Chatswood serves the life and health insurance sector in New Zealand with market intelligence, data, and bespoke consulting services. Some of these are provided in conjunction with Quality Product Research Limited - a subsidiary that brings you Quotemonster.

We believe that good decisions are more likely to occur when we have good information about the market environment in which we operate. Intuitive leaps and creative decisions are always required, of course, but the more they are based on a firm foundation of observation, the better they tend to be.

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Fidelity Life announces growth plans

Campbell Mitchell, Fidelity Life Chief Executive, has told delegates at the Engage Conference the company’s intentions to grow to a $1 billion company.

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Partners Life release claims statistics

Partners Life have released historical and current claims statistics.

Some interesting statistics have been released by Partners Life around claims. Since Partners Life launched in 2011:

  • Partners Life have paid out more than 70,000 claims worth more than $1.25 billion.

  • Their biggest monthly disability claim paid was for $1,617,691

  • The longest running claim paid for monthly disability cover was 4,068 days and the average claim length was 293 days

  • Partners Life paid 13,379 monthly disability cover claims totalling $225,954,755

  • Their biggest life cover claim paid was for $2,964,706

  • Partners Life paid 1422 life cover claims totalling $334,281,111

  • Partners Life paid 51,827 private medical cover claims totalling $353,468,683

  • Their biggest private medical cover claim paid was for $982,800

  • Partners Life paid 3,948 trauma cover claims totalling $357,357,574

  • Their biggest trauma cover claim paid was for $3,218,899

For the year ended 31 March 2024, Partners Life

  • paid 93% of claims

  • paid $51,020,381 of monthly disability cover claims cost across 3,332 claims paid

  • paid $61,130,350 of life cover claims across 208 claims paid

  • paid $71,705,905 of private medical cover claims across 12,891 claims paid

  • paid $66,106,600 of trauma cover claims across 655 claims paid

 

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nib launches nib meno care

nib NZ has launched a new health management initiative, nib meno care, aimed at supporting women through the stages of perimenopause and menopause.

nib NZ has launched a new health management initiative, nib meno care, aimed at supporting women through the stages of perimenopause and menopause. The programme has been developed in collaboration with Dr Linda Dear, a specialist in menopause care.

nib members will be able to access expert advice on managing menopause symptoms – covering topics from lifestyle adjustments, to natural remedies and available medical treatments.

A 2023 survey Dear conducted found 64% of NZ women were unaware their symptoms, such as sleep disturbances and weight gain, were linked to menopause.

nib’s chief medical officer, Dr Rob McGrath, said

“Menopause is a personal journey, and no two women experience it the same way. That’s why we wanted to develop a tool to help women manage their symptoms on their own terms by making expert support easy to access and apply.”

 

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Southern Cross Health Society Group annual results released

Southern Medical Care Society Group has shared their annual results for the year ended 30 June 2024.

Southern Medical Care Society Group has shared their annual results for the year ended 30 June 2024. By the numbers:

  • Group deficit of $88.2 million after tax. $43.1 million of the deficit is attributable to a change in international financial reporting standards introduced this financial year. The balance of the deficit is driven by higher claims costs from a high inflationary environment combined with high member demand for private health services, particularly in the second half of the financial year.

  • Group reserves of $470.7 million.

  • Claims paid at a rate of $6 million per business day (up from $5.2 million in FY23).

  • 15,196 net new members, with total membership now at 955,301.

  • This represents 60% of the New Zealand health insurance market by customer numbers but 71% per cent of the value of all health insurance claims paid.

  • 99% of claims were submitted electronically.

Southern Cross Health Insurance

  • Reported a deficit of $99.1 million.

  • Paid $1.498 billion in claims from $1.605 billion received in premiums.

  • Claims costs increased 15% on FY23 (up 13.9% when adjusted for member growth).

  • Premiums increased 9% on FY23 (up 6.6% when adjusted for member growth).

  • 93.4 cents paid in claims from every dollar received in premiums (compared to an industry average excluding Southern Cross) of 73 cents.

  • Operating costs grew by 4%, less than inflation.

  • 3.2 million claims in FY24

  • 50% of members claimed over the financial year.

  • 39,326 virtual GP consultations with Care HQ.

  • 4,635 annual health check-ups with MedPro.

  • 4,016 online mental health sessions with Raise.

  • Net promoter score of 53.7%.

 Nick Astwick, Chief Executive for Southern Cross Health Society said

“We have never been in more demand by our members as they prioritise their health needs, largely in the private system. In 2019 33% of our membership claimed, last year it was 50%.”

“The cost of claims in 2024 was steep and rapid, driven by a combination of price, volume, and the mix of claims. The growth in the volume of claims results from an increase in the number of members claiming, the frequency, and claims being made for more expensive procedures.”

 

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2024 Haven award winners announced

Committee recommended changes to the Contracts of Insurance Bill

Travis Hamilton says Total and permanent disability (TPD) cover is being underestimated

Jon-Paul Hale suggests ways insurers can improve systems for advisers

Tony Vidler recommends how advisers can value themselves appropriately

The Government has completed a cost-benefit analysis for potential third medical school

Wayne Langford appointed to the Board of the Mental Health and Wellbeing Commission

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If you have an adviser – you tend to get better claim outcomes

Jon-Paul Hale questions the use of automated portals when it comes to claims time.

Regulatory reviews in Australia have found the claims acceptance rates for the life insurance industry between distribution channels. The difference is marked – claims acceptance rates for advised retail policies was 92.1% compared to 87.8% for direct policies. For a good review check out Jack Howitt’s article here. 

Jon-Paul Hale emphasises the importance of advisers at claim time, which perhaps provides an explanation for part of the gap: Hale has questioned the use of automated portals when it comes to claims time. From his experience, there are plenty of claims where, had the clients claimed through the portals without his involvement, the clients wouldn’t have had such good outcomes. He gives a range of examples and cautions that clients can forget what cover they have and how it works – all at a time when they may be feeling overwhelmed from the medical situation they are facing. 

On the other hand, the difference between group and retail policies in Australia leans back the other way – more towards how the policy was underwritten as a potential cause for the difference in outcomes. Group insurance policies have some of the highest claims acceptance rates at just over 95%. Howitt’s explanation is compelling:

“This is likely due to the fact that group life insurance policies are typically underwritten on a group basis, which means that insurers have less risk associated with each individual policy. Retail advised policies may have lower claims acceptance rates due to the fact that they are typically more complex and may involve higher risk individuals. Direct policies may have lower claims acceptance rates due to the fact that insurers have less information about policyholders.”

 

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Committee recommends Contracts of Insurance Bill moves forward

New Zealand’s Finance and Expenditure Committee has recommended that the Contracts of Insurance Bill move forward. After reviewing the bill, the committee proposed several key amendments.

New Zealand’s Finance and Expenditure Committee has recommended that the Contracts of Insurance Bill move forward. After reviewing the bill, the committee proposed several key amendments:

  •  Insurers are allowed reasonable time to gather information when processing claims.

  • That dishonesty be treated as a lack of reasonable care rather than outright fraud.

  • That a power to create some regulation of the use of genetic tests in underwriting is included in the draft law.

Government officials anticipate the bill to be passed by the end of this year. Changes insurers will need to prepare for once the bill comes into force include reviewing existing contracts to ensure compliance with new consumer protection measures; preparing for potential regulations on the use of genetic data; and ensuring claims processing procedures meet the new ‘reasonable time’ requirements.

With regard to the power to regulate the use of genetic tests, the report states:

“We agree that this issue is important. Our view is that a cautionary approach to genetic testing is needed to avoid undue genetic discrimination. However, we also grappled with the question of how to address genetic testing in this bill. We considered the implications of different options, including a full legislative ban on “genetic discrimination”.

“Ultimately, we recommend inserting new regulation-making powers, in Part 3, new subpart 4A (clauses 86A, 86B, and 86C), that would enable the Governor-General, on a recommendation of the Minister, to prohibit or regulate the conduct of insurers in relation to genetic testing. Before recommending any regulations, we expect the Minister to conduct a full policy development and consultation process.”

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From 1 October 2024, Keytruda will be funded for eligible people with certain cancers

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AIA release 'Claims Compass' report analysing claims data

AIA have released a new report ‘Claims Compass’ analysing their claims data. Cancer was responsible for AIA’s highest number of claims across all insurance categories last year.

AIA have released a new report ‘Claims Compass’ analysing their claims data. Cancer was responsible for AIA’s highest number of claims across all insurance categories last year, with AIA paying out $133.9m for life insurance claims for cancer and $244.1m for cancer claims across all categories. AIA’s top cancer claims in 2023 were breast cancer (33.4%), melanoma and skin cancers (20.3%), bowel cancer (6.5%), prostate cancer (6%) and lung cancer (4.6%). Cancer is the leading cause of death and serious illness in New Zealand, with 71 people diagnosed with cancer every day in New Zealand.

Angela Busby, AIA NZ Chief Customer Officer, said

“Almost every New Zealander will have some experience with cancer throughout their lifetime – whether that’s personally or through a friend, neighbour or loved one…”

“The prevalence of these cancers highlights the critical importance of regular screening and taking preventative measures to manage your health and encouraging loved ones to do the same.”

“Because while developing cancer might appear to be something that is beyond our control, we know that early detection is the best form of protection. Many cancers can be successfully treated if diagnosed early, with an estimated one in three people recovering in New Zealand.”

AIA accepted 92% of all claims for the year ended 31 December 2023, paying out $734.8m. Of the total paid, $263.5m was paid out in life insurance claims and $143.1m was paid in health claims. The image below shows the reasons for claims across AIA’s life, health, trauma, income protection and total permanent disablement categories.

Reasons for claims across AIA’s life, health, trauma, income protection and total permanent disablement categories
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AIA release their 2023 Sustainability Report

AIA has released its 2023 Sustainability Report: Sustaining Healthier, Longer, Better Lives.

AIA has released its 2023 Sustainability Report: Sustaining Healthier, Longer, Better Lives. Key highlights include:

  • Achieved Toitū carbonreduce certification

  • Paid 92% of claims received, totalling $734.8M in 2023

  • Grew to 55,000+ AIA Vitality members, encouraging members to improve their physical and mental wellbeing

  • Invested into the Betashares Global Sustainability Leaders and Australian Sustainability Leaders funds

  • Began transitioning fleet to hybrid vehicles to reduce fuel usage

  • 2023 Gallup Engagement Survey Top Quartile in global finance and insurance industry benchmark

  • Partnered with the Sustainable Business Council, hosting a webinar highlighting their Environment and Our Health Report.

AIA was recognised for its sustainability efforts, winning the 2023 Australian and New Zealand Institute of Insurance and Finance Awards for Excellence in Environmental, Social and Governance (ESG) Change, and the Financial Services Council of New Zealand Award for Excellence in Sustainable Practices.

Nick Stanhope, AIA NZ CEO, said

“At AIA NZ, our dream is for New Zealand to be one of the healthiest and best protected nations in the world. We understand that environmental sustainability not only has an impact on the wellbeing of our planet, but on our physical and mental health as well.

By rolling out initiatives and practices which support our ESG goals, we’re demonstrating our commitment to safeguarding the environment and the health of our communities.”

 

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Jon-Paul Hale critiques insurers' use of “MedSafe indicated” wording in policies

Jon-Paul Hale critiques insurers' use of 'MedSafe indicated' wording in policies, saying if clinicians and customers were more aware of what the wording meant they may change their treatment plans.

Jon-Paul Hale critiques insurers' use of 'MedSafe indicated' wording in policies, saying if clinicians and customers were more aware of what the wording meant they may change their treatment plans to ensure that coverage extends to the use of the medicine.

In policy wordings, “MedSafe indicated” can significantly limit access to treatment; where MedSafe guidelines include "indicated first-line treatment", this means the medication is only authorised for use as the first treatment. Hale suggests that clients consider any mediations with ‘first-line’ indications may wish to be treated with these medications first, as insurers are unlikely to approve them for later use.

What may surprise you is that many, many, medicines are prescribed that are outside Medsafe indications. Some are prescribed even though the medicine is unapproved for any purpose in New Zealand. Several insurers will not cover medicines that are unapproved. Obtaining a Medsafe approval for the use of a medicine can be time consuming and expensive. We are a small market and some disorders are rare. That means that while it may be economically viable to gain approvals in the United States and Europe, sometimes the New Zealand market may be too small for these companies to consider seeking approval economically viable, especially when some medical professionals will still prescribe an unapproved medicine.

At Quality Product Research Limited we are committed to ensuring that research scores are descriptive of these differences, which are increasingly important. There is a review of the non-PHARMAC coverage item in our health / medical insurance research which is being consulted on right now. If you would like to participate in the review please contact us. Results of the review will be announced at our forthcoming national roadshow which runs from 23 July to 29 August. Register for the roadshow, at a venue near you, here.

References:

Medsafe – about and role: https://www.medsafe.govt.nz/other/about.asp

Medsafe – use of Unapproved Medicines and Unapproved Use of Medicines: https://medsafe.govt.nz/profs/riss/unapp.asp#need

 

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AIA releases data on claims by age bracket

AIA has released information on claims by age bracket – counter to what is often seen in the media about elderly people having the highest health costs, the age bracket that had the most claims in 2023 was those aged 50 – 59.

 AIA has released information on claims by age bracket – counter to what is often seen in the media about elderly people having the highest health costs, the age bracket that had the most claims in 2023 was those aged 50 – 59. This age group was paid out more than $197 million in 2023 out of $734.8 million in total claims.

Those aged 60 – 69, while still making up a large proportion of total claims, had  a total of more than $139 million in claims paid out, with $65.55 million being on life policies, while those aged 70 and over claimed just $71 million, with $50.52 million being against life policies. The lower level of claims of those aged over 70 could be due to people reducing or dropping their cover as they get older and no longer have dependants to consider or mortgages to pay off.

It comes as no surprise that those aged 20 – 29 had a low level of claims, with only $2.6 million paid in claims against life policies and $7.7 million paid on health policies in this age bracket.

 

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