2015 GREENLIGHT Claims Statics
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Transcript of 2015 GREENLIGHT Claims Statics
BILLION REASONS WHY ADVICE MATTERSYou trusted us and because you believed in your financial adviser’s advice, we paid out R3.99 billion in claims in 2015.
4
OVER 170
YEARS OF EXPERIENCE
VOTED THE MOST
TRUSTED INSURER
TOP INSURANCE
BRAND IN SOUTH AFRICA
Our customers are at the heart of everything we do, along with our promise to pay their claims in the event of death, disability or severe illness.
By truly understanding the needs of our customers and offering them the right advice, we’ve been able to recommend the relevant solutions and pay them what we promised.
Please take a look through this guide for more information about claims paid in 2015.
It includes claims paid for the Conventional, Flexi and GREENLIGHT product ranges. It does not include any group
cover or investment and savings products. All Rand amounts shown include all claims paid for benefits that were either fully or partially underwritten or via a conversion option with reduced underwriting.
Old Mutual is a global company with a footprint in various countries around the world. In South Africa we have been voted the most trusted insurer by Reader’s Digest and were named the number one brand in the long-term insurance industry by TGI Ask Afrika in 2015.
WITH OVER 17O YEARS OF ENABLING BETTER FUTURES FOR OUR CUSTOMERS, WE CAN APPRECIATE THE VALUE OF GOOD ADVICE.
WE PAID R3.99 BILLION FOR UNDERWRITTEN COVER• Death – R3.08 billion
• Disability – R399 million
• Severe illness and functional impairment – R 498 million
• Retrenchment – R8 million
Since 2005, a massive R106 million for immediate cover was paid to GREENLIGHT customers that had not even paid one premium.
WE HAVE EXCLUDED INVALID CLAIMS• Where a claim was submitted under an incorrect
benefit (i.e. a disability claim for a fractured arm under a death benefit), or
• Where the benefit was paid up or cancelled before the claim event occurred.
HOW WE CALCULATED OUR PAYOUT RATIOS FOR RISK COVER THAT WAS UNDERWRITTENWe calculated claim payout ratios based on valid claims received. This means claims paid and claims rejected.
OF ALL VALID CLAIMS RECEIVED WERE PAID
83% SEVERE ILLNESS
93% DISABILITY INCOME
78% DISABILITY LUMP SUM
99% DEATH
WE ARE TRANSPARENT AND HAVE SOME OF THE BEST PAYOUT RATIOS IN THE INDUSTRYSource: Claim stats brochures of insurers
UN
DERW
RITI
NG
PREMIU
MS
CLAIMS
We underwrite thoroughly upfront so that the risks are well understood. This means that we price accurately which allows us to deliver on our promise when you claim.
BILLION PAID
R3.99UNDERWRITTEN CLAIMS
AVERAGE WORKING DAY PAYOUT:
R16 MILLION
Our largest death benefit claim in 2015
R119 MILLIONTERMINAL ILLNESS
Average age55
Youngest
22
Oldest 89
Average age55
Youngest 6
Oldest 92
43% Female
57% Male
WHY WE DIDN’T PAY
Benefit definition not met 62%
Non-disclosure 27%
Fraud 4%
General exclusion 3%
Suicide exclusion (within the first 2 years) 2%
Underwriting exclusion 2%
Cancer and tumours 30%
Cardiovascular disorders 20%
*Other 10%
Central nervous system disorders 10%
Trauma, lifestyle and accidents 9%
Musculoskeletal disorders 8%
Respiratory system disorders 6%
Sensory and communicationdisorders
4%
Connective tissue disorders 3%
CAUSES OF CLAIMS PAID
• Blood disorders• Psychiatric disorders• Child benefits• Urinary system disorders
• Dermatological disorders• Digestive system disorders• Endocrine disorders
*OTHER CONSISTS OF
COMBINED PAYOUT RATIOS FOR ALL CATEGORIES
WE PAID
DEATH CLAIMS
DEATH CLAIMSIn 2015, we paid 99% of all the valid death claims that we received. R3.08 billion was paid in total. Of this, R227 million was paid for terminal illness claims. 88% of terminal illness claims were for cancer.
88%DUE TO CANCER
R227MILLION
TERMINALILLNESS CLAIMS
“IT GIVES YOU A LOT OF SATISFACTION TO KNOW THAT YOU’VE FULFILLED THAT FINANCIAL NEED FOR YOUR CUSTOMER.”
Abey Karam – Old Mutual financial adviserScan the code for more information on our death benefit.Or visit our website.
ACCIDENTAL DEATHMotor vehicle accidents 61%
Crime and violence 16%
Shooting accidents 8%
Other* 6%
Accidents outside the home 5%
Accidents in the home 4%
DEATH CLAIMS
• Train accidents • Drowning • Electrocutions • Burns
• Accidental poisoning • Aeroplane accidents
*OTHER CONSISTS OF
Cardiovascular disorders 26%
Cancer and tumours 25%
Accidental death 14%
Respiratory system disorders 11%
Other* 11%
Central nervous system disorders 7%
Systemic disorders 6%
• Urinary system disorders• Blood disorders• Connective tissue disorders• Endocrine disorders
• HIV/AIDS• Musculoskeletal disorders• Suicide• Digestive system disorders
*OTHER CONSISTS OF
WHY WE DIDN’T PAY 1% OF DEATH CLAIMS
Average age60
Youngest23
Oldest 88
Average age58
Youngest 19
Oldest 92
42% Female
58% Male
12%SUICIDE
EXCLUSION
19%FRAUD
2% GENERAL
EXCLUSION
3%BENEFIT
DEFINITION NOT MET
64%NON-
DISCLOSURE
Biggest cause of claims for males was for cardiovascular diseases.
Biggest cause of claims for females was for cancer.
DISABILITY CLAIMSIn 2015, we paid 84% of all valid disability claims that we received.
• 93% of valid claims received for income benefits were paid
• 78% of valid claims received for lump sum benefits were paid
R399 million was paid for disability claims in total.
“MOST PEOPLE FEEL THAT THEY WILL NEVER BE DISABLED SO WHY PAY FOR SOMETHING THEY’LL NEVER NEED.”
Marius Laas - Old Mutual Disability Cover policyholder
Scan the code for more information on our disability benefit.Or visit our website.
34%MUSCULOSKELETAL
DISORDERS
R399MILLION
DISABILITY CLAIMS
78%LUMP SUM
93%INCOME
HIGHEST IN THE INDUSTRY
Average age43
Youngest 22
Oldest 65
Average age46
Youngest18
Oldest 65
42% Female
58% Male
DISABILITY CLAIMS
TIP: You can add a lump sum of up to R750 000 to your income benefit to cover your debt.
58% OF INCOME CLAIMS WERE FOR THOSE YOUNGER THAN 45
Biggest causes of claims for males and females were for: • musculoskeletal disorders (34%)• central nervous system disorders (15%)
Biggest single cause of claims for males was: • knee surgeries (6%)• major depression (6%)
Biggest single cause of claims for females was: • breast cancer (8%)• shoulder injury (7%)
Musculoskeletal disorders 46%
Central nervous system disorders 11%
*Other 9%
Psychiatric disorders 7%
Urinary system disorders 7%
Cardiovascular disorders 5%
Cancer and tumours 5%
Sensory and communication disorders 5%
Connective tissue disorders 5%
CAUSES OF CLAIMS PAID OUT FOR INCOME
• Dermatological disorders• Systemic disorders• Trauma and lifestyle
• Endocrine disorders• Respiratory system disorders• Digestive system disorders
*OTHER CONSISTS OF
• Urinary system disorders• Dermatological disorders• Digestive system disorders
• Child benefits
*OTHER CONSISTS OF
Central nervous system disorders 23%
Musculoskeletal disorders 22%
Cancer and tumours 14%
Psychiatric disorders 13%
Connective tissue disorders 6%
Trauma and lifestyle 5%
*Other 5%
Cardiovascular disorders 4%
Respiratory system disorders 4%
Sensory and communication disorders 4%
CAUSES OF CLAIMS PAID OUT FOR LUMP SUM
67%BENEFIT DEFINITION
NOT MET
28%NON-
DISCLOSURE
4%UNDERWRITING
EXCLUSION
1%GENERAL
EXCLUSION
WHY WE DIDN’T PAY 16% OF DISABILITY CLAIMS
SEVERE ILLNESS CLAIMSIn 2015, we paid 83% of all valid illness claims received. Of this, the BIG FOUR illness claims which are cancer, heart attack, stroke and coronary artery bypass graft represented 85% of all the claims paid. The remaining 17% of all claims received is made up of a range of illnesses.
“MEDICAL AIDS DON’T PAY FOR EVERYTHING. FORTUNATELY I HAD SEVERE ILLNESS COVER AND I DON’T KNOW WHAT I WOULD HAVE DONE WITHOUT IT.”
Wyno Strydom – Old Mutual Severe Illness Cover policyholder
Scan the code for more information on our severe illness benefits.Or visit our website.
WE PAID
HIGHEST IN THE INDUSTRY
SEVERE ILLNESS CLAIMS
*OTHER CONSISTS OF
Cardiovascular disorders 32%
11% Central nervous system disorders
2% Respiratory
6% Other*
system disorders
Cancer, blood and tumours 49%
• Connective tissue disorders• Dermatological disorders• Digestive system disorders• Endocrine disorders• Musculoskeletal disorders• Sensory and communication
disorders• Trauma and lifestyle • Urinary system disorders
Average age49
Youngest 23
Oldest 76
Average age51
Youngest 6
Oldest 78
45% Female
55% Male
22%NON-
DISCLOSURE
60%BENEFIT DEFINITION
NOT MET
3%OUTSTANDING REQUIREMENTS
NOT MET
15%GENERAL
EXCLUSION
WHY WE DIDN’T PAY 17% OF SEVERE ILLNESS CLAIMS
OF SEVERE ILLNESS CLAIMS WERE FOR
THE BIG 485%
CANCER57%
STROKE9%
CABG14%
HEARTATTACK
20%
Biggest causes of claims for females were: • Cancer and tumours (69%) • Central nervous system (10%) • Cardiovascular disorders (11%)
Biggest causes of claims for males were: • Cardiovascular disorders (49%) • Cancer (34%)
Cancer, blood and tumours 49%
R8.2bn IN TOTAL
WE PAID ALMOST R1 MILLION EVERY HOUR
R2.9bnCORPORATE
R3.99bn UNDER-WRITTEN
R1.3bnNON
UNDER-WRITTEN
We remain the leading insurer in the long-term insurance industry for claims paid, with a massive payout of R8.2 billion in 2015.
This includes R3.99 billion in underwritten benefits, R2.9 billion for corporate benefits and R1.3 billion in benefits that were not underwritten.
The total value of claims paid went back into our economy to enable a better future for our customers.
This equates to almost R1 million paid out to customers every hour.
WE DELIVERED WHEN NEEDED
You trusted us with your money and we kept our promise to you. We would like to continue with you on your journey to financial greatness.
Let one of our accredited financial advisers design a financial plan that will suit your needs, consider your circumstances and help you reach your goals. This comprehensive plan will ensure that you have all the solutions you need on your path.
SAVE
Start saving today. Get into the habit of putting away some money every month. The earlier you start, the sooner you’ll reach your goal. Put away as much as you can afford to; you will thank yourself in the future.
INVEST
Make sure that your future self is financially secure. Ask your financial adviser about our investment solutions that will suit your specific needs. Always remember to pay yourself first.
PROTECT
You are your biggest asset. Protect yourself with our range of solutions that will financially cover you from different types of risks varying from death to loss of income.
Partner with South Africa’s top insurer (as voted for by Sunday Times Top Brands in 2015) for advice that matters. Let us help you do great things.
WE’VE PAID, NOW LET US HELP YOU MAKE YOUR MONEY WORK FOR YOU
ENJOY THE FULL BENEFITS OF YOUR CLAIMS PAYOUT BY MANAGING AND INVESTING IT WISELY
WHAT’S NEXT?
OLD MUTUAL INVEST TAX FREE PLAN
The Tax Free Plan is a great discretionary investment that can also be used to boost
your retirement savings. This plan provides tax-free growth and puts you in control of your savings by giving you the peace of mind that you can access your money
at any time.
OLD MUTUAL INVEST FLEXIBLE PLAN
The Flexible Plan puts you in control of your savings and encourages you to save while giving you the peace of mind that
you can access your money at any time. It is a simple, transparent savings solution that aims to meet your savings needs.
MAX INCOME Allows you to buy a guaranteed
stream of income for a specified term or for life. All you need to do is use the proceeds from your GREENLIGHT claim to purchase a Max Income, Income for Term or Income for Life product. Various different income options and payment
frequencies are available to suit your specific needs.
MAX INVESTMENTS
OPTIMAL RETIREMENT PLAN
The Max Investments Optimal Plan is a recurring-premium retirement annuity that allows you to increase the amount you invest as you are able to. You can also decrease your payments, or take a payment holiday when life throws you that unexpected curve ball. After five years, it also gives you Investment
Boosters that increase your fund value.
DEAL WITH THE
CURVEBALL
TAILOR
INCOME
SOLUTIONS
BENEFIT CAN BE USED FOR NEED SOLUTION
DEATH
• Funeral expenses• Estate duty and
liquidity • Capital reinvested
• Income • Max Income
DISABILITY
• Medical expenses• Rehabilitation cost• Replace lost income
Lifestyle adjustment or changes.
• Supplement retirement
• Continuity• Additional
retirement funding
• Old Mutual Invest Tax Free Plan
• Old Mutual Invest Flexible Plan
• Max Investments Optimal Plan
SEVERE ILLNESS
• Medical expenses• Rehabilitation cost• Lifestyle adjustment• Supplement retirement
either permanently or temporarily.
• Fund a full recovery
• Additional retirement funding
• Old Mutual Invest Flexible Plan
• Max Investments Optimal Plan
• Max Income
BENEFIT CAN BE USED FOR NEED SOLUTION
YOUR
GOALS
100% TAX FREE
WE CONSISTENTLY DELIVER ON THE PROMISE OF GOOD ADVICE THAT ENABLES POSITIVE FUTURES FOR OUR CUSTOMERS.
For more information about Old Mutual’s claims statistics for 2015, please contact your financial adviser or call us on 0860 50 60 70 or visit www.oldmutual.co.za/greenlight.
Old Mutual is a Licensed Financial Services Provider
OLD
M00
0004
89