Sorry, I was ambiguous. I meant that it is now increasingly possible (not definite or even clear how likely) that an insurer will rapidly pull back from pushing BPS rubbish or stop telling you to get exercise eventually. Some will still push you towards Vitality 360 or other quackery, or look for it on medical records for the purposes of claim management.
It's an evolving mixture of awareness and opportunism, governed by how enlightened an insurer's own self-interest is. Their advisors and claims management nurses are medical professionals and not scientific professionals, hence captives of the ME specific digression medicine has take away from science.
What are the variables that determine the insurer's approach?
- Ostensibly, NICE guidance was the legal cover for pushing in the UK. But given that recentish NICE clarification that patient choice exists and that the clarification came in the context of the NICE review, pushing 2007 guidance hard against someone's will is problematic. This pro-pwme point was always legally makeable, just simpler now and the implications more immediate.
- The medics involved and on the beneficiary's medical records. Some are more likely to be medics an insurer would prefer not to mess with in a legal setting, in extremis. This is also important to avoid public precedent.....
- How clearly the patient is aware of the science Vs medical norms. And how legally informed they appear - this in particular is a 'smell test'. The implications are similar to pt 2
- To what extent a specific insurer has internal momentum/careers that still negatively influence trajectory Vs ME.
These are all in the context of each other, and
don't actually paint a rosy picture, as they assume a lot... Most people will not line up that well on the middle two points until later in their illness, if ever. It's just a different version of nasty, with some glimmers of hope being injected in by context.
Bear in mind I'm referring to the claim management stage. Determining actual cover is at the application stage and is policy applicant/holder specific.
- If the applicant and policy holder is the beneficiary, it is individually underwritten for a person or persons.
- If the policy holder is an employer, it is underwritten for a group, a statistical sample, and not individually.
It also depends which policy. It many countries to exclude ME explicitly from some form of disability insurance would likely be unlawfully discriminatory. But critical illness insurance, for example, is largely based on inclusions with exceptions instead. And ME is very specifically not included normally.
Apologies for typos and logic burps. I can correct if anyone sees something weird
