Monday, April 24, 2017
Heart attack and stroke for men and cancer for women top reasons for insurance claims
04-18-2017

Zurich International Life’s latest claim statistics reveals that heart attack and stroke were the most common reasons for life and critical illness cover claims by men in the Middle East, while cancer was the leading cause for life and critical illness cover claims by women. Their claims data shows that the majority of claims made by men are from those aged 40 and above, whereas for women, the majority of claims were paid to women in their 30s. The findings were presented as part of the Middle East Claims Statistics and Insights – Jan 2014 to Dec 2016, which Zurich has published annually since 2011. Zurich continues to be the only life insurance provider in the Middle East to issue yearly claims statistics specific to the region.

Substantial variation between insurance claims patterns for condition, gender and age. 

The total value of claims Zurich paid out from Jan 2014 to Dec 2016 in the Middle East was just under AED 250 million (USD 67 million), with the largest life cover payout being AED 5.5 million (USD 1.5 million). The Zurich data shows significant variation in the causes of premature death and critical illness by condition. For life insurance, almost half (48%) of male claims were due to heart attack and stroke with a quarter (26%) from cancer, while for women, half of the claims (50%) were for cancer and 19% were for cardio vascular disease. When it comes to critical illness, over two-thirds (68%) of claims for men were paid out due to cardio vascular disease while four out of five (81%) claims paid out to women were for breast and cervical cancer. In general, statistics show that the majority of the claimants (73%) were men, which is reflective of the portfolio gender split of Zurich, revealing that women remain underinsured in the region. 

Higher expectations of health and longevity 

Findings from a recent report by Zurich reveal that 97% of UAE residents considered themselves to be healthy, with 88% believing they would remain healthy for the next five years. However, Zurich’s claims records demonstrate that the youngest claimants for life cover is 27, while for critical illness, it is 29 years. 

Helping customers with the claims process

Committed to paying out all valid claims quickly and easily to deliver strong customer service, last year, Zurich paid out 94% of life cover claims and 91% of critical illness. The top reason why some insurance claims are not paid out is due to serious non-disclosure of a previous or existing condition such as heart attack, cancer, diabetes, etc. A small percentage was due to fraud or a condition being diagnosed within the three-month waiting period on Critical Illness cover, preventing the company from attaining its ideal goal of 100% of claim payouts. 

Commenting on the lack of awareness of residents in the region to matters related to insuring both their life and their future, Chris Bagnall, Chief Underwriting Officer and Head of Claims, from Zurich Middle East said: “Insights from our claims data highlight the different risks people face and how they differ between men and women.  As you cannot predict the future, it is important to protect it and seek advice from a financial professional to ensure you have the right protection for yourself, your family and business. Zurich continues to work hard to increase the levels of disclosure. This period has seen an increase in the percentage of valid Critical Illness claims paid out. The percentage of rejected death claims increased this year as Zurich continues to be diligent in detecting attempted fraudulent claims.” 
He added, “It remains of upmost importance to Zurich customers that these fraudulent claims are detected as this helps to keep premium levels low.”


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