Flat out refused: "I didn’t get life insurance due to my history of PND and postnatal PTSD"
Elizabeth is a GP, married with two kids and a relatively recent house owner. When she learns her request for life insurance isn’t even reviewed due to her mental health history, she decides to take action and reaches out to Make Birth Better.
In capital letters, “WE ARE UNABLE TO OFFER YOU COVER AT THIS TIME” sprawled across my inbox. My heart sank. As a healthy, non-smoking thirty-something-year doctor, I had recently applied for life insurance. I had excitedly gone through the stressful process of purchasing a family home with my husband and two young children and needed cover to protect my husband and children financially in the event of my death. Given my good health, and rather reassuringly low-key lifestyle, this process should have been straightforward. Yet here I was staring at my letter of refusal.
My births
In 2018 my first daughter was born; it was a mismanaged induction of labour resulting in an exceptionally traumatic delivery and a very difficult recovery. As I struggled to come to terms with my perinatal experience I was eventually diagnosed with postnatal depression, anxiety, and PTSD, and after appropriately accessing psychological support and medication I fully recovered within a year. For the birth of my second child I was subsequently offered additional support from the perinatal mental health team to ensure that my birthing experience second time round was a calmer, more positive experience: it was.
“Accessing psychological support is quite obviously less risky than trying to cope alone”
Flat out refused
The problem is, however, that I am now listed as requiring recent mental health support. This flags me up as a risky choice for insurance companies. This is compounded by the fact that as a young teen battling hormonal and emotional changes beyond my understanding and ability to access adequate support at the time, I had used a pen knife to try to scratch my arms once or twice in an act of defiant frustration. Despite how superficial these scratches were – they barely even drew blood – and the fact that it had happened over twenty years ago, my honesty and transparency with my perinatal team meant that ‘self-harm’ was recorded in my notes. This combination of factors meant that my application had never even reached the underwriters for review. It was flat out refused.
Fighting my case
As awareness of the importance of supporting perinatal mental health is increasing, and women are being empowered to seek help, they need to do so in the knowledge that this will not hang heavy over their families’ future financial stability. As I appealed against the decision, spending over ten exhausting hours arguing my case with various agents and underwriters, trying desperately to enjoy the last few weeks of maternity leave in the middle of a pandemic, it became increasingly apparent that the companies simply hadn’t bothered to improve their algorithms for calculating risk. The underwriters agreed with me, yet nothing changed. It took a couple of months and much discussion, but thankfully they ended up amending my record in order to circumvent the algorithm thereby granting me insurance. It was a really horrible experience, having to constantly revisit the issues which had caused me so much distress in the first place; I didn’t have the energy to file a formal complaint in the end. That said, I did get a phone call a few weeks later from a senior advisor to apologise and ensure that the case had been resolved.
“The idea that every single person with varying levels of psychological distress is at high risk of suicide and thus deemed uninsurable is appalling”
Lazy and ignorant algorithm writing
This is an area which needs addressing. Accessing psychological support is quite obviously less risky than trying to cope alone, and in requesting help one proves insight, willingness to engage, and a desire to get better. The idea that every single person with varying levels of psychological distress, for often quite obvious and recoverable reasons, are all at high risk of suicide and thus deemed uninsurable is appalling. It is offensively lazy and ignorant algorithm writing which is, ironically, causing severe distress and anxiety to women up and down the country.
The importance of support
Not only do mental health charities need to campaign against this discriminatory practice, but perinatal teams also need to recognise just how important support for women is throughout the perinatal period, and how far reaching an impact poor birthing experiences can have. I, for one, have the emotional resilience to fight my corner, but I know many vulnerable women for whom this experience would be far too distressing to fight against, leaving their families financially exposed.
After Elizabeth contacted us, we reached out to Irwin Mitchell, a medical negligence practice committed to improving maternity care and safety outcomes and Make Birth Better training sponsor.
Victoria Gammon, Chartered Financial Planner at Irwin Mitchell Asset Management and Julianne Moore, Partner at Irwin Mitchell, look at some practical tips on applying for life insurance when you have a history of mental health problems.
If you are concerned that you may find it difficult obtaining life insurance if you have a history of mental health problems, firstly it is important to remember you are protected against disability discrimination by the Equally Act 2010. This means that no life insurance provider can lawfully treat you differently for having a mental health problem without good reason.
This can be not offering life cover but it must be on the basis of information that the decision is reasonable, reliable and relevant.
Relevant means there must be a connection between your mental health problem and the purpose of the insurance, so for example if they refuse life insurance on the basis that you may fatally harm yourself, but the policy states that they will not pay out on in the event of suicide then that would not be relevant as the policy would not pay out in those circumstances.
Other examples could include having mental problems in childhood, which may not be relevant to the current day, or mental health problems arising around the time of pregnancy and birth which have resolved and could be “ring fenced” around that period.
For them to be lawful under the heading of reasonable, they must adequately explain their reasons why they have denied cover when asked.
What to do if you are denied life insurance
If you have been denied life insurance and you wish to challenge that decision, then there is a 4 stage process and during any of those stages, the matter may be resolved.
Step 1 – Write/email the insurance company and ask them to set out their reason for rejecting your application. If the insurance company calls to provide a response, remember to keep notes of any telephone calls.
Step 2 – Make a formal complaint to the insurance company. If following Step 1 the matter remains unresolved and you remain unhappy with the response from the insurance company, then write a formal letter of complaint setting out why you are unhappy with their decision. The insurance company will then have to provide a formal response. Most insurance companies have a complaint procedure and details can be found on their websites.
Step 3 – Complain to the Financial Ombudsman Service. The Financial Ombudsman Service (FOS) exists to help resolve complaints when it has not been possible. The service they provide is free and impartial. The FOS will then review the complaint and the insurance company will also provide the FOS full details of their response. Initially, FOS will try and resolve it by mediation. If mediation fails, then the FOS will begin a formal investigation. Once the FOS have completed their investigation, they will make a decision. Insurance companies are bound by their decision, which could include the insurance company agreeing to insure you or pay compensation. There is a time limit for bringing a complaint to the FOS namely 6 months following the final response from the insurance company.
Step 4 – Take Legal Action. If you remain unhappy or do not want to accept the FOS’ decision then you may be able to take legal action against the insurance company. Going to court can be stressful and be costly so this should only be considered as a last resort.
Practical point when looking to apply for life insurance
One way to try and improve your prospects of having a successful application is to use aninsurance broker with knowledge of specialist insurance providers. Brokers can be really useful as they will have a working knowledge of providers that are likely to accept clients and ones that are likely to reject.