Swiss Re lifts hood on its ‘holistic’ approach to mental health underwriting

The stigma around mental health issues has cast a long shadow over millions worldwide, preventing many from seeking the care and support they need.   

While negative perceptions around mental health challenges are slowly lifting, the insurance industry has a role to play in accelerating progress on mental health, especially by shining a light on its impact on overall well-being.

Natalie Kelly (pictured), 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 that came out of COVID-19 is that people are much more willing to talk about mental health and mental health challenges now,” said Kelly.

“Willingness to talk about mental health is essential to move the needle because the sooner people recognise that they’re having a mental health challenge and the sooner they’re able to seek help, the better the outcome is for them.”

Swiss Re’s approach: a holistic view of mental health

Speaking to Insurance Business, Kelly shared 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, and social and lifestyle factors.

“Mental health has always been a key topic for us, particularly when it comes to our disability portfolio,” she said. “The conversation is changing and gaining more prominence now, which we welcome.

“There are two key points to our approach, and the first is we want to offer as much cover 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 is what underpins our underwriting approach and philosophy. 

“The second point, specifically when it comes to mental health and how we underwrite and manage claims, is we look at the whole human being, 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 comorbidities and genetic predispositions, while psychological factors cover stress, previous trauma, abuse, and other triggers. Social factors, on the other hand, account for an individual’s cultural and family background.

“All these factors play a role in trying to understand how best to provide cover for people if they suffer a mental health event, how we help them to get better, and how we can encourage them to go back to work in a way that works for them,” Kelly said.

How does Swiss Re underwrite mental health conditions?

Kelly also lifted the hood on Swiss Re’s framework for underwriting mental health conditions. She noted that while physical ailments, for instance, high blood pressure, can manifest similarly among different individuals, this often isn’t the same 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 which points to look at, what questions to ask an individual, and how to assign 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 judgment and experience to optimise [the coverage] we’re able to offer to people.”

This approach applies to a range of mental health conditions, from stress, mild depression, and anxiety to more severe illnesses such as bipolar disorder and schizophrenia, she added.

While Swiss Re’s frame 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 worldwide have responded to the growing demand for accessible and effective mental health solutions by leveraging technology. Apps are an innovative way to work with policyholders and help them take their mental health and wellness into their own hands. 

While convenient and affordable, apps aren’t always successful at engaging people in a sustained, prolonged fashion. Kelly spoke about designing mental health apps to users’ needs, whether they choose 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 are a solution in and of themselves. But they are part of a wider ecosystem because of the scale and the reach they enable us to have and because they allow us to tailor and personalise the experience to each person.

“I think that when a need is being satisfied, it will help drive engagement because people can see the clear benefit, and they feel the relief and the help almost immediately by being able to connect with the community or receive some helpful pointers.”

In what ways do you think the insurance industry can support mental health progress? Share your thoughts in the comments.