Underwriting and Claims Implications
Amid these challenges, the life and health insurance industry is making progress in adapting underwriting approaches to widen the scope of acceptable risks. 49% of respondents have updated underwriting philosophies or practices within the last two years in response to mental health trends. With a growing emphasis on expanding access to cover, 48% have plans to update their philosophies or practices in the next two years.
Survey findings revealed that 82% agreed or strongly agreed that existing underwriting guidelines have contributed to a conservative approach to mental health risk assessment. Top underwriting challenges included obtaining sufficient information to paint the full picture of risk, receiving appropriate disclosures from customers, and acquiring adequate medical evidence to make an accurate risk assessment.
The area of claims management yielded a variety of responses regarding the evolution of processes to support claimant mental health, including through specialist resources and value-added services, particularly for disability products. 43% of respondents reported the use of dedicated claims management resources for mental health cases. Regional responses varied, with resources primarily offered in North America and Australia and New Zealand, indicating this is an area of opportunity globally.
Among insurers providing disability/income protection products, 50% of respondents currently offer counseling networks (with mental health experts), 41% offer interventions designed to support or enable claimants to return to work, and 39% offer virtual medical care to support overall wellbeing. The top-rated challenge regarding the assessment and management of disability claims was difficulty receiving support from the attending physician in facilitating return-to-work support.
The life and health insurance industry has an opportunity and a responsibility to increase and improve support for mental health initiatives. This includes supporting advocacy, education, and research; adapting underwriting practices to expand eligibility for applicants with mental health issues; enhancing coverage for mental health conditions; and providing greater access to services. None of these steps can be taken in isolation – all are dependent on one another as part of a comprehensive solution.
Education and research lead to reduced stigma, which facilitates the evolution of claims and underwriting practices, which enables expansion of eligibility and enhanced coverage, which ultimately leads to greater access to mental health services for those who need them.
Similarly, insurers cannot work in isolation. The entire industry and relevant ecosystem partners must work together to bring about the transformation required. The noble purpose of insurance is to protect people in times of need, and the industry can and must play a vital role in addressing evolving global mental health needs.
The scale of the current crisis is staggering and its toll on the economy, individuals, and health systems continues to increase. It is time for the industry to heed this urgent call to action, accelerate progress, and realize the significant impact insurance can have on mental health treatment and outcomes.
Contact us to learn more about survey insights and how RGA is helping insurers meet the growing demand for mental health coverage.