Key performance indicators

Working hard for our members.

Average premium per member (£)

Average bonus per member (£)

Bonuses and benefits to premium income ratio (%)

Average duration of short-term claims (days)

Insured members who claimed (%)

Annualised returns to members over ten years (%)

 

Annual claim statistics

The statistics below show you the areas and ages of all claims paid in 2016 as well as examples of claims and a summary of complaints over the last few years.

Highlights for 2016
  • The total number of claims paid was 1,166
  • The total amount of benefits we paid was over £4.2 million
  • The average age of claimants was 47
  • The average number of claims we paid each month was 97
  • The average duration of a short term claim was 19 days
  • Nine per cent of our working members claimed1
  • The average payment per claim paid was £3,600
  • The largest claim paid during 2016 was £62,400

1Taken as average of insured members throughout 2016

Claims by gender

The pie charts below show analysis of the claims paid in 2016 by gender.

 

Claims by illness or injury

This table shows analysis of the claims paid in 2016 by type of illness or injury. An overwhelming majority of the claims paid in 2016 were for conditions that would not be covered by other protection products, for example critical illness cover or life assurance.

Injury or illness Male Female
Musculoskeletal disorders 32% 38%
Infectious & communicable diseases 9% 7%
Psychiatric disorders 17% 18%
Accidents 14% 9%
Cancers 5% 13%
Cardiovascular diseases 5% 0%
Other 18% 15%

 

Example of claims paid to individual members in 2016
  • A member in their late 40s fractured their arm in a cycling accident and we paid them over £7,000 for the three months they were recovering
  • We paid a dentist in their 30s over £21,000 for a tumour that saw them off work for  over a year
  • A member in their late 20s broke their leg and we paid them over £3,000 for the almost three months they were recovering
  • A dentist in their early 40s experienced sciatica and we paid them over £23,000 for the nine and half months they were off work
Complaints statistics and claims received and paid
Complaint statistics  2016 2015 2014
The total number of claims paid 1,166 1,286 1,301
Claims-related complaints received 8 5 3
Claims-related complaints referred to Financial Ombudsman Service (FOS) 0 0 1
Complaints upheld by FOS 0 0 1

The FOS is the Financial Ombudsman Service

In 2016 we paid 97.7% of new claims.

Claims received and paid 2016
New claims received  915
Of which, new claims paid  894
New claims declined* 21

*Claims were declined because: The claimant didn't meet the definition of incapacity (11); Their condition was not covered by their plan (3); The claimant didn't provide all of the information needed to assess their claim (4); Other plan rules weren't met (3).

Contact

If you have any questions please contact our company secretary Simon Elliott on 020 7400 5700.

 
 

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