In the first half of 2016, insurer Zurich paid 89% of critical illness (CI) claims. Over £30.6 million was paid out in total to 380 Zurich customers with CI cover.
Breast cancer accounted for one in five claims (20%) making it the most common, followed by heart attack (17%), stroke (8%) and bowel cancer (7%).
Nine claims, amounting to £225,000, were paid out for child CI cases.
Unsuccessful CI claims were either because of non-disclosure of medical information or because the claimant’s condition was not covered by the definition laid out in the policy.
In one case that was declined, the Zurich customer had suffered a stroke, but despite very specific questions on the policy application form, they failed to disclose tests they had undergone for high blood pressure and high cholesterol, as well as the fact they were taking prescribed drugs and seeking medical advice.
The highest CI pay out by Zurich in the first half of this year was £550,000, while the average was £83,336. The number of successful income protection (IP) claims paid out by Zurich in the same period was 87%.
Mental illness, including anxiety, stress and depression, accounted for a quarter of all IP claims, followed by cancer (15%), musculoskeletal (13%) and spinal disorders (13%).
Two IP claims were declined because there was actually no loss of income to cover, while four others were denied because the Zurich customers were not disabled throughout the deferred periods of the plans.
A total of over £4.7 million was paid out over the period, with an average of 544 IP claims in payment each month. Successful Zurich IP claimants received, on average, of £1,460 per month.
The vast majority (98%) of life claims during the same period were paid by Zurich, while just 2% were declined because of failure to disclose medical information. In total, over £68.3 million in life claims was paid to 854 Zurich customers in the first half of this year.
Of all the successful life claims, the highest pay out was £2 million and the average pay out was £40,660.
Overall, Zurich paid out £103.6 million to more than 1,250 customers in the first six months of this year.
Peter Hamilton, head of retail partnerships at Zurich, said: “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.”
He also said that he hopes the statistics will reassure people that the majority of insurance claims are, indeed, paid.
We believe this sort of data demonstrates that insurers always look to pay claims and only decline for valid reasons. However, it is vitally important clients complete application forms correctly and we can help clients with this process.
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