PPS Total Claims PaidThe statistics reveal that professionals are not immune to developing the most severe of illnesses or even dying many years before their time, with medical professionals being most at risk across all categories of claims.

In this modern age of information and data being readily available, so too is human destroying fast food or contaminated food supply bought from the so called mass retailers. Add to this the long and strenuous hours of ongoing work stress, a true recipe for what we are witnessing in claim payouts.

Claim statistics released for the year 2014 reveal, heart disease and cancer are by far the leading causes of all claims across critical illness, death and disability income benefits, followed by vehicle accidents and stroke. This is very much in line with other western world countries, although they are first world, we tread very closely in the working class market and even more so in the more affluent individual space.

The startling statistics show:
• Heart disease accounted for 42% of all the claims, which includes strokes. Claims demographics reveal that men and women in the age group between 41 and 50 were the highest claimants.
• The second leading cause of claims across all benefits was cancer at 20%, although higher in specific life insurance providers.
• Prostate, breast, colon and metastatic cancers were the most common cancer types claimed for during the period.

South Africa’s largest life insurer, Old Mutual stated that of the R3.4 billion in claims were paid out in 2014. An amount of R2.6 billion was for death claims, R343 million for disability, R441 million for illness and physical impairment and the balance to other.
The four highest and more or less in line with global statistics, show that non-communicable diseases accounted for 83% of pay-outs of illness claims, 60% towards cancer claims, heart related claims amounted to 40%. Strokes were included at 10% of all heart disease claims.

One of South Africa’s life insurer’s, (PPS) has their focus on individuals who have attained a 4 year degree. One cannot take up membership with the assurer unless this prerequisite has been met. What is alarming in the release of previous claims statistics is the spread of claims and the greater percentage paid to person’s in the medical professions.

PPS Sickness Claims 2014

There is no getting away with the other professions, however one would not expect the medical profession to claim for the conditions that many are very knowledgeable about however show up in the form of sickness, disability and even death.

PPS boasts in excess of 200 000 members who enjoy access to a comprehensive suite of financial and healthcare products that are specifically tailored to meet the needs of graduate professionals.  PPS is the largest South African company of its kind that still embraces an ethos of mutuality, which means that it exists solely for the benefit of its members. With such high claims, I do not see how this benefits members, except on one’s death bed or when severe, life debilitating illness strikes one.
PPS published details of its life assurance claims from January 2014 to December 2014. A total of 19 000 claims were paid over the period, amounting to a little over R1,066 billion.

On the other side of this, one of the most progressive health insurer’s who have a life insurance business, published details of its life assurance claims from January 2015 to December 2015. A total of 19 591 claims were paid over the period, amounting to R2.8 billion, up in two years by a mind boggling R800 million since 2013. The life insurance business paid a total of R573 823 762 in claims for severe illness. Males made up 62% of these claimants and females 38%. Although these statistics are changing quickly as females edge closer each year.

The Association for Savings and Investment South Africa (ASISA) revealed that life insurers pay record underwritten death benefits of R12.3 billion in 2015 

The senior medical adviser at the second largest life insurer, has stated that international statistics place the lifetime likelihood of suffering from cardiovascular disease at one in two, strokes at one in six, and cancer at between one in two and one in three. Our research shows that the South African experience is very close to these global trends.

The professional status, age and gender claims statistics reveal that everyone is vulnerable, with the youngest and oldest disability claimants aged 22 and 64 respectively, while the ages of those for whom death claims were paid ranged from 19 to 92.

Ill health can place a significant strain on a household’s finances, which is where cover for non-communicable disease or dread disease is available. It is important to understand why these staggering amounts in claims were paid.

If you are not on top of knowing your own vitals and living a life that will bring about vitality and longevity, then to to adopt the attitude that it won’t happen to me, is very foolish. Claims statistics show just how many things can, and do, go wrong and no one person is immune, no matter your profession or line of work.

For any further insight on this article or the right cover you may require, you welcome to leave a comment, or send a message to psmanjak@infiniterisk.com.

Peter Šmanjak

Owner and Founder at Infinite Risk

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