Results of the 3rd high cost claims analysis of phi in Germany

Results of the 3rd high cost claims analysis of phi in Germany

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Speaker: Jürgen Fischer

Munich Re is currently performing for the third time (after 2010 and 2014 and 2017) the so-called High Cost Claims analysis in the Private Health Insurance sector of Germany. A High Cost Claim (HCC) is defined as all benefits paid by a private health insurer for one insured person within one calendar year larger than 100,000 €. In 2014 80% of the PHI-market took part and contributed with more than 22,000 high cost claims for a 6-year-period.

The analysis shows frequencies, trends, medical reasons (ICD-10 coding for diagnosis) for those claims. One result example is that maximum HCC in Germany show amounts of almost 5 Mio. €. We will also look into the reasons for such highest claims, i.e. which diagnosis lead to it. There will also be charts about those diagnoses which are most often causing HCC.

The analysis is split into three categories: comprehensive health insurance, supplementary health insurance and travel health insurance. We will show a number of relations. Whereas comprehensive and supplementary health insurance is very much based on Germany, the travel health insurance part is for international interest, as there will be claims from everywhere.

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