Episode 5 – Claims and Support

Hi everyone, this is the fourth episode of our Mental Health in Life Insurance week. So far this week we have gone through why someone may need or want insurance, how they can get it, the things that lead insurers to make decisions over what can be available to someone, and we are now at the point where everything comes together for the whole point of this: the claim.

In this episode we talk about what happens in terms of support for people living with a mental health condition when they make a claim on insurance, and more importantly the extra support they can access from the policy even if they don’t make a claim. We also talk about how mental health needs to be considered with every claim, as these are times when people are often at their most vulnerable.

The key takeaways:

  1. Insurers now often offer extra support services for people that have policies with them e.g. mental health support lines, access to remote GPs, fitness and nutrition plans.
  2. Mental health causes a large amount of income protection claims and insurers partner with specialist firms to help people that are struggling to work.
  3. Mental health support can be accessed by policyholders but it’s important to be aware that there are times that this service will not be the most appropriate option.

The next episode of the podcast is going to be a bit different. We are hosting a webinar to round off this mental health in life insurance week, and the audio from it will be added as our next episode. I hope that you have found our walkthrough of insurance and mental health useful.

Remember, if you are listening to this as part of your work, you can claim a CPD certificate on our website, thanks to our sponsors Octo Members.

If you want to know more about how to arrange protection insurance, take a look at my Protection Insurance in Practice course here.

Kathryn:       Hi everyone, this is episode five of season five and we’re on our last day of the podcast for our Mental Health Awareness Week and I have Vanessa Sallows with me from Legal & General and Monica Garcia from Monica Garcia Consulting with me.  Hi both of you!

Vanessa:     Hi!

Monica:       Hi Kathryn, hi Vanessa!

Kathryn:       Hi.  Well today, as I say we’re on day four and we are going to be focussing upon mental health and what happens when it comes to making a claim on insurance and kind of like all the mental health touchpoints at that point.  And this is the Practical Protection Podcast.  How are you both doing then?  Let’s start off with a nice little just ‘how are you doing?’

Vanessa:     Yeah, I’m good thank you.  It’s been a busy January already as you would expect in the insurance world.  But yeah, feeling good both physically and psychologically at the moment so it’s a great start to the year.

Kathryn:       Fantastic.

Monica:       Same here, thank you, yeah, it’s the end of January, so it’s that feeling again that, “Oh my gosh, it’s 2022 already and you know, one month is already gone, so yeah, feeling good, but scary it’s going fast!

Kathryn:       Absolutely, absolutely!  I have to say I am very, very grateful it’s the end of January, because I’ve just had a month of role plays and appraisals and everything else, so my calendar has just been meetings, meetings, meetings, so I’ve just said to myself, “Just have a bit of a chillout at the end of January.”  That would be nice, just over the next day or so, just maybe the weekend, I’ll just have a little bit of moment where I just kind of let myself collapse a little bit, which will be very, very nice.  But let’s get straight into things because I know that everybody’s going to want to hear from your points of view, especially after everything we’ve been listening to this week.  So if I start with you Vanessa.  Obviously you have a medical background, as well as a lot of experience of insurance and specifically the claims journey.  So how entwined is mental health with claims?

Vanessa:     The top three causes of income protection claims for both group and retail or individual claims is essentially musculoskeletal, cancer and mental health.  In no particular order, but they actually make up over 70% of income protection claims. Then if you actually look at any underlying psychological consequences, so for any physical condition, cancer being one but also chronic pain, chronic fatigue is another example and chronic pain conditions, there is often a psychological or mental health underlying aspect to those claims as well.  So it is absolutely fundamental and key and within Legal & General we actually have it as a foundation of our wellbeing.  That actually, we all have mental health, it impacts us all in different ways and actually we just need to look after ourselves from that perspective as well.  But that’s why we actually implemented our early intervention and proactive claims management approach is very much founded around the mental wellbeing of everybody.

Kathryn:       I think that’s brilliant and it’s so important.  I mean the things that sort of like stand out for me for that well is the long-term things, so like long Covid, obviously so many of us are hearing about that now.

Vanessa:     Yes.

Kathryn:       You know, people who, people I’ve been speaking to, you know, that spent their life without any health condition at all and suddenly they’ve got something and they’re no longer, you know, this person who is able to go off and do marathons or triathlons and things like that.  So, everything that they had as kind of like as their support structure in some ways, to not have a mental health – sort of like a condition, is suddenly gone and then they’ve got this as well and it’s intense.

Vanessa:     And it is intense and I absolutely agree Kathryn, you know, essentially, we’ve always isolated mental health or physical conditions but actually they are interchangeable, they are part of what we actually are as human beings and help us to become whole.  And to help us actually thrive within the workplace, we actually have to acknowledge that we’ve all got that mental health, we’ve all got the propensity to have mental illness or physical illness at any given point in time.  And I think you’re right, with long Covid and the pandemic we’ve been going through, it’s really highlighted that and brought it to the forefront.

Kathryn:       Absolutely.  I think something that’s stood out for me as well all the time, is something I’ve been saying for a while now, is the fact that you were just saying, you know, we all have mental health, it’s a case of well we do, you know, it’s like being anxious is a very natural, normal response to certain situations.

Vanessa:     Yeah.

Kathryn:       There are times where – and I obviously certain am one of these people, I’ve not been shy about my own mental health, my anxiety – there are times that my anxiety kicks in, when it in a sense it should – I’m going to say shouldn’t do and I know you two can see me doing bunny ears to say ‘shouldn’t do’ and no one else can see that but, you know, there are times that it kicks in, my fight and flight sort of like goes into overdrive and for me it probably happens, as I say, in places it shouldn’t do, but it’s also normal.  It’s going for your driving exam, it’s going on that first date with somebody, anxiety’s quite – it’s there, for us all.  It’s – just is it manageable in some ways, maybe.

Vanessa:     Exactly.  I mean, at the end of the day, it’s just a natural and normal stress reaction to certain amounts of pressure.  Stress in itself isn’t an illness, it’s not a clinical illness, it’s pressure, it’s a normal reaction to those types of situations that we find ourselves in.  It’s life, you know, and I absolutely agree, you know, I’ve had significant mental illness issues within my close family for a number of years.  My husband’s bipolar so, you know, essentially, it’s normal and we need to actually ensure that it is understood as normal within each of our working lives.

Kathryn:       Monica, many insurers now offer mental health services and, you know, support services, especially at the times of claim and even not necessarily just at times of claim, just generally available.  So what kind of mental health support do people potentially need when they are in this kind of situation, where they are needing a claim?

Monica:       Yeah, so I think what we need to bear in mind is that within the income protection industry, we are talking now specifically about the working population, right?  So these are individuals who for any reason, they are perhaps struggling at work to a point that, you know, they become absent.  So the most common reasons really are related to, as Vanessa mentioned, you know, stress, worker stress, the reactive types of depression and anxiety.  Now these conditions luckily have a good prognosis, you know, based on evidence and, you know, people are likely to get well if they receive treatment.  Now here’s the but and you can see my, you know, my inverted commas there, but I think what we struggle with is the fact that, you know, individuals face a postcode lottery via the NHS.  And it may be that some claimants are waiting for a long, long period of time.  And what it means is that the condition perhaps becomes more severe in terms of symptoms and then other successive changes occur as well for these individuals at home, you know, things get more complicated.

So, I mean really, in a succinct answer to your question, the support can vary, you know, the type of counselling, the type of a specific therapy intervention.  But I think what is most important is that it has to be tailored to a specific individual, to their specific circumstances at the time.  And that might be very, very different, you know, it may be that you have developed a mental health condition as a result of bereavement for example.  You know, we’ve seen that during 2020, many people not being able to say goodbye to their loved ones, you know, that’s been really hard.  But of course, you know, there are many other factors as well playing at the same time and, you know, that might mean that some people do actually develop a mental health condition and others don’t.

The other thing as well to bear in mind within our industry is the fact that there are many IP products available out there and that makes a difference in terms of the type of interventions that may be suitable and that are available for people.  So in the case of group income protection, you know, you have more, as Vanessa mentioned, more comprehensive tools, because you are engaging with employers’ schemes and, you know, you have the individuals having access to early intervention resources within the waiting period in the majority of cases, which is fantastic, because the earlier you get the more chances you have of, you know, helping that individual to overcome those symptoms, manage those symptoms and help them to get back to work.  On the individual income protection side of things, you might have products with deferred periods of 12 months for example, so the insurer might not hear about the sickness absence until the person has been off work for a year, so things are a lot more complex in that scenario and I think things are changing in the industry as well, in terms of what type of support can be available for those claimants really.

Vanessa:     But certainly I think that’s a great opportunity for the industry?

Monica:       Yeah.

Vanessa:     From an education perspective?  Because within Legal & General, we treat all income protection claimants exactly the same.  It’s almost irrelevant how the product is distributed.  It all sits under my remit and we provide the same vocational rehabilitation early intervention and support for individuals suffering from mental health, irrespective as to whether it’s a retail or an individual product, or a group product.  So I see that as a really fantastic opportunity for us to educate people to remind them about the products that they’ve purchased.

Kathryn:       Yeah.

Vanessa:     Because again, that’s often what happens on an individual product.  I agree with you Monica, is that essentially individuals forget that they’ve even got the product sometimes.  They’ve bought it a number of years ago, sometimes associated with a mortgage and they just don’t even know they’ve got it until they really need it and so we should be educating them to remind them of all the fantastic benefits that we can actually provide to help them remain in good work.

Monica:       Yeah.  And I think as Vanessa mentions as well, you know, the role of vocational rehabilitation is key and is something that the industry really has moved forward at an incredibly fast pace, you know, in the last five – six years or so.  And that’s important because, you know, if you don’t have IP cover for example, you might be waiting on the NHS, you know, for counselling or psychotherapy or CBT treatment – you might have PMI access insurance, but that doesn’t guarantee that you are actually going to get the specific return to work support you’re going to need.  So it can be that you are able now to manage your depression, your anxiety symptoms but you are actually petrified about returning to the workplace, you know, you have been deconditioned, you are scared.  It can be that your vocational rehabilitation consultant helps you in that transition, you know, to successfully and safely go back to the workplace and working with employers as well, that’s maybe something we can talk about in another podcast, you know, the role of employers, you know, who have to support employees back to work as well.

Kathryn:       Absolutely and I think what was interesting as well, something that we just touched upon then as well is, I kind of think of like the mental health and knock-on effect that it can have from other areas as well.  So not even just income protection, if we think about life insurance, we think about critical illness and life insurance, you’ve got the family facing bereavement or you potentially have someone whose – who knows that they’re facing – they’re going to be passing in the next 12 months if they’ve got a terminal illness, you know.  There’s so much mental health there with the critical illness.  You might have somebody in a sense, grieving their health that they now have lost, if they’ve been in good health.  But I think as well, something that kind of pops into my mind is that we kind of probably think of this as like either that someone’s had mental health and then, you know, this is kind of resulting in a claim or maybe there’s been something quite significant like cancer where we kind of automatically think, “Oh yeah, you know, there’s going to need to be probably some mental health support there.”

Then I was just thinking about what happens if you’ve got someone – I’ve just gone off back to the triathlon person I was mentioning. What happens if you’ve got someone there who’s got a, you know, they’ve broken their leg and they’re suddenly facing that they don’t have – they’re not going to be and it’s been an – let’s say its been a not nice break and, you know, they’re not going to be able to do what they did before and that was kind of their stress relief, you know, and everything was about – they identified as this running man in a sense.  I imagine, you know, some people with a broken leg you’d be a case of, “Well they maybe don’t need mental health support,” not assuming that but, you know, they maybe wouldn’t do – some people?  But then there could be others that they really need it, so I imagine it’s very complex trying to establish all of that kind of vision of what that individual person needs.

Vanessa:     Exactly.  And that’s where I referred to the underlying psychological overlay previously.  It’s there absolutely and it is what we actually utilise – is we’ve got our own vocational clinical specialists, as Monica has actually alluded to.  So we will actually carry out what we call a triage interview with every individual to actually ascertain what their needs are.  Part of that is very much going through some psychometric testing as well.  These are all clinicians.  We’ve got a multidisciplinary team and that is the best approach.  That is the approach as recommended by NICE.  It’s also the same approach as we’re using for the long Covid support programmes and indeed the NHS and NICE have made those recommendations in exactly the same way.  So we’ll use clinicians, occupational health advisors, occupational health physicians, OT’s, physiotherapists and nurses with varying degrees of experience and expertise in mental health, cancer, musculoskeletal – all the different disciplines, so that we can actually carry out an initial in-depth assessment of that individual to actually identify what their complex needs are and then actually identify the right care pathway – what support they need, using that stepped care approach.

Monica:       Yeah.  I think I agree with Vanessa and I think the important thing is that what I’ve seen in the industry, you know, in the last few years, is that they have really adopted this biopsychosocial model of health approach.  So, you know, we see in healthcare settings that you need to understand the process of health and illness from a biological, psychological and social perspective, so I think adopting a holistic approach of the assessment of that particular case will enable you, you know, to understand what is it that is, you know, preventing that person, you know, from recovering and from returning to work?  So it can be a broken leg, it can be a broken arm, it can be anything but we must not undermine, you know, the mental health aspects and how that person is coping or not coping really.

Kathryn:       Absolutely.  So Vanessa, so something else that I sort of like wanted to quickly touch upon before we go onto the next bit –

Vanessa:     Yes!

Kathryn:       So there’s obviously a lot of insurers now do what’s known as the value added support services.  So this is where a claim isn’t necessarily being made, it’s something that people can access throughout the time of the policy and we’ll have people listening who sort of like know about this, don’t know about it and obviously a lot of them do include mental health support services in there.  But I’m just wondering if you could be – sort of like help us sort of like and the listeners to understand sort of like do those – there are times I think isn’t there, where they’re sort of like – those mental health support services, I think they’re sort of like – they’re there as sort of like as an initial kind of support but then there does come a point where it would maybe be that somebody does need to probably go and speak to maybe a GP or somebody else – maybe a charity or something.

Vanessa:     Yes.

Kathryn:       So how does that kind of work?

Vanessa:     Absolutely.  So, you know, under the step – under the NICE guidelines, under the stepped care approach, there are actually five different steps.  You’ve got the very early stages, step one and two, whereby individuals are just beginning to struggle, they’re feeling unhappy and that’s where you might use your mindfulness app or some other tools and there are thousands and thousands of apps out there and available to individuals.  And then you come into where you might need an EAP – an employee assistance programme or access to some of the counselling support and then finally onto the psychological interventions such as CBT that Monica has already alluded to – cognitive behavioural therapy – you’ve got other forms of talking therapies.  And they are used often in conjunction with medication but sometimes on their own because NICE recommendations is initially for just that to be used in the first instance.

Now, of course, there are some severe cases whereby those types of talking therapies aren’t appropriate until an individual is clearly stabilised.  So for instance, if an individual is really struggling, has suicidal thoughts, then they should be talking to a specialist charity or primarily their GP.  That’s really important and I can’t emphasise that enough that, you know, we want to stop suicide, it’s tragic, it’s absolutely tragic and what we want to do is get people with the right support in the first instance.  So talk to your GP.  Talk to your friends and colleagues.  If you’re in the workplace, reach out to mental health first aiders.  There’s plenty of charities such as MIND, Rethink Mental Health, Mind Canyon – there’s so many charities out there that essentially people can access in the first instance to talk to somebody.  Insurers aren’t the NHS and we’re not PMI providers under the health benefits, so we can’t actually put in place medication or recommend medication.  We can provide all the other support services but it is really important individuals access their primary carer in the first instance.

Kathryn:       Absolutely.  Because I was going to say, I – obviously I speak to a lot of people that are living with mental health and one of the things that I’ll be saying to them is, “Oh, we’re going to go to this insurer, they offer these things as extras,” and then I have to obviously be careful as well, because it’s a case of –

Vanessa:     Yes.

Kathryn:       It might be that they have a mental health, you know, condition, that I’m speaking to them about, where actually, maybe the mental health support line through the insurer, through that sort of extra support service, isn’t going to be necessarily the best route.

Vanessa:     Yes.

Kathryn:       Or to at least make them aware to say, “Look, you can access this, but I’m not completely sure how much they’re going to be able to do, because obviously you’ve got this support here, obviously you’ve been speaking to your GP –” hopefully obviously most of the time somebody has spoken to their GP.  So I think that’s good you know, rather than sort of, I’m sort of thinking from an advisor point of view it’s really important to say –

Vanessa:     Yes.

Kathryn:       Advisors don’t think, “Ooh, this person’s got a mental health condition, ooh there’s mental health support here, I’ll just signpost them there,” and actually go, “Well actually, that might be an okay route, but depending upon the situation, it may be that, you know, there is other things that we need to do as well.”

Monica:       Yeah.

Kathryn:       Because the last thing we want to do is someone to come to us for us help, for us to say, “We’re going to help you and by the way there’s this is extra support here,” for them to then go to that and then it’s not right for them.

Monica:       Yeah.

Vanessa:     Exactly.  Absolutely.  You know, within the UK, we have an amazing primary care system.  I know it’s been struggling phenomenally throughout the pandemic but ultimately the first point of contact should always be an individual’s GP or the local mental health services for an individual.  And the GP will then help to signpost that individual if they need further psychiatric input from a consultant psychiatrist, via secondary care, via the NHS or if an individual has PMI.

Monica:       Yeah and I think Kathryn, what you’ll also find is that many income protection claimants find that their insurer for example will liaise with their GP and will say, you know, “We have finished our vocational rehab course or our CBT course and, you know, we are sort of returning the care back to you.”  Because it may be that in some conditions, they will require long-term care and as I say, some medication or access to a psychotherapist, where it’s important that that care is monitored by their GP, as Vanessa mentions.

Monica:       Yeah and that’s a really great point Monica, because even if we are providing the CBT or the psychological intervention – because often it’s quicker to get that via your insurer than it is via the postcode lottery that you referred to earlier, essentially we will always be liaising with the GP as the primary carer.  You know, our case managers, both from a claims perspective but also from a vocational rehabilitation perspective, are linking in with the GP and if there’s a consultant psychiatrist or psychologist involved, they’ll be sharing evidence, of course with the individual’s consent, because we make sure we get the full informed consent from outset and we ensure that they’re aware that we’re going to be sharing this information, because it’s in their best interests that we’ve got a fully holistic process for them, so that everybody has the same focus to help them get better.

Monica:       Yeah.

Kathryn:       Absolutely.  Monica, I think, you know, obviously we’ve said before, you know, that mental health accounts for so much of the income protection claims in the UK and, you know, it isn’t something to think of as, you know, that it’s unusual for people to be having mental health, you know, difficulties let’s say or maybe flare ups of some sort.  You know, it can happen to anybody.  You know, Alan has been very open recently how last year, you know, he’s – Alan is so laid back, he’s complete opposite of me, incredibly laid back.  He’s one of those people though that every now and then, he’ll sort of like – he’ll build up lots of stuff and suddenly go “Urgh,” but he’s usually fine, he does that ‘urgh’ thing and then he goes back to normal resets.  And I just talk constantly about everything that’s kind of going on in my head.  And last March – April time so, you know, a good year into the lockdown, he suddenly really, really struggled.

You know, he’s 37, he’s never had anything mental health-wise, you know, he’s obviously he’s been – well he’s seen me obviously for many years with my mental health and, you know, has always been very distinct, you know, he’s kind of like so different, in like in the case of, you know, I’ll see something and my mental health will flare up, but he’s just kind of like, “Yeah, whatever.”  You know, like not, “Yeah whatever,” to me but, you know, sort of like, if it was him facing that, it just completely glides over him and all of a sudden everything was just suddenly there and on top and he just couldn’t see a way out.  You know, he’s kind of like that whole thing of you trying to like swim through the darkness kind of thing and he just couldn’t get out of it.  And I think what’s really important and obviously we’ve had so many people talk about their mental health in the last few years, especially in our industry and I think we’re seeing it across society as well to just try and say to each other, “This is okay, you know, it’s not a shameful thing.”

Vanessa:     Yeah.

Kathryn:       And Monica, I was just wondering how important is it that people really take their mental health seriously and engage with – say like the mental health services that are generally available in society but also those things that are available through insurers just to try and – I don’t know, keep themselves okay?

Monica:       Yeah, absolutely, you’re absolutely right.  I think – I mean one of the – if I could say a positive thing out of this whole pandemic scenario is that we’ve all seen that we can be vulnerable, you know?  I think somehow we think that, “Oh yes, we can go by on our day-to-day basis,” but actually, you know, things have been tough.  I think we’ve all been affected, you know, by Covid in one way or another.  But I think particularly during the initial lockdowns and lockdown one, two and three, you know, as they happened, from a research and evidence perspective, what’s happened is that people were suddenly cut off of usual sources of social and emotional support.  And that’s a key buffer actually of the stress.  So, you know, it can be that, you know, before lockdowns you will go to the pub to see your mates and just talk about things or watch a football game, you know, so things were stopped, you know?  So that’s on a kind of daily basis but then, you know, you can start feeling overwhelmed if things are not going well or if you have experienced a bereavement within the family.  So it could be all, you know, all sorts of things that can happen to people.

But I think what we’ve seen in the pandemic is that vulnerable groups have been particularly affected, because access to community support rehabilitation services for example were suspended, you know, so that’s been really, really difficult for them.  And I think for the rest of the population it has been the fact that actually, you know, probably the first time as you say, as in the case of Alan, you know, people are experiencing those symptoms.  But I think what is important is that we need to be able to recognise those early signs and symptoms and it can be completely different for each individual.  So for example, if you like eating, suddenly you might not eat at all, you know, or if – or the other way around.  So it’s very difficult to generalise and to say what symptoms you should look at, you know, apart from I guess, disturbed sleeping and that sort of thing, you know, for depression and anxiety.  But it’s a very, very individual aspect, you know?  You see some people struggle with back problems for example, musculoskeletal pain or tummy problems, you know and they say, “What’s going on?”  You know, and they don’t realise that actually, “I’m feeling overwhelmed, I’m feeling stressed.”

Something else as well that we’re seeing – I mean, that was the first phase I guess, you know, during the pandemic lockdowns.  But now that we went back to work is the issue around hybrid work.  So I think from an insurance perspective, we’re going to see many cases potentially where, you know, people are struggling to deal with this hybrid model, you know, where depending on the occupation, you know, dealing with technology fatigue, isolation because, you know, remote work doesn’t work for everyone.  So I think a lot of employers are struggling in terms of what support can be available for them, you know, to manage those remote things.  So it’s going to be – I guess an opportunity, you know, for the industry as well, you know, particularly from a group income protection side of things and Vanessa can tell you more in terms of those early intervention and prevention strategies that can be put in place for them.

But I think we shouldn’t forget, I guess, about the positive things and opportunities.  I mean, one of the things I’m doing now with my work is – and I really enjoy – is working again directly with claimants – income protection claimants and people with mental health conditions and cases that are classified as complex, you know, people who are out of work for a long period of time and I’ve seen cases where actually remote work wasn’t available for them before and it wasn’t an option and now they’re able to go back to work, you know, on a remote basis, without struggling with travel anxiety and, you know, feeling under pressure to be with colleagues that, you know, perhaps they don’t want to talk about their mental health in terms – you know, because I think we can park that again for another podcast around the stigma which, you know, things are moving forward but I think that there is still a huge stigma.  I see employers really not knowing how to speak to employees after a mental health condition – not knowing how to support them in the workplace.

Kathryn:       Yeah.  No, of course.  I was going to say, it is hard, it’s really hard as an employer.  I mean obviously we do – we have a lot that’s, you know, available.  We do a lot, you know.  We obviously, well, there’s so many of us that are there to chat, we’ve got mental health first aiders and, you know, but again it’s that whole thing of, you know, everybody’s individual, so it’s quite hard to know exactly what to do with everybody and that you need to make sure that – you have to have that culture I think, from the start as well, of approachability and –

Vanessa:     Absolutely.

Kathryn:       You know, people – that there’s no stigma, there’s nothing that’s going to say, “Well actually, you know, if you need to do a four-day week, you know, then in a sense, wherever possible, then that’s fine,” you know, in a sense and actually that person probably is going to be so much more productive, so much more – and so much happier that, you know, it’s going to work out best for everybody involved.  But I think an important thing as well to sort of move us towards and it’s coming towards the end of the session today, because obviously we’re talking about obviously mental health for somebody who’s a claimant, maybe mental health for somebody who’s, you know, there’s obviously people who are supporting claimants, you know, in a sense, family members and obviously as well, they also have their mental health.  But I think sometimes what we can potentially forget a bit about and it is an area that I think about quite a bit, because I often think about my team when they’re listening to stories about mental health and how I, obviously – we make sure we’ve got support structures there for them, but I think Vanessa obviously, you’ll see it so much in your team with your claims handlers, how much that kind of an emotional situation – how involved it can be in terms of listening to someone’s story or potentially if a claim doesn’t get paid.  I know that doesn’t happen much, but it can happen and that must be a huge emotional toll for your team.

Vanessa:     It is and I’m really pleased you’ve actually raised that Kathryn because it’s often the forgotten when we’re talking about mental health but, you know, it’s really important that we safeguard and protect all of our claims handlers.  We provide the right support, all of our line managers are trained in counselling as well as coaching to help support their actual teams.  And of course we’re very lucky within Legal & General, we have our own clinical team, so again we ensure that there is that ability to debrief and talk to colleagues about the cases they’ve actually discussed.  And we even do that, you know, virtually.  It’s been key that we’ve continued this approach through the pandemic.  What we’ve also done – I mean, you know, sadly we have seen an exponential increase in death claims so sadly, also income protection and in the first year there was a reduction in critical illness claims but now we’re seeing an increase through 2021 sadly.  And it’s been really important that we’ve actually provided counselling and support.

So what we’ve done is had Samaritans sessions with all of our claims handlers.  We’ve also provided counselling sessions, both individually but on a group basis to help support them so that they feel that they can actually talk to somebody.  It’s really important that we actually operate an open, honest, transparent and trusting working environment.  I think that, you know, whatever you’re doing, it’s so important that we actually provide that environment so people feel free that they’re able to talk to colleagues but talk to their line managers and tell us when they’re struggling.  We’ve also carried out lots of surveys and it’s “How are you doing?” surveys what we’ve been doing within our own claims team and it’s just done on a monthly basis and they can give a thumbs up or a thumbs down, or a smile, or a frown and it’s just to give us an indication so that we can then initiate that conversation.  If they don’t want to initiate it, then myself or one of the team managers or the senior managers within the area can actually then initiate that conversation and say, “How are you?”

I’ve also been doing coffee and chats every month – I’ve had coffee and chats with all of my people on an individual basis and in groups just to give them the opportunity to talk about – it’s an open, free agenda.  It can be work or it can be home or it can be anything that they want to talk about.  So it’s really important that we’ve actually provided all of that support to the claims handlers because ultimately they are dealing with very vulnerable individuals in their hour of need.  And they can only deliver the service that our customers deserve if they are fully supported.

Vanessa:     Absolutely.  And I think claims handlers are actually the face of insurers, you know?  They’re that first port of contact, you know, in terms of their claim, but I’ve seen cases where, you know, claims handlers have been in tears, you know, after the assessment of a claim because some stories are absolutely heart-breaking and we’re all human beings, you know?  So I’m very pleased to hear Vanessa that you have, you know, those mechanisms in place for your claim handlers and I shall hope that, you know, all insurers will have similar approaches really.

Kathryn:       I would think so as well.  But I think it’s very much a point, I think claims handlers are very much – I imagine an empathetic-type person.

Vanessa:     Yeah.

Monica:       Yeah.

Kathryn:       So obviously, usually in that role.  So that is something that is going to absorb into them, those stories and then it’s going to feed into probably the feelings of, “What’s that going to mean to that family member and that family member?” and it’s so much the process.  But I think, you know, from what you were saying Vanessa as well, it’s like, I mean we have like obviously similar things in place for our teams.  Again, we hear obviously things that have happened to people that aren’t particularly easy to hear and, you know, it’s a number of different things, I’ve spoke about different places, we’ve got like certain SOS systems if we’re really worried about people, you know, whether or not that’s, you know an employee who needs to notify us of something about themself or about, you know, potentially someone we’re speaking to.  But I do think, you know, it’s just something you said then, I don’t think there’s much that can really beat a cuppa and a biscuit as well.

Vanessa:     Exactly.

Monica:       Yes!

Kathryn:       Just, you know, just a nice gentle hand on the shoulder.  I know with Covid, so we’re not all together yet but, you know, before Covid times, you know, it would be a case of you can maybe hear someone on the phone and you’d go up and you’d just tap them on the shoulder, very lightly touching their shoulder and you’d just be like, do the symbol for cuppa to them and then it would just be 10 or 15 minutes, you know, away from everybody, maybe longer, you know, there was times, you know, that we actually said to somebody, you know, at times, “Right, just clock-off for the day, just go, just process.”  And obviously, as long as they were happy with that, if they needed to stay to kind of not face things, in a sense the, you know, that’s also – you do what each person needs, but yeah, the power of a cuppa and a chat is a good thing.

Vanessa:     Yes.  And I agree, you know, we used to do that as you say, when you’re actually in the environment, in an office environment, you could hear the conversations.  You know, we sat – I sat right in amongst all of my people so I could hear and see what was going on.  You couldn’t do that virtually, so we just had a little symbol or something, that they needed a quick cuppa or a quick chat outside the formality as well.  Just so they felt that they could contact somebody, because the worst thing in the world is for them to feel isolated as well –

Monica:       Yes.

Vanessa:     Having dealt with a really tragic claim and having to speak to the bereaved but also to individuals that are struggling with their own mental health or any form of claim.

Monica:       Yeah.

Kathryn:       Absolutely.  I think it’s one of those things, it’s a lesson I think for probably everybody, it doesn’t – you don’t need to be a claims handler, you don’t need to be an advisor or anybody, anybody in any organisation, you know, if we need, you know, if you need to be able to reach out and get support then really, you know, all organisations should have something there really, just to give everybody a little bit of an outlet if need be.

Vanessa:     Yeah, completely agree.

Kathryn:       Well thank you so much both of you for joining me.  It’s been lovely to have you on.  This is the last of the Mental Health Awareness Week podcasts and tomorrow we’re going to have a webinar, hosted by John Brazier at Cover, where everybody can join in and quiz an advisor, an underwriter and an actuary, about mental health and put forward all those questions that you want to ask us that maybe you don’t always get a chance to ask.  If anybody would like a reminder of the next episode, please do drop a message on social media or visit the website practical-protection.co.uk and as always, please don’t forget that if you’ve listened to this as part of your work, you can claim a CPD certificate on the website too, thanks to our sponsors, Octomembers.  So, thank you Monica, thank you Vanessa.

Vanessa:     You’re very welcome and thank you Kathryn as well.

Monica:       Thank you, thank you Kathryn and thank you Vanessa as well.  Good to see you.

Episode 5 - Claims and Support

Hi everyone, this is the fourth episode of our Mental Health in Life Insurance week. So far this week we have gone through why someone may need or want insurance, how they can get it, the things that lead insurers to make decisions over what can be available to someone, and we are now at the point where everything comes together for the whole point of this: the claim.

In this episode we talk about what happens in terms of support for people living with a mental health condition when they make a claim on insurance, and more importantly the extra support they can access from the policy even if they don’t make a claim. We also talk about how mental health needs to be considered with every claim, as these are times when people are often at their most vulnerable.

The key takeaways:

  1. Insurers now often offer extra support services for people that have policies with them e.g. mental health support lines, access to remote GPs, fitness and nutrition plans.
  2. Mental health causes a large amount of income protection claims and insurers partner with specialist firms to help people that are struggling to work.
  3. Mental health support can be accessed by policyholders but it’s important to be aware that there are times that this service will not be the most appropriate option.

The next episode of the podcast is going to be a bit different. We are hosting a webinar to round off this mental health in life insurance week, and the audio from it will be added as our next episode. I hope that you have found our walkthrough of insurance and mental health useful.

Remember, if you are listening to this as part of your work, you can claim a CPD certificate on our website, thanks to our sponsors Octo Members.

If you want to know more about how to arrange protection insurance, take a look at my Protection Insurance in Practice course here.

Kathryn:       Hi everyone, this is episode five of season five and we’re on our last day of the podcast for our Mental Health Awareness Week and I have Vanessa Sallows with me from Legal & General and Monica Garcia from Monica Garcia Consulting with me.  Hi both of you!

Vanessa:     Hi!

Monica:       Hi Kathryn, hi Vanessa!

Kathryn:       Hi.  Well today, as I say we’re on day four and we are going to be focussing upon mental health and what happens when it comes to making a claim on insurance and kind of like all the mental health touchpoints at that point.  And this is the Practical Protection Podcast.  How are you both doing then?  Let’s start off with a nice little just ‘how are you doing?’

Vanessa:     Yeah, I’m good thank you.  It’s been a busy January already as you would expect in the insurance world.  But yeah, feeling good both physically and psychologically at the moment so it’s a great start to the year.

Kathryn:       Fantastic.

Monica:       Same here, thank you, yeah, it’s the end of January, so it’s that feeling again that, “Oh my gosh, it’s 2022 already and you know, one month is already gone, so yeah, feeling good, but scary it’s going fast!

Kathryn:       Absolutely, absolutely!  I have to say I am very, very grateful it’s the end of January, because I’ve just had a month of role plays and appraisals and everything else, so my calendar has just been meetings, meetings, meetings, so I’ve just said to myself, “Just have a bit of a chillout at the end of January.”  That would be nice, just over the next day or so, just maybe the weekend, I’ll just have a little bit of moment where I just kind of let myself collapse a little bit, which will be very, very nice.  But let’s get straight into things because I know that everybody’s going to want to hear from your points of view, especially after everything we’ve been listening to this week.  So if I start with you Vanessa.  Obviously you have a medical background, as well as a lot of experience of insurance and specifically the claims journey.  So how entwined is mental health with claims?

Vanessa:     The top three causes of income protection claims for both group and retail or individual claims is essentially musculoskeletal, cancer and mental health.  In no particular order, but they actually make up over 70% of income protection claims. Then if you actually look at any underlying psychological consequences, so for any physical condition, cancer being one but also chronic pain, chronic fatigue is another example and chronic pain conditions, there is often a psychological or mental health underlying aspect to those claims as well.  So it is absolutely fundamental and key and within Legal & General we actually have it as a foundation of our wellbeing.  That actually, we all have mental health, it impacts us all in different ways and actually we just need to look after ourselves from that perspective as well.  But that’s why we actually implemented our early intervention and proactive claims management approach is very much founded around the mental wellbeing of everybody.

Kathryn:       I think that’s brilliant and it’s so important.  I mean the things that sort of like stand out for me for that well is the long-term things, so like long Covid, obviously so many of us are hearing about that now.

Vanessa:     Yes.

Kathryn:       You know, people who, people I’ve been speaking to, you know, that spent their life without any health condition at all and suddenly they’ve got something and they’re no longer, you know, this person who is able to go off and do marathons or triathlons and things like that.  So, everything that they had as kind of like as their support structure in some ways, to not have a mental health – sort of like a condition, is suddenly gone and then they’ve got this as well and it’s intense.

Vanessa:     And it is intense and I absolutely agree Kathryn, you know, essentially, we’ve always isolated mental health or physical conditions but actually they are interchangeable, they are part of what we actually are as human beings and help us to become whole.  And to help us actually thrive within the workplace, we actually have to acknowledge that we’ve all got that mental health, we’ve all got the propensity to have mental illness or physical illness at any given point in time.  And I think you’re right, with long Covid and the pandemic we’ve been going through, it’s really highlighted that and brought it to the forefront.

Kathryn:       Absolutely.  I think something that’s stood out for me as well all the time, is something I’ve been saying for a while now, is the fact that you were just saying, you know, we all have mental health, it’s a case of well we do, you know, it’s like being anxious is a very natural, normal response to certain situations.

Vanessa:     Yeah.

Kathryn:       There are times where – and I obviously certain am one of these people, I’ve not been shy about my own mental health, my anxiety – there are times that my anxiety kicks in, when it in a sense it should – I’m going to say shouldn’t do and I know you two can see me doing bunny ears to say ‘shouldn’t do’ and no one else can see that but, you know, there are times that it kicks in, my fight and flight sort of like goes into overdrive and for me it probably happens, as I say, in places it shouldn’t do, but it’s also normal.  It’s going for your driving exam, it’s going on that first date with somebody, anxiety’s quite – it’s there, for us all.  It’s – just is it manageable in some ways, maybe.

Vanessa:     Exactly.  I mean, at the end of the day, it’s just a natural and normal stress reaction to certain amounts of pressure.  Stress in itself isn’t an illness, it’s not a clinical illness, it’s pressure, it’s a normal reaction to those types of situations that we find ourselves in.  It’s life, you know, and I absolutely agree, you know, I’ve had significant mental illness issues within my close family for a number of years.  My husband’s bipolar so, you know, essentially, it’s normal and we need to actually ensure that it is understood as normal within each of our working lives.

Kathryn:       Monica, many insurers now offer mental health services and, you know, support services, especially at the times of claim and even not necessarily just at times of claim, just generally available.  So what kind of mental health support do people potentially need when they are in this kind of situation, where they are needing a claim?

Monica:       Yeah, so I think what we need to bear in mind is that within the income protection industry, we are talking now specifically about the working population, right?  So these are individuals who for any reason, they are perhaps struggling at work to a point that, you know, they become absent.  So the most common reasons really are related to, as Vanessa mentioned, you know, stress, worker stress, the reactive types of depression and anxiety.  Now these conditions luckily have a good prognosis, you know, based on evidence and, you know, people are likely to get well if they receive treatment.  Now here’s the but and you can see my, you know, my inverted commas there, but I think what we struggle with is the fact that, you know, individuals face a postcode lottery via the NHS.  And it may be that some claimants are waiting for a long, long period of time.  And what it means is that the condition perhaps becomes more severe in terms of symptoms and then other successive changes occur as well for these individuals at home, you know, things get more complicated.

So, I mean really, in a succinct answer to your question, the support can vary, you know, the type of counselling, the type of a specific therapy intervention.  But I think what is most important is that it has to be tailored to a specific individual, to their specific circumstances at the time.  And that might be very, very different, you know, it may be that you have developed a mental health condition as a result of bereavement for example.  You know, we’ve seen that during 2020, many people not being able to say goodbye to their loved ones, you know, that’s been really hard.  But of course, you know, there are many other factors as well playing at the same time and, you know, that might mean that some people do actually develop a mental health condition and others don’t.

The other thing as well to bear in mind within our industry is the fact that there are many IP products available out there and that makes a difference in terms of the type of interventions that may be suitable and that are available for people.  So in the case of group income protection, you know, you have more, as Vanessa mentioned, more comprehensive tools, because you are engaging with employers’ schemes and, you know, you have the individuals having access to early intervention resources within the waiting period in the majority of cases, which is fantastic, because the earlier you get the more chances you have of, you know, helping that individual to overcome those symptoms, manage those symptoms and help them to get back to work.  On the individual income protection side of things, you might have products with deferred periods of 12 months for example, so the insurer might not hear about the sickness absence until the person has been off work for a year, so things are a lot more complex in that scenario and I think things are changing in the industry as well, in terms of what type of support can be available for those claimants really.

Vanessa:     But certainly I think that’s a great opportunity for the industry?

Monica:       Yeah.

Vanessa:     From an education perspective?  Because within Legal & General, we treat all income protection claimants exactly the same.  It’s almost irrelevant how the product is distributed.  It all sits under my remit and we provide the same vocational rehabilitation early intervention and support for individuals suffering from mental health, irrespective as to whether it’s a retail or an individual product, or a group product.  So I see that as a really fantastic opportunity for us to educate people to remind them about the products that they’ve purchased.

Kathryn:       Yeah.

Vanessa:     Because again, that’s often what happens on an individual product.  I agree with you Monica, is that essentially individuals forget that they’ve even got the product sometimes.  They’ve bought it a number of years ago, sometimes associated with a mortgage and they just don’t even know they’ve got it until they really need it and so we should be educating them to remind them of all the fantastic benefits that we can actually provide to help them remain in good work.

Monica:       Yeah.  And I think as Vanessa mentions as well, you know, the role of vocational rehabilitation is key and is something that the industry really has moved forward at an incredibly fast pace, you know, in the last five – six years or so.  And that’s important because, you know, if you don’t have IP cover for example, you might be waiting on the NHS, you know, for counselling or psychotherapy or CBT treatment – you might have PMI access insurance, but that doesn’t guarantee that you are actually going to get the specific return to work support you’re going to need.  So it can be that you are able now to manage your depression, your anxiety symptoms but you are actually petrified about returning to the workplace, you know, you have been deconditioned, you are scared.  It can be that your vocational rehabilitation consultant helps you in that transition, you know, to successfully and safely go back to the workplace and working with employers as well, that’s maybe something we can talk about in another podcast, you know, the role of employers, you know, who have to support employees back to work as well.

Kathryn:       Absolutely and I think what was interesting as well, something that we just touched upon then as well is, I kind of think of like the mental health and knock-on effect that it can have from other areas as well.  So not even just income protection, if we think about life insurance, we think about critical illness and life insurance, you’ve got the family facing bereavement or you potentially have someone whose – who knows that they’re facing – they’re going to be passing in the next 12 months if they’ve got a terminal illness, you know.  There’s so much mental health there with the critical illness.  You might have somebody in a sense, grieving their health that they now have lost, if they’ve been in good health.  But I think as well, something that kind of pops into my mind is that we kind of probably think of this as like either that someone’s had mental health and then, you know, this is kind of resulting in a claim or maybe there’s been something quite significant like cancer where we kind of automatically think, “Oh yeah, you know, there’s going to need to be probably some mental health support there.”

Then I was just thinking about what happens if you’ve got someone – I’ve just gone off back to the triathlon person I was mentioning. What happens if you’ve got someone there who’s got a, you know, they’ve broken their leg and they’re suddenly facing that they don’t have – they’re not going to be and it’s been an – let’s say its been a not nice break and, you know, they’re not going to be able to do what they did before and that was kind of their stress relief, you know, and everything was about – they identified as this running man in a sense.  I imagine, you know, some people with a broken leg you’d be a case of, “Well they maybe don’t need mental health support,” not assuming that but, you know, they maybe wouldn’t do – some people?  But then there could be others that they really need it, so I imagine it’s very complex trying to establish all of that kind of vision of what that individual person needs.

Vanessa:     Exactly.  And that’s where I referred to the underlying psychological overlay previously.  It’s there absolutely and it is what we actually utilise – is we’ve got our own vocational clinical specialists, as Monica has actually alluded to.  So we will actually carry out what we call a triage interview with every individual to actually ascertain what their needs are.  Part of that is very much going through some psychometric testing as well.  These are all clinicians.  We’ve got a multidisciplinary team and that is the best approach.  That is the approach as recommended by NICE.  It’s also the same approach as we’re using for the long Covid support programmes and indeed the NHS and NICE have made those recommendations in exactly the same way.  So we’ll use clinicians, occupational health advisors, occupational health physicians, OT’s, physiotherapists and nurses with varying degrees of experience and expertise in mental health, cancer, musculoskeletal – all the different disciplines, so that we can actually carry out an initial in-depth assessment of that individual to actually identify what their complex needs are and then actually identify the right care pathway – what support they need, using that stepped care approach.

Monica:       Yeah.  I think I agree with Vanessa and I think the important thing is that what I’ve seen in the industry, you know, in the last few years, is that they have really adopted this biopsychosocial model of health approach.  So, you know, we see in healthcare settings that you need to understand the process of health and illness from a biological, psychological and social perspective, so I think adopting a holistic approach of the assessment of that particular case will enable you, you know, to understand what is it that is, you know, preventing that person, you know, from recovering and from returning to work?  So it can be a broken leg, it can be a broken arm, it can be anything but we must not undermine, you know, the mental health aspects and how that person is coping or not coping really.

Kathryn:       Absolutely.  So Vanessa, so something else that I sort of like wanted to quickly touch upon before we go onto the next bit –

Vanessa:     Yes!

Kathryn:       So there’s obviously a lot of insurers now do what’s known as the value added support services.  So this is where a claim isn’t necessarily being made, it’s something that people can access throughout the time of the policy and we’ll have people listening who sort of like know about this, don’t know about it and obviously a lot of them do include mental health support services in there.  But I’m just wondering if you could be – sort of like help us sort of like and the listeners to understand sort of like do those – there are times I think isn’t there, where they’re sort of like – those mental health support services, I think they’re sort of like – they’re there as sort of like as an initial kind of support but then there does come a point where it would maybe be that somebody does need to probably go and speak to maybe a GP or somebody else – maybe a charity or something.

Vanessa:     Yes.

Kathryn:       So how does that kind of work?

Vanessa:     Absolutely.  So, you know, under the step – under the NICE guidelines, under the stepped care approach, there are actually five different steps.  You’ve got the very early stages, step one and two, whereby individuals are just beginning to struggle, they’re feeling unhappy and that’s where you might use your mindfulness app or some other tools and there are thousands and thousands of apps out there and available to individuals.  And then you come into where you might need an EAP – an employee assistance programme or access to some of the counselling support and then finally onto the psychological interventions such as CBT that Monica has already alluded to – cognitive behavioural therapy – you’ve got other forms of talking therapies.  And they are used often in conjunction with medication but sometimes on their own because NICE recommendations is initially for just that to be used in the first instance.

Now, of course, there are some severe cases whereby those types of talking therapies aren’t appropriate until an individual is clearly stabilised.  So for instance, if an individual is really struggling, has suicidal thoughts, then they should be talking to a specialist charity or primarily their GP.  That’s really important and I can’t emphasise that enough that, you know, we want to stop suicide, it’s tragic, it’s absolutely tragic and what we want to do is get people with the right support in the first instance.  So talk to your GP.  Talk to your friends and colleagues.  If you’re in the workplace, reach out to mental health first aiders.  There’s plenty of charities such as MIND, Rethink Mental Health, Mind Canyon – there’s so many charities out there that essentially people can access in the first instance to talk to somebody.  Insurers aren’t the NHS and we’re not PMI providers under the health benefits, so we can’t actually put in place medication or recommend medication.  We can provide all the other support services but it is really important individuals access their primary carer in the first instance.

Kathryn:       Absolutely.  Because I was going to say, I – obviously I speak to a lot of people that are living with mental health and one of the things that I’ll be saying to them is, “Oh, we’re going to go to this insurer, they offer these things as extras,” and then I have to obviously be careful as well, because it’s a case of –

Vanessa:     Yes.

Kathryn:       It might be that they have a mental health, you know, condition, that I’m speaking to them about, where actually, maybe the mental health support line through the insurer, through that sort of extra support service, isn’t going to be necessarily the best route.

Vanessa:     Yes.

Kathryn:       Or to at least make them aware to say, “Look, you can access this, but I’m not completely sure how much they’re going to be able to do, because obviously you’ve got this support here, obviously you’ve been speaking to your GP –” hopefully obviously most of the time somebody has spoken to their GP.  So I think that’s good you know, rather than sort of, I’m sort of thinking from an advisor point of view it’s really important to say –

Vanessa:     Yes.

Kathryn:       Advisors don’t think, “Ooh, this person’s got a mental health condition, ooh there’s mental health support here, I’ll just signpost them there,” and actually go, “Well actually, that might be an okay route, but depending upon the situation, it may be that, you know, there is other things that we need to do as well.”

Monica:       Yeah.

Kathryn:       Because the last thing we want to do is someone to come to us for us help, for us to say, “We’re going to help you and by the way there’s this is extra support here,” for them to then go to that and then it’s not right for them.

Monica:       Yeah.

Vanessa:     Exactly.  Absolutely.  You know, within the UK, we have an amazing primary care system.  I know it’s been struggling phenomenally throughout the pandemic but ultimately the first point of contact should always be an individual’s GP or the local mental health services for an individual.  And the GP will then help to signpost that individual if they need further psychiatric input from a consultant psychiatrist, via secondary care, via the NHS or if an individual has PMI.

Monica:       Yeah and I think Kathryn, what you’ll also find is that many income protection claimants find that their insurer for example will liaise with their GP and will say, you know, “We have finished our vocational rehab course or our CBT course and, you know, we are sort of returning the care back to you.”  Because it may be that in some conditions, they will require long-term care and as I say, some medication or access to a psychotherapist, where it’s important that that care is monitored by their GP, as Vanessa mentions.

Monica:       Yeah and that’s a really great point Monica, because even if we are providing the CBT or the psychological intervention – because often it’s quicker to get that via your insurer than it is via the postcode lottery that you referred to earlier, essentially we will always be liaising with the GP as the primary carer.  You know, our case managers, both from a claims perspective but also from a vocational rehabilitation perspective, are linking in with the GP and if there’s a consultant psychiatrist or psychologist involved, they’ll be sharing evidence, of course with the individual’s consent, because we make sure we get the full informed consent from outset and we ensure that they’re aware that we’re going to be sharing this information, because it’s in their best interests that we’ve got a fully holistic process for them, so that everybody has the same focus to help them get better.

Monica:       Yeah.

Kathryn:       Absolutely.  Monica, I think, you know, obviously we’ve said before, you know, that mental health accounts for so much of the income protection claims in the UK and, you know, it isn’t something to think of as, you know, that it’s unusual for people to be having mental health, you know, difficulties let’s say or maybe flare ups of some sort.  You know, it can happen to anybody.  You know, Alan has been very open recently how last year, you know, he’s – Alan is so laid back, he’s complete opposite of me, incredibly laid back.  He’s one of those people though that every now and then, he’ll sort of like – he’ll build up lots of stuff and suddenly go “Urgh,” but he’s usually fine, he does that ‘urgh’ thing and then he goes back to normal resets.  And I just talk constantly about everything that’s kind of going on in my head.  And last March – April time so, you know, a good year into the lockdown, he suddenly really, really struggled.

You know, he’s 37, he’s never had anything mental health-wise, you know, he’s obviously he’s been – well he’s seen me obviously for many years with my mental health and, you know, has always been very distinct, you know, he’s kind of like so different, in like in the case of, you know, I’ll see something and my mental health will flare up, but he’s just kind of like, “Yeah, whatever.”  You know, like not, “Yeah whatever,” to me but, you know, sort of like, if it was him facing that, it just completely glides over him and all of a sudden everything was just suddenly there and on top and he just couldn’t see a way out.  You know, he’s kind of like that whole thing of you trying to like swim through the darkness kind of thing and he just couldn’t get out of it.  And I think what’s really important and obviously we’ve had so many people talk about their mental health in the last few years, especially in our industry and I think we’re seeing it across society as well to just try and say to each other, “This is okay, you know, it’s not a shameful thing.”

Vanessa:     Yeah.

Kathryn:       And Monica, I was just wondering how important is it that people really take their mental health seriously and engage with – say like the mental health services that are generally available in society but also those things that are available through insurers just to try and – I don’t know, keep themselves okay?

Monica:       Yeah, absolutely, you’re absolutely right.  I think – I mean one of the – if I could say a positive thing out of this whole pandemic scenario is that we’ve all seen that we can be vulnerable, you know?  I think somehow we think that, “Oh yes, we can go by on our day-to-day basis,” but actually, you know, things have been tough.  I think we’ve all been affected, you know, by Covid in one way or another.  But I think particularly during the initial lockdowns and lockdown one, two and three, you know, as they happened, from a research and evidence perspective, what’s happened is that people were suddenly cut off of usual sources of social and emotional support.  And that’s a key buffer actually of the stress.  So, you know, it can be that, you know, before lockdowns you will go to the pub to see your mates and just talk about things or watch a football game, you know, so things were stopped, you know?  So that’s on a kind of daily basis but then, you know, you can start feeling overwhelmed if things are not going well or if you have experienced a bereavement within the family.  So it could be all, you know, all sorts of things that can happen to people.

But I think what we’ve seen in the pandemic is that vulnerable groups have been particularly affected, because access to community support rehabilitation services for example were suspended, you know, so that’s been really, really difficult for them.  And I think for the rest of the population it has been the fact that actually, you know, probably the first time as you say, as in the case of Alan, you know, people are experiencing those symptoms.  But I think what is important is that we need to be able to recognise those early signs and symptoms and it can be completely different for each individual.  So for example, if you like eating, suddenly you might not eat at all, you know, or if – or the other way around.  So it’s very difficult to generalise and to say what symptoms you should look at, you know, apart from I guess, disturbed sleeping and that sort of thing, you know, for depression and anxiety.  But it’s a very, very individual aspect, you know?  You see some people struggle with back problems for example, musculoskeletal pain or tummy problems, you know and they say, “What’s going on?”  You know, and they don’t realise that actually, “I’m feeling overwhelmed, I’m feeling stressed.”

Something else as well that we’re seeing – I mean, that was the first phase I guess, you know, during the pandemic lockdowns.  But now that we went back to work is the issue around hybrid work.  So I think from an insurance perspective, we’re going to see many cases potentially where, you know, people are struggling to deal with this hybrid model, you know, where depending on the occupation, you know, dealing with technology fatigue, isolation because, you know, remote work doesn’t work for everyone.  So I think a lot of employers are struggling in terms of what support can be available for them, you know, to manage those remote things.  So it’s going to be – I guess an opportunity, you know, for the industry as well, you know, particularly from a group income protection side of things and Vanessa can tell you more in terms of those early intervention and prevention strategies that can be put in place for them.

But I think we shouldn’t forget, I guess, about the positive things and opportunities.  I mean, one of the things I’m doing now with my work is – and I really enjoy – is working again directly with claimants – income protection claimants and people with mental health conditions and cases that are classified as complex, you know, people who are out of work for a long period of time and I’ve seen cases where actually remote work wasn’t available for them before and it wasn’t an option and now they’re able to go back to work, you know, on a remote basis, without struggling with travel anxiety and, you know, feeling under pressure to be with colleagues that, you know, perhaps they don’t want to talk about their mental health in terms – you know, because I think we can park that again for another podcast around the stigma which, you know, things are moving forward but I think that there is still a huge stigma.  I see employers really not knowing how to speak to employees after a mental health condition – not knowing how to support them in the workplace.

Kathryn:       Yeah.  No, of course.  I was going to say, it is hard, it’s really hard as an employer.  I mean obviously we do – we have a lot that’s, you know, available.  We do a lot, you know.  We obviously, well, there’s so many of us that are there to chat, we’ve got mental health first aiders and, you know, but again it’s that whole thing of, you know, everybody’s individual, so it’s quite hard to know exactly what to do with everybody and that you need to make sure that – you have to have that culture I think, from the start as well, of approachability and –

Vanessa:     Absolutely.

Kathryn:       You know, people – that there’s no stigma, there’s nothing that’s going to say, “Well actually, you know, if you need to do a four-day week, you know, then in a sense, wherever possible, then that’s fine,” you know, in a sense and actually that person probably is going to be so much more productive, so much more – and so much happier that, you know, it’s going to work out best for everybody involved.  But I think an important thing as well to sort of move us towards and it’s coming towards the end of the session today, because obviously we’re talking about obviously mental health for somebody who’s a claimant, maybe mental health for somebody who’s, you know, there’s obviously people who are supporting claimants, you know, in a sense, family members and obviously as well, they also have their mental health.  But I think sometimes what we can potentially forget a bit about and it is an area that I think about quite a bit, because I often think about my team when they’re listening to stories about mental health and how I, obviously – we make sure we’ve got support structures there for them, but I think Vanessa obviously, you’ll see it so much in your team with your claims handlers, how much that kind of an emotional situation – how involved it can be in terms of listening to someone’s story or potentially if a claim doesn’t get paid.  I know that doesn’t happen much, but it can happen and that must be a huge emotional toll for your team.

Vanessa:     It is and I’m really pleased you’ve actually raised that Kathryn because it’s often the forgotten when we’re talking about mental health but, you know, it’s really important that we safeguard and protect all of our claims handlers.  We provide the right support, all of our line managers are trained in counselling as well as coaching to help support their actual teams.  And of course we’re very lucky within Legal & General, we have our own clinical team, so again we ensure that there is that ability to debrief and talk to colleagues about the cases they’ve actually discussed.  And we even do that, you know, virtually.  It’s been key that we’ve continued this approach through the pandemic.  What we’ve also done – I mean, you know, sadly we have seen an exponential increase in death claims so sadly, also income protection and in the first year there was a reduction in critical illness claims but now we’re seeing an increase through 2021 sadly.  And it’s been really important that we’ve actually provided counselling and support.

So what we’ve done is had Samaritans sessions with all of our claims handlers.  We’ve also provided counselling sessions, both individually but on a group basis to help support them so that they feel that they can actually talk to somebody.  It’s really important that we actually operate an open, honest, transparent and trusting working environment.  I think that, you know, whatever you’re doing, it’s so important that we actually provide that environment so people feel free that they’re able to talk to colleagues but talk to their line managers and tell us when they’re struggling.  We’ve also carried out lots of surveys and it’s “How are you doing?” surveys what we’ve been doing within our own claims team and it’s just done on a monthly basis and they can give a thumbs up or a thumbs down, or a smile, or a frown and it’s just to give us an indication so that we can then initiate that conversation.  If they don’t want to initiate it, then myself or one of the team managers or the senior managers within the area can actually then initiate that conversation and say, “How are you?”

I’ve also been doing coffee and chats every month – I’ve had coffee and chats with all of my people on an individual basis and in groups just to give them the opportunity to talk about – it’s an open, free agenda.  It can be work or it can be home or it can be anything that they want to talk about.  So it’s really important that we’ve actually provided all of that support to the claims handlers because ultimately they are dealing with very vulnerable individuals in their hour of need.  And they can only deliver the service that our customers deserve if they are fully supported.

Vanessa:     Absolutely.  And I think claims handlers are actually the face of insurers, you know?  They’re that first port of contact, you know, in terms of their claim, but I’ve seen cases where, you know, claims handlers have been in tears, you know, after the assessment of a claim because some stories are absolutely heart-breaking and we’re all human beings, you know?  So I’m very pleased to hear Vanessa that you have, you know, those mechanisms in place for your claim handlers and I shall hope that, you know, all insurers will have similar approaches really.

Kathryn:       I would think so as well.  But I think it’s very much a point, I think claims handlers are very much – I imagine an empathetic-type person.

Vanessa:     Yeah.

Monica:       Yeah.

Kathryn:       So obviously, usually in that role.  So that is something that is going to absorb into them, those stories and then it’s going to feed into probably the feelings of, “What’s that going to mean to that family member and that family member?” and it’s so much the process.  But I think, you know, from what you were saying Vanessa as well, it’s like, I mean we have like obviously similar things in place for our teams.  Again, we hear obviously things that have happened to people that aren’t particularly easy to hear and, you know, it’s a number of different things, I’ve spoke about different places, we’ve got like certain SOS systems if we’re really worried about people, you know, whether or not that’s, you know an employee who needs to notify us of something about themself or about, you know, potentially someone we’re speaking to.  But I do think, you know, it’s just something you said then, I don’t think there’s much that can really beat a cuppa and a biscuit as well.

Vanessa:     Exactly.

Monica:       Yes!

Kathryn:       Just, you know, just a nice gentle hand on the shoulder.  I know with Covid, so we’re not all together yet but, you know, before Covid times, you know, it would be a case of you can maybe hear someone on the phone and you’d go up and you’d just tap them on the shoulder, very lightly touching their shoulder and you’d just be like, do the symbol for cuppa to them and then it would just be 10 or 15 minutes, you know, away from everybody, maybe longer, you know, there was times, you know, that we actually said to somebody, you know, at times, “Right, just clock-off for the day, just go, just process.”  And obviously, as long as they were happy with that, if they needed to stay to kind of not face things, in a sense the, you know, that’s also – you do what each person needs, but yeah, the power of a cuppa and a chat is a good thing.

Vanessa:     Yes.  And I agree, you know, we used to do that as you say, when you’re actually in the environment, in an office environment, you could hear the conversations.  You know, we sat – I sat right in amongst all of my people so I could hear and see what was going on.  You couldn’t do that virtually, so we just had a little symbol or something, that they needed a quick cuppa or a quick chat outside the formality as well.  Just so they felt that they could contact somebody, because the worst thing in the world is for them to feel isolated as well –

Monica:       Yes.

Vanessa:     Having dealt with a really tragic claim and having to speak to the bereaved but also to individuals that are struggling with their own mental health or any form of claim.

Monica:       Yeah.

Kathryn:       Absolutely.  I think it’s one of those things, it’s a lesson I think for probably everybody, it doesn’t – you don’t need to be a claims handler, you don’t need to be an advisor or anybody, anybody in any organisation, you know, if we need, you know, if you need to be able to reach out and get support then really, you know, all organisations should have something there really, just to give everybody a little bit of an outlet if need be.

Vanessa:     Yeah, completely agree.

Kathryn:       Well thank you so much both of you for joining me.  It’s been lovely to have you on.  This is the last of the Mental Health Awareness Week podcasts and tomorrow we’re going to have a webinar, hosted by John Brazier at Cover, where everybody can join in and quiz an advisor, an underwriter and an actuary, about mental health and put forward all those questions that you want to ask us that maybe you don’t always get a chance to ask.  If anybody would like a reminder of the next episode, please do drop a message on social media or visit the website practical-protection.co.uk and as always, please don’t forget that if you’ve listened to this as part of your work, you can claim a CPD certificate on the website too, thanks to our sponsors, Octomembers.  So, thank you Monica, thank you Vanessa.

Vanessa:     You’re very welcome and thank you Kathryn as well.

Monica:       Thank you, thank you Kathryn and thank you Vanessa as well.  Good to see you.