CityPress - - Business -

Over the past year, long-term in­sur­ers have ex­pe­ri­enced higher-than-ex­pected claim ra­tios, es­pe­cially when it comes to stress-re­lated ill­nesses and death. Henk Mein­t­jes, head of risk prod­uct de­vel­op­ment at Lib­erty, says last year’s claim statis­tics for in­di­vid­ual busi­ness show an in­crease in stress-re­lated claims such as car­diac and car­dio­vas­cu­lar dis­eases, and dis­or­ders and sui­cide. Look­ing at in­come pro­tec­tion claims, mus­cu­loskele­tal dis­eases and dis­or­ders (of­ten in the form of chronic back­ache), as well as men­tal ill­ness, also in­crease dur­ing times of eco­nomic hard­ship.

Mein­t­jes says the se­vere drought will also have had a sig­nif­i­cant ef­fect in farm­ing com­mu­ni­ties, and noted that, of the con­firmed sui­cides in the Western Cape that led to claims last year, most were farm­ers older than 55.

While it is more dif­fi­cult to link can­cer claims di­rectly to stress, it can be a sig­nif­i­cant con­tribut­ing fac­tor to the in­ci­dence of can­cer, which con­tin­ues to rise at an alarm­ing rate.

Ac­cord­ing to re­cent statis­tics from Lib­erty, can­cer ac­counts for nearly a quar­ter of all claims. For women older than 30, the num­ber of can­cer claims rises to one in ev­ery three.

John-Henry Horn, life claims spe­cial­ist for rein­surer Mu­nich Rein­sur­ance Com­pany of Africa Lim­ited, says it is gen­er­ally ac­cepted that the dis­abil­ity claims in­ci­dence cor­re­lates with the eco­nomic cy­cle, which means sig­nif­i­cantly more claims are lodged dur­ing a re­ces­sion or dur­ing a slower eco­nomic growth pe­riod.

Al­though good claims man­age­ment by an in­surer can limit the fi­nan­cial ef­fect of false claims, back pain and psy­cho­log­i­cal claims re­quire more sub­jec­tive cri­te­ria, which can re­sult in more claims be­ing paid.

Dawie de Vil­liers, CEO of San­lam Em­ployee Ben­e­fits, says that, when it comes to cor­po­rate group cover, San­lam is ex­pe­ri­enc­ing an in­crease in claims such as dis­abil­ity due to back­ache, as well as men­tal is­sues.

“We are see­ing more claims, larger claims and a longer du­ra­tion on dis­abil­ity, which are all af­fected by the econ­omy,” says De Vil­liers.

If you are fi­nan­cially se­cure and en­joy­ing your job, you are less likely to ex­pe­ri­ence phys­i­cal pain or suf­fer from de­pres­sion.

If, how­ever, you are stressed about money, pol­i­tics and your job se­cu­rity, that stress will man­i­fest it­self in you phys­i­cally.

Cape Town-based chi­ro­prac­tor Rob Beffa says his prac­tice is see­ing sig­nif­i­cantly more cases of back spasm, which di­rectly re­lates to stress.

“Your body can cope bet­ter with phys­i­cal stress if you are en­joy­ing your job. While sit­ting at a desk behind a com­puter all day may put stress on your back, if, for ex­am­ple, you are a gamer de­vel­op­ing a new online game and that is all you want to do, your tol­er­ance for sit­ting in that po­si­tion will be much higher than for some­one who is man­ag­ing out­stand­ing cred­i­tors,” he says.

The bot­tom line is that the less stress you feel, the more your body can cope with its en­vi­ron­ment. As the fi­nan­cial ef­fect of the weaker econ­omy and South Africa’s po­lit­i­cal tur­moil takes its toll on us emo­tion­ally, we see its phys­i­cal man­i­fes­ta­tion in ill­ness and pain. De Vil­liers says that, from the per­spec­tive of a group em­ployee ben­e­fits scheme, em­ploy­ers are also more likely to sign off on dis­abil­ity claims in a re­ces­sion be­cause this is a way to re­duce the em­ployee head count with­out go­ing through the re­trench­ment process.

Horn says the rein­surer has seen in­stances of em­ploy­ers ap­par­ently com­plet­ing the med­i­cal in­ca­pac­ity process and sub­mit­ting dis­abil­ity claims rather than fol­low­ing a re­trench­ment process.

“It is, how­ever, not pos­si­ble to state ex­actly how com­mon it is. This only be­comes ev­i­dent to the in­di­vid­ual as­ses­sors across the in­dus­try, and there is no cen­tral re­port­ing of such in­stances,” says Horn.

In­sur­ers are also ex­pe­ri­enc­ing a trend where, once a per­son is off work due to tem­po­rary dis­abil­ity, the com­pany is less likely to en­cour­age them to re­turn to work.

Horn says some com­pa­nies com­plete a med­i­cal in­ca­pac­ity process early on, dis­charg­ing in­di­vid­u­als for med­i­cal in­ca­pac­ity even if the in­surer might con­sider a po­ten­tial re­turn to work.

“This cre­ates more cer­tainty at em­ploy­ers in terms of their pay­roll expenses, but makes a re­turn to work dif­fi­cult,” says Horn.

He adds that the changes to tax reg­u­la­tions may also have a role to play in the ex­tended du­ra­tion of dis­abil­ity claims

“Tax reg­u­la­tions changed in 2015 and this re­sulted in claimants’ ben­e­fits no longer be­ing tax­able. The in­crease in net ben­e­fits is thought to in­cen­tivise pol­i­cy­hold­ers seek­ing to claim, and dis­in­cen­tivise them from re­turn­ing to work – al­though it is too soon af­ter the tax change to con­firm this.”

De Vil­liers says the length of time for dis­abil­ity claims has been in­creas­ing.

“Apart from a greater num­ber of claims, we are see­ing the length of time for dis­abil­ity claims ex­tend­ing,” says De Vil­liers

He ex­plains that this means in­sur­ers need to keep more money in re­serve.

The prob­lem is that, if this trend con­tin­ues, it will start to af­fect our in­sur­ance pre­mi­ums.

De Vil­liers says that, in the group scheme en­vi­ron­ment, the in­surer can pass on the in­creased costs fairly eas­ily through higher an­nual in­creases to the com­pany, how­ever, it may take a bit longer on the in­di­vid­ual re­tail side to see this in­crease as pol­icy hold­ers of­ten have a pre­mium guar­an­tee for a pe­riod of time.

If the econ­omy does start to pick up and our pol­i­tics are pos­i­tively re­solved, our pre­mi­ums will hope­fully re­main unaf­fected.

How­ever, if the cur­rent en­vi­ron­ment drags on, we will all be in more phys­i­cal pain and will ex­pe­ri­ence greater ill­ness, which will ul­ti­mately cost us more in in­sur­ance pre­mi­ums.

Apart from a greater num­ber of claims, we are see­ing the length of time for dis­abil­ity claims ex­tend­ing

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