Long COVID insurance claims rejected under mental health exclusions

Summarised by Centrist

Insurance company Partners Life is facing questions over its decision to reject Long COVID insurance claims using mental health exclusions attached to policyholders' existing policies.

Christchurch software engineer Tales Azevedo Alves was diagnosed with ADHD while attending university in Brazil about 15 years ago.

After contracting COVID in 2022, he developed severe fatigue, heart problems, headaches, dizziness and cognitive difficulties that eventually left him unable to work.

When he claimed on his income protection policy in August 2026, Partners Life declined the claim, relying on a mental health exclusion that included fatigue-related disorders.

Azevedo Alves disputes the decision, arguing that Long COVID is a physical post-viral illness rather than a mental health disorder.

A similar case involved Auckland woman Nicola Coombe, whose total and permanent disability claim was declined under an exclusion introduced because of her earlier experience with anxiety and depression.

Lawyer Tim Gunn, who represents several claimants, argues that applying these exclusions to Long COVID may constitute unlawful discrimination under the Human Rights Act 1993.

The Human Rights Commission said that insurers must be able to justify exclusions using reliable actuarial or statistical evidence.

Its 2007 guidance also states that exclusions for pre-existing conditions should be as specific as possible, and that insurers must establish a reasonable basis for extending them to other conditions.

However, the Commission stressed that whether a particular exclusion is lawful would ultimately be determined by the courts.

Gunn says his clients have not been provided with data justifying Partners Life's decisions.

The Financial Markets Authority, which oversees insurers' obligations to treat customers fairly, has invited affected consumers to raise concerns.

Read more at The Waikato Times (paywalled)

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