Anyone who attended the Association of Medical Insurers and Intermediaries (AMII) annual general meeting last week could not fail to have been moved by the presentation by Mike McCarthy, the former Sky News reporter whose son, Ross, took his own life in February 2021. Mr McCarthy is campaigning in his son’s memory for better mental health provision in the UK after Ross was put on a six-month waiting-list for therapy and died a few weeks later.
Separately, I recently had a discussion with a mother whose adult son had been diagnosed with bipolar disorder and was in considerable distress. I asked if he was enrolled on a group private medical insurance scheme through his employer and she said that he was, but it did not include mental health cover. This reinforced to me why we are loath to arrange or renew a group PMI scheme without the mental health option included.
In our industry we are acutely aware of NHS waiting lists, given the symbiotic relationship between the public and private healthcare sectors. We are also mindful that mental health is a particularly under-resourced area, and that having PMI cover in place can be the difference between getting support and not.
The oft-quoted phrase is that mental health should be seen as analogous to a broken leg. Some mental health professionals take issue with this oversimplification but the broader point is that mental and physical health should be seen as equally important and that mental health issues should be destigmatised.
For those of us in the industry who have a sense of purpose that goes beyond simply selling policies, mental health is one area where the plans that we arrange can make a real difference, given the paucity of provision on the NHS.
Several years ago, the market ‘levelled up’ in respect of cancer cover, with insurers rolling full cancer cover into their core propositions. Cancer cover is one area where PMI really comes into its own and where insurers distinguish themselves in respect of the service and support that they offer to their members.
Given that mental health cover falls into the same ‘you don’t know that you need it until you need it’ category, I do wonder whether the time has come to roll mental health into core cover on group PMI schemes. While cover for complementary therapies and dental & optical cashback are nice-to-haves, there is a strong argument that mental health cover is no less important than cover for hip replacements and heart conditions.
Within the industry, we often talk about how PMI can plug a gap in public healthcare provision, and mental health cover provides the opportunity for us to make a difference. Whatever extra funding is allocated to the NHS, areas such as cancer and orthopaedics are likely to be at the front of the queue, so mental health provision is unlikely to see a marked improvement.
Another theme touched on briefly at the AMII conference was the issue of taxation and PMI. Only the most optimistic of us holds out hope for the abolition of Insurance Premium Tax on PMI, but exempting the product from P11D, bringing it into line with group life and income protection, is perhaps a more realistic target.
Given that the NHS is unlikely to ever meet demand for mental health services, this is one area where our industry can make a difference to the nation’s wellbeing. And if we can demonstrate that PMI can meet a need that would otherwise be unmet, we strengthen our case for the product to be exempt from the benefit-in-kind regime.
Those of us advising on PMI know that adding mental health cover to a group policy only results in a modest premium uplift, and I suspect that there is already cross-subsidy between this benefit and the core element of cover. Most group schemes will be arranged with mental health cover included anyway, so it would be a welcome development to see the ‘big four’ insurers enter into a pact to include it as standard so that none are left at a competitive disadvantage.
In the meantime, I would urge brokers to challenge any group administrator who thinks that their scheme can do without mental health cover. Access to timely mental health support can make all the difference.
