Articles

The Spark of Human Connection:
Benefits of an Interview by an Underwriter for Depression and Anxiety Cases

By Lincoln Tedeschi, President, IBU, Inc.

Determining the mortality risk for cases involving depression and anxiety has evolved significantly over the past few decades. With the availability of new medications for mental health disorders, a growing social acceptance, and an increased prevalence of diagnosed cases, underwriters are faced with more and more cases involving conditions that in the past were considered substandard risks.

Today, underwriting “triggers” such as being on a prescribed medication no longer provide definitive guidance. For example, an applicant who discloses that they take Paxil may or may not represent a significant mortality risk. Often, Attending Physician Statements (APS’s) that simply confirm the medication do not provide any additional insight about the individual’s history. This presents a real challenge for underwriters to determine proper risk classification.

For a variety of reasons APS’s from mental health professionals often don’t provide information that aids underwriting departments in separating the good risks from the bad. The underwriting value of these APS’s, therefore, is not the same as APS’s requested for other types impairments not related to mental health. Very often, the information in the mental health APS is not sufficient because much of what patients talk about with their psychiatrist is discussion therapy and not documented in the medical record. As a result, what is often reflected on the chart is that the patient is doing well and taking medication. But “doing well” doesn’t provide underwriters with the information needed to properly classify the risk.

For their part, applicants typically don't volunteer much information about their mental health condition on the initial application either. Agents generally don’t want to probe too deeply, or they may know the applicant. In these instances, the applicant is unlikely to divulge sensitive information about him or herself.

Telephone interviews by experienced underwriters are proving to be a valuable solution to this challenge. When an underwriter conducts an interview with an applicant, the focus is on obtaining the specific details necessary to take final action. In cases involving depression and anxiety that means asking the right questions to determine the root cause and extent of the problem.

Experienced underwriters’ knowledge about health-related matters and conversational tone creates a sense of trust with applicants, which encourages them to open up. While conventional wisdom is that people won’t talk to strangers on the telephone about very private matters such as their state of mental health, insurers are finding that interviews by underwriters for cases involving depression and anxiety offer significantly better information than the APS’s obtained from mental health professionals.