My Open Letter to the Health Underwriting Department of State Farm Insurance

photo-1453928582365-b6ad33cbcf64When I transitioned to being 100% self employed, I very much wanted to replace the disability insurance policy I had with my previous employer. I’m known as someone who plans and prepares for things not likely (or never) to happen, but it makes me feel secure. So seeking a policy such as this fit that bill. I was not under the impression I would be replacing the exact policy I had previously, nor did I really have any expectation of the cost. I was also not expecting to receive the letter I did “explaining” why I am now paying 25% more for 15% less coverage.

The letter I received read:

Dear Ms. Watson,

 Your policy has been issued on a modified basis.

 The decision was based on earned income and medical history of anxiety and attention deficit/hyperactivity disorder.


It was not signed, and there was no company policy sited to assist with the rationale. The letter was simply what you read above. As soon as I read the letter, I was shocked and angry and sad. The message this two sentence letter sent was that I was being penalized because I experience anxiety and struggle with executive functioning. As a champion for others who are either at risk of or identified as having mental health disorders, I never considered that I would have to advocate for myself. The stigma surrounding mental health disorders is ever present and widespread, and I have made my life’s work helping support my clients and their families who face this regularly. I imagine contributing to this stigma is not State Farm’s intent, but it is important to know and understand how your decisions and dissemination of the decisions absolutely do.

I think we’re doing better raising awareness about mental health conditions, but we’ve not made the strides needed to assure individuals will not be pigeon holed into inaccurate stereotypes and/or discriminated against. The fact that I’m writing about electively seeking additional insurance for a “what if” moment vs. access to medical care or a job is not lost on me, but if we start minimizing the perceptions of individuals at the receiving end, we put ourselves in a very precarious situation. While I cannot speak for anyone else, I can and would like to tell you how this impacted me.

I felt an immediate sense of shame. I felt that somehow my history of anxiety and ADHD meant I was automatically disqualified from receiving the full benefit of a service I was and am willing to pay for. I also felt that perhaps State Farm was being proactive and cautious because you believe that my history may lead to me utilizing this policy for the reasons it was modified. I felt as if I had done something wrong. I am a master level therapist with a successful practice, who has worked hard my entire life. That was diminished in 17 words. This experience has also allowed my efforts in responsibly preparing and planning for an unfortunate event feel undermined.

My history of anxiety and ADHD has never EVER rendered me unable to function, in any sense of the word, which begs the question(s). If I feel this way, how do those who have much more significant and chronic/persistent mental health conditions feel when they receive a letter like mine? Can they even get affordable coverage in establishing a safety net? Now, I am not usually one to complain just to complain, and I feel strongly that if I am going to express a grievance (you will be receiving my formal, official letter next week), I need to offer some recommendations regarding how change could be promoted.

Your limitations for “Mental and Nervous Disorders” is not clear when paired with certain policies (they weren’t interpreted as if they even applied to my policy), so perhaps educating staff on terminology or operationally defining what those “disorders” are, would be helpful. A more compassionate and detailed rationale enclosed within your letters would also be a tremendous improvement. I would be remiss if I didn’t also suggest looking at the reason individuals with certain histories have to pay more for less coverage. Is the rationale rooted in accurate knowledge of mental health conditions? A company like State Farm has influence, no doubt, but is it perpetuating the stigma surrounding mental health, even if it’s doing so unknowingly?

The only way we can continue to decrease this stigma is by getting to the root of the issue, systemically. Sharing a collective voice by reducing perceptions and stereotypes that are mostly entrenched in negativity and misinformation can be done by educating and raising awareness. Actively challenging these stereotypes is how we’re going to get the biggest foothold on a movement that continues to require positive contributions by legislators, large companies and their CEOs, and individuals alike. My hope is that State Farm can begin to measure the impact vs. intent of certain procedures employed, so that meaningful conversations and potential positive changes can take place.


Erin Watson MSW LCSW
Mental & Behavioral Health Therapist & Possible Former Policy Holder

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