It's been seven years since Ella Ingram was first diagnosed with depression, and over three years since she won a landmark court case against a huge insurance company for discriminating against her on mental health grounds.

But as a report out on so-called insurance discrimination by the Victorian Human Rights and Equal Opportunity Commission has found not much has changed in that time.

In fact, the Commission found evidence of "widespread discrimination" that undermined laws around equality.

"Insurance discrimination is when a person is treated unfairly or unequitably because of a particular attribute," Commissioner Kristen Hilton told Hack.

"In this investigation we found that a number of travel insurers were discriminating against people with mental health conditions."

"We found that there were 365,000 contracts of insurance that included unlawful mental health exclusions," Kristen said. "That number in and of itself shows how widespread and pervasive this issue is."

The investigation spanned eight months and initially examined the policies of five major insurers.

However, during the course of the investigation, two companies changed their policies in relation to mental health, meaning the investigation focused on the remaining three companies - World Nomads Group, Suncorp and Allianz. These three companies together make up one-third of the overall insurance market.

How do insurers discriminate on mental health grounds?

To explain exactly what insurance discrimination is, let's go back to Ella's story for a sec.

Ella experienced her first depressive episode in the summer holidays between Year 11 and Year 12.

"I was just down a lot. I remember feeling apathetic. I was tired all the time, I didn't want to connect with any friends," Ella told Hack.

I was starting to have suicidal thoughts, and that was really scary for me.

"It was the second day of Year 12 that I got diagnosed with depression," she said.

Just weeks later, Ella had a major depressive episode and ended up in hospital.

That was just before a planned school trip to New York. Ella and her mum spoke to her doctor and decided Ella just wasn't well enough to travel.

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Whatsapp Ella Ingram took QBE to court in 2015 after they refused to cover her cancelled trip. June 11, 2019.

"I remember thinking at the time, when I was talking to my mum, 'we're going to lose all this money'. And she said no, that's why we have travel insurance," Ella said.

The school had organised insurance through QBE. Ella and her mum decided to recoup the costs of the trip to New York.

"We put forward a claim not long after we decided not to go on the trip... We got a letter from QBE denying my claim. They didn't give us a lot of information so we went through the whole process of disputing it," Ella said.

Ella and her mum discovered that QBE had, at the time, a blanket exclusion on mental health coverage. (The company has since removed blanket exclusions on mental health coverage and did not take part in the Commission's investigation.)

"What that meant is that people with mental health conditions, irrespective of the severity or the length or the risk that might pose, were denied either taking out insurance in the first place, or where they didn't have a pre-existing mental health condition, but they became unwell during the period they were insured, they were denied being able to claim on their insurance," Kristen said.

In other words, insurers would be able to exclude pay-outs related to mental health claims, even if the person had never experienced problems before.

Ella and her mum decided to challenge QBE, saying that rule was unfair. After a gruelling few years navigating the legal system, the Victorian Civil and Administrative Tribunal found QBE had discriminated against Ella.

What are the implications of mental health discrimination?

Ella's case was meant to spark widespread change within the insurance industry, but as the Commission's report finds, discrimination on mental health grounds is continuing to this day.

It means, in a nutshell, that people who experience mental health concerns are treated differently from people with other health conditions.

The blanket nature of the travel insurance exclusions mean that someone who may have experienced mild depression after the break up of their marriage is treated in the same way as someone who requires intensive care for their psychosis, for example.

"Unfortunately the industry hasn't really kept pace with what we understand about mental health conditions," Kristen said.

"Where people were excluded in an unfair way from accessing insurance, that had financial implications," Kristen said. "It could discourage people from seeking support and it also embeds stigma about mental health issues in the broader community."

Kristen is worried that insurance discrimination could stop people from getting the help they need, because insurers have access to medical records.

"Because people might be denied insurance, or denied the safety net of insurance in the first place, this could actually dissuade people from seeking treatment, because they'll have to disclose that they sought treatment for their mental health condition."

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Whatsapp The travel insurance industry is failing to understand the complexities of mental illness, Kristen Hilton says.

What now?

The three companies investigated by the Commission have all pledged to remove blanket exclusions on mental health coverage from their policies.

"Despite finding widespread discrimination against people with a mental health condition in the travel insurance industry, the investigation revealed an industry that is ready to change, and that has already taken positive steps to better understand mental health conditions and improve industry policy and practice," the report said.

The travel insurance industry has promised to improve awareness of anti-discrimination laws, and will look at recommendations on how best to serve people with pre-existing mental health concerns.

Kristen said that's a step in the right direction for not just the travel insurance industry, but could have implications for things like income insurance, too.

There's no doubt that some of the issues we've found have broad applications to other insurers who might be offering other products as well.

Last year, the Banking Royal Commission recommended that insurers change the way it deals with mental health concerns in their policies.