1. BILLION
REASONSWHY ADVICE MATTERS
You trusted us and because you believed in your financial adviser’s
advice, we paid out R3.99 billion in claims in 2015.
4
3. Our customers are at the heart of everything we do, along
with our promise to pay their claims in the event of death,
disability or severe illness.
By truly understanding the needs of our customers and
offering them the right advice, we’ve been able to recommend
the relevant solutions and pay them what we promised.
Please take a look through this guide for more information
about claims paid in 2015.
It includes claims paid for the Conventional, Flexi and
GREENLIGHT product ranges. It does not include any group
cover or investment and savings products. All Rand amounts
shown include all claims paid for benefits that were either
fully or partially underwritten or via a conversion option with
reduced underwriting.
Old Mutual is a global company with a footprint in various
countries around the world. In South Africa we have been
voted the most trusted insurer by Reader’s Digest and were
named the number one brand in the long-term insurance
industry by TGI Ask Afrika in 2015.
WITH OVER 17O YEARS OF ENABLING BETTER FUTURES FOR OUR
CUSTOMERS, WE CAN APPRECIATE THE VALUE OF GOOD ADVICE.
4. WE PAID R3.99 BILLION FOR
UNDERWRITTEN COVER
• Death – R3.08 billion
• Disability – R399 million
• Severe illness and functional impairment –
R 498 million
• Retrenchment – R8 million
Since 2005, a massive R106 million for immediate cover
was paid to GREENLIGHT customers that had not even
paid one premium.
WE HAVE EXCLUDED INVALID
CLAIMS
• Where a claim was submitted under an incorrect
benefit (i.e. a disability claim for a fractured arm
under a death benefit), or
• Where the benefit was paid up or cancelled before
the claim event occurred.
HOW WE CALCULATED OUR PAYOUT RATIOS FOR
RISK COVER THAT WAS UNDERWRITTEN
We calculated claim payout ratios based on valid claims received. This means claims paid and claims rejected.
5. OF ALL VALID CLAIMS
RECEIVED WERE PAID
83%SEVERE
ILLNESS
93%DISABILITY
INCOME
78%DISABILITY
LUMP SUM
99%DEATH
WE ARE TRANSPARENT AND
HAVE SOME OF THE BEST PAYOUT
RATIOS IN THE INDUSTRY
Source: Claim stats brochures of insurers
6. UNDERW
RITING
PREMIUMS
CLAIMS
We underwrite thoroughly
upfront so that the risks are
well understood. This means
that we price accurately
which allows us to deliver
on our promise when you
claim.
BILLION
PAID
R3.99
UNDERWRITTEN CLAIMS
AVERAGE WORKING
DAY PAYOUT:
R16 MILLION
Our largest death benefit claim in 2015
R119 MILLION
TERMINAL ILLNESS
7. Average age
55
Youngest
22
Oldest
89
Average age
55
Youngest
6
Oldest
92
43%
Female
57%
Male
WHY WE
DIDN’T PAY
Benefit definition not met 62%
Non-disclosure 27%
Fraud 4%
General exclusion 3%
Suicide exclusion (within the first 2 years) 2%
Underwriting exclusion 2%
Cancer and tumours 30%
Cardiovascular disorders 20%
*Other 10%
Central nervous system disorders 10%
Trauma, lifestyle and accidents 9%
Musculoskeletal disorders 8%
Respiratory system disorders 6%
Sensory and communication
disorders
4%
Connective tissue disorders 3%
CAUSES OF
CLAIMS PAID
• Blood disorders
• Psychiatric disorders
• Child benefits
• Urinary system disorders
• Dermatological disorders
• Digestive system disorders
• Endocrine disorders
*OTHER CONSISTS OF
COMBINED PAYOUT RATIOS FOR ALL CATEGORIES
9. DEATH CLAIMS
In 2015, we paid 99% of all the valid death claims that we received. R3.08 billion was
paid in total. Of this, R227 million was paid for terminal illness claims. 88% of terminal
illness claims were for cancer.
88%
DUE TO CANCER
R227
MILLION
TERMINAL
ILLNESS CLAIMS
“IT GIVES YOU A LOT OF SATISFACTION TO KNOW THAT YOU’VE
FULFILLED THAT FINANCIAL NEED FOR YOUR CUSTOMER.”
Abey Karam – Old Mutual financial adviser
Scan the code for more
information on our death
benefit.
Or visit our website.
10. ACCIDENTAL DEATH
Motor vehicle accidents 61%
Crime and violence 16%
Shooting accidents 8%
Other* 6%
Accidents outside the home 5%
Accidents in the home 4%
DEATH CLAIMS
• Train accidents
• Drowning
• Electrocutions
• Burns
• Accidental poisoning
• Aeroplane accidents
*OTHER CONSISTS OF
Cardiovascular disorders 26%
Cancer and tumours 25%
Accidental death 14%
Respiratory system disorders 11%
Other* 11%
Central nervous system disorders 7%
Systemic disorders 6%
• Urinary system disorders
• Blood disorders
• Connective tissue disorders
• Endocrine disorders
• HIV/AIDS
• Musculoskeletal disorders
• Suicide
• Digestive system disorders
*OTHER CONSISTS OF
11. WHY WE DIDN’T PAY 1% OF DEATH CLAIMS
Average age
60
Youngest
23
Oldest
88
Average age
58
Youngest
19
Oldest
92
42%
Female
58%
Male
12%
SUICIDE
EXCLUSION
19%
FRAUD
2%
GENERAL
EXCLUSION
3%
BENEFIT
DEFINITION
NOT MET
64%
NON-
DISCLOSURE
Biggest cause of claims for males was for
cardiovascular diseases.
Biggest cause of claims for females was for
cancer.
12. DISABILITY CLAIMS
In 2015, we paid 84% of all valid disability claims that we received.
• 93% of valid claims received for income benefits were paid
• 78% of valid claims received for lump sum benefits were paid
R399 million was paid for disability claims in total.
“MOST PEOPLE FEEL THAT THEY WILL NEVER BE DISABLED
SO WHY PAY FOR SOMETHING THEY’LL NEVER NEED.”
Marius Laas - Old Mutual Disability Cover policyholder
Scan the code for more
information on our disability
benefit.
Or visit our website.
34%
MUSCULOSKELETAL
DISORDERS
R399
MILLION
DISABILITY
CLAIMS
14. Average age
43
Youngest
22
Oldest
65
Average age
46
Youngest
18
Oldest
65
42%
Female
58%
Male
DISABILITY CLAIMS
TIP: You can add a lump sum of up
to R750 000 to your income benefit
to cover your debt.
58% OF INCOME CLAIMS WERE FOR
THOSE YOUNGER THAN 45
Biggest causes of claims for males and
females were for:
• musculoskeletal disorders (34%)
• central nervous system disorders (15%)
Biggest single cause of claims for males was:
• knee surgeries (6%)
• major depression (6%)
Biggest single cause of claims for females was:
• breast cancer (8%)
• shoulder injury (7%)
15. Musculoskeletal disorders 46%
Central nervous system disorders 11%
*Other 9%
Psychiatric disorders 7%
Urinary system disorders 7%
Cardiovascular disorders 5%
Cancer and tumours 5%
Sensory and communication disorders 5%
Connective tissue disorders 5%
CAUSES OF CLAIMS PAID OUT
FOR INCOME
• Dermatological disorders
• Systemic disorders
• Trauma and lifestyle
• Endocrine disorders
• Respiratory system disorders
• Digestive system disorders
*OTHER CONSISTS OF
• Urinary system disorders
• Dermatological disorders
• Digestive system disorders
• Child benefits
*OTHER CONSISTS OF
Central nervous system disorders 23%
Musculoskeletal disorders 22%
Cancer and tumours 14%
Psychiatric disorders 13%
Connective tissue disorders 6%
Trauma and lifestyle 5%
*Other 5%
Cardiovascular disorders 4%
Respiratory system disorders 4%
Sensory and communication disorders 4%
CAUSES OF CLAIMS PAID OUT
FOR LUMP SUM
67%
BENEFIT DEFINITION
NOT MET
28%
NON-
DISCLOSURE
4%
UNDERWRITING
EXCLUSION
1%
GENERAL
EXCLUSION
WHY WE DIDN’T PAY 16% OF DISABILITY CLAIMS
16. SEVERE ILLNESS CLAIMS
In 2015, we paid 83% of all valid illness claims received. Of this, the BIG
FOUR illness claims which are cancer, heart attack, stroke and coronary
artery bypass graft represented 85% of all the claims paid. The remaining
17% of all claims received is made up of a range of illnesses.
“MEDICAL AIDS DON’T PAY FOR EVERYTHING. FORTUNATELY
I HAD SEVERE ILLNESS COVER AND I DON’T KNOW WHAT
I WOULD HAVE DONE WITHOUT IT.”
Wyno Strydom – Old Mutual Severe Illness Cover policyholder
Scan the code for more
information on our severe
illness benefits.
Or visit our website.
18. SEVERE ILLNESS CLAIMS
*OTHER CONSISTS OF
Cardiovascular disorders 32%
11%
Central nervous system disorders
2% Respiratory
6% Other*
system disorders
Cancer, blood and tumours49%
• Connective tissue disorders
• Dermatological disorders
• Digestive system disorders
• Endocrine disorders
• Musculoskeletal disorders
• Sensory and communication
disorders
• Trauma and lifestyle
• Urinary system disorders
19. Average age
49
Youngest
23
Oldest
76
Average age
51
Youngest
6
Oldest
78
45%
Female
55%
Male
22%
NON-
DISCLOSURE
60%
BENEFIT DEFINITION
NOT MET
3%
OUTSTANDING
REQUIREMENTS
NOT MET
15%
GENERAL
EXCLUSION
WHY WE DIDN’T PAY 17%
OF SEVERE ILLNESS CLAIMS
OF SEVERE ILLNESS CLAIMS WERE FOR
THE BIG 4
85%
CANCER
57%
STROKE
9%
CABG
14%
HEART
ATTACK
20%
Biggest causes of claims for
females were:
• Cancer and tumours (69%)
• Central nervous system (10%)
• Cardiovascular disorders (11%)
Biggest causes of claims for
males were:
• Cardiovascular disorders (49%)
• Cancer (34%)
20. R8.2bnIN TOTAL
WE PAID ALMOST R1 MILLION
EVERY HOUR
R2.9bn
CORPORATE
R3.99bn
UNDER-
WRITTEN
R1.3bn
NON
UNDER-
WRITTEN
21. We remain the leading insurer in the long-term insurance industry for
claims paid, with a massive payout of R8.2 billion in 2015.
This includes R3.99 billion in underwritten benefits, R2.9 billion
for corporate benefits and R1.3 billion in benefits that were not
underwritten.
The total value of claims paid went back into our economy to enable
a better future for our customers.
This equates to almost R1 million paid out to customers every hour.
WE DELIVERED WHEN NEEDED
22. You trusted us with your money and we kept our promise to
you. We would like to continue with you on your journey to
financial greatness.
Let one of our accredited financial advisers design a
financial plan that will suit your needs, consider your
circumstances and help you reach your goals. This
comprehensive plan will ensure that you have all the
solutions you need on your path.
SAVE
Start saving today. Get into the habit of putting away some
money every month. The earlier you start, the sooner you’ll
reach your goal. Put away as much as you can afford to;
you will thank yourself in the future.
INVEST
Make sure that your future self is financially secure. Ask
your financial adviser about our investment solutions that
will suit your specific needs. Always remember to pay
yourself first.
PROTECT
You are your biggest asset. Protect yourself with our range
of solutions that will financially cover you from different
types of risks varying from death to loss of income.
Partner with South Africa’s top insurer (as voted for by
Sunday Times Top Brands in 2015) for advice that matters.
Let us help you do great things.
WE’VE PAID, NOW LET US HELP YOU MAKE
YOUR MONEY WORK FOR YOU
23. ENJOY THE FULL BENEFITS OF YOUR
CLAIMS PAYOUT BY MANAGING AND
INVESTING IT WISELY
WHAT’S
NEXT?
OLD MUTUAL INVEST
TAX FREE PLAN
The Tax Free Plan is a great discretionary
investment that can also be used to boost
your retirement savings. This plan provides
tax-free growth and puts you in control of
your savings by giving you the peace of
mind that you can access your money
at any time.
OLD MUTUAL INVEST
FLEXIBLE PLAN
The Flexible Plan puts you in control of
your savings and encourages you to save
while giving you the peace of mind that
you can access your money at any time. It
is a simple, transparent savings solution
that aims to meet your savings needs.
MAX INCOME
Allows you to buy a guaranteed
stream of income for a specified term
or for life. All you need to do is use the
proceeds from your GREENLIGHT claim
to purchase a Max Income, Income for
Term or Income for Life product. Various
different income options and payment
frequencies are available to suit
your specific needs.
MAX
INVESTMENTS
OPTIMAL RETIREMENT
PLAN
The Max Investments Optimal Plan is
a recurring-premium retirement annuity
that allows you to increase the amount
you invest as you are able to. You can
also decrease your payments, or take a
payment holiday when life throws you
that unexpected curve ball. After five
years, it also gives you Investment
Boosters that increase your
fund value.
DEAL WITH THE
CURVE
BALL
TAILOR
INCOME
SOLUTIONS
BENEFIT CAN BE USED FOR NEED SOLUTION
DEATH
• Funeral expenses
• Estate duty and
liquidity
• Capital reinvested
• Income • Max Income
DISABILITY
• Medical expenses
• Rehabilitation cost
• Replace lost income
Lifestyle adjustment or
changes.
• Supplement retirement
• Continuity
• Additional
retirement funding
• Old Mutual Invest Tax
Free Plan
• Old Mutual Invest Flexible
Plan
• Max Investments Optimal
Plan
SEVERE
ILLNESS
• Medical expenses
• Rehabilitation cost
• Lifestyle adjustment
• Supplement retirement
either permanently or
temporarily.
• Fund a full
recovery
• Additional
retirement funding
• Old Mutual Invest Flexible
Plan
• Max Investments Optimal
Plan
• Max Income
BENEFIT CAN BE USED FOR NEED SOLUTION
YOUR
GOALS
100%
TAX FREE
24. WE CONSISTENTLY DELIVER ON THE PROMISE OF GOOD ADVICE THAT
ENABLES POSITIVE FUTURES FOR OUR CUSTOMERS.
For more information about Old Mutual’s claims statistics for 2015, please contact your financial adviser
or call us on 0860 50 60 70 or visit www.oldmutual.co.za/greenlight.
Old Mutual is a Licensed Financial Services Provider
OLDM00000489
