According to the just-released claim statistics by Old Mutual, the proportion of heart attack claims have increased by 113% since 2016, moving heart attacks from being the least claimed ‘Big 4’ illness to the second spot.
According to the Old Mutual statistics they paid out R11.3 billion in personal cover claims in 2019. These pay-outs include underwritten, non-underwritten and corporate claims. John Kotze, Protection Product Head at Old Mutual points out in the media release that the Covid-19 pandemic has shown how unpredictable life is, and why it is important to have adequate cover that protects individuals and loved ones from sudden and life-changing events.
Claims statistics report for 2019 summary:
Underwritten claims amount to R5.33 billion of the overall amount paid and consists of the following:
| ● | R4.02 billion in Death cover claims (a 99% payout ratio, for the fourth year in a row) | |
| ● | R739 million in Severe Illness and Physical Impairment cover claims | |
| ● | R561 million in Disability cover claims | |
| ● | R10 million in Retrenchment cover claims | |
| ● | Only 3% of underwritten claims that were correctly submitted did not qualify for a pay-out | |
| ○ | 66% of these did not meet the benefit definition, meaning that the condition they claimed for was not as described in their contract | |
| ○ | 18% were due to the customer not disclosing important information | |
| ○ | The remainder were due to suicide exclusion (6%), fraud (5%), an underwriting exclusion (3%) and a general exclusion (2%) | |
Main causes of claims:
| ● | Death cover claims – Cancer & tumours (23%), cardiovascular disorders (23%) and accidental death (22%) |
| ● | Severe Illness claims – Cancer and tumours (48%), cardiovascular disorders (28%) central nervous system disorder claims (12%) |
| ● | Disability cover – 11% of Disability Income cover claims were paid out towards psychiatric disorders; a significant increase of 59% since 2016. |
“Our overall experience with psychiatric disorders shows that most claims were for major depression. Other psychiatric disorder claims are attributed to bipolar mood disorders, post-traumatic stress disorder, depressive episodes, adjustment disorders, and stress,” Dr Kerissa Naidoo, Old Mutual’s Chief Medical Officer elaborated.
These statistics are likely to change significantly next year, as the effect of the pandemic kicks in.
Click here to read more about the alarming increase in psychiatric and suicide claims.
Click here to read more about Old Mutual’s claim statistics.
