Aviva individual protection policies paid out £981,997,431 to more than 26,500 UK customers and their families during 2019, with just 3.7% of all claims received being declined.
The UK insurer paid more than £582m to the families of life insurance customers who died or were diagnosed with a terminal illness last year. A total of 16,363 life and terminal illness claims were paid, representing 98.6% of claims received.
Additionally, a further £353m was paid out on policies where either the customer or one of their children had been diagnosed with a critical illness, or where the customer met the definition for total permanent disability. A total of 4,957 claims, or 93.1%, were accepted.
Some 44% of adult critical illness claims were made by customers who had been diagnosed with a covered critical illness under the age of 50, with Cancer the most common condition claimed for across all ages at 66%, (rising to 79% amongst females). Heart Attack was the second most common reason at 11% (rising to 21% amongst males).
However, 6.9% of critical illness claims were declined, with 5.3% due to the medical diagnosis not meeting the policy definition which was set out when the policy was bought.
Of the 1.4% of Life insurance and terminal illness benefit claims declined, 0.7% were due to misrepresentation where inaccurate statements about health or lifestyle were made during the application.
Common reasons for income protection claims being declined include misrepresentation during the application, not being totally disabled from working and no loss of income.
Jacqueline Kerwood, claims philosophy manager at Aviva, said: “This year we have been forced to face how uncertainty can hit us all and how our lives can change in a matter of days. The coronavirus pandemic has sadly demonstrated how anyone can be a victim of a serious illness, which can have a lasting impact on quality of life and the loss of loved ones.
“Our top priority is always to make sure our people and our customers are safe and that we are there, helping and supporting people in times of need. We remain committed to continuing to pay out on claims and to providing a first-class service and support for our customers.”
She added: “We are doing all we can to reduce the burden on the NHS, with existing processes well placed to obtain medical evidence via other sources, rather than GPs and Consultants, to help assess claims. Thanks to our strong relationship with cancer nurse specialists, we are also gathering information over the phone which is speeding up the process for cancer claims.
“As one of the biggest insurers in the market, we have adopted the Association of British Insurers (ABI) protection pledges1 in supporting all our customers, especially the vulnerable ones, who may be affected by the impact of Covid-19 when making a claim on a life, critical illness or income protection policy.”