The group’s new Mental Health and Insurance green paper found that the insurance sector faces “systemic difficulties” in its dealings with mental health coverage, despite nearly half the adult population experiencing a mental health issue at some point in their lives.
“Difficulties can arise in many areas of the insurance process and there are many potential opportunities for improvement,” said Actuaries Institute president Jenny Lyon.
“Some improvements could be readily achievable and others require a longer-term commitment.”
One of the challenges facing the industry is a lack of data, the report said, and that better data would enable more efficient diagnoses and claims processes.
The report also questioned the appropriateness of lump sum payments as a means of assisting a claimant’s recovery or encouraging them to return to work – which is sometimes in the best interest of the claimant.
Ms Lyon said there is “an opportunity for doctors, life insurers and employers to work together” and improve outcomes for everyone involved.
The report said the industry could improve insurance outcomes for those afflicted with mental health issues through early intervention and shifting the industry’s focus towards recovery and wellness rather than claims eligibility.
“Insurers and doctors want the same outcome: a return to health for the patient or the consumer. Change needs the support of the industry, medical professionals, policy makers, consumers and their advocates,” Ms Lyon said.
“There are no simple solutions. But the institute hopes that by raising some of these issues, and applying a high level of technical financial expertise and integrity to the problem, we can stimulate worthwhile discussion and change.”
