As the number of COVID-19 cases in the country increased, insurance claim payouts due to the pandemic hit P8.2 billion in the first nine months of last year, a survey conducted by the Insurance Commission revealed.

In a statement, Insurance Commissioner Dennis B. Funa said on Monday, Jan. 31 that payouts by health maintenance organizations (HMOs) and life insurers amounted to P7.67 billion, or 93 percent of the total COVID-19 claims from January to September 2021.

Payouts by the HMO industry constituted 45 percent, or P3.68 billion, of the COVID-19 claim payouts, while life paid the 48 percent of the pandemic-related claims amounting to P3.99 billion.

Meanwhile, non-life insurers paid two percent and mutual benefit associations (MBAs) cornered the five percent, or P180 million and P377.1 million, respectively.

The survey conducted by the commission also reflected the relationship between COVID-19-related claims paid and the reported number of new reported cases in the Philippines.

“The figures we obtained reflect that the claims paid increased drastically from February to April 2021, dipped slightly during the months of May, June and July, and then spiked in August to September of the same year,” Funa noted.

Notably, the survey revealed that when the number of new COVID-19 cases passed the 500,000-mark in September, the amount of claims paid by insurers, HMOs, and MBAs increased to more than P1.4 billion.

From July to September, 48.27 percent of the total P3.88 billion paid by life and non-life insurers, HMOs, and MBAs pertained to death benefits, amounting to P1.87 billion,”

This is followed by in-patient benefits, amounting to P1.23 billion or 31.62 percent of the total. Meanwhile, insurers paid P613.9 million in Out-Patient claims, accounting for 15.83 percent of the P3.88 billion total from July to September 2021.

“These three benefits make up 96 percent of the total amount of claims paid,” said Funa.

In terms of the number of claims from July to September, however, claims for out-patient benefits ranked first, with 217,675 claims out of a total of 260,053.

This is followed in ranking by 13,105 claims for in-patient benefits and 12,196 claims for Other Benefits (e.g., Emergency Care, Financial Assistance benefits, etc.), respectively.

“In both 2020 and the first three quarters of 2021, claims for Death Benefits has the highest amount of COVID-19-related claims paid by insurers, HMOs, and MBAs, followed by In-Patient Benefits and Out-Patient Benefits,” Funa said.

“Also worth mentioning is the fact that unlike in the survey for the first semester of 2021, there are no claims paid for Travel and Business Interruption benefits during the third quarter of 2021,” he added.

“Since the start of the pandemic until end-September 2021, total COVID-19-related claims paid by the life and non-life insurance industries, HMOs, and MBAs reached P12.12 billion.

Of this amount, P8.23 billion, or 68 percent, was paid in the first three quarters of 2021, while P3.89 billion, or 32 percent, was paid in 2020.

“The claims paid during the first three quarters of 2021 is already more than double of the total claims paid for the year 2020,” Funa said.

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