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Health-based risk neutralization in private disability insurance
Elisabeth C Wijnvoord1,2,3, Jan Buitenhuis4,3,5, Sandra Brouwer4
1Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, Groningen, Netherlands e.c.wijnvoord@umcg.nl.
European Journal of Public Health
|July 3, 2016
Summary
Individuals with exclusions in their insurance policies face a higher risk of sickness absence (SA) and more SA days. This study examined the impact of these exclusions on the risk of SA for insured self-employed persons.
Area of Science:
- Occupational health
- Insurance medicine
- Health economics
Background:
- Insurers use exclusions to manage elevated sickness absence (SA) risks.
- Medical risk differentiation may conflict with anti-discrimination principles, such as the UN Convention on the Rights of Persons with Disabilities (2006).
Purpose of the Study:
- To determine if individuals with insurance contract exclusions have a different risk of SA compared to those without exclusions.
- To investigate the association between insurance exclusions and the incidence and recurrence of sickness absence.
Main Methods:
- A dynamic cohort study of 15,632 self-employed individuals seeking private disability insurance in the Netherlands.
- Follow-up averaged 8.94 years, with sickness absence (SA) duration and frequency analyzed from insurance data.
Main Results:
- Self-employed individuals with an insurance exclusion experienced a higher hazard of one or more SA periods.
- Those with exclusions also had, on average, more SA days than individuals without exclusions.
Conclusions:
- Individuals with insurance exclusions exhibit a significantly higher risk of sickness absence (SA).
- The societal implications of risk-based exclusions, considering health inequality and solidarity, require further consideration.
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