Mental health is now one of the top three claim categories in UK PMI, and the area where insurer differences matter most to clients. This is a side-by-side comparison of how each major insurer handles mental health in 2026.
AXA Health
AXA Health includes mental health (in- and outpatient) as standard on most personal and SME plans. Talking therapy sessions are capped per condition per year, with structured access through AXA's mental health team. Direct-access referral is available on supported plans.
Bupa
Bupa's Direct Access pathway lets members self-refer for mental health concerns without a GP referral on supported By You variants. Talking therapy is session-capped. Inpatient admissions for psychiatric care are covered but require pre-authorisation.
Aviva
Aviva's mental health cover is an optional module. If the client wants mental health, the broker must add it explicitly — a common oversight at quote stage. Once added, the module covers in- and outpatient with session limits set by the chosen variant.
Vitality
Vitality includes talking therapies with structured session limits, routed through Vitality's mental health network. Condition-led pathways apply for more complex presentations.
WPA
WPA's mental health cover is a configurable module with WPA's shortfall protection — meaning members are less likely to face gaps between consultant charges and the insurer's schedule.
Common exclusions across all five
- Addiction treatment as a standalone condition is typically excluded.
- Chronic mental health conditions (defined in policy) are normally outside acute PMI cover.
- Self-harm and suicide-attempt-related admissions are handled inconsistently — check each insurer's exact wording.
What to ask the client
- Is there a current or recent mental health diagnosis to declare?
- Does the client want CBT/talking therapy access without GP gatekeeping?
- Is the client likely to need inpatient psychiatric admission?
The answers point to AXA or Bupa for most clients, with Aviva acceptable if the optional module is added and Vitality acceptable for engaged users who'll work through the structured pathway.