• Breast cancer most common cause of critical illness claims
• Mental illness including anxiety, stress and depression most common cause of income protection claims
• £225,000 paid out in children’s critical illness claims
Critical illness
During H1, over £30.6m was paid out to 380 customers with critical illness cover. Breast cancer was the most common reason accounting for one in five claims (20%), followed by heart attack 17%, stroke 8% and bowel cancer 7%. Nine claims were paid for child critical illness cases, an added and invaluable benefit of cover that many people overlook, amounting to £225,000.
Over 89% of claims were successful. While the vast majority are paid quickly and efficiently, there are some that we can’t and shouldn’t pay, and these are included in the claims statistics. These are either because the customer’s condition did not meet the definition set out in the policy or because of non-disclosure of medical information.
One case that was declined was for a customer who suffered a stroke. Despite specific questions on the application form, the customer did not disclose:
- recent tests for high blood pressure
- tests for raised cholesterol
- the taking of prescribed drugs
- that he was seeking medical advice (he was under ongoing review for his blood pressure)
In addition, his weight was understated by more than 2 stone. These facts would have made a very material difference to our underwriters when deciding whether to offer cover and underline the importance of answering the questions fully and honestly.
The average pay out during H1 was £83,336 with the highest amounting to £550,000.
Income protection
For income protection, 87% of new claims were also successful. Nearly a quarter were triggered by mental illness including anxiety, stress and depression (23%), followed by cancer 15%, musculoskeletal (excluding spinal) 13% and spinal disorders 13%.
Just four claims were declined as customers were not disabled throughout the plans deferred period and two because there was no loss of income to cover. Throughout the period, an average of 544 claims were in payment each month amounting to over £4.7m. Average monthly payments to customers were £1460.
Life cover
Over £68.3m was paid in life claims to 854 customers. The majority of (98%) were paid with just 2% declined because of non-disclosure of medical information. The highest claim paid was for £2m while the average pay out was £40,660.
Peter Hamilton, head of retail partnerships said: “With ongoing improvements to our protection products, including major enhancements this year to make critical illness cover easier to understand and claim for - we hope that these statistics reassure people that the vast majority are paid, making a huge difference to customers at what will normally be a very difficult time.
“While successful claims continue to increase year on year, we will continue to reinforce for customers the importance of fully disclosing their medical history, to ensure the claims process will be smooth, quick and successful."
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