Clients who use mental health services, though they do not suffer from mental health issues, are in danger of being denied protection cover, according to Krystle Skelton, protection adviser at Cura.
Skelton (pictured) was speaking at today’s ProtectX8, an online event featuring seven speakers talking for seven minutes around a particular topic. The topic was ‘The Humanity of Protection – Trust’.
Skelton said a client of hers with a long-standing medical condition, but who does not suffer with their mental health in any way, chose to access a mental health service offered through their employer.
“One of the areas that we have seen an increase in recently is mental health,” she noted. “Mental health is a huge area, and absolutely a sliding scale with major extremes.”
The idea for the client was to just discuss their existing medical condition, and talk about the impact it had on their life and how they dealt with it.
“But due to this, her income protection application cover was turned down due to the cumulative effect of the other medical conditions that were in place,” she said.
“The client was classed as suffering with that mental health – but the client was not suffering with mental health. They had accessed a support service that we actually provide as an industry benefit, and that was used against them. Is this the right thing?”
Claims processing
Another issue affecting trust is claims processing, especially when advisers try to help their clients with the insurer.
“For many clients that approach us who may have medical conditions, the best thing that we can do as advisors is speak to the insurers and look at who may be able to offer the best terms,” she said.
She added: “When we’ve then contacted the insurer a week or later to ask where the claims process is, we’ve been told by the claims handler that they are not able to discuss the client’s case with us due to data protection.”
“Even with signed consent from the client, some insurers will still not tell our advisers about when a claim is taking place – even when we are the ones who actually provided them with all of the client’s medical information in the first place.
“Is this right? Does this help the industry to create trust and show that we are working together?”
Claims statistics
And a third issue is that of claims statistics, where every insurer provides their own statistics, giving valuable information on their performance. But that in itself is not enough.
“The issue with claims statistics is that they are not standardised,” she said.
“This means that claim statistics potentially are not accurate. They’re not comparable, and we can’t look at them and break them down and say, ‘They’re doing very well in this and they are doing very well in that.’
“Should claims statistics now be standardised? Should all insurers have to follow set guidelines of what is included within their claims statistics?”
