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JAMAICA: Health insurance claims fell 10% while life claims rose in COVID year

Jamaica’s insurance industry paid out JM$20.1 billion dollars in health insurance benefits, which was 10 per cent less than 2019 when claims were JM$22 billion, according to the Insurance Association of Jamaica (IAJ).

While most categories under health saw a decline in claims, the sole exception was maternity, which saw a 10 per cent uptick from JM$186 million to JM$205 million in claims.

Prescription drugs accounted for 28 per cent of all health insurance claims in 2019 and 2020, making it the largest claim by segment.
(Photo: Harvard Health)

Health claims included hospitalisation, surgery, doctors’ fees, lab/X-Ray, prescription drugs, maternity, dental, optical, disability, among others.

Line item claims

Data from the IAJ on June 4, 2021, indicated that hospitalisations declined from JM$2.38 billion in 2019 to JM$2.24 billion in 2020. Surgery slid from JM$3.25 billion in 2019 to JM$3.1 billion last year.

At the same time, doctors’ fees, which were JM$2.2 billion in 2019, fell to $1.8 billion in 2020. Lab and X-ray claims also declined, sliding from JM$2.56 billion to JM$2.46 billion in 2020. 

Prescription drugs was the category with the largest claim segment, accounting for 28 per cent of all claims in 2019 and 2020. Like other segments in the medical insurance category, claims for prescriptions dipped — from $6 billion in 2019 to $5.6 billion in 2020.

“[In] 2020, despite financial constraints, there was an increase in the number of policies in force and there was a greater effort by persons to secure higher insurance coverage”

— Dr Adrian Stokes, president, Insurance Association of Jamaica

Dental claims declined from JM$2.2 billion in 2019 to $1.9 billion in 2020. Meanwhile, optical was relatively stable at JM$1.61 billion in 2020, moving from JM$1.62 billion in 2019 .

Other claims remained flat at JM$1.1 billion for 2019 and 2020.

Companies providing group insurance include CUNA Life, Guardian Life, Sagicor Life, JN Life, NCH Insurance, Canopy Insurance, and Scotia Group Life.

Canopy Insurance is one the providers of group life and health insurance in Jamaica. (File photo)

Life insurance coverage growing

With regard to life insurance, claims for death and living benefits from individual life insurance policies rose by five per cent to JM$24.4 billion dollars.

Comparatively, claims amounted to JM$23 billion in 2019.

President of the Insurance Association of Jamaica Dr Adrian Stokes said the industry is on a campaign to increase per capita coverage on the life side. He noted that takeup in the category increased in 2020.

President of the Insurance Association of Jamaica Dr Adrian Stokes (File photo)

“Life Insurance protection is at the core of the Life Insurance Business, as it seeks to provide protection for those dependent on the support of their breadwinner, in the event of the breadwinner’s untimely death or disability,” he said during the IAJ’s press briefing on June 2, 2021.

“It was gratifying to see that in 2020, despite financial constraints, there was an increase in the number of policies in force and there was a greater effort by persons to secure higher insurance coverage,” he added.

The president pointed out that, over the years, life insurance in Jamaica has become a vehicle for investment as well as insurance protection. Sixty per cent of all policies include an investment component. 

“The life insurance industry has established itself over the years as the largest mobiliser of mediumJM- to long-term savings and investment in Jamaica. It has over JM$360 billion in invested assets and is the largest player in the pension fund market with over JM$300 billion in pension funds under management,” Dr Stokes stated.