Burnout requires a joint approach by insurers and employers

Although the number of cases of burnout is growing exponentially, you cannot automatically assume insurance contracts will pay out. Thus, employers who want to make good provisions, need to adopt a proactive approach as well as taking out insurance.

Burnout requires a joint approach by insurers and employers

In the past, it was back complaints that were the greatest cause of long-term work incapacity, but now it is psycho-social disorders. In the last few years, the proportion of psychological ailments that account for sick benefits has risen to 35%. Along with the results of an aging population, they are the most important cause of long-term illnesses in our country. Is this an illness of our time? Burnout. From a recent survey, at least half of the Flemish population worry about falling victim to burnout in the long or short term.

Catch-all term

This encroaching ailment is also causing problems on the work floor. How can companies best protect themselves against burnout?

Many employers have taken out collective insurance to guarantee income for their employees. But not all insurance policies cover burnout. Anyone who reads their policy details carefully, will find that “subjective disorders or psychological disorders that cannot be objectively discerned” are excluded. To substantiate objectivity, insurers make use of the DSM V system, an international framework for uniform diagnosis of mental illnesses. Unfortunately, for now, there is no uniform diagnosis available for burnout. This disorder is at present not included in the DSM. Burnout remains a catch-all term that is often applied incorrectly to other problems such as depression or stress. As a result of this, it falls outside the standard remit of work incapacity insurance.

Conditions and restrictions

Due to the increased attention paid to this disorder, we are seeing more insurers offering the option to cover burnout. But, and here is the catch, an additional premium is often charged, and other conditions and limitations apply. Thus, many insurers will request a diagnosis by a recognised psychiatrist, and reports from psychologists are not accepted. An amended qualifying period and duration are also the norm. Sometimes the insurers contribution may be limited to fixed amounts. In this way, an insurer may only start to contribute after six months, paying 90% of the usual benefit or they may limit the cover for psychological ailments to two years’ payments.

Reintegration is also increasingly becoming a part of the insurance package. Insurers make use of third parties to help employees return to work after employees have given their permission to do so. This counselling is quite extensive: it ranges from conversations with psychologists, career coaching sessions and physical help, to facilitating modifications on the work floor.

Role of the employer

Another important trend is that government agencies and insurers are increasingly stressing the importance of the employer. Thus, many insurance companies link insurance premiums to whether or not a company has a prevention policy in place. This comes as no surprise, if you know that a proportion of burnout cases in Flanders is due to a conflict in the workplace.

When it comes to reintegration, employers can no longer just stand by and watch. At the end of last year a Royal Decree came into force, ensuring that reintegration of incapacitated employees had to be speeded up by a tailor-made programme. The government has also put some pressure on: employers who don’t put enough effort into reintegrating and enabling their employees, will face a fine in future.

Proactive

At Vanbreda, we really believe in adopting an all-encompassing approach. Thus, we work using a an alternative model. We do not involve third parties but simply let the insurance doctor and company doctor work together in dealing with long-term absences.

The insurance doctor has an insight into the medical condition of the employee, whilst the company doctor is better able to assess the workplace context. By bringing both together, we are better able to assess how the medical situation affects the employee’s financial work incapacity. This results in the correct payment of benefits to sick employees and more efficient reintegration programmes. This allows the practical experiences of the company doctors to contribute to the effective prevention policy of the employer.

This is a sound method, in which the employee, employer and insurer work successfully in close cooperation. Thus, the number of payments will be reduced, the employer’s premiums are likely to be lower and employees who (partially) resume work quicker, will get better faster. In this way the employer will have to play a major part in proactive prevention and by re-engaging the employees. The companies that start doing this now, will be ahead of the game.

Evelyne Lauwers

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