Health Shield pays 97.4% of claims

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Cash plan provider Health Shield has revealed it paid 446,268 claims in 2014 representing 97.4% of all claims made during the year.

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.

Meanwhile, 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. This is the highest level in its 138 year history. 

The Society now covers over 210,000 members and their families. The number of claims paid by Health Shield in the previous year (2013) was 97.5%.

Jonathan Burton, chief executive of Health Shield 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 added: "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."

Further reading: 

Health Shield launches virtual GP and product enhancements

Opinion: Why honesty is the best claims policy

Claims stats alone do not 'mean very much' - Cirencester CEO

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