Contact us: 1800 111 456Freecall Australia
 

Insurance Claims Statistics – All the facts and figures

Which are the best life insurance companies for paying claims?

Claims Statistics The number one question we get asked at Insurance Watch is “Do life insurance companies really pay claims?”.

In order to address this question we have gathered together, all in one place, insurance claims statistics and information from a variety of sources.

What do the industry regulators say about insurance claims payout rates?

We know from studies done by ASIC and APRA that, for the industry as a whole, more than 90% of all claims are being paid.  The overall percentage of claims paid was between 92% and 94% in the years 2016 to 2020.

The percentage of claims paid varies depending on the type of insurance. The percentage of Life insurance and Income Protection claims paid is typically higher than for TPD and Trauma claims.

ASIC has also found that direct life insurance had a lower claims payout ratio than fully underwritten policies taken out through advisers/brokers.

The following infographic from ASIC summarises the findings of their 2016 report into claims handling.

In March 2019 ASIC and APRA released for the first time statistics on the payout rates of individual insurers. The latest data, released 20 April 2021, covers the 12 month period ending 31 December 2020.

For each life insurance company these statistics show:

  • – Average claims accepted rate, i.e. the percentage of claims an insurer accepted for payment out of all claims that were decided, and
  • – Average claim time in months that it took for an insurer to decide whether or not to accept a claim.

Using the industry data for insurance policies taken out through a financial adviser/broker, Insurance Watch has collated the statistics across the four product types to rank companies based on their average deviation from the industry claims acceptance rates.

The table below shows our overall ranking of insurers for claims acceptance – from best (1st) to worst (10th).

Best Claims Paying Life Insurance Companies 

Life Insurance CompanyClaims Ranking
2020
Claims Ranking
2019
Claims Ranking
2018
CommInsure137
ClearView286
Asteron3102
Westpac/BT478
MLC511
Zurich624
AMP/Resolution Group743
OnePath8610
AIA955
TAL1099

 
More information about each of these insurers can be found at Compare Life Insurance Companies.  To compare the policy benefits and premiums offered by these insurers use Compare Quotes Online.

The 2020 claims statistics (for policies taken out through financial advisers/brokers) are shown in the graphs below by different policy types e.g. Life, TPD, Trauma and Income Protection. Where no result is shown for an individual insurer this is because APRA have reported that the number of claims was too small to provide a reliable result.  Claims statistics for other sales channels can be viewed on MoneySmart.

2020 Life Insurance Claims Statistics –

For life insurance claims, the industry average acceptance rate in 2020 was 96.4%.

MLC had the lowest claims acceptance rate of 93.7% and OnePath and Asteron the highest acceptance rate of 98.3%.

The average time for a life insurance claim to be accepted was 1.5 months.

AMP paid claims the fastest at 1.0 months on average with the slowest being Asteron at 2.1 months.

2020 TPD Insurance Claims Statistics –

For TPD insurance claims the industry average acceptance rate in 2020 was 81.5%.

TAL had the lowest claims acceptance rate of 69.0% and CommInsure the highest acceptance rate of 92.3%.

The average time for a TPD insurance claim to be accepted was 6.8 months.

There was significant variation between the fastest paying insurers AMP, MLC and Zurich at 5.7 months on average and the slowest being AIA at 11 months.

2020 Trauma Insurance Claims Statistics –

For Trauma insurance claims, the industry average acceptance rate in 2020 was 85.7%.

AMP had the lowest claims acceptance rate of 81.1% and ClearView the highest acceptance rate of 95.5%.

The average time for a Trauma insurance claim to be accepted was 1.6 months.

ClearView paid claims the fastest on average at 1.1 month with the slowest being CommInsure at 2.2 months.

2020 Income Protection Claims Statistics –

For Income Protection insurance claims, the industry average acceptance rate in 2020 was 94.0%.

AIA had the lowest claims acceptance rate of 91.0% and Asteron the highest acceptance rate of 96.5%.

The average time for an Income Protection insurance claim to be accepted was 1.5 months.

MLC and TAL were the fastest on average at 1.2 months with the slowest being Clearview at 2.2 months.

ASIC notes in its report that, under the Life Insurance Code of Practice, insurers should make their initial decision within 2 months of a claim for income protection and within 6 months for other cover types.

To compare the policies offered by the above insurance companies go to Compare Quotes Online Now

Compare Quotes Online Now >

Which insurers have the most claims disputes?

In 2019/20 the Australian Financial Complaints Authority (AFCA) handled 76,872 disputes related to financial services. Of these, only 2.83% were related to life insurance including TPD, Trauma and income protection insurance. The biggest source of disputes was Credit Cards accounting for 13.49% of the total, followed by Housing Finance at 12.85%.

ASIC and APRA have also released claims dispute statistics for individual companies for the year ending 31 December 2020. These statistics include disputes lodged with an insurer, an external dispute resolution scheme like AFCA, or a Court or Tribunal. The reasons for these disputes include dissatisfaction with claims decisions, amount received or the claims process.

The absolute number of disputes need to be viewed relative to the number of lives insured by that insurer. Therefore the data from ASIC below shows for each insurer the number of disputes for every 100,000 people insured (data shown below is for policies taken out through financial advisers/brokers only).

On this adjusted basis in 2020 AMP had the highest number of disputes for Life, TPD and income protection policies, while CommInsure had the highest number of disputes for Trauma policies.

 

What is the claims experience of other industry players?

Over time Insurance Watch has helped many of its customers to make successful claims on their policies.  In other parts of the website we provide examples of these Life Insurance, Trauma and Income Protection claims.  In our experience very few claims are declined, although non disclosure can put clients at risk.  As every claim is different in its circumstances, it is difficult to generalize these results across insurers.

A recent survey of advisers tried to obtain an industry wide perspective of the relative claims performance of insurance companies.  The survey results ranked insurers according to adviser perceptions of how the companies managed claims. However as the claims experience of each adviser may be limited, the results are likely to be subjective rather than based on factual data.

What is the experience of customers who have submitted claims?

Customer reviews have been left on our website by over 1,000 Life, TPD, Trauma and Income Protection policyholders.  From these we can learn about the claims experiences of individuals – both good and bad.  But again we can’t know the full circumstances behind each claim (e.g. were these superannuation or retail policies, was non-disclosure involved etc) or how indicative these particular claims are of an insurer’s overall performance.

What we do know is that good news stories often don’t often receive much publicity.  So we have collected claims videos from various insurers telling the moving stories of clients who have needed to make a claim and how this has made a difference to their lives and the lives of their families.

You can watch videos of their real life stories below:

Life Insurance and TPD Claims Stories
Trauma / Critical Illness Claims Stories
Income Protection Claims Stories

What do the detailed claims statistics from the insurance companies show?

Below we have collated the claims statistics from all the companies we cover including their latest published document giving a breakdown of claims paid.

The absolute dollar value of claims paid must be viewed in the context of the size of each insurer and their premiums in force.  In some cases the insurer has only provided claim statistics for the retail sector of the market, which does not include claims from group/super or direct policies.

Equally the mix of claims for each insurer will be influenced by the composition of their customers.  For example, each insurer has a different mix of Life/TPD/Trauma/Income Protection insurance policies, group/super versus individual/retail policies, policyholder ages and occupations.

What these statistics DO show is that claims get paid and in very large numbers.  The Financial Services Council has released aggregate figures across the whole Australian life insurance market which show that over 100,000 claims were paid during 2019 amounting to over $12 Billion.  This should give confidence to buyers of insurance policies that help will be there when they need it the most.

Compare the premiums and benefits offered by these companies at Compare Quotes Online

AIA

Total Claims Paid (2019): $305 M (Retail Only)

Death/Terminal Illness – $99 M

TPD – $22 M

Trauma – $88 M

Income Protection – $96 M

2019 AIA Claims Statistics Graph

2019 AIA Insurance Claims Statistics Report

AMP

Total Claims Paid (2019): $1,144 M

Death/Terminal Illness – $400 M

TPD – $292 M

Trauma – $95 M

Income Protection – $357 M

2017 AMP Insurance Claims Statistics Report

ASTERON

Total Claims Paid (2017): $390 M

Death/Terminal Illness – $146.7 M

TPD – $46.5 M

Trauma – $61.3 M

Income Protection – $135.5 M

2017 Asteron Insurance Claims Statistics Graph

2017 Asteron Insurance Claims Statistics Report

BT

Total Claims Paid (2018): $381 M

Death/Terminal Illness – $148 M

TPD – $68 M

Trauma – $82 M

Income Protection – $83 M

2018 BT Insurance Claims Statistics Graph

2018 BT Insurance Claims Statistics Report

CLEARVIEW

Total Claims Paid (2019): $64 M

Death/Terminal Illness/TPD – $15 M

Trauma – 13 M

Income Protection – $36 M

2019 ClearView Insurance Claims Statistics Graph

2019 ClearView Insurance Claims Statistics Report

COMMINSURE

Total Claims Paid (2019): $980 M

Death/Terminal Illness – $292 M

TPD – $301 M

Trauma – $90 M

Income Protection – $297 M

2019 CommInsure Insurance Claims Statistics Graph

2019 CommInsure Insurance Claims Statistics Report

MLC

Total Claims Paid (2018): $602.5 M (Retail Only)

Death/Terminal Illness – $192.8 M

TPD – $78.3 M

Trauma – $138.6 M

Income Protection – $192.8 M

2018 MLC Insurance Claims Statistics Graph

2018 MLC Insurance Claims Statistics Report

ONEPATH

Total Claims Paid (2019): $592 M (Retail Only)

Death/Terminal Illness – $170 M

TPD – $90 M

Trauma – $138 M

Income Protection – $194 M

2019 OnePath Insurance Claims Statistics Graph

2019 OnePath Insurance Claims Statistics Report

TAL

Total Claims Paid (2019): $2,300 M

Death/Terminal Illness – $828 M

TPD/Trauma/Income Protection – $1,472 M

2019 TAL Insurance Claims Statistics Graph

2019 TAL Insurance Claims Statistics Report

ZURICH

Total Claims Paid (2019): $305 M

Death/Terminal Illness – $113 M

TPD – $50 M

Trauma – $58 M

Income Protection – $84 M

2019 Zurich Insurance Claims Statistics Graph

2019 Zurich Insurance Claims Statistics Report

Other useful information:

  • – To find out how to make a claim watch the video “Understanding the Claims Process
  • – To compare quotes and benefits of the policies offered by the above insurance companies go to Compare Quotes Online Now
  • – To find out who owns the above insurance companies, their size and their background go to Compare Insurance Companies
  • – To obtain advice on your personal situation from one of our qualified advisers, including insurance strategies and policies to suit your needs, go to Get Advice

Summary of findings:

Which are the best life insurance companies for paying claims in Australia?

Using the 2020 ASIC/APRA claims data, Insurance Watch has identified the top three life insurance companies for paying claims are: CommInsure, ClearView and Asteron. See all

Who is the best company for paying income protection claims?

In 2020 the ASIC/APRA claims data shows that Asteron was the best at accepting income protection insurance claims with an acceptance rate of 96.5%. AIA was the worst, accepting only 91% of claims. See all

Who is the best company for paying trauma insurance claims?

In 2020 the ASIC/APRA claims data shows that ClearView was the best at accepting trauma insurance claims with an acceptance rate of 95.5%. AMP was the worst, accepting only 81.1% of claims. See all

Who is the best company for paying TPD insurance claims?

In 2020 the ASIC/APRA claims data shows that CommInsure was the best at accepting TPD insurance claims with an acceptance rate of 92.3%. TAL was the worst, accepting only 68% of claims. See all

Compare Quotes Online Now >