The Mind guide to insurance cover and mental health. guide to. insurance cover and mental health

Transcription

1 The Mind guide to insurance cover and mental health guide to insurance cover and mental health

2 The Mind guide to insurance cover and mental health This booklet is for anyone who wants to know how a mental health problem may affect their ability to get insurance. It explains your rights, the steps you can take if you feel that you have been treated unfairly, and lists companies that have policies for people with disabilities.

3 Contents How does getting insurance work? 4 Do I have to say I have a mental health problem? 5 Are insurance companies allowed to treat me differently? 5 Can my insurance company access my medical records? 8 What do I need to know about different types of insurance? 9 What can I do if I think I ve been treated unfairly? 14 Are there specialist insurance companies available? 15 Useful contacts 18 3

4 The Mind guide to insurance cover and mental health How does getting insurance work? Insurance companies can decide who they will insure and who they won t insure. They can also decide how much to charge you, based on your personal circumstances. These decisions are made by assessing how likely it is that they will have to pay out for a claim. If they think it is likely they will have to pay, they are less likely to insure you or may ask you to pay more for your insurance. When you try to buy insurance, the insurance company will ask you questions about you and your life. On the basis of your answers, they will decide whether you are a normal risk or a higher than average risk customer. If they think you are high risk, they may then refuse to insure you or ask you to pay more for your insurance. Getting insurance with a mental health problem Unfortunately, some companies make their assessments without adequate information or asking the right questions about the risks of many mental health problems. When you are applying for insurance, you may find that you are asked one general question about whether you have, or have ever had, a mental health problem. If you say yes you may find that you are refused insurance, because this single answer has placed you in a high risk category. This can happen regardless of whether they know anything about the details of your mental health problem or the rest of your life. However, the law offers protection against this sort of unfair practice. If you have difficulty getting insurance because of a mental health problem, there may be things you can do. The law about this is complex, and allows different treatment of people with mental health problems in some circumstances. This means that 4

5 Do I have to say I have a mental health problem? different insurance companies may have different rules. It s a good idea to contact several insurance companies for quotes before you choose who to get a policy with. Do I have to say I have a mental health problem? Understandably, you may be worried about what might happen if you tell an insurance company about your mental health problem. However, if you are asked about your health when applying for insurance, and you still want to take out the cover, it is best to tell the truth about your medical history. If you do not answer questions about your mental health truthfully, and the insurance company finds out later, you may find that your policy becomes invalid. This can happen whether the claim is related to your mental health problems or not (see Making a claim on your insurance on p.7). This can also affect any applications or claims that you make in the future. Are insurance companies allowed to treat me differently? Under the Equality Act 2010, it is illegal to discriminate against people who have a disability, or have had one in the past. This includes refusing to provide a service for someone with a disability, or providing the service on worse terms than for non-disabled people. The Equality Act defines a disabled person as someone who has a physical or mental impairment which has a substantial and long-term adverse effect on his or her ability to carry out normal day-to-day activities. If your existing or previous mental health problem meets this definition, you will be protected against disability discrimination. 5

6 The Mind guide to insurance cover and mental health This means that: 6 If an insurance company refuses to insure you, or increases the premium on the basis that you have said you have a mental health problem, they must be able to show that this was justified (see below). If an insurance company cannot show their decision was justified, they will be breaking the law. The Equality Act specifies some circumstances where insurance companies are legally allowed to treat you differently than someone without a disability, for example by refusing to insure you or by charging you higher premiums for the insurance. The Equality Act says that insurance companies can only treat people with a disability (including people with mental health problems) differently if they can show an objective and reasonable basis for this difference. It specifies that the insurance company s decisions must be based on information relevant to the assessment of the risk to be insured and from a reliable source. This may include: statistical data about risk or life expectancy medical research information a medical report. Insurance companies must make sure that the information is accurate and that their use of it is reasonable. For example, if the evidence of increased risk of car accidents involving people with schizophrenia is thirty years old, or based on a very small sample, a court might agree that it wasn t reasonable to use this as evidence of risk. Or, if the company used this evidence to justify increased premiums for someone with depression, this would usually be seen as unreasonable as it isn t relevant to the mental health problem in question.

7 Are insurance companies allowed to treat me differently? This example shows how the law requires insurance companies to act: A man applies for life cover and income protection insurance. He answers yes to a question that asks whether he has ever had any form of mental or stress-related illness that involved treatment and/or resulted in time off work. His GP provides a report indicating that he experienced anxietyrelated symptoms and had two weeks off work seven years ago, but had no prior history of anxiety. He was prescribed Seroxat and, over the next two years, the anxiety was gradually resolved and the treatment stopped. Since then, he hasn t experienced any symptoms of anxiety. In this case, the insurance company should offer the life cover and income protection insurance on standard terms with no extra premium. The Association of British Insurers (ABI) produces best-practice guidelines for insurance companies (see Useful contacts on p.18). It advises that insurance companies should offer full cover wherever possible. Even where this means charging more money, this is normally better than refusing cover completely. If you challenge the insurance company s action in court or through the Financial Ombudsman Service (FOS) (see p.19), it is up to the insurance company to convince the court or Ombudsman that this different treatment is lawful. For example, the company would need to show the evidence on which they relied and that they acted reasonably on the basis of that evidence. Making a claim on your insurance It is illegal for insurance companies to refuse to pay out on a valid claim simply because you have a mental health problem, if this is not related to your claim. For example, if you have depression, and disclosed this to the insurance company when you took out car insurance, your insurance cannot refuse to compensate you if your car is broken into because of your depression. In this case, your depression is not related to the theft. 7

8 The Mind guide to insurance cover and mental health Similarly, if you have a car accident, your insurance company would have to pay out on a claim, unless they could show that your accident was directly caused by your depression (for example, if it was a suicide attempt). However, if you didn t answer questions about your mental health history honestly when you bought your insurance, your claims can be rejected. This is the case even if your claim was completely unrelated to your mental health problem. Can my insurance company access my medical records? If you disclose a mental health problem, insurance companies will often ask for further information from your doctor. An insurer can only contact your doctor if they have your written consent. However, if you refuse to give permission, you are likely to be refused insurance. The insurance company can also ask you to see a doctor of their own choice. This doctor will then prepare a report. If your doctor writes a report about your health for an insurance company, you have the right to see it before it is sent, under the Access to Medical Reports Act If you see the report and are unhappy with it for example, if you feel it involves an unacceptable breach of your privacy or misrepresents the position you have the right to stop it being sent. But if you do, the insurer may not be willing to offer you the insurance policy. Note: the rights described in the previous paragraph only apply to reports by doctors who are or have been involved in your medical care. A report by an independent doctor, who has never treated you and acts solely for the insurer is not subject to the Access to Medical Reports Act However, you will still have a right to see a copy of the report under the Data Protection Act But, you have no right to stop the report being sent, even if you disagree with it. 8

9 What do I need to know about different types of insurance? What do I need to know about different types of insurance? There are many different types of insurance, and they all work slightly differently. For different types of cover, there may be circumstances when insurance companies are legally permitted to treat disabled people differently. If you are in work, it is also a good idea to check whether you have an insurance policy through your employer. For example, some companies cover their staff for private medical insurance. Because employers are purchasing coverage for all their employees, the insurance company is less likely to ask detailed questions about individuals. Private health insurance Private health insurance covers you for private medical treatment if you become ill. Different insurance companies will provide different types of cover. With private health insurance, hospital treatment, whether it relates to physical or mental health conditions, is generally limited to a specific timescale. Outpatient treatment also usually has a maximum cost ceiling. Insurance companies will generally offer private health insurance to people with mental health problems, but refuse to cover claims for conditions and illnesses that exist at the time an insurance contract is taken out. These are called pre-existing conditions. To be lawful, any refusal to provide cover would have to be reasonable and based on accurate evidence. (See Are insurance companies allowed to treat me differently? on p.5.) This means that you should only be refused cover if you have a condition that affects many aspects of your health, that could lead to a wide variety of medical claims. This is because the insurance company would have to include so many exceptions that you would not actually be able to make a claim through your policy. 9

10 The Mind guide to insurance cover and mental health Travel insurance If you are travelling abroad, it is a good idea to get travel insurance. This is because it can protect you financially if any of the following things go wrong: your trip is cancelled or cut short for reasons beyond your control you miss transport or departures are delayed for reasons beyond your control medical and other emergencies personal injury or death lost, stolen or damaged items, including baggage, passports and money accidental damage or injury caused by you. If you travel abroad, getting medical treatment can be expensive, and you may not be able to get emergency healthcare unless you pay for it. If you are travelling in the European Union (EU), and you are an EU national or long-term resident in the UK, you can apply for a free European Health Insurance Card (EHIC). The card lasts for three to five years, and means you can receive free or reduced-cost emergency healthcare when visiting EU countries. You can apply for one on the EHIC website or at a local Post Office. (See Useful contacts on p.18.) Even if you take out travel insurance, it is still worth getting an EHIC. However, the card doesn t cover the cost of cancelled travel arrangements, lost money or luggage. If you would like to be covered for these things, you will also need to take out travel insurance. Be aware that if you are sold a standard insurance policy with a holiday, they often have exclusions in the small print that stop you being able to claim for specific things. This often includes anything relating to an existing or previous mental health problem. For example, if you have a diagnosis of a mental health problem, and become unwell with this while 10

11 What do I need to know about different types of insurance? you are on holiday, your insurance company may refuse to cover any treatment you need while you are away. However, this should not affect claims that are not related to your mental health problem. For example, if you break your leg or lose your bags, and this is clearly not related to your mental health problem, the claim should be paid as normal. If you would like to extend insurance you are sold as part of a holiday so that it covers all risks including those related to your mental health condition, your travel agent may offer specialist policies that provide this, but it is usually quite expensive. Alternatively, you can choose to take out a separate insurance policy from an insurance company. Life insurance Life insurance is designed so that if you die, an amount of money will be paid to your family or friends, or whoever you say should be paid as part of your policy. If you have a mental health problem, insurance companies may assess that you have an increased risk of suicide or accidental death. This can make life insurance hard to get. You may find that insurance companies want to charge you higher premiums because of your mental health problem, or they might refuse to insure you altogether. If this is the case, the insurance company would need to show that your mental health problem increases the risk of you dying, and to demonstrate how this is reflected in the increased charges. If you can get a medical report from your GP to show that this is not the case, this might make the insurance company change their mind. Failing that, you could use it as evidence as part of a legal claim for discrimination. (See What can I do if I think I ve been treated unfairly? on p.14.) 11

12 The Mind guide to insurance cover and mental health Car insurance If you drive, you are legally required to have insurance to cover damage to someone else's vehicle or property, or injury to someone else in an accident. This is the minimum amount of insurance that you must have. You may also choose to get a comprehensive policy which also pays for repairs to your own car. When you apply for car insurance, the insurance company will want to know about any medical conditions that might affect your driving. This may include a mental health problem (it is safest to check with your doctor if you are unsure). Many insurance companies will treat your application the same as someone without such a problem, provided that you have told the DVLA, and have a valid driving licence. Example: Some car insurance companies may judge that you have an increased risk of accident because of your mental health problem, and increase your premiums to reflect this. This example shows how you may be able to challenge this: A woman with a diagnosis of bipolar disorder applies for car insurance. Based on data relating to the risks posed by a person driving when in a manic episode, the insurance company tells her that she will have to pay double the normal premium. However, she produces credible evidence to show that she has been stable on medication for some years and that she has a clean driving licence. In these circumstances, charging a higher premium is unlikely to be justified, and the insurance company should issue the car insurance on standard terms, with no extra costs. 12

13 What do I need to know about different types of insurance? Home contents insurance Home contents insurance insures you for loss, theft or damage to your personal and home possessions. It can also cover you if you take items out of the home for example, when you go on holiday. As with other types of insurance, home contents insurance companies cannot refuse cover unless they can support their decision with reliable data and statistics. There will be few, if any occasions, when insurance companies can legally justify charging higher premiums or refusing insurance for home contents insurance because of your mental health history. Illness insurance Illness insurance will pay money to replace your income if you are unable to work because of an accident, long-term ill health or disability. There are different kinds of illness insurance. Some pay out a single lump sum, some will pay out a regular monthly income, while others will cover payments for specific things, such as your mortgage or credit card payments. Often the insurance will only apply to particular medical conditions for example, you will only be entitled to claim if you have cancer or heart disease. Some insurance companies will not cover mental health problems at all, or will only provide payment of such claims for a limited period. For example, they may only pay a mortgage for a maximum of two months where the illness which prevents work is a mental health condition. This applies regardless of whether the person taking out the policy has a previous history of mental health problems. If you do get illness insurance, you would not normally be able to make a claim related to any pre-existing mental health problem, or a history of such problems. For example, if you have a history of severe depression, you wouldn t be able to claim if you were unable to work because of your depression. 13

14 The Mind guide to insurance cover and mental health However, if you develop a new mental health problem that you didn t have when you took out the insurance, this would be covered. For example, if you previously had an episode of depression and subsequently experienced problems which led to a diagnosis of schizophrenia, the insurance company should pay under your insurance policy. However, in this case, you would probably need to provide a report from your doctor stating that the two conditions are unrelated. What can I do if I think I ve been treated unfairly? If you think you have been treated unfairly by an insurance company because of a mental health problem, you can make a complaint. To do this, you can take the following steps: Complain to the insurance company Firstly, you should complain directly to the insurance company. Most of them have a complaints procedure and should be able to tell you about this if you ask. Complain to the Financial Ombudsman Service (FOS) If you are not happy with how the insurance company deals with your complaint, you can then make a complaint to the Financial Ombudsman Service (FOS) (see Useful contacts on p.19). The majority of complaints to the FOS are resolved relatively early, and often in favour of the consumer. If your complaint is valid, the insurance company may give you an apology and/or compensation. However, the organisation receives a large number of complaints, and the process can take a long time. Take legal action If you feel you have been unfairly treated because of a mental health problem, you may be able to take legal action against an insurance company under the Equality Act

15 Are there specialist insurance companies available? You must do this within six months of the date when the incident you are complaining about happened. If your claim succeeds, you may get financial compensation and/or a ruling that the treatment about which you have complained is unlawful so that, for example, the insurer will have to provide you with insurance at a fair rate. If you want to make a legal claim, you should get legal advice first. The Citizens Advice Bureau or a local Law Centre can provide this service free of charge. You can also contact Mind s Legal Advice Service for more information. Or you may choose to see a private solicitor. The Law Society can provide a list of qualified private solicitors in your area. (See Useful contacts on p.18.) Are there specialist insurance companies available? Some companies advertise insurance for people who are disabled and/ or have a pre-existing medical condition. In some cases, they also refer specifically to people with depression or other mental health problems. A list of companies that advertise this type of policy is provided below. However, these details are provided for information only. Mind does not specifically recommend any of these insurance services and you may be able to find other companies that also provide a similar service. The British Insurance Brokers' Association (BIBA) also offers a signposting service. This can help you find specialist insurance companies that offer specific types of cover based on factors such as age and medical condition. (See Useful contacts on p.18.) Bipolar UK tel: web: bipolaruk.org.uk Charity for people affected by bipolar disorder. It offers a travel insurance scheme for its members. 15

16 The Mind guide to insurance cover and mental health En Route Insurance tel: web: enrouteinsurance.co.uk Specialises in car, travel and home insurance for disabled people. Free Spirit tel: web: free-spirit.com Travel insurance for people with pre-existing medical conditions. Good to go insurance tel: web: goodtogoinsurance.com Travel insurance for any age group, with or without pre-existing medical conditions. The Insurance Surgery Ltd tel: web: the-insurance-surgery.co.uk Finds life, travel and other types of insurance for people with pre-existing medical conditions. If you would like to buy insurance with this company, they have offered to make a donation to Mind. You can do this via the Fundraising pages on our website. However, we recommend getting quotes from several companies before you do this, and making sure they provide a competitive policy that works for you. 16

17 Are there specialist insurance companies available? MIA Online Ltd tel: web: miaonline.co.uk Travel insurance for people with pre-existing medical conditions. Also provides a service for customers to store their medical records online so that they can be accessed from anywhere in the world. Orbis Insurance tel: web: orbisinsurance.co.uk Provides home, travel and life insurance for people with medical conditions. Platinum Financial Consulting tel: web: life-insurance-help.co.uk Can provide help finding life insurance, critical illness insurance or travel insurance for people with pre-existing medical conditions. 17

18 The Mind guide to insurance cover and mental health Useful contacts Mind Mind Infoline: (Monday to Friday 9am to 6pm) web: mind.org.uk Details of local Minds and other local services, and Mind s Legal Advice Line. Language Line is available for talking in a language other than English. Association of British Insurers (ABI) web: abi.org.uk Provides information about insurance and produces bestpractice guidelines for insurance companies. British Insurance Brokers' Association helpline: web: biba.org.uk Provides a 'Find a Broker' service to locate specialist insurers who can offer specific types of cover based on factors such as medical condition. Citizen s Advice tel: (England); (Wales) web: citizensadvice.org.uk Free, confidential and independent advice on a range of issues. Use the website to find a local office near you. Civil Legal Advice tel: web: gov.uk/civil-legal-advice Legal advice line for England and Wales. Equality Advisory Support Service (EASS) tel: web: equalityadvisoryservice.com Free advice and information for people who think they have experienced discrimination. European Health Insurance Card tel: web: ehic.org.uk This card allows you to receive free or reduced-cost emergency health care when visiting EU countries. 18

19 Useful contacts Financial Ombudsman Service (FOS) tel: web: financial-ombudsman.org.uk An independent organisation that deals with individual complaints between consumers and companies that supply financial services. A telephone interpretation service is available for non-english speakers. Law Centres Network tel: web: lawcentres.org.uk Provides free legal advice and representation for people who can t afford to pay for a lawyer. The Law Society tel: web: lawsociety.org.uk Has an online database to help you find a solicitor in your area. Rethink Mental Illness helpline: web: rethink.org Charity for people affected by serious mental illness. Includes advice about getting insurance with a mental health problem. 19

20 The Mind guide to insurance cover and mental health Further information Mind offers a range of mental health information on: diagnoses treatments practical help for wellbeing mental health legislation where to get help To read or print Mind's information booklets for free, visit mind.org.uk or contact Mind Infoline on or at info@mind.org.uk To buy copies of Mind's information booklets, visit mind.org.uk/shop or phone or publications@mind.org.uk Support Mind Providing information costs money. We really value donations, which enable us to get our information to more people who need it. Just 5 could help another 15 people in need receive essential practical information booklets. If you found the information in this booklet helpful and would like to support our work with a donation, please contact us on: tel: dons@mind.org.uk web: mind.org.uk/donate This information was written by Caroline Gooding in collaboration with Mind. Published by Mind To be revised 2016 ISBN No reproduction without permission References available on request Mind is a registered charity No Mind (National Association for Mental Health) Broadway London E15 4BQ tel: fax: web: mind.org.uk 20

21 Mind We're Mind, the mental health charity for England and Wales. We believe no one should have to face a mental health problem alone. We're here for you. Today. Now. We're on your doorstep, on the end of a phone or online. Whether you're stressed, depressed or in crisis. We'll listen, give you advice, support and fight your corner. And we'll push for a better deal and respect for everyone experiencing a mental health problem. Mind Infoline: info@mind.org.uk mind.org.uk