Total Covid-19 related claims paid by the insurance industry amounted to P326.95 million, with medical benefits comprising the bulk of the amount at P258.8 million, according to results of a survey by the Insurance Commission (IC).
The survey was conducted from April 16 to May 8 across four insurance s ectors: life insurance industry, non-life insurance industry, mutual benefit associations (MBA) and health maintenance organizations (HMO). It was designed to assess the financial impact of the coronavirus disease 2019 (COVID-19) and determine how these entities have responded to the related claims, the IC said.
Out of 147 regulated entities, 142 participated in the survey, with 100-percent participation from the life and MBA sectors, 96 percent from non-life insurance sector, and 89 percent from the HMO sector.
The survey revealed that 58 percent of respondents issued health insurance products. Of this, 61 percent covered pandemic cases.
While the four industries received Covid-19 related claims amounting to P308.16 million, the IC said they actually paid more than the amount by paying ex gratia (out of kindness) settlements.
Broken down, the respondents said they have paid P307.26 million in contractual obligations and P19.68 million in ex gratia payments, which brought the total payouts to P326.95 million.
The Covid-19 related claims were classified as medical benefits, death benefits or other benefits, which included travel inconvenience, travel cancellations and delays and cash assistance, among others.
Medical benefits cornered the bulk of Covid-19 related claims paid by the four industries at P258.8 million. Of the said amount, P239.5 million were paid out of contractual obligation and P19.2 million were paid ex gratia.
Of the total medical benefits paid, P110 million were for in-patient benefit claims, P74.89 million for out-patient claims, P73.299 million for critical illness benefits, P0.449 million for daily hospitalization benefits and medical reimbursement benefits (paid exclusively by the life insurance sector) at P0.13 million.
Meanwhile, death benefits amounted to P61.54 million while those that fell under “Other Benefits” reached P6.611 million.
Insurance Commissioner Dennis B. Funa said in a statement on Thursday that the four sectors “displayed financial resiliency in the handling and payout of Covid-19-related claims.
“The respondents honored their contractual obligations to their customers, and some have even gone above and beyond said obligations by paying ex gratia settlements,” Funa said.
Further, the IC concluded that the Covid-19 pandemic also “positively influenced the four industries in terms of willingness to consider providing pandemic coverage in their products in the future.”
The survey, Funa added, also displayed the responsiveness of, and consumer benefit provided by health insurance and HMO agreements with pandemic cover, specifically in addressing costs incurred by an individual infected by Covid-19.
“This may be said to inspire consumer confidence in the four respondent industries, which may later translate into an increase in the number of Filipinos covered by insurance and HMO contracts,” the IC chief said.
