The most common benefits for claims were dental (144,267 or 32%), combined physiotherapy (98,126 or 22%) and optical (86,525 or 19%) – totalling 74% of all claims.
Claims data over the last three years (2012, 2013 and 2014) shows that dental claims have increased by 8%, combined physiotherapy by 14% and optical claims by 12%. Health Shield has paid almost 1.3 million claims over that period.
2.6% of claims were declined in 2014 for reasons including:
- Maximum amount already paid – 32.2%
- Receipt too old – 6.7%
- Admin cost not covered – 6.7%
- Sundry item not covered – 6.1%
- Member not qualified at the time of treatment – 5.8%
- Benefit not covered under the Plan – 5.1%
Health Shield recently reported a 26% increase in new members in 2014 and a 7% increase in premium income to more than £29 million, the highest level in its 138-year history. The Society now covers more than 210,000 members and their families. The number of claims paid by Health Shield in the previous year (2013) was 97.5%.
Jonathan Burton, Health Shield Chief Executive, said: “People must be able to trust that insurance policies will pay out when they expect them to, and these figures continue to prove that the overwhelming majority of claims are being paid. By sharing our claims data we are demonstrating not only our commitment to paying claims, but also re-assuring intermediaries, employers and members that cash plans provide an invaluable benefit for managing everyday health.”
Roy McLoughlin of Master Adviser said: “Publishing claims data is essential for reassuring clients that claims are paid. It brings transparency to the industry and is of great benefit to advisers when discussing clients’ needs. When providers can show they consistently pay a high level of claims it means advisers can recommend their products with confidence.”
Alternatively for more information about our Health Cash Plans call us on 01270 588 555.