Long COVID and life insurance – A global perspective

With surging cases of the COVID-19 Omicron variant, Australian insurers are likely to see more Long COVID claims in the future. What can we learn from overseas markets about how to help clients with COVID fatigue?

For most of the first two years of the COVID pandemic, Australia’s border and lockdown restrictions saw it maintain relatively low case numbers. However, a recent surge in cases of the ultra-transmissible Omicron variant has now seen more than 500,000 cases occur in NSW alone since the start of the COVID outbreak.

When it comes to dealing with COVID claims and potential Long COVID claims, Australian life insurers can learn from the experience of offshore insurers.

According to research from the Swiss Re Institute collected from studies in the UK and China, around 5 to 10 per cent of those infected with COVID will carry symptoms three months after initial infection, while three quarters of those hospitalised with COVID report symptoms six months after they were first infected.

In a 2021 Swiss Re podcast, the reinsurer’s claims service manager for Australia and New Zealand, Lucy Hartley, described four key types of ongoing COVID symptoms:

1. Post-viral fatigue syndrome;
2. Permanent damage to the lungs and heart;
3. Intensive care syndrome for those hospitalised and in ICU; and
4. Mental health symptoms such as depression and anxiety as a result of contracting the virus.

“These ongoing symptoms have a health impact on hospital systems, and secondly there’s an economic impact because people aren’t returning to work as quickly as anticipated, which is something that significantly impacts us working in claims,” Ms Hartley said.

The economic impact of Long COVID is particularly significant for income protection insurers, as Long COVID sufferers are likely to spend some time on claim and require more rehabilitation and retraining support.

According to Swiss Re data, approximately 1 in 4 patients in UK COVID clinics are not expected to ever return to work, while 1 to 5% of all severe COVID patients will develop a long-term disability.

UK-based psychologist and insurance consultant Monica Garcia, who also contributed to the Long COVID podcast, said accessing accurate medical information for claimants was another challenge for UK insurers facing increasing numbers of Long COVID-related income protection claims.

“There are a couple of common themes we have seen with various insurers - when they are assessing new claims they have experienced delays in obtaining medical evidence because of the stress on the [UK] NHS, there’s the length [of time] in accessing treatment and diagnostic services which has an impact on the insurance sector,” Ms Garcia said.

“We know that several COVID clinics have been set up but unfortunately availability is scarce and we anticipate rapid access to care depends on local availability - we’re not reliant on that and we don’t think all of our IP customers will have adequate access.”

Ms Garcia noted that UK insurers were quick to put in place early intervention programs for those on claim with Long COVID, citing a case study of a “common Long COVID scenario” where a local insurer’s rehabilitation support had helped a sufferer that was struggling to return to work.

“Our rehabilitation provider who provide support for CFS (chronic fatigue syndrome) and fatigue management helped a 48 year old female back to work recently [who] became unwell with COVID in March 2020,” Ms Garcia explained.

“She works as a manager in the finance sector and she managed to go back to work in April even though she was experiencing shortness of breath, but she couldn’t cope with it and she crashed. She tried to go back again in June and again couldn’t manage, so in November the insurer put in place rehab support for her - in addition to physical symptoms she was experiencing anxiety in relation to returning to work, because they lose confidence when they have many failed attempts.

“She underwent rehab sessions to normalize her breathing, increase lung capacity and manage the fatigue gradually so she could build that stamina back in a controlled setting and she received psychological support for her anxiety. She went back to work in December in a reduced capacity with a provider working in occupational health and she’s still at work.”

Given the challenges faced by Long COVID patients, Ms Hartley said it was important for insurers to take a holistic approach to tailoring support for those on claim as more cases of Long COVID emerged locally.

“There’s a few things we can think about with these claims – firstly to complete a robust assessment, clarifying the diagnosis and making sure it’s not being confused for other co-morbid conditions, and undertaking a holistic assessment so we’re looking at those bio-psycho-social factors that might be impacting recovery,” Ms Hartley said.

“Also thinking about our rehab toolkit and what’s in there that might be able to support some of the problems people are having, whether that’s to support sleep hygiene or graded exercise, pacing and return to work support as well.”

Gerard Kerr
General Manager, Life Insurance