CLHIA-ACCAP

Canadian Life and Health Insurance Facts, 2014 Edition

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16 critical illness), and 1.2 per cent for accidental death and dismemberment. About 40 per cent were indemnity benefits providing direct compensation for loss, while the remainder was reimbursement benefits, which can be paid either directly to the provider of care through an assignment of benefits or to the insured person who paid for the care. Individual health insurance benefits exceeded $1.6 billion, with 28 per cent for disability income, 24.8 per cent for medical/hospital benefits (including prescription drug expenses), 19.2 per cent for travel health insurance, 19.1 per cent for critical illness claims, and 4.2 per cent for personal accident claims. In 2013, benefits paid under uninsured contracts administered by insurance providers amounted to almost $13 billion. Of these, 58.7 per cent were for medical/hospital benefits (including prescription drug expenses), 32.7 per cent for dental, and 8.6 per cent for disability income. Benefits paid under these plans have increased one and a half times the 2003 levels (nearly $8.5 billion). Policyholder dividends Dividend payments to participating Canadian policyholders of life insurance, health insurance and annuities totalled almost $3.1 billion in 2013. Today, about 11 per cent of all life insurance owned by Canadians is participating and, as such, qualifies for dividend payments. Ten years ago, participating policies accounted for almost 18 per cent of life insurance ownership. Of the total dividends, the majority (nearly $2.4 billion or 76.6 per cent) was paid out under life insurance policies. Of the remainder, dividends under health insurance policies accounted for almost 23.4 per cent, with a negligible amount under annuities. Individual plans accounted for 62 per cent of the total dividend payments, with the remainder paid under group contracts. Canadian life and health insurers with share capital (stock companies) are subject to legislation regulating the distribution of "profits" arising from participating policies to participating policyholders and to shareholders. Participating policyholders are entitled to at least 90 per cent of such profits distributed by small companies, grading up to almost 97.5 per cent for the largest companies. Disability income 23.0% Medical/hospital 48.4% Creditors' disability* 23.7% Dental care 1.8% 3.1% Other benefits Source: CLHIA special survey ("Health Insurance Benefits in Canada – 2013") Includes business of all health care providers, including 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 insurance companies and not-for-profit health care benefit providers such as provincial Blue Cross organizations *Includes Creditors' critical illness coverage Total Health Payments by Benefit Type – 2013

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