The following information from MIND is intended for people with Mental Health Problems - as this is the category of Health which ADD/ADHD fails into it should also therefore be of help to those of us with ADD/ADHD. However it would still be worth speaking to a number of Independent Insurance Brokers who may be able to deal with things on your behalf although you will probably have to give a fairly comprehensive explanation of the condition to enable them to find the best quotes around. Plus, now that the Affordable Care Act is providing better healthcare coverage for patients, insurance options have become more plentiful as well as cheaper too!
This information sheet however has various information of people who could be helpful but again it is for Mental Health in general and therefore anyone listed here may have good knowledge of Mental Health in general and about discrimination but may not have full working knowledge of ADD/ADHD. I do however feel that any understanding of Mental Health Issues makes this helpful as a starting point when it comes to insurance for an ADDer!
This factsheet is intended for people wanting information about insurance and the possible effect that any previous or existing mental health problems could have on their obtaining cover. It gives background information on discriminatory practices affecting people with mental health problems and ways of making a complaint or seeking redress, particularly under the Disability Discrimination Act 1995. It also gives contact details of organisations and insurers who may be able to help.
Mind receives numerous calls and letters from people who have, or have had, mental health problems and cannot get insurance cover. Many people find that when they inform some insurance companies about previous or existing mental health problems, they are either refused cover or asked to pay an increased premium.
In the past, before information advances, insurance companies found it difficult to obtain medical records or reliably assess risk from mortality rates. As a result, insurance companies worked together to create their own mortality tables based on the national average. Under this system, most people could access insurance.
Discrimination against people with mental health problems (and other groups seen as 'high risk') began to occur as certain large insurance companies moved away from this system.
Advances in information exchange meant that these companies could access individual medical records and exclude anyone seen as presenting an unacceptable risk. This is called 'cherry picking' and the main motivation behind it is increased profits for insurers. Some insurers ask a single blanket question about whether a person experiences (or has experienced) mental health problems and decide that anyone answering 'yes' to this question poses too high a risk to insure.
The problem with cherry pickers is that they put pressure on the traditional companies (many of whom really believed in insurance for everyone under the old system), leaving them to pick up all of the 'high risks'. 1 The result is that many of these smaller firms have been forced to adopt the same practices as the larger companies, which means that many people with any form of mental health history are unable to access insurance at all or are forced to pay premiums that are unacceptably high. This creates two categories of people: those who are 'insurable' and those seen as 'uninsurable'. People with mental health problems generally fall into the latter group.
Ivan Massow, who first sold insurance specifically to gay people who had been turned down by mainstream firms over concerns of HIV and Aids, says that it is essential that the Association of British Insurers, and possibly the Social Exclusion Unit, take note and work together to try and get companies to agree to the original code so that more people can get affordable insurance. Ivan Massow has also launched 'Survivors', an insurance and financial services scheme for people who are discriminated against in the traditional system (see 'Recent initiatives' and 'Useful contacts' sections in this factsheet).
The Disability Discrimination Act 1995
The Disability Discrimination Act 1995 makes it illegal to provide goods, facilities and services to a disabled person (including people with mental health problems) on terms which are unjustifiably different from those given to other people.
Since 1996, the Disability Discrimination Act has made it illegal to refuse insurance, or charge higher premiums, unless the company can demonstrate statistically higher risks as a direct result of a specific mental health condition.
When deciding about whether to insure someone, a risk assessment should always be carried out by the insurer and should include a statistical analysis that a person presents "a higher than average risk" (since an individual could sue an insurance company under the Disability Discrimination Act if they were unfairly declined insurance). However, people are reluctant to take out cases against big institutions and only a small handful of cases taken out under the Disability Discrimination Act have been successful.2
Insurers may still ask the single question about whether or not the person applying for insurance has ever experienced a mental health problem and either refuse insurance or increase premiums on the basis of a person saying that they have. If you are applying for insurance and this happens to you (or you believe that your insurer has treated you unjustly), you could have a case under the Disability Discrimination Act 1995 and you may wish to seek legal advice (see 'Useful contacts' at the end of this factsheet).
There are, however, many instances where insurers can still justify discrimination despite the existence of disability legislation (for more information please see the separate sections in this factsheet on private health insurance, travel insurance and life insurance).
Successful claims against insurers under the Disability Discrimination Act
Despite some of the failures of the Disability Discrimination Act to protect people from discrimination, there have been some successes. The experience of psychologist Rachel Perkins, who has been diagnosed with manic depression, is one of the examples to be handed over to the Social Exclusion Unit.
After a pay rise five years ago, she applied to increase her payments to her health insurers. But when she declared her spells in psychiatric hospital, her insurance firm refused.
Rachel, a member of the Disability Rights Commission's Mental Health Action Group, then wrote to her insurance firm detailing how she intended to pursue a case of discrimination under the Disability Discrimination Act.
After a two-year battle, the insurance firm granted Rachel her increased cover. "I am delighted Abbey Life changed their mind," says Rachel. "But at the time I was very angry.
"Under the Disability Discrimination Act, insurers are required to treat disabled people no differently than anyone else. The act requires them to make reasonable adjustments. This just does not happen." 3
Mind and a number of other leading mental health organisations have called for the law to be strengthened to outlaw this kind of discrimination.
Association of British Insurers (ABI) Code of Practice guides
The Association of British Insurers (ABI) sets out the general principles and exceptions relating to insurance from the Disability Discrimination Act (see the end of this factsheet for contact details). In general, an insurance company must be fair and reasonable in its dealings with disabled people (including people with mental health problems) and must account for any difference in treatment between disabled and non-disabled people. Insurers' decisions must be based on information relevant to the assessment of the risk to be insured and from a reliable source.
These may include:
actuarial or statistical data
medical research information
a medical report, or
opinion on an individual from a reliable source.
Insurers must make sure that the information is accurate and that their use of it is reasonable. It must be shown that the disabled person has a higher risk; if not, there should be no differentiation in their treatment. Again, if you believe that your insurer has acted unfairly, you may wish to seek legal advice (see 'Complaints' and 'Legal redress' sections of this factsheet).
Different types of insurance
This section covers different types of insurance. It sets out instances where insurers still justify discrimination despite the existence of the Disability Discrimination Act. It is not a statement of the law and so if you are unsure about whether or not you have been treated unjustly by your insurer, you should consider seeking legal advice or taking up a complaint with the Financial Services Ombudsman (see 'Complaints' and 'Useful contacts' sections of this factsheet).
Private health insurance
Despite the existence of the Disability Discrimination Act, special exemptions can still apply to private health insurance. Insurers can refuse cover for conditions and illnesses which exist at the time the insurance contract is taken out (called pre-existing conditions). They may also include an 'exclusion clause' which means that they will not provide cover for the first years of a policy if the person has experienced a serious condition before the start of the policy. Refusal to provide cover must be based on objective evidence that the person's recent medical history increases the risk of them making a claim.
Proof of an additional risk may be based on claims information, government statistics, medical research or industry sources. Health insurers may also request a medical report on an individual. There must be reasonable grounds for a decision to refuse cover, for instance, evidence that the person's pre-existing medical condition is likely to increase risk. However, the decision must be based on the person's health condition and not just because the person is disabled.
Private health insurers tend to exclude people with a pre-existing condition. If existing members develop a mental condition, such as schizophrenia or bi-polar disorder (manic depression), hospital treatment is generally limited to a specific timescale and outpatient treatment is limited to a maximum ceiling. Specific terms may be related to the severity, stabilisation and likelihood of recurrence, but there is a measure of discretion in individual circumstances.
A travel insurer cannot refuse a travel policy to a disabled person, which includes a person with mental health problems. However, claims arising out of the disability may be excluded if the insurer can justify that the condition represents an increased risk. A travel insurer may also exclude cover in relation to a medical condition existing before or at the time the contract is made. This means that if you have a pre-existing condition of, say, schizophrenia, and you experience symptoms whilst you are on holiday, your insurer may refuse you cover for treatment of this particular condition. If the claim is not connected to the disability it should be paid as normal.
If a person who has experienced mental health problems takes out a travel insurance policy, they are offered the standard policies available from travel agents (which almost always exclude pre-existing conditions, including mental health problems), or a specialist policy which gives full cover but costs far more money. If you have a mental health problem (or have experienced mental health problems in the past) be aware that holidays are often sold with standard insurance policies which have exclusions in the small print. These policies are more or less useless if you then try to take out a claim for anything which might be connected to your mental health problem (or any other pre-existing condition) whilst you where away on holiday.
If life insurance cover is refused or premiums are increased, the insurer would need to show that the disability or medical condition would directly affect life expectancy. In cases of 'severe mental health problems' (such as schizophrenia), the insurer could argue that this diagnosis increases the risk of suicide.
The Ivan Massow Group specialises in life insurance for people with mental health problems. See the 'Useful contacts' section in this factsheet for information about how to contact the company, and the 'Recent initiatives' section for details of their services.
There is no national policy with regard to motor insurance for people who experience mental health problems. The Association of British Insurers say the decision is up to the individual insurance companies, who may exercise discretion about whether or not they provide insurance or only offer it at a higher premium.
It seems that if the DVLA approve the driving licence then an insurance company may agree to insure the individual involved; they may, however, charge a higher premium depending on the circumstances.
When to make a complaint
Complaints about insurance can be made to the Insurance Ombudsman Bureau (IOB), which is now part of the Financial Ombudsman Service, which has stated the following principles on mental health issues:
Cancellation of a holiday through anxiety, depression or mental illness should be treated in the same way as other illnesses.
Cancellation of a holiday by parents through their son or daughter suffering a mental breakdown should be compensated for because the policy was in respect of them and not their son or daughter.
Where a person took his own life and, at the time of doing so, there was no doubt that 'the balance of his mind was disturbed', he remains covered by the insurance.
Policyholders are only required to disclose information about a pre-existing condition if there is an opportunity to do so.
For details of how to contact the Financial Services Ombudsman, please see the 'Useful contacts' section of this factsheet.
You may also wish to seek advice about possibly taking out a case against an insurer under the Disability Discrimination Act 1995.
If you decide upon this route, you will need to seek legal advice from a solicitor who specialises in disability legislation. The first step is to establish with the solicitor whether or not the law can help you and whether or not your case is likely to succeed.
Mind has a list of solicitors who specialise in disability; for more information contact MindinfoLine. The Law Society can also advise on suitably qualified solicitors (see 'Useful contacts' for details of both organisations).
The Manic Depressive Fellowship's (MDF) Travel Insurance Scheme
The Manic Depressive Fellowship (MDF) set up the first travel insurance scheme for people with mental health problems (specifically manic depression). The organisation liaised with brokers to arrange travel insurance for people who are MDF members.
The MDF has outlined the importance of helping insurance firms understand that many people diagnosed with a mental health problem are not high risk clients.
The Rethink Advice Service has issued a factsheet on travel insurance and keeps a list of insurance companies and brokers who try to help customers with mental health problems.
See the 'Useful contacts' section at the end of this factsheet for information about how to contact the Manic Depression Fellowship and the Rethink Advice Service.
Ivan Massow Group's 'Survivors' Project
Ivan Massow is former chairman of Mind's enquiry into mental health and social exclusion. 'Survivors', his latest initiative follows an approach from internet site www.loonscape.com, which is collating case studies of alleged discrimination by financial service providers.
The Ivan Massow Group has discussed with financial service providers how to provide a range of tailor-made services, particularly life insurance, for people with mental health problems.
Massow Survivors specialises in providing insurance and other financial services to survivors of transplant, major surgery, cancer and mental health problems. It provides advice to people who otherwise would find themselves rejected or facing huge premiums for their insurance because of their condition. See 'Useful contacts' for information about how to contact the Massow Group.
Insurance Code of Practice and Complaints Association of British Insurers (ABI), 51 Gresham Street, London EC2V 7HQ
tel: 020 7600 3333, fax: 020 7696 8999 email: firstname.lastname@example.org, web: www.abi.org.uk
Financial Services Ombudsman, South Quay Plaza, 183 Marsh Wall, London E14 9SR, tel: 0845 080 1800, fax: 020 7964 1001
email: email@example.com, web:www.financial-ombudsman.org.uk
The Law Society, The Law Society's Hall, 113 Chancery Lane, London WC2A 1PL, tel: 0870 606 6575, fax: 20 7831 0344
email: firstname.lastname@example.org, web: www.lawsoc.org.uk
The law society cannot give legal advice. It can direct enquirers towards solicitors who specialise in disability discrimination legislation and has an online database of solicitors at www.solicitors-online.com
MindinfoLine can also give details of solicitors who specialise in this area of the law (see Information Services list in this section).
Manic Depression Fellowship (MDF), Castle Works, 21 St. George's Road, London SE1 6ES, tel: 020 7793 2600
email: email@example.com, web: www.mdf.org.uk
Manic Depression Fellowship Wales, 1 Palmyra Place, Newport, Gwent NP20 4EJ, tel: 0163 324 4244, fax 0163 324 4111
email: firstname.lastname@example.org, web: www.mdfwales.org.uk
MindinfoLine, Mind, PO Box 277, Manchester, M60 3XN, MindinfoLine is open Mondays to Fridays 9.15am to 5.15pm
tel: 0845 766 0163, email: email@example.com, web: www.mind.org.uk
We can give details of Legal Network solicitors who specialise in advising about claims under the Disability Discrimination Act
Rethink, Head Office, 30 Tabernacle Street, London EC2A 4DD, tel: 020 8974 6814
email: firstname.lastname@example.org, web: www.rethink.org
The companies whose details are given below have assured us that they will not exclude people solely on the basis of having a mental health problem, either currently, or in the past. It is their policy to look at the merits of each case. However, they may wish to obtain a medical report from your general practitioner or psychiatrist.
The Ivan Massow Group is probably the most advanced in terms of its understanding of the problems people with a history of mental distress can face when applying for insurance. It has responded by producing a range of financial services, including insurance, as part of its 'Survivors' service.
Please note that neither Mind or adders.org is unable to specifically recommend any of the insurance services listed below; their details are given purely for information purposes.
Ivan Massow Group's 'Survivors' Service, Regional offices:
London, tel: 020 7297 9610, fax: 020 7297 9611, free phone: 0800 328 0625, email: email@example.com
Manchester, tel: 0161 254 4221, fax: 0161 2544 253, email: firstname.lastname@example.org
Tamworth, Staffordshire - Felix Financial Ltd, tel: 01827 311 950, fax: 01827 520 67, email: email@example.com
You can arrange your insurance online at www.massow.co.uk or telephone any of the above numbers to speak with an advisor.
Manic Depression Fellowship - Travel Insurance
Manic Depression Fellowship (MDF), Castle Works, 21 St. George's Road, London SE1 6ES, tel: 020 7793 2600
email: firstname.lastname@example.org, web: www.mdf.org.uk
Privilege Insurance, 3 Edridge Road, Croydon, Surrey CR9 1AG, tel: 0113 292 5555
Primarily for motor insurance
Jeffrey Flanders Ltd, The Old Barn, Vicarage Hill, Loxwood, Billingshurst, West Sussex RH14 0RH
tel: 08703 300 2001
Cover for all types of insurance except for travel
Travelability, Folgate Insurers, Upton Road, Poole, Dorset BH17 7AG, tel: 01202 668 066, fax: 01202 668 064
A specialist travel insurance policy for people with disabilities
Medicover (call centre based), tel: 0870 735 3600, web: www.medi-cover.co.uk
They cover travel insurance
[SUP>1 Massow, Ivan (2003) Information circulated to Mind regarding the Ivan Massow group's 'Survivors' service (unpublished).
2 Mind (1999) press release to the BBC, quoted online
3 Perkins, Rachel (2003) quoted in the online journal Psychminded
© adders.org 2004