CLAIM STATISTICS INSIGHTS The foresight to ensure that you are fully protected

Transcription

1 CLAIM STATISTICS INSIGHTS 2014 The foresight to ensure that you are fully protected

2 A positive outlook on life, knowing that you are fully protected. We don t know what life has in store for you, nor which of life s risks you will encounter along the way. But we do know that you need to be adequately prepared for these. So we have developed comprehensive solutions to cover you against the curveballs life can throw at you and your family. Our solutions ensure that various aspects of your financial goals are achieved in the face of adversity, like ensuring that your children s school fees are covered, even if you are no longer around. As the market leader * in risk protection we have the knowledge to guide you on risk protection that you can be confident in. We take care of you and your family s cover needs holistically so that you can focus on fulfilling your vision of financial freedom. * Liberty has consistently sold the highest volumes of new risk cover for the past 11 years according to the Swiss Re Individual Risk Market New Business Volumes Survey. We are extremely proud of this achievement as testimony to our commitment to consistently providing innovative, customer-focused solutions.

3 CLAIM STATISTICS INSIGHTS In 2014 we paid claims of R Delivering on our promise is our commitment to you and your family. R408 million was paid for critical illness cover R411 million was paid for income protection R2.2 billion was paid for life cover Lump sum payments Monthly recurring payments R302 million R109 million The largest claim paid to a customer in 2014 was R50 million for Life Cover. Whilst this can never compensate for the loss of a loved one, those left behind are financially secure.

4 60s 3 CLAIM STATISTICS INSIGHTS 2014 Life stages Certain risks are more common than others depending on your lifestyle choices, age and gender. We don t know which of these you may encounter, so we have designed Lifestyle Protector with a range of benefits to ensure your cover remains appropriate. Seventies & beyond Old age impairments can eat into your hard-earned retirement savings. Twenties General good health although accidents pose a huge risk. Building a career means changes in your lifestyle and responsibilities. Sixties 70s 20s Thirties Retirement is in sight and priorities change. Visits to doctors and hospital stays can become more frequent. 50s 40s 30s Starting a family and the increased pressure and responsibility that comes with it. Stress, cholesterol and blood pressure risks increase. Fifties Forties Heart disease, strokes and diabetes become common risks. Higher risk of breast cancer in women and prostate cancer in men. Weight gain is an increasing worry. Early signs of poor lifestyle choices begin to show. See what others like you have claimed for Do you know what your peers claimed for at different stages of their lives? To see their realities visit

5 CLAIM STATISTICS INSIGHTS Factors that impact on your likelihood of claiming Your age and lifestyle choices can have a significant impact on your likelihood of claiming and the most likely causes of claim. In the figures below we highlight the most frequent causes of assessed claims. Your risk of claiming for natural causes increases as you get older Natural causes Unnatural causes Motor vehicle accidents 40% Under 30s 59% % % % Over 60s 60% 41% 21% 10% 3 % 37.9% of all natural claims are for cancer Smoking significantly increases the likelihood of being diagnosed with cancer and claiming as a result of it. The type of cancer that is most prevalent also depends on your smoker status. 40.7% of all unnatural claims are for retrenchments Motor vehicle accidents make up 22% of unnatural claims for under 30 year olds. For claimants younger than 30 cardiovascular disorders and musculoskeletal disorders are more prevalent than cancer. Other than retrenchments, accidental causes continue to be a major threat for people of all ages. Assess your risk Liberty has an innovative online assessment tool called Risk Revealer ( which measures your lifestyle and accidental risk level compared to other South Africans. If this is lower than average, we may offer you a premium discount on a new Lifestyle Protector policy.

6 CLAIM STATISTICS INSIGHTS Causes of claims Life Protection Having cover in place to protect your loved ones against an untimely death will leave the legacy you ve always envisioned. We don t know when that inevitable day will arrive but we do know that we can give you and your loved ones peace of mind that they are protected if you suffer from an untimely death. With our Life Cover in place, you can be confident that your commitment to protecting your family s financial future will continue when you are no longer around. In addition, our market leading EduCator benefit gives you the peace of mind of knowing that your child s education is covered, from pre-primary school to university, should you pass away, become disabled or critically ill. Underwriting protects insurers to the benefit of all customers by ensuring that anti-selection and early claims from natural causes are avoided. This means that unnatural claims make up a higher proportion of claims in the first three years, but cancer and cardiovascular disorders remain risks that could occur at any time. Life Protection claims by cause Natural causes Cardiac and cardiovascular disorders Respiratory diseases and disorders Genito-urinary disorders Central nervous system and strokes Other natural causes Unnatural causes Motor vehicle accident Other trauma and unnatural causes Claims in the first three years Claims in any years of the policy 8.3% 16.2% 22.8% 5.1% 20.9% 18.2% 13.9% 27.1% 20.4% 18.5% 3.8% 6.6% 4.7% 5.4% 8.1% Education - a lasting legacy Passing away before you have fulfilled your parental duties of education is often overlooked in a financial plan. A 17 year old, Susan van Niekerk** had the misfortune of losing both her parents in a car accident when she was just 11 years old. Susan had the terrible task of coping with the difficulty of losing her parents and moving home all at the same time. Dealing with these drastic changes was eased by the payout from the EduCator cover that Susan s parents had in place. Now in grade 11, Susan and her guardians haven t had to worry about her schooling expenses. Last year, Susan received a payment as her special achievement award for receiving national colours in drama. Thanks to her EduCator benefit she will never have to worry about her schooling expenses, as these are covered right up until she finishes her first university degree should she choose to study further. While Susan s parents may have made the decision to add an EduCator benefit quite casually, they could never have imagined just how much of a lasting legacy their simple action would leave for their little girl.

7 CLAIM STATISTICS INSIGHTS Loss of Income Protection Our holistic income protection benefits are designed to protect you against everything that could negatively affect your ability to earn an income. Traditional income protection policies only provide cover for events that lead to an inability to work, referred to as occupational disability. Our Income Protector is the most comprehensive in the market and protects you against anything that could negatively affect your ability to earn an income including disability, impairment, fractures, illness, retrenchment and even maternity leave. Loss of Income Protection claims by cause Natural causes Musculoskeletal diseases and disorders 5.0% 8.2% 15.1% Central nervous system and strokes Mental disorders Other natural causes 7,8% 18.3% 12.7% 5.6% 10.7% Unnatural causes Retrenchment Musculoskeletal injuries Motor vehicle accident Other trauma and unnatural causes 16.6% Provision for when a holiday turns bad Luke Cook** (aged 27) was looking for a break from his demanding business when he decided to go on a safari holiday. The idea of riding a horse in the wilderness appealed to his adventurous spirit but tragically this once in a lifetime adventure turned into a nightmare. Luke fell off the horse, causing him to fracture his spine, resulting in him becoming paralysed from the waist down. Losing the use of limbs is not easy for a young man to deal with but while we could not compensate Luke for the drastic changes he faced in his life, we could ensure his financial independence. He received a lump sum of R from his Living Lifestyle Plus and Absolute Protector benefits, as well as a monthly income of R for 23 months under his Absolute Income Protector benefit. The knowledge that he was financially secure helped to relieve a little bit of the stress and heartache he endured as a result of this accident, knowing that he was still financially secure.

8 CLAIM STATISTICS INSIGHTS Lifestyle Protection Having cover focused against critical illnesses will help you to maintain your quality of life by providing cash payout which can be used towards modifying your home or hiring a caregiver. We don t know if or when you might suffer from a critical illness or impairment, but do know that these could have a significant impact on your lifestyle. Our Lifestyle Protection benefits ensure you and your family can pay for non-medical costs and any lifestyle changes that you need to make, following one of these. It includes two market-leading features: The Medical Advancements Protection (MAP) feature is automatically included and ensures that your cover remains relevant, no matter how medicine improves. With this feature you are protected fully against the risk that claim definitions become outdated due to medical advancements in the future. Our Catch-All benefit, also automatically included, protects you against a wide range of diseases not specifically listed in your terms and conditions. Some of these may not even be known about in medical journals today. Lifestyle Protection claims by cause Natural causes Cardiac and cardiovascular disorders Central nervous system and strokes Musculoskeletal diseases and disorders 5.1% 12.2% 44.7% 1,7% 29.5% 2.4% 1,5% Endocrine diseases and disorders Autoimmune diseases 3.0% Other natural causes Unnatural causes Other unnatural causes An unexpected heart attack Malcolm Lottering**, a 53 year old father and husband, experienced a tragic event after a long day at the office. Whilst having dinner, Malcolm suffered a serious heart attack. Thankfully Malcolm has now made a full recovery through a rehabilitation programme but during his recovery time he had to make significant changes in his lifestyle, such as changing his diet and living more healthily. Malcolm received a payment of R from his Living Lifestyle Protector benefit, which he could use to pay for the different stages of his rehabilitation process and take care of the cost of a professional dietician to help adjust his lifestyle to lower the risk of further heart problems.

9 CLAIM STATISTICS INSIGHTS Policy Protection An accurate snapshot of your policies will reveal how much protection your cover is providing. That s why we have options to help you stay covered, no matter what life has in store for you. Your ability to keep your cover matters to us as much as it does to you. We all go through financial difficulties from time to time. These tough times shouldn t be made worse by an inability to pay your risk cover premiums. That s why we offer Premium Protector benefits, which pay your premiums and ensure you won t lose your cover if you are retrenched, become disabled or if either you or your spouse pass away. Taking out new cover at a later stage could mean you need to be reassessed then, in an older and possibly less healthy state. That may mean higher premiums, or not qualifying for cover at all when you need it most. Our Future Protector benefit ensures that you will have access to further cover as you get older even if you become uninsurable due to deterioration of your health. Our Policy Protection range is completed by Financial Protector, which is a savings component that gives you financial backing to pay your premiums when you are unable to do so. The pressure of the current economic climate is a reality for most. This is evident through a large proportion of our Policy Protection claims being for people who were retrenched over the past year. Policy Protection claims by cause Natural causes Central nervous system and strokes 5.3% 3.2% Musculoskeletal diseases and disorders Mental disorders Other natural causes 7.4% 13.7% 3.2% 64.2% Unnatural causes 3.2% Retrenchment Musculoskeletal injuries Protecting your policy s life Elna De Beer**, a 45-year-old receptionist, considered herself to be fighting fit until one Sunday afternoon when she suffered from an unlikely and unfortunate stroke. Elna contributed heavily to her household and recovering from this stroke hindered her ability to fulfill her duties as a receptionist and bringing home a monthly income. She received a payout of R under the Absolute Protector Plus benefit and R under her Living Lifestyle Plus benefit. As Elna could no longer work while recovering, she also claimed from her Premium Protector benefit. This will continue to pay all her monthly premiums ensuring that her other risk benefits can remain intact.

10 9 CLAIM STATISTICS INSIGHTS 2014 Claims by age and gender Regardless of whether you are a man or a woman, a young executive or a retired homemaker, it is never too early or too late to consider Lifestyle Protector s comprehensive risk cover that is tailored to your specific needs. Our statistics reveal that men and women claim for significantly different types of cover and that this also changes by age. Men have a higher propensity to take out life cover and consequently a higher proportion of claims are in respect of this. This applies to men of all ages. Women, on the other hand, tend to insure themselves proportionately more against critical illness and income protection. This leads to higher claims in these two areas of protection. Lifestyle Protector provides customised solutions for both men and women across all types of cover, ensuring that no matter your gender or insurance needs, you and your family are covered. Spread of claims across cover type by age and gender Men 67.8% of all claims Women 32.2% of all claims 26% 43% 25% 6% Under 35s 13% 53% 27% 7% 23% 41% 32% 4% % 33% 42% 5% 37% 24% 37% 2% % 31% 39% 3% 54% 13% 32% 1% % 12% 44% 1% 93% 1% 6% Over 65s 95% 1% 4% Life Protection Loss of Income Protection Lifestyle Protection Policy Protection Protection against the unique challenges faced by women Liberty provides cover for serious pregnancy complications and congenital birth defects through the Female Living Lifestyle benefit. The Maternity Pause Option, under Income Protector, is a free benefit that pays four times your monthly Income Protector premiums as a lump sum when you go on maternity leave.

11 CLAIM STATISTICS INSIGHTS Causes of assessed claims by gender Musculoskeletal injury 47.2% Second biggest cause 22.5% Unnatural Biggest cause retrenchment % 18.8% of all claims were unnatural 37.8% Second biggest cause 14.4% Biggest cause cancer % 78.1% of all claims were natural Natural Central nervous system Retrenchment 67.8% 32.2% Cardiac and cardiovascular disorders Biggest cause cancer % 36.0% 81.2% of all claims were natural Natural Second biggest cause 30.6% Unnatural 21.9% of all claims were unnatural Biggest cause retrenchment % Second biggest cause 11.5% 29.0% Retrenchment Motor vehicle accidents A mother s life turned upside down Thandeka Kuzwayo**, a 39 year old housewife and mother of two, was undergoing her routine mammogram. She had experienced this exam so many times before that she genuinely did not expect to receive any bad news. Yet on that fateful day, her gynaecologist informed her of the terrible news that he may have found a cancerous lump inside her left breast. After all the necessary tests were done, his fears were confirmed and she was diagnosed with stage 2 breast cancer. Fortunately the detection was made early enough for Thandeka to have multiple treatment options including a life-saving mastectomy. As terrible and scary as hearing the word cancer can be, Thandeka held her head high and was determined to beat it for the sake of her family. She was fortunately covered on her husband s policy for critical illness. After submitting a claim she received 100 % of her Living Lifestyle Plus (with the Top-Up and Extended options) sum insured, amounting to R Although this money could never make up for the trauma that she and her family suffered, it allowed her to undergo reconstructive breast surgery and pay for the various other lifestyle adjustments she had to make, such as hiring a full time nanny to help run her household whilst she was recovering.

12 11 CLAIM STATISTICS INSIGHTS 2014 Top claims causes per cover type by age and gender Knowing that your risk profile changes as you get older, ensures that you can put the right cover in place based on your needs at that time. Although many young adults overlook the need for risk cover, the reality is that accidents can happen at any point in time. As a young family, your needs may also be very different to when you were single. As you get older and wiser, you generally start taking fewer risks. However, the lifestyle choices you made earlier in your life may start impacting on your health. and cardiovascular disorders become more prevalent at these ages and account for almost half the claims over the age of 35. Top claims causes by gender and age 7.1% Proportion of claims 92.9% Under 35 Over 35 Trauma Motor vehicle accidents Cardiovascular disorders 39.4% 9.1% 51.5% Life Protection 23.4% 19.2% 57.4% Motor vehicle accidents Retrenchment Musculoskeletal disorders 58.2% 13.4% 28.4% Loss of Income Protection 17.0% 15.3% 67.7% s Cardiovascular disorders Cardiovascular disorders 55.3% 18.4% 26.3% Lifestyle Protection 39.5% 37.6% 22.9% Respiratory disorders Motor vehicle accidents Cardiovascular disorders 70.8% 12.5% 16.7% Life Protection 27.6% 15.5% 56.9% 46.6% Maternity Retrenchment Musculoskeletal disorders Retrenchment Loss of Income 17.8% 35.6% Protection 21.5% 18.1% 60.5% Respiratory disorders Central nervous system disorders & strokes 50.0% 11.5% 38.5% Lifestyle Protection 63.9% 12.3% 23.7% Providing for your business even on your sick bed Dr Rajesh Naidoo**, a 35 year old dentist, was well aware of his responsibilities to his staff when he decided to take out the Overhead Expenses Protector benefit in addition to his Absolute Income Protector. Rajesh understood the financial reliance that his loyal employees had on his ability to do his job. This cover was welcomed when Rajesh had to go through emergency surgery, with a lengthy recovery ahead of him. Rajesh was capable of resting easy for two months due to the total payout of R from his policy. Rajesh was still able to manage the expenses of his business, even though he was unable to physically perform the duties required to receive his income. This eased the process of recovery for him and ensured the financial wellbeing of his staff members who were so dependent on him.

13 CLAIM STATISTICS INSIGHTS claims claims are covered across all four types of protection of Lifestyle Protector, ensuring that you are fully protected. Over the last few years, cancer has become a reality in most families and is now our most common cause of claims. With medical improvements and cancer increasingly being diagnosed at younger ages, one simply cannot afford to be without appropriate cover. affects all ages, although to a different extent. For men, prostate cancer is the leading cause after age 45. For under 45s, lymphoma and skin cancer are more common. For women, breast cancer is the leading cause across all life stages. 21.7% of claims paid to men were cancer claims Top 4 cancers for men Proportion of male cancer claims Prostate 28.1% Skin 10.7% Colorectal 9.9% Lung 8.6% 24.7% of claims paid were cancer claims 32.4% of claims paid to women were cancer claims Top 4 cancers for women Proportion of female cancer claims Breast 49.4% Skin 8.3% Endometrial 6.3% Colorectal 5.9% Spread of cancer claims by age Spread of cancer by cover type Under 35s 2.3% % % % 47.3% 8.3% 44.1% 0.3% Life Protection Loss of Income Protection Lifestyle Protection Policy Protection Over 65s 24.0%

14 13 CLAIM STATISTICS INSIGHTS 2014 Insights into 2014 claims outcomes You can rest assured in our commitment to paying 100% of all valid claims. Unfortunately some claims submitted to us are not valid, for a number of reasons. 95.7% Valid claims that were paid 3.4% The condition claimed for did not meet the claims requirements specified in the policy document 0.7% The policyholder did not disclose important information at the application stage of the policy <0.1% Deferred claims, where it is not yet clear whether the claim is valid or not and a claim cannot be made until this is determined 0.2% The claim event was specifically excluded in the policy documents. An open book is a safe book Carol Sharp**, a 35 year old divorcee and single mother, was diagnosed with multiple sclerosis. She had gone through an extremely difficult time dealing with high-pressure situations in her life in the six years preceding her diagnosis, this led to multiple unfortunate episodes of depression for which she was receiving treatment. When she took out her Living Lifestyle Plus policy, she failed to disclose her history of depression. When Carol claimed for her multiple sclerosis diagnosis she was not expecting that her claim would be declined for any reason. She was however told that not disclosing parts of her medical history could in fact result in her policy terms and conditions being reviewed or even cancelled. Upon reconstructing her benefit, Carol was informed that a depression exclusion would have been applied to her policy from inception had she disclosed the medical history. She was requested to accept the exclusion to keep the policy active and to qualify for the R payout she eventually received. To avoid disappointment at claim stage please ensure that you fully and accurately disclose all information when you take out your policy, understand what you are and are not covered for and take note of all exclusions that apply to your cover.

15 Keeping our promise to you We believe in transparency and were the first to publish our claims statistics in Since then we have paid out more than R20 billion in claims R1.128 billion 2007 R2.387 billion 2008 R2.030 billion 2009 R2.218 billion 2010 R2.572 billion 2011 R2.597 billion 2012 R2.333 billion 2013 R2.715 billion 2014 R3.019 billion **Names have been changed for the testimonials

16 ROGUE/4530 Contact us For more information please speak to your Liberty financial adviser or broker, contact our call centre on or visit Liberty Liberty Group Limited Registration number 57/02788/06 1 Ameshoff Street, Braamfontein PO Box 10499, Johannesburg 2000 Disclaimer The information contained in this document does not constitute advice by Liberty. Any legal, technical, or product information contained in this document is subject to change from time to time. This document is a summary of the features of the product as at the time of publication. If there are any discrepancies between this document and the contractual terms and conditions or, where applicable any fund rules, the latter will prevail. Any recommendations made must take into consideration your specific needs and unique circumstances. Lifestyle Protector is underwritten by Liberty Group Ltd. Liberty Group Ltd is an Authorised Financial Services Provider in terms of the FAIS Act (no. 2409) Liberty Group Ltd All rights reserved.