According to the National Alliance on Mental Illness (NAMI), suicide was among the nine leading causes of death for people ages 10-64 in 2020. And the CDC notes suicide was responsible for 48,183 deaths in 2021—which is about one death every 11 minutes. That same year, 12.3 million American adults seriously thought about suicide, with 1.7 million attempted suicides.
It’s a difficult question—and one most people wouldn’t want to consider—but as a business owner or human resource professional, do you know the ins and outs of insurance if one of your employees chooses to end their life?
The insurance your company offers will vary, but here are some guidelines.
Does Health Insurance Cover Injuries Caused by Suicide Attempts?
The Health Insurance Protection and Accountability Act (HIPAA) protects against discrimination in eligibility, benefits, and premiums in group health plans based on a person’s health status. The Affordable Care Act (ACA) extends HIPAA protections to people enrolled in individual market plans, as well.
NAMI notes that if an individual is injured during a suicide attempt, federal regulations require the insurer to cover the treatment, “if the injuries are the result of a medical condition (such as depression),” and if the treatment would otherwise be covered if the injuries were not self-inflicted. Medical conditions do not have to be diagnosed prior to the self-injury.
If a plan incorrectly denies a claim because the diagnosed health or mental health condition is not noted, resubmit the claim with the diagnosis added. Keep in mind, not all insurance plans are covered by HIPAA, such as short-term limited duration plans, so be sure to check with your carrier. You can also recommend your employee file an appeal with the health plan or a complaint with your state insurance division’s consumer service office.
For more information, check out the report released by NAMI on the subject.
Does Life Insurance Cover Suicide?
For surviving family members, the grief of having a loved one end their life can be compounded by the financial strains that death can bring. In most cases, life insurance has special provisions that limit the payment of benefits in cases of suicide, and they typically will not pay a death benefit if the policy holder ends their life within one to two years of the policy being in force. This is known as the exclusion period. Moreover, any changes to the benefit can reset the clock and the exclusion period will begin anew.
The type of insurance will determine the benefits. Term life insurance, for example, will pay beneficiaries the benefit, in full or in part, if the policyholder passes after the exclusion period. Whole life insurance may provide the plan’s cash value even if the policy is currently under the exclusion period. Group Life Insurance, the type of policy most people obtain through employers, does not generally have a suicide clause, so death benefits are typically paid in full.
If a policyholder passes away, the insurance company will request a death certificate when the beneficiaries file a claim. The certificate will note the cause of death, including if it was self-inflicted. If it does not, the insurance company may require additional documentation, such as an autopsy or medical examiner’s report. These added steps could mean that the claims process is more drawn out. However, this should not deter beneficiaries from filing claims—the grief caused by the self-inflicted death of a loved one can be especially challenging and the accompanying financial stress can only add to the trauma.