What You Should Know About Mental and Behavioral Health and Their effect on Life Insurance

What You Should Know About Mental and Behavioral Health and Their Effect on Life Insurance

Mental Illness Awareness Week takes place the first week of October each year.  Participants across the United States dedicate this time towards fighting social stigma, providing support, educating the public, and advocating for equal care.  Take a look at these facts from the World Health Organization:

  • More than 300 million people of all ages suffer from depression worldwide.
  • Around 20% of the world’s children and adolescents have mental disorders or problems.
  • It is estimated that 1 in 4 of all patients who visit a health service provider have some form of mental, neurological, or behavioral disorder.
  • Mental and substance use disorders are the leading cause of disability worldwide.
  • War and disasters have a large impact on mental health and psychosocial wellbeing.
  • Close to 800,000 people die due to suicide every year.
  • 90% of those who die by suicide have an underlying mental illness.
  • Even though there are known effective treatments, less than 10 percent of people with a mental or behavioral disorder receive treatment due to social stigma and lack of understanding.

What is mental health?

The World Health Organization defines mental health as a state of wellbeing in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community.

What is behavioral health?

Behavioral health is an umbrella term that refers to your overall wellbeing and how it is impacted by your behaviors.  While behavioral health and mental health tend to overlap, and many organizations substitute one term for the other, distinct differences do exist between the two.  And while some mental health issues may be impacted by behavior, many mental health disorders have neurological or biological causes, meaning that simply changing a person’s behavior may not cure them of that illness.

What constitutes a mental or behavioral disorder?

Someone with a mental or behavioral disorder is generally characterized by displaying some combination of atypical thoughts, emotions, behavior, and relationships with others and/or having an atypical reaction to certain events.

These disorders can usually be described as affective or organic.  Like it sounds, an affective disorder, also referred to as a mood disorder, affects the way a person behaves, such as bipolar disorder.  An organic disorder is due to a medical or physical disease, such as dementia.

The Main Classes of Mental Illness
  • Neurodevelopmental disorders
  • Schizophrenia spectrum and other psychotic disorders
  • Bipolar and related disorders
  • Depressive disorders
  • Anxiety disorders
  • Obsessive-compulsive and related disorders
  • Trauma- and stressor-related disorders
  • Dissociative disorders
  • Somatic symptom and related disorders
  • Feeding and eating disorders
  • Elimination disorders
  • Sleep-wake disorders
  • Sexual dysfunctions
  • Gender dysphoria
  • Disruptive, impulse-control and conduct disorders
  • Substance-related and addictive disorders
  • Neurocognitive disorders
  • Personality disorders
  • Paraphilic disorders

Diagnosing and Classifying Mental and Behavioral Disorders

The classification and diagnosis of mental and behavioral disorders is challenging because individuals are commonly affected in different ways.  According to the Mayo Clinic, to determine a diagnosis, you may undergo:

  • A physical exam
  • Lab tests
  • A psychological evaluation

Health care providers mainly use the Diagnostic and Statistical Manual of Mental Disorders to assist in diagnoses.  Unfortunately, many individuals go undiagnosed and untreated.  Stigma, shame, embarrassment, and poverty can all play a role in the decision to not seek treatment.  According to the National Alliance on Mental Illness, despite effective treatment, there are long delays – sometimes decades – between the first appearance of mental illness symptoms and when people get help.

Mental and behavioral illness can manifest themselves in common physical symptoms such as headache, fatigue, chest pain, palpitations, difficulty breathing, gastrointestinal complaints, or muscle, joint, and back pains.  Substance abuse, marital strife, a poor work record, or financial trouble may also be masking an underlying disorder.

Mental and Behavioral Disorders and Life Insurance

There are many different types of mental and behavioral disorders and each are underwritten independently.  Someone with a history of anorexia is not going to be underwritten the same as someone with dementia.  These are two very different diagnoses with different treatment plans and have different levels of insurance risk.

Life insurance companies also have to consider that the same disorder may impact individuals differently.  Two people diagnosed with post-traumatic stress disorder may have very different symptoms and lead opposite lives.  So, not only do underwriters have to evaluate the disorders independently, but also on a case-by-case basis.

For applicants with a history of a mental or behavioral disorder, underwriters have many factors to consider and evaluate:

  1. The applicant’s physical and mental health
  2. The applicant’s job and employment history
  3. The applicant’s social activities and family dynamics
  4. Whether there is evidence of substance abuse (particularly alcohol)
  5. If there is any history of suicide attempts
  6. If applicant has any chronic medical conditions (such as heart disease)
  7. The severity and duration of the applicant’s diagnosis
  8. The applicant’s treatment history

Life insurance underwriters determine whether or not you will be approved for life insurance and which risk class you belong in.  The better your risk class, the lower your premiums will cost.

Characteristics Underwriters Assess to Determine Risk Class
Favorable CharacteristicsUnfavorable Characteristics
Stable environment and occupationNo overt marital or family disharmony

No criticism of habits

Good insight into condition

No underlying physical condition

Good family history

Long duration since diagnosis

Stable personality

Good social network and support

Occupational instability

Work-related pressures/stresses

Marital and/or family disturbance

Alcohol/drug misuse

Poor insight into condition

Poor physical health

Family history of mental disorders

Recently diagnosed

Behavior disturbance

Financial difficulties

The more unfavorable characteristics you have, the higher the risk to insure you.  Depending on your diagnosis and how severe it is, you could qualify for the best risk class (typically referred to as Preferred Plus) or be table rated.

Being table rated means your level of risk is outside the norm and in order for the life insurance carrier to accept you, you have to pay extra to cushion the risk.  If table rated, your life insurance will typically cost the Standard price plus 25% for every step down the table you are.  Take a look at the table below to get an idea of how risk class affects what you pay for life insurance coverage.

The Average Monthly Cost of a 20-Year Term Policy
for a 30-Year-Old Male Based on Risk Class
Preferred Plus$16
Standard Plus$24
Table A$35
Table B$42
Table C$49
Table D$56
Table E$63
Table F$70
Table G$77

To get a more in-depth understanding of risk class and table ratings, take a look at these blog posts:
What Is a “Risk Class” and How Does it Affect Me?
What Are Table Ratings? What Do They Mean?

No two life insurance companies underwrite the exact same way.  For example, let’s say the 30-year-old male in the sample table above has been diagnosed with bipolar disorder, but it’s well managed.  Insurance Company ABC may only offer him Table C, which means he’d be paying $49 per month for coverage.  Meanwhile, Insurance Company XYZ would offer him Standard – which would cost him only $28 per month for the same coverage.

Quotacy is an independent agency.  This means that we work with multiple life insurance companies – not just one.  If you have been diagnosed with a mental or behavioral disorder, having more company options increases your chances of being approved for life insurance coverage at a fair price.

Most mental illnesses don’t improve on their own, and if untreated, a mental illness may get worse over time and cause serious problems.  Don’t be afraid to seek help.  61,500,000 Americans experience a mental health disorder in a given year – you are not alone.  National Depression Screening Day is on October 5th and you can get a free mental health screening at HelpYourselfHelpOthers.org.


Photo credit to: Elisabetta Foco

Quotacy.com Insurance Blog/Natasha Cornelius