Am I insured against burnout?

The term burnout has been a constant in the media for the past few weeks and months. It has been a topic of discussion in numerous seminars, articles and interviews. Googling the term produces no less than 112,000,000 hits. But what about the financial side of burnout? Are we, both as employer and employee, properly insured against this form of incapacity for work?

In order to answer this question, the illness firstly needs to be defined. There seems to be consensus in this regard and specialists give the terms burnout and depression clear and different descriptions. While depression is a mood disorder, burnout is a work-related energy disorder. This psychological, work-related condition is not yet recognised in Belgium as an occupational illness, unlike in Sweden and Denmark, for example, and so no financial compensation is possible. Nevertheless, the legislature has already imposed a series of prevention measures on employers via the recent Royal Decree entitled ‘Psychosocial risks in the workplace’.

If burnout is indeed work-related, why is the incapacity for work or months of absence from work that usually ensues, not insured via the employer?
The only insurance that an employer is obliged to take out for its employees is occupational accident insurance. Given that burnout is an illness and not an accident, it is not covered by this insurance at all. As burnout is also not an occupational illness, an employee suffering from it does not receive any payment from the Occupational Illnesses Fund. The only remaining solution is via voluntary additional insurance that an employer can take out as a non-statutory benefit for its employees: a group invalidity insurance and/or hospitalisation insurance.

Group invalidity insurance or income guaranteed under a group policy supplements the statutory payment under health insurance. If the payment via the health insurance fund is limited to around 60% of a capped salary (or around €2,053 a month for 2015), such insurance pays up to a maximum of 80% of the full annual salary in case of illness. For someone with a gross monthly salary of €4,000, this quickly means an additional €1,600 on top of the health insurance fund payment, given that this only pays 12x a year and the private insurer can calculate the payment at 13.92x the monthly salary. Whether burnout is recognised as an illness by both the health insurance and private insurer remains an open question.

In case of a diagnosis of burnout, a family doctor will generally prescribe sick leave and this will be accepted by the health insurance fund.  However, a perusal of various general conditions that apply to invalidity policies shows that there are many differences among them. There are very few insurers that will follow the health insurance fund’s position if this differs from their own policy conditions. Burnout falls under ‘psychological disorder’, ‘psychological illness’ or ‘psychological condition’ and mostly appears to be an excluded risk. And even if burnout is insured under a series of conditions, every company places a time limit on payments. In most cases, this time limit is two years (consecutive or otherwise) during the period of insurance, while one insurer gives three years. Some policy conditions even stipulate a 12-18 month waiting period before an employee can be eligible for payment.

Group hospitalisation insurance also offers little by way of a solution. A contribution is made only if there is an actual admission to hospital and/or if you suffer from an insured ‘serious illness’. Neither burnout nor any psychological illness is listed in the policy conditions. Admission to a specialist centre for ‘mental health care’ is covered by some insurers, but is always subject to a time limit.

We can therefore state that private insurance currently does not provide a clear-cut payment solution in case of incapacity for work and any medical expenses due to burnout. The burnout sufferer will mainly be dependent on statutory health insurance and receive a supplement on this, in exceptional cases, via the private insurer.  It is thus important to check your insurer’s policy conditions and estimate how great the loss of income will be for the employee concerned.

However, we are seeing developments in the market and some insurers are offering ‘modular’ products with an option for ‘psychological illness’ cover, obviously at an added premium. Both employers and employees should check their insurer’s policy conditions and estimate how great the loss of income could be.