The case of a former Commonwealth Bank employee provides a chilling insight into how the bank’s insurance arm delays and dodges paying legitimate mental health claims – even one from one of its own.

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atthew Attwater’s voice cracks as he recalls the day his world shattered. What began as a disagreement with a family member quickly got out of hand.

The relative, who had a history of violence, went on a rampage, beating Attwater and decapitating the miniature fox terrier that he’d loved since he was 11.

“It was something my coping mechanism wasn’t able to process,” Attwater says.

It was an event that would send his life spiralling - and the safety net he had spent years paying for would provide little protection.

The day after the attack, Attwater showed up to work at Commonwealth Bank covered in bruises.

He loved his customer service job and was one of the bank’s best. Customers wrote letters of thanks to him and managers showered him with praise.

In 2010, the bank even flew him and a friend to Hobart for the “Best of the Best” gala award night where he took out a top honour, chosen from amongst the bank’s 44,000 workers.

Ralph Norris, then chief executive, personally praised the young man.

Attwater was looking forward to a bright future. Instead, a year later, his world started falling apart as he struggled to cope with the aftermath of the violent attack in 2011.

At about the same time, police raided his house, finding an illicit party drug, GBL. He would be eventually sentenced to 400 hours of community service with the court finding that mental illness contributed to the offence.

Matthew Attwater “I NEEDED SUPPORT FROM MY EMPLOYER”

At work, things were going downhill. Attwater started on anti-depression medication but it made him tired and he began to lose concentration.

Colleagues noticed that after tense calls with customers he would slam down the phone and rant. Managers started micro-managing his work.

Attwater, now 32, didn’t know it at the time but he was suffering from post-traumatic stress disorder.

“That job was the last thing that I had in my life that was any type of link to my past. It was the last little bit of independence that I had,” he says.

“It was the last thing that I had control of. And it was systematically broken down by management that were not interested.”

The bank organised for him to see a forensic psychiatrist.

He went to the appointment in the belief the bank wanted to help get him back on track, to be “that best of the best, to be that employee that made them smile, that made them lots of money”.

It wasn’t to be.

The psychiatrist’s report questioned whether Attwater would be able to function in the bank or the general workforce “at any foreseeable time in the future or in any ongoing manner”.

It found that his symptoms were “severe” including that Attwater “presents as a severely disabled person who is markedly affected by a cluster of psychiatric symptoms which would fall under the broad heading of PTSD. In addition there were strong elements of social phobia.”

In 2013, he advised that Attwater be medically retired from the bank and the workforce in general – an assessment backed by the bank’s chief medical adviser.

There was a silver lining. As a Commonwealth employee, Attwater was insured for total and permanent disability by the bank’s own insurance arm, CommInsure, through Commonwealth Bank Group Super.

Having been deemed incapable of working by the bank, it seemed clear he would be entitled to a payout.

But even for a once-lauded former employee, getting a payout from CommInsure wasn’t to be so simple.

Mental health

issues ... ... account for 21% of claims made to CommInsure and 24% of claims paid by dollar value.

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or the $44 billion life insurance industry, mental health is proving to be one of its greatest challenges. One in five Australians will experience at least one bout of mental illness and, according to the World Health Organisation, by 2030 depression will be the biggest health burden, economically and sociologically.

It is understood that mental health claims against CommInsure represent 21 per cent of claims by volume and a whopping 24 per cent of claims paid by dollar value.

It is clear that the life insurance industry is scrambling to cope with Australia’s burgeoning mental health crisis.

And there is evidence that insurers, in trying to reel in mental health-related costs, are unfairly denying people coverage or rejecting claims – often on the basis of flimsy diagnoses or outdated beliefs about mental illness.

​Our joint Fairfax-Four Corners investigation has unearthed how CommInsure insurance underwriters are told to ​be on the ​look ​out​ for long lists of risk factors or markers in customers​ that might foreshadow future mental health problems, even in people with no history of such issues.

These include perfectionism, working excessive hours, having financial problems, being new in business and being older than 50. These are then used as a pretext to amend or deny insurance coverage.

​It is understood that ​CommInsure underwriters are instructed to refuse applications from asylum-seekers and refugees until they have been in the country for two years.

When considering a new life insurance policy, underwriters are told to be aware of any of the following symptoms in new mothers: a persistently low mood, feelings of inadequacy, confusion, poor self care, insomnia, guilt or fear of being rejected by partner.

The problem is that ​insurance underwriters have no formal qualifications ​to assess mental health disorders​, says ​Beyond Blue chief executive Georgie Harman​. She​ says CommInsure is using outdated mental health stereotypes to risk ​-​ assess policyholders.

“To have people without formal qualifications assessing risk in this way would be like assuming somebody has cancer because they have lost weight,” she says. “Symptoms like sleeping difficulties, or personal traits such as perfectionism, are widespread in the community and not necessarily indicative of any underlying mental health conditions.”​

Insurance is one of the few sectors that is allowed to discriminate under law but this discrimination must be justified with rigorous actuarial data.

Since 2002, Beyond Blue has tried to work with the industry to get the statistical data that backs up how it discriminates against the mentally ill. But the industry has so far failed to hand it over.

It is understood that CommInsure paid out more than $70 million on suicide claims in the five years to 2012, most of which came from its “wholesale” insurance business – the insurance policies provided to industry super fund members.

In June 2012, CommInsure is believed to have considered imposing a 13 month exclusion period on suicide claims from industry super fund members, in a bid to reel in costs. Concerned about a backlash at such a move, it proposed offering instead a $20,000 funeral benefit.​

Jeff Kennett Beyond Blue

chairman “It’s a David and Goliath job.”

Matthew Attwater thought he was on safe ground with his forensic psychiatrist’s report confirming he could no longer work.

“I was retired from the workforce,” he says. “It was a blanket statement which stipulated that I could no longer work in any industry doing anything.”

But his claim with CommInsure for total and permanent disability was rejected.

From Commonwealth Bank Group Super To Matthew Attwater “You are not totally and permanently disabled in terms of the definition in the policy of insurance.” Read full letter here

CommInsure deployed its own interpretation of the forensic psychiatrist report used to discharge Attwater from employment to justify its argument that he had a chance of re-entering the workforce at some point.

The report said should medical retirement be considered it would be "appropriate" for Attwater to receive psychiatric treatment to help through the adjustment. CommInsure argued this meant he could recover with the help of treatment.

Attwater was trapped in a bureaucratic vicious cycle. Without an insurance payout, he had no means of paying for a psychiatrist.

“They knew that I was unable to pay $500 an hour to get to see a psychiatrist. They declined me on a technicality.”

Attwater’s lawyer, William Barsby from Shine Lawyers, says Attwater’s claim was straightforward and lawyers should never have needed to be involved.

“The bank made that decision and they even obtained their own expert evidence to support that… then faced with that evidence CommInsure and the CBA super scheme attempt to deny his claim.”

Barsby said the bank had tried to “hide under the corporate veil” by arguing that its divisions involved in the case – the bank, which Attwater worked for, the CBA super fund and CommInsure – each operated as separate bodies.

“But the reality is they’re all under one veil and they all come down to the same information and to hide behind that corporate veil is just absurd in my view.”

The delays and denials added to Attwater's mental and financial stresses, which, at times, included him being forced to sleep in his car.

Attwater’s dismissal shocked Beyond Blue chairman Jeff Kennett, who describes it as “disgraceful” and totally wrong.

“You don’t go and dismiss someone because they’ve got mental illness. There are programs internally and programs externally to help,” he says.

“If you’re saying to an individual you’re no good or your illness can’t be treated, you’re doing great psychological damage to that individual.”

Matthew Attwater “It was like a slap in the face.”

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elays in processing claims can place people under enormous mental pressure.

“There’s three key things that they do. They deny the case, they’ll delay it and they’ll defend it and in Matthew’s case they delayed it from the very outset,” Barsby says.

Kennett agrees. “And please remember, these companies are taking premiums every year and then they deny a person that claims,” he says.

“They don’t offer to pay the premiums back but they will, invariably as seems to be the case here, delay the process, they weaken the individual so these cashed-up organisations literally trample over the individual rights of so many citizens. And it is wrong.”

Commonwealth chief executive Ian Narev says he accepts that the bank has “much more work to do to bring our understanding of mental illness up to the level it ought to be at.”

Ian Narev CEO of CBA “We have got a long way to go.” Watch the full interview here

Asked about Mr Attwater's situation, Mr Narev said, “I understand from what you said how he must be feeling, and again I reiterate, I think from the employment perspective, from the insurance perspective, from all different ways in which we participate in the community, we have got a long way to go on mental illness.”

According to the Financial Ombudsman Service, complaints about delays in handling total and permanent disability (TPD) claims contributed to a surge in disputes between insurers and customers last year. The service handled 188 TPD disputes in 2014-15, up sharply from 133 the year before.

Since Attwater was “ill-health retired” from the bank, his lawyers have arranged for seven different psychiatrist and other medical reports, all supporting his claim.

During the joint investigation, CommInsure finally decided to settle Attwater’s case.

It took him three years and pushed him to the brink.

“I have thought of taking my own life,” he says.

“There are multiple times where I’ve sat there and thought... how could a company that I was so passionate about, that I was so proud to work for, how could that company systematically destroy my life?

“Words can’t explain just how negative the experience has been with CommInsure. It’s horrible.”

For support or information, call Lifeline 131 114 or BeyondBlue 1300 224 636

Do you know more? Email Adele Ferguson aferguson@fairfaxmedia.com.au Financial Ombudsman Service 1800 367 287 • CommInsure 1800 106 133 Senate inquiry into financial advice economics.sen@aph.gov.au