The state of health in South Africa according to Discovery Life’s claim experience 2016

Discovery Life published insights of its life assurance claims from January 2016 to December 2016. A total of 20 247 claims were paid over the period, amounting to R3.2 billion. This brings the total amount that Discovery Life has paid out to date up to R18.7 billion.

From January to December 2016, claim payouts were split between benefits as follows:

• Life Cover: R1 662 698 008
• Severe Illness Benefit: R647 725 506
• Capital Disability Benefit: R552 794 490
• Income Continuation Benefit: R238 022 230
• Health Plan Protector: R83 676 131
• Global Education Benefit and Family Benefits: R23 450 636
• Overhead Expenses Benefit: R8 576 159
• Other: R6 050 318
• Funeral Benefit: R5 042 956.

Health insights in relation to claims in key South African regions

In the Western Cape, the main cause of death was cancer. Cancer-related death claims from this region were 22% higher than the national average. Cancer-related disability claims were 44% higher than the national average, and severe illness claims 13% higher.

In Kwa-Zulu Natal, the main cause of death was heart- and artery-related conditions, which was 17% higher than the national average. Heart- and artery-related conditions also caused the most severe illness claims, 38% higher than the national average. For disability claims, Kwa-Zulu Natal had the lowest incidence of nervous system conditions, at 23% lower than the national average.

Gauteng had a 25% higher incidence of nervous conditions, while the incidence of heart-related conditions was 21% lower than the national average.

In inland provinces (provinces situated in the interior of the country, rather than on the coast), death claims as a result of unnatural deaths were 9% higher than the national average. Inland provinces also had the highest incidence of musculoskeletal conditions, at 40% higher than the national average for disability claims, and 34% higher for severe illness claims.

Life Cover claim statistics

More than one in five death claims were due to unnatural causes that can affect clients regardless of their age or underlying health. 42% of these deaths were as a result of motor vehicle accidents. This highlights the need for life cover, irrespective of health or age.

Death due to unnatural causes accounted for more than 70% for those under the age of 30. In this same age group, motor vehicle accidents caused 56% of deaths. This highlights the need for safer driving, as incentivised by the Vitality drive Integrator.

70% of death claim payouts were paid to males, and 30% to females. The oldest male died at the age of 86, as a result of cardiac respiratory failure, while the youngest died of an accidental fall at the age of 24.

The oldest female was 87 years old and died as a result of Parkinson’s disease, and the youngest female, 28, died as a result of a motor vehicle accident.

For males, the conditions that caused the most deaths were heart and artery conditions (30%) and unnatural deaths (25%). For females, the most common causes were Cancer (38%) and heart and artery conditions (30%).

Motor vehicle accidents were the leading cause of death among the younger clients, while cancer and heart-related conditions were much more prevalent among the older age bands.

Severe illness claims statistics

In 2016, 63% of severe illness claims were submitted by males, and 37% by females. Among males, cancer and conditions of the heart and arteries were the causes of the most claims, at 33% and 35% respectively.

Among females, the highest causes of claims were cancer, at 48%, and nervous system conditions, at 14%.

The impact of Vitality engagement on life cover claims

Vitality is the wellness programme that encourages and rewards clients for managing their health and wellness. By incentivising clients to lead healthier lifestyles through Vitality, highly engaged clients significantly lowered their risk of claiming. In 2016, life cover claims from clients who were on Gold and Diamond Vitality status were 61% less than clients on Blue Vitality status.

Discovery’s Shared-Value Insurance model

Discovery Life’s focus is to provide clients with innovative insurance products that provide for all their insurance needs, while simultaneously making them healthier by rewarding them for taking active steps to manage their health and wellness. One of the ways in which clients get rewarded is through the PayBack benefit. In 2016, a total of R720 million was paid out to clients through this benefit. Since this benefit was launched, it has paid out a total of R2.4 billion to clients.

Discovery Life’s Shared-Value Insurance model is a dynamic approach that incentivises clients to control their underlying risk through engagement with Vitality and Vitality drive. This results in healthier clients, with fewer claims and lower lapse rates. It also drives Discovery Life’s profits, which are then channeled back to the clients.

“We are excited to see the positive outcomes of our Shared-Value Insurance model in our claims statistics,” said Gareth Friedlander, head of Research and Development at Discovery Life. “As we continue to grow, we expect our model to have an even bigger impact on the health outcomes of our clients and society as a whole. We aim to be a powerful source for social good, and we believe that our insurance model will help us achieve this.”