Busting the myth that insurers don’t pay
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Two in three people1 believe insurers are not fair. It's a common misconception that insurance companies try to avoid paying out or hide behind bureaucracy to make it difficult for customers to get their money.
The simple truth is, we do pay.
Paying claims is what we do. It’s why we exist. I hope the fact we paid out on 98% of all claims reassures our customers and our people. But we’re not complacent about it. And we’re not stopping at just reporting our claims payout ratio. We’re working to improve the claims experience for customers. We want to pay as many genuine claims as possible.
In 2017 we paid out 98% of all claims across the group. This is a service level that very few industries can match.
Of course, paying claims is what we do. So, while we don’t want to pat ourselves on the back for simply doing what’s right, we think it’s important to be transparent about our claims, to give our customers the confidence and reassurance that we're here when they need us.
And while 98% is a good number, we’re not complacent about it. There is still a small number of customers who see their claims rejected and we want to understand and fix the reasons why. We want to pay all genuine claims.
Below you will find more information about our claims story and what we're doing to improve the experience for those customers who need to make a claim with us.
Read this infographic for a summary of our story.
Our claims story
Of all claims received are paid (2017 data)
In 2017 we paid out 98% of our claims. This number reflects the total claims we paid as a proportion of all claims we received across the fourteen markets where we operate, for all our insurance product lines2.
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This is a figure very few industries can beat. In fact, some of the services that most of us take for granted have much lower reliability statistics. For example, Swiss trains, known as among the most reliable in the world, have an on-time rate of 90%.
![Graph of reliability statistics](http://static.aviva.io/content/dam/aviva-corporate/images/article-page-and-carousel-840-x-473/different-sized-images/reliability-aviva-claims-payment-pie-01.jpg)
Overall, we paid out £7.5 billion to customers in 2017. This is over £20 million every day. We asked some people how they'd spend this kind of money - watch the short video below to find out what they said.
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We are a multi-line insurer, meaning we cover for many eventualities and paid out on life, critical illness, car, home, travel and health insurance policies, among others. Just to give a flavour of how this money made a difference, the money we paid out:
- in income protection claims was the equivalent of 250,000 monthly salaries for people who lost their source of income
- in health insurance claims was the equivalent of over two million MRI scans to diagnose a health issue
- in car insurance claims was the equivalent of replacing 100 million windscreens – that’s enough windscreens for every new car built last year across the world
- in home protection claims was the equivalent of buying one million new boilers.
![Equivalent pay out figures](http://static.aviva.io/content/dam/aviva-corporate/images/article-page-and-carousel-840-x-473/different-sized-images/our-claims-in-figures-infographic.jpg)
Most common reasons for refused claims
We rejected a small proportion of claims – just 2% of all the claims received. While we're working to reduce this proportion even more, here are some tips that can help customers make sure they have their claims paid.
Risk not covered: the most common reason why we reject a claim is a mismatch between what customers believe their policy covers and what polices actually cover. While we're working to make the language of our policies clearer and simpler, we also encourage customers to understand what a new policy includes when they take it out so there are no surprises. Customers can also call us any time to check on their coverage.
Non-disclosure: we reject a small proportion of claims because of a pre-existing condition that the customer did not disclose when taking out the policy. While in most cases this is a genuine oversight, we need to make sure we keep a disciplined approach to our claims process. This means we cannot accept claims for risks we didn’t know about.
Evidence missing: sometimes we can't accept claims because we can’t verify their validity. We're taking action to simplify and speed up the process to make a claim, but there is still a need for customers to submit documentation to demonstrate the validity of their claim. Whether it’s evidence of an accident or a copy of an invoice they want to get reimbursed, we can't pay if we don’t receive the relevant documents.
Fraud: we have zero tolerance for fraud. By detecting and avoiding paying fraudulent claims, we help to keep premiums low for genuine customers.
Improving our claims payout
We want to pay as many genuine claims as possible.
A small number of customers see their claims rejected
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Claims paid out to customers
98.0%
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Claims rejected - most commonly because the risk is not covered, non-disclosure, evidence missing or fraud
2.0%
While 98% of claims paid is a good ratio, we’re not complacent about it. And we’re not stopping at just reporting our claims payout stats. We're working to improve them too.
Simplifying the process
At Aviva we're committed to making insurance easier for our customers, including simplifying the language and content of our policy documents to make it clearer to customers about what’s covered. Through our digital business, we’ve cut the number of unnecessary questions we ask when customers get a quote which helps to avoid confusion and uncertainty about whether a claim will be paid.
We have a partnership with Amazon to offer our UK customers a gift voucher they can spend right away to replace lost or damaged goods.
In Hong Kong, our new life insurance joint venture offers digital only products, explained in simple terms and allowing customers to select, and pay for, only those risks they want to be covered for.
Looking at what we cover
In Poland, we've improved coverage of cancer treatment and in Singapore we've also extended our critical illness coverage to include re-diagnosis of an illness that has been claimed for in the past, so customers can be reassured they’re still protected should their illness strike again.
Investing in technology
Our UK customers can now make a vehicle repair claim using the MyAviva app and choose the repairer, location and time that works best for them, while tracking the entire repair online. Over 60% customers choose to manage their repair claim this way.
For those who have our free Aviva Drive app with dashcam functionality, footage taken by the app can be used as evidence, which helps speed up the claims process.
In Poland, we're speeding up travel claims by automatically processing travel insurance claims if a customer’s flight is delayed or cancelled and we have their flight number recorded.
Ultimately, we want to help our customers protect what’s important to them, and stop some bad things from happening in the first place.
Focusing on prevention
We're using data and predictive modelling so we can be better prepared for natural catastrophes. 2018 has been one of Canada’s worst storm seasons historically, with three windstorms in April alone and more catastrophes since, including the tornadoes that devastated the Ottawa-Gatineau area.
Our use of data has made sure that our response improved with each event, and we had teams of adjusters on the ground helping customers from the morning after the tornadoes hit.
In the UK, we offer our customers a discount for driving safely. Customers who use our free dashcam functionality in the Aviva Drive app and are shown to be driving safely can save up to £170 on the annual cost of their insurance.
We're the first insurer to offer LeakBot, a device that detects leaks anywhere in the water mains supply in their home. If a leak is detected, customers receive an alert on their mobile phones so they can act swiftly.
![LeakBot device under a kitchen sink](http://static.aviva.io/content/dam/aviva-corporate/images/stockimages/LeakBot%20HR_RT2_rgb_300dpi.jpg)
Our claims story across our markets
UK
We published our first claims report for the UK in July 2018, encouraging the industry to join us in comprehensively publishing information about how insurers manage customer claims, why some claims are declined and how consumers can do more themselves to understand whether the cover they have is what they need. Read our UK claims report.
In the UK, we paid out 96% of all claims received in 2017. That was £3.6 billion across motor, home, travel, protection, health and commercial business insurance.
France
In France we paid over 98% of all claims received. Most of these relate to life and health insurance. We offer health insurance products in France that complement the public health services, helping customers get the right treatment without worrying about whether it’s covered by the national health system.
For car and home insurance, we paid out over 99% of all claims received and we're using more and more digital routes to improve the experience for customers. Including halving the time for some car repairs through quicker sourcing of parts and delivering SMS updates on the progress of repairs.
We also send our customers weather forecast alerts when driving conditions are bad and use data effectively to improve the process of getting a new policy for customers and brokers alike.
In total, we paid over €860 million (over £765 million) to our French customers.
Poland
We offer a multi-line range of products in Poland. In 2017, we paid 90% of our total life claims and over 91% of our general insurance claims. The overall claims payout ratio for Poland is 89%.
We identified that a number of critical illness claims were being rejected as some illnesses weren’t covered during the early stages. As a result, we changed things to make our critical illness coverage more comprehensive We're also working to automatically process claims for travel policies if a customer’s flight is delayed or cancelled and we have their flight number recorded.
Canada
In Canada we paid 98% of all claims received. We offer general insurance in Canada, so these claims include home and motor insurance. We paid out around four billion Canadian dollars to our customers.
We're using data and predictive modelling so we can be better prepared and have our teams ready when they are needed. 2018 has seen some of Canada’s worst storm seasons historically, with three windstorms in April alone and more catastrophes since, including the tornadoes that devastated the Ottawa-Gatineau area.
Our use of data has made sure that our response improved with each event, and we had teams of adjusters on the ground helping customers from the morning after the tornadoes hit.
We know it is not just about being on the ground. We’re also making better use of data using predictive modelling so we can be better prepared and make sure staff are ready when they are needed.
Italy
We paid 90% of all claims received in Italy. Most of these relate to car and home insurance. We're working on improving and speeding up the process for claims on home insurance for our customers by connecting them directly with loss adjusters via video streaming. In the next few months we’ll be extending this to our motor claims service too. We're incorporating data analytics to reduce the documentation required and speed up payment for most of our motor and home claims.
Ireland
We paid 97% of all claims received in Ireland3 across car, home and life insurance. We paid over €250 million in claims to our customers in Ireland in 2017.
We place a strong focus on prevention. In June 2017 we released SmartHome insurance a new policy which provides a monitored alarm system, heating controls, a smart smoke alarm and two smart plugs that allow customers to control things such as the lights throughout their homes. By using a smartphone or tablet, customers can control and monitor safety in their homes, and their premiums will reflect the steps they've taken to prevent any damages.
Singapore
We paid 94% of our general insurance claims and 91% of our life insurance claims in Singapore. Overall, we paid 88% of our claims. The rejections are mostly driven by discrepancies in health insurance claims with hospitals on specific expenses. This means we accepted hospital treatments for most patients but rejected some additional costs that hospitals billed for.
To ensure we pay out on more claims, we have extended critical illness coverage for our customers. We’ve designed our critical illness plan to cover customers and allow multiple claims, including re-diagnosis, so even if the illness strikes again, the customer can be assured that their cover is still intact. We're moving away from the traditional “claim once” plans so we remove any uncertainty around cover in case of any future re-occurrence.
We are also using digital technology to simplify the claims process for our customers – including a completely paperless claims process and a clinic e-card payment system by which we settle payment directly with hospitals so customers don’t have to pay the costs themselves.
References:
1 According to Aviva's Consumer Attitudes Survey, March 2018.
2 The percentage was calculated by dividing all paid and rejected claims by the total number of claims received between 1 January and 31 December 2017. The figure includes all insurance product lines across all our businesses and excludes benefits and pensions, which have a payout ratio of 100%. It also excludes invalid or incomplete claims, such as instances where claims were opened in error, abandoned or withdrawn by customers.
3 Data excludes claims figures for Friends First.