The stigma surrounding mental health issues has cast a long shadow over millions of people around the world, preventing many from seeking the care and support they need.
While the negative perceptions surrounding mental health issues are slowly changing, the insurance industry has a role to play in accelerating progress on mental health, particularly by shining a light on its impact on overall well-being.
Natalie Kelly, Swiss Re’s Head of Life & Health Global Underwriting, Claims and R&D, said the pandemic was a catalyst for change in the mental health conversation.
“One of the few good things to come out of COVID-19 is that people are now much more willing to talk about mental health and mental health challenges,” Kelly said.
“The willingness to talk about mental health is critical to moving the needle, because the sooner people recognise that they have a mental health challenge and the sooner they’re able to seek help, the better the outcome for them.”
Swiss Re’s approach: a holistic view of mental health
Speaking to Insurance Business, Kelly outlined Swiss Re’s holistic, evidence-based approach to mental health in claims and underwriting, which recognises that mental health is intertwined with physical health, psychological, social and lifestyle factors.
“Mental health has always been a key issue for us, particularly when it comes to our disability portfolio,” she said. “The conversation is now changing and becoming more prominent, which we welcome.
“There are two key points to our approach, and the first is that we want to offer as much coverage to as many people as possible. Swiss Re’s vision is to make the world more resilient, so being able to offer cover to people underpins our underwriting approach and philosophy.
“The second point, particularly when it comes to mental health and how we underwrite and manage claims, is that we look at the whole person and that each person is separate and individual.”
In practice, Swiss Re follows a biopsychosocial model in underwriting and claims, which considers biological, psychological and social factors and their interactions within an individual in the context of a mental health diagnosis.
Biological factors include potential co-morbidities and genetic predisposition, while psychological factors include stress, past trauma, abuse and other triggers. Social factors take into account an individual’s cultural and family background.
“All of these factors come into play in trying to understand how best to cover people when they have a mental health event, how to help them get better and how to encourage them to return to work in a way that works for them,” says Kelly.
How does Swiss Re underwrite mental health conditions?
Kelly also lifted the lid on Swiss Re’s framework for underwriting mental health conditions. She noted that while physical conditions, such as high blood pressure, can manifest similarly in different people, this often isn’t the case with mental health.
“People with depression can have very different experiences and manifestations, so that’s where treating each person as an individual comes in,” she said.
“We have a framework and a structure that helps underwriters know what points to look at, what questions to ask an individual and how to give relative weightings to try and come up with a transparent score. It’s not a black box calculator; it’s more of a guide.
“We want to empower our underwriters to combine the framework, the data and the science with their judgement and experience to optimise [the coverage] we’re able to offer people.”
This approach applies to a range of mental health conditions, from stress, mild depression and anxiety to more severe conditions such as bipolar disorder and schizophrenia, she added.
While Swiss Re’s framework is structured, it’s not rigid, Kelly stressed, encouraging underwriters to consider the specific circumstances of the individual applying for coverage.
The role of apps in insurance’s mental health mission
Insurers around the world have responded to the growing demand for accessible and effective mental health solutions by embracing technology. Apps are an innovative way to engage with policyholders and help them take control of their mental health and well-being.
While they’re convenient and affordable, apps don’t always succeed in engaging people in a sustainable, long-term way. Kelly spoke about designing mental health apps to meet the needs of users, whether they want to engage in a continuous or episodic way.
“I agree that apps are an important part of this journey,” she said. “They have a role to play. I don’t think they’re a solution in themselves. But they are part of a wider ecosystem because of the scale and reach they give us, and because they allow us to tailor and personalise the experience to each individual.
“I think when a need is met, it helps drive engagement because people can see the clear benefit and feel the relief and help almost immediately by being able to connect with the community or get some helpful pointers.”
