Trauma Insurance Claims Statistics

Trauma Insurance claims accounted for 13% of all life insurance claims in 2013 with over $620 million paid from over 4,500[1] in trauma claims, including over $54 million by TAL[2], one of Australia’s largest insurers.

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What are the most common claims?

Generally cancer, heart attack and stroke are the most frequent cause of trauma or critical illness claims in Australia across most insurers.

This is not surprising given cancer and heart diseases are among the most common chronic illnesses in Australia.

Cancer Claims

Cancer was generally the most claimed upon condition for trauma insurance, with claim rates of 51 – 65%[3] across insurers.

Among the most common cancers to be claimed upon was breast cancer and prostate cancer.

In 2010, breast cancer was the most common form of cancer amongst women, accounting to 28.0%[4] of all new cancer cases in women, while prostate cancer was the most common cancer in men accounting for 30.0%[5] of all new cancer cases in men.

Heart Attack Claims

Claims relating to heart conditions including heart attack and heart disease is one of the most frequently claimed upon conditions, accounting for approximately 20%[6] of trauma claims.

This includes heart attack and heart disease.

Cardiovascular disease affects 1 in 12[7] Australians or 3.72 million people, prevents 1.4 million[8]people from living a full life due to a disability and was the primary cause of over 520,000[9] hospitalisations in 2011/12.

What is Trauma Insurance ?

Trauma Insurance, also known as critical illness insurance, pays a lump sum benefit if you suffer from a critical illness. The payment can be used to help pay for medical expenses, mortgage and rent costs or day to day living expenses. Essentially it can be used as you see fit.

Conditions typically covered by trauma cover include:

  • Cancer
  • Heart conditions including major heart attack, open heart surgery and cardiac arrest
  • Brain conditions including Alzheimer’s and dementia
  • Nervous system disorders including encephalitis and meningitis
  • Blindness and deafness
  • Paralysis, motor neurone disease and multiple sclerosis
  • Kidney failure, liver and lung disease
  • Burns, coma and severe diabetes

For a full list, speak to your financial adviser.

How to be eligible for a trauma insurance claim

In order to be eligible for a trauma insurance claim you need to:

  • Suffer from a critical illness that is covered by your policy
  • Meet or exceed the definition of that illness that is stated in the PDS
  • Satisfy the waiting period, which is generally 90 days from the start of the policy


Published: April 1, 2017

Ask an Expert?


  • Vanessa |

    I’m interested in taking out Trauma insurance and would like to speak to someone about this..

      Russell |

      Hi Vanessa thank you for your question, the quickest way to get a quote is to give us a quick call on 1300 135 205 or alternatively please complete the above trauma insurance quote form request & we will prepare a detailed comparison report for you to review.

  • Mel |

    Hi, Can you tell me what percentage of claims are made for a medical condition that was loaded at time of underwriting?

      Brett Lenertz |

      Hi Mel, That is the best question we have had in the last 12 months without a doubt! It is also a topic that would make a great research piece. However, unfortunately this is data that is not easy to come by nor is it made available to us. But, once again thank you for your great question.

  • Stephen |

    Is it possible to get claim data on angioplasties? The number of insurance claims due to angioplasties and how much the claims add up to (total claim size) for angioplasties (with reference if possible). I am currently doing a paper on it.