CLHIA-ACCAP

Canadian Life and Health Insurance Facts, 2014 Edition

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15 for the year, compared with over $4.1 billion a decade ago. Of the total, death benefits under life insurance policies accounted for almost $6.4 billion, including additional benefits paid on a policyholder's accidental death as provided in some life insurance policies. The remainder, $249 million, was paid out under comparable benefits provided in health insurance contracts as Accidental Death and Dismemberment or Personal Accident coverages. Individual policies accounted for 61 per cent, or $4 billion, of the total death benefit payments. Payments to beneficiaries under group contracts totalled nearly $2.6 billion. Group insurance has fallen as a proportion of total death benefit payments compared to 2003, when they accounted for 45 per cent. Based on a special CLHIA survey, an analysis of one month's death benefit payments under life insurance policies in 2009 shows that: ❖ most claims are on policyholders over age 65 at death (67 per cent). ❖ immediate family members receive most of the death benefits (72 per cent). ❖ almost all payments (over 99 per cent) to beneficiaries are taken in a lump sum. ❖ almost half of the individual claims (47 per cent) were for policies issued over 30 years ago. ❖ one of every three claim dollars was paid under individual policies less than ten years old. ❖ more than half of the payments (56 per cent) under individual insurance were on whole life policies. ❖ one of every ten individual life claims was on substandard or extra-risk policies. Payments to living policyholders In 2013, more than nine out of every ten dollars made in payments by life and health insurers went to living policyholders. These were paid out as annuity and disability benefits, reimbursement or payment of health care costs, dividends to policyholders, cash surrender values and matured endowments. These payments totalled more than $69.6 billion in 2013. Over the last couple of decades, the growth in annuity benefits has resulted in an increasing amount of benefits being paid to living policyholders. During 2013, annuity payments increased 7.5 per cent to record levels of $35.3 billion, making up nearly half (46 per cent) of total benefits for the year. This is comparable to the 43 per cent level of a decade ago. Total benefit payments by insurance providers to Canadians under health and disability products (insured and uninsured) rose 6.4 per cent to almost $30 billion during 2013, about one and a half times the 2003 payments. Benefit payments under group health and disability products accounted for 95 per cent of the total with more than $15.3 billion paid under insured plans and almost $13 billion under uninsured contracts that are administered by life insurers and not-for-profit health care benefit providers such as Blue Cross organizations. The remainder, over $1.6 billion, was paid out under individual health insurance policies. Health benefit payments by type During 2013, benefits paid under group health insurance contracts amounted to more than $15.3 billion, with 42.1 per cent for medical/hospital benefits (including prescription drug expenses), 34.7 per cent for disability income, 18.2 per cent for dental, 3.4 per cent for creditors' disability (including creditors' Atlantic provinces 6.5% Prairie provinces 15.7% Quebec 20.4% Ontario 46.1% British Columbia 11.3% Total Policy Payments by Region – 2013 Sources: OSFI, CLHIA Includes business of insurance companies (life and property and casualty), fraternal benefit societies, and not-for-profit health care benefit providers such as provincial Blue Cross organizations Includes payments under uninsured contracts administered by life and health insurance providers

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