understand the additional risks and the nuances of the shared symptoms associated with various mental illnesses? How does a history of mental illness affect claims?

Swiss Re hosted an Expert Forum to explore these questions and more including the most important one: How can the insurance industry use its expertise and perspective to bring positive change  to this field?

This dive into the implications of mental health on the insurance industry is designed to discover new ways to:

  1. Better understand and prevent mental illness which contributes to a more resilient society.
  2. Improve insurance products and the customer experience associated with mental health.

Key Facts

Mental health by the numbers:

15 Average number of years a severe mental illness like schizophrenia, or severe depression will reduce life expectancy

25 Percent of people who are unwell, are suffering from a neuropsychiatric illness

1435 Number of mental health apps currently available

Championing a different approach to mental health

Mental health is inherently more complex than physical health due to the relative lack of general understanding about the specific characteristics of each condition. There are significant symptomatic overlaps across many of the disorders which often lead to difficulties in diagnosis and treatment.  This is one of many challenges faced by insurers when underwriting mental illnesses.

Following discussions with mental health experts, Swiss Re is determined to shift the focus to more positive interactions with consumers and, where possible, champion early intervention before symptoms become chronic. This approach will not only benefit consumers by minimising risks associated with mental illness, but it also benefits insurers with more policyholders who enjoy improved health, wellbeing and reduced claims experience.

Swiss Re is passionate in its mission to close the protection gap, and by increasing our research base in the field of mental health, we aim to help insurers make more accurate and fair risk assessments, which could allow us, as an industry, to extend cover to people who couldn’t previously be insured.

Together with our panel of experts, we agreed that a supportive, resilience-building approach to assess mental health conditions should consider:

Let’s work together to find solutions

  • Co-morbidities – Studies indicate that numerous mental and physical conditions demonstrate a bi-directional relationship. Mapping these with greater precision will help insurers to determine risks associated with particular conditions and provide the confidence they need to offer cover.
  • Behavioural factors – Currently, prior sickness absence due to a mental illness is an indicator of a person’s susceptibility to go off sick for mental illness in the future. However, assessment of alternative parameters attributable to resilience will allow insurers to identify individuals at greater risk, and those who will benefit most from increased psychological support.
  • Lifestyle factors – It is currently unclear which lifestyle factors most contribute to the development of mental illnesses, or how these interact in the context of a psychological disorder. Further research is needed on how to encourage positive behaviours to mitigate such risks.

How can insurers make a difference?

Provide financial peace of mind

A person’s financial situation, if unfavourable, could contribute to their mental ill health. It’s here that insurance can provide peace of mind. Our industry has a role to play in influencing the psychological resilience of its consumers, which may also be nurtured through improving the consumer journey for individuals making a mental health claim.

Use alternative data to support underwriting

The presence of co-morbidities can make risk assessment for mental health conditions seem formidable, but it is not impossible. As more alternative data sources emerge, the task of categorising risk also becomes less daunting. At Swiss Re we aim to be at the front of understanding these risks and will use the latest data available and ensure it is reflected in Life Guide to provide a fair and informed risk assessment process. Improved application questions will help determine co-morbidity risk factors, ensuring more accurate  risk assessment, a more transparent claims process, and may form the basis for more targeted, and fewer, exclusions surrounding mental health underwriting.

Early and tailored intervention

When reassessing guidelines, Swiss Re and the insurance industry should consider early intervention, a concept  that underpins all treatments for psychological disorders. However, a one-size-fits-all approach doesn’t work for mental health. Here are some of the ideas we are exploring:

  • Monitoring engagement with endorsed digital mental health self-help materials.
  • Offering better terms based on an individual’s effective management of their condition. Developing these platforms may assist in underwriting decisions as we gain a deeper insight into the parameters used by digital health providers.
  • Expanding even further, and even earlier in the consumer journey, the supportive approach that Claims teams already embrace to provide specialist referrals for rehabilitation services to promote recovery.
  • Providing continuous support and reassessment via a live policy, to reflect the dynamic nature of mental ill health. Psychological disorders can be difficult and isolating; Swiss Re is committed to supporting people on this journey through using a granular rather than binary approach to risk.

Let’s work together to find solutions

The differences in these preliminary ideas illustrates just how wide the scope is for insurance-based solutions. At Swiss Re we aim to work with our clients to create tangible solutions in the mental health space, either through early intervention, accurate  classification or post-diagnostic  rehabilitation of those with mental illnesses.

With continuous collaboration and guidance from our Underwriting, Claims, Products & Pricing experts, in conjunction with academic and clinical professionals, we aim to consider all mental illnesses accurately at each stage of the customer journey.

We envisage a tailored consumer experience  that considers any individual circumstance using enhanced risk classification guidelines; greater underwriting precision via a more holistic approach, including co-morbidities. This would then carry forward to the claims stage, for a timely decision due to more defined boundaries  and strengthening the current Claims emphasis  on effective rehabilitation to promote recovery (Fig. 1).

Early intervention and ongoing support improves mental health outcomes

Figure 1. Current vs future ideal end-to-end journey for a mental health condition

Red: Current end-to-end-journey for (1) individual with history of mental ill health and (2) individual with no previous mental health diagnoses.

Green: Potential future journey yields better outcomes.

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