Risk factors include youth, loneliness, and excessive screen time. Adolescents and young adults are particularly vulnerable, though adults are by no means immune. Screen time exceeding four hours daily has been linked to an increased risk of adverse health effects – an important threshold given how quickly digital consumption habits have normalised.
Regional Variation
New age addiction does not manifest uniformly across the globe. Cultures with high acceptance of digital technologies show correspondingly higher rates of problematic digital use.7 Gaming disorder is particularly prevalent in parts of East and Southeast Asia, where academic pressure and competitive gaming cultures intersect. In the Middle East and North Africa, young adults report significant difficulty disconnecting from social media.
Understanding these regional differences is essential for insurers operating across diverse geographic portfolios.
The “Always on” Workplace and its Health Consequences
Globally, smartphone usage increased significantly during COVID‑19 lockdowns.8 As the world of work has changed, we have seen a blurring of the boundaries between work and leisure. Smartphones make it easy to stay connected after hours, preventing the psychological detachment and recovery time essential to mental wellbeing.9 The result, as Mary Enslin previously explored, is a growing culture of being permanently “on duty” – with direct consequences for disability claims.10
The WHO conceptualised burnout in the ICD‑11 as an occupational phenomenon resulting from chronic workplace stress that has not been successfully managed.11 It is characterised by feelings of energy depletion or exhaustion, increased mental distance from one’s job, and reduced professional efficacy. Although burnout is not itself a medical diagnosis nor a mental health disorder, its characteristic features – significantly amplified by always‑on workplace culture and excessive smartphone use – have a potential impact on Disability claims management.
It may therefore be useful for society to go beyond the traditional concept of work-life balance and incorporate the notion of screen-life balance as an emerging occupational health consideration.
Beyond Mental ill-Health – The Physical Consequences of Digital Addiction
It is tempting to frame digital addiction primarily as a mental health story – and the mental health impact is real and significant. However, the physical health consequences of prolonged screen usage and sedentary digital behaviour represent a distinct, and in some cases more immediately life-threatening, set of risk pathways.
Sleep Disruption and the Brain
The 2022 review “Digital Addiction and Sleep” highlights that sleep dysfunction is a core aspect of digital addiction, which involves compulsive and uncontrolled device use affecting time management and leading to disturbed sleep.12 The authors propose that dopamine-serotonin imbalances contribute to impaired impulse control and insomnia, with both neurotransmitter deficits linked to anxiety and depression. Sleep problems are not just symptoms but central features of digital addiction, which also reduces exercise, increases stress, and lowers melatonin and vitamin D levels.
For insurers, the implications of chronic sleep disruption are significant and cross multiple product lines. Poor sleep quality is a well-established risk factor for cardiovascular disease, metabolic syndrome, and cognitive decline. Disability claims featuring fatigue, burnout, and reduced concentration may have sleep disruption – driven by digital addiction – as a contributing factor.
Musculoskeletal and Physical Strain
Adolescents and young adults who spend more time using smartphones and computers demonstrate significantly worse scores across both physical and mental domains of health-related quality of life.13 This confirms what physiotherapists are observing in clinical practice: increased computer use is associated with trunk asymmetry, neck and shoulder pain, and musculoskeletal discomfort that negatively impacts quality of life.
While musculoskeletal claims are typically shorter duration in individual cases, the scale of the at‑risk population and the early age at which patterns are forming mean that cumulative exposure to musculoskeletal morbidity from digital device use represents a material long-term claims consideration, particularly for health and income protection policies.
Cardiovascular Risk and Stroke – Emerging Evidence
Among the most serious physical consequences of prolonged screen time are its associations with cardiovascular disease and stroke. A 2023 study based on the China Health and Nutrition Survey – a large national prospective cohort – examined the relationship between daily screen time and stroke risk in middle-aged and elderly adults.14 The study found that participants with greater screen time were significantly more likely to develop stroke than those with lower screen time, after controlling for lifestyle factors including physical activity.
Prolonged immobility, hypertension, dyslipidaemia, metabolic syndrome, and poor diet are independent stroke and heart disease risk factors. Screen time amplifies these risks by encouraging sedentary behaviour.
Significantly for Critical Illness and Life insurers, these are not remote or hypothetical associations. The China study adds to a wider body of evidence linking sedentary leisure time – including television viewing and computer use – to elevated stroke and cardiovascular mortality, with findings now replicated across multiple populations and geographies.
Impact on Claims Across Product Lines
The intersection of mental health, digital addiction, and the physical health consequences of prolonged screen usage creates a compounding risk for insurers to understand at a product-specific level.
Disability and Income Protection Insurance
This is where the impact of mental health on insurance is most immediately and materially felt. Mental ill-health is consistently among the leading causes of Disability claims in developed markets. For Disability claims managers, digital addictions add a further layer of complexity. Many claims will feature co‑morbid anxiety, depression, or other mental illnesses alongside underlying problematic digital use. The subjectivity of symptoms and the absence of objective clinical markers mean that claims teams must be equipped with specialised knowledge and training.
Physical complications resulting from prolonged device use are also becoming a basis for claims:
- Vertebral artery dissection and ischaemic stroke – A 25‑year-old woman developed vertebral artery dissection and subsequent ischaemic stroke following repetitive motion using a fitness video game.15
- A second case documents the same injury in a 39‑year-old woman after extended gaming sessions involving prolonged neck strain.16
- “Gamer’s thrombosis” (deep vein thrombosis or DVT) – A 31‑year-old male developed extensive DVT after playing PlayStation for approximately eight hours daily over four days, requiring thrombolysis and anticoagulation.17
- “eThrombosis” – A 32‑year-old male developed life-threatening venous thromboembolism from prolonged sitting at a computer, prompting the coining of this term in peer-reviewed literature.18 Subsequent cases confirm multiple DVT presentations linked to extended computer use of 12 hours or more daily.19
The key mechanisms identified across these cases – prolonged immobility, cervical strain from sustained abnormal posture, and lack of movement reducing blood flow – are directly relevant to disability and health claims assessment. While examples are currently infrequent, the direction of risk is clear as the insured population’s digital usage patterns are trending in a concerning direction.
Life Insurance – Mortality Considerations
The Life insurance implications of mental health trends are real, if less immediate than in Disability claims. Serious mental health conditions are associated with materially elevated physical health-related mortality. Research demonstrates that the physical health consequences of psychiatric impairment – cardiovascular disease, metabolic disorders, and others – account for the majority of premature mortality in this population, rather than suicide alone.20
For Life insurers, the relevant pathways include not only elevated suicide risk in undertreated populations, but also the accelerated physical morbidity that results from sedentary behaviour, poor sleep, social isolation, and emotional dysregulation – all of which are documented consequences of excessive digital dependency. The screen time to stroke relationship identified in the China Health and Nutrition Survey is directly pertinent here: if prolonged screen time independently elevates stroke risk, then insured populations with heavy digital usage carry a heightened mortality risk.
Critical Illness Insurance – An Evolving Opportunity
Critical Illness insurance (CI) pays a lump sum to the policyholder if they are diagnosed with a specified illness. Today, only a handful of CI products explicitly cover mental health disorders – despite their significant impact on quality of life, the ability to work, and the risk of premature mortality.21
The challenge of incorporating mental health into CI definitions is genuine. Unlike typical CI conditions such as cancer, mental health disorders cannot be confirmed by objective clinical markers such as an imaging or blood test. Diagnosis depends on clinical interview and observation by a qualified specialist. However, as my colleague Sarah Hogekamp explored in her 2024 publication, there is a recommended framework for approaching mental health disorders in CI definitions:22
- Diagnosis must be made by a medical expert trained in the relevant field and must fulfil the diagnostic criteria of the DSM‑5 or ICD‑11, or a later version of either.
- A severity threshold is essential – Criteria should be of reasonable severity to support insureds experiencing conditions that significantly reduce quality of life and impose a high financial burden.
- Proof of inpatient stay of several weeks in a specialised psychiatric clinic is a valuable objective marker for the most severe presentations, such as severe schizophrenia.
- Consideration should be given to requiring confirmation by more than one medical expert or naming a medical expert subject to agreement by the insurer.
Beyond mental illness, the growing body of evidence linking screen time and sedentary behaviour to physical illness, such as stroke – an already well-defined CI claimable event – means that digital lifestyle factors may be increasingly relevant to CI claims experience. Portfolios comprising younger, highly digitally engaged insured populations may demonstrate an increased incidence of stroke. Early monitoring of CI claims experience against population screen-usage trends may be valuable.
Long-Term Care Insurance
Long-term mental health risks are rising, with chronic depression, social isolation, and similar conditions linked to cognitive decline and dementia. Digital addiction also worsens sleep, decreases real-world social interaction, and increases stress, contributing to these risks. Mental health conditions are also prevalent among long-term care recipients themselves, creating complex physical-psychiatric comorbidity claims that materially increase both care intensity and duration.
As previously mentioned, the sedentary nature of digital addiction increases the risk of physical illnesses such as stroke, a common cause of long-term care claims.
Health and Medical Insurance
Health and medical reimbursement claims face the most immediate and measurable cost pressure. Demand for mental health services continues to grow rapidly across developed markets, driven by greater awareness, reduced stigma, and regulatory requirements to treat mental ill health equally.
Physical health claims linked to digital device use are also adding to cost pressures. For example, musculoskeletal injuries, neck and shoulder pain, repetitive strain injuries and postural disorders are resulting in claims. The emerging DVT and stroke case examples, while currently representing lower incidence, result in high-cost claims.
The Evolving Litigation Landscape
No assessment of the digital addiction risk landscape for insurers would be complete without acknowledgement of the litigation environment. Courts in the U.S. and other jurisdictions are increasingly receptive to claims that social media companies have knowingly designed products that are harmful, particularly to minors. Proceedings have been filed and, in some instances, successfully prosecuted against companies where the courts have accepted that platform design intentionally exploits addictive neurological pathways. Life, Health, and Disability insurers should be monitoring these proceedings closely.
Treatment, Management, and Digital Detoxification
Governments and healthcare systems are beginning to respond. China regulates online gaming, whereby children are restricted to the days, hours of the day and total weekly use allowed.23 Japan passed an Ordinance that recommends maximum usage and restrictions on after hours use.24 The UK’s National Health Service offers specialised treatment for gaming addiction.25 In November 2024, Australia passed a world-first law banning social media accounts for those under the age of 16, with the legislation taking effect in December 2025.26
Managing digital addiction focuses on controlling behaviour instead of total abstinence, since technology is integral to daily life. The aim is to re‑establish healthy usage and reduce negative effects, not to stop use completely.
Established therapeutic approaches remain foundational. Cognitive behavioural therapy (CBT) and dialectical behaviour therapy (DBT) are used to address compulsive behaviours and maladaptive thought patterns, supported by psychoeducation and interventions aimed at re-engaging individuals with offline activities. Pharmacological treatment may be appropriate in more severe cases, particularly where co‑morbid psychiatric conditions are present. Validated tools such as the Game Addiction Scale (GAS), Smartphone Addiction Scale, and Test for Mobile Phone Dependence (TMPD) assist in both assessment and monitoring.27
In addition to these approaches, strategies that focus on changing behaviour are becoming popular because they are practical and easy to implement. Examples include setting specific limits on screen time, restricting access to certain platforms, and establishing designated "offline" periods. The goal is not only to cut down on usage but also to promote better self-control over how people engage with technology.
Digital detoxification – defined as deliberate, time-limited reduction or cessation of device use – has gained traction as both a clinical and a public health intervention. Evidence suggests that even short interventions can produce measurable benefits. A large study involving more than 400 participants found that restricting smartphone internet access for two weeks significantly reduced usage and improved attention, mental health, and overall wellbeing. Improvements in sustained attention were comparable to reversing approximately a decade of age-related cognitive decline.28 Shorter interventions also demonstrate benefit. Reductions in smartphone use over one week have been associated with decreases in anxiety, depression, and insomnia, while partial restrictions – such as limiting access to specific applications – produce similar improvements.29 These interventions may break habitual, reward-driven usage, reduce cognitive distraction, and restore sleep and attention.
For insurers, digital detox and behavioural interventions have two key implications. First, they may support improved recovery and reduce claim duration. Second, they present a potential prevention strategy within existing wellness programmes.
Practical Considerations in Claims Assessment
From a claims management perspective, digital behavioural conditions introduce evidentiary challenges: reliance on self-reported impairment, the absence of objective clinical markers, and overlapping diagnoses complicate functional assessment and the determination of work incapacity. Where discrepancies exist, validating the reported symptoms via the tools that are available to claims managers may be reasonably warranted.
Claims managers must be equipped with, or have access to, specialised knowledge and training to evaluate these cases effectively. Claims managers need to understand the biopsychosocial obstacles involved and employ collaborative care models – involving treating clinicians, occupational therapists, and specialised claims professionals – as they tend to produce better outcomes for both policyholders and insurers than adversarial approaches.
Stay-at-work and return-to-work support, where applicable, remains an important tool for managing Disability claim duration. Physical sequelae from device use – musculoskeletal presentations, DVT, and vascular events – require claims assessors to take a holistic history that specifically explores digital device usage patterns.
It is essential to fully understand the physical, psychological, and cognitive requirements of the occupational duties. By comparing these demands with the policyholder’s demonstrated functional capacity, claims managers can identify any gaps and help the policyholder bridge them, facilitating a sustainable return to work.
Conclusion
Rapid digitisation has fundamentally altered how individuals interact with technology, giving rise to behavioural patterns that increasingly resemble dependency, consequently creating new challenges for Life and Health insurers. Crucially, the risk is not confined to mental ill-health. The physical sequelae of digital addiction – sleep disruption, musculoskeletal injury, cardiovascular disease, stroke, and venous thromboembolism – span Disability, Life and Critical Illness lines.
At the same time, the industry’s own digital transformation journey creates a responsibility to design customer experiences thoughtfully – in ways that serve policyholders without inadvertently compounding the very risks being assessed and managed.
At Gen Re, we recognise that addressing this challenge proactively – by implementing informed underwriting, specialised claims assessment, and strategic product and process design – presents an opportunity to manage risk while delivering meaningful value to policyholders facing complex situations.