AIA NZ paid out $790 million in total insurance claims in 2025 - of those, $177.31 million related specifically to health insurance claims

The country’s largest life insurer, AIA NZ, paid out $790 million in total claims in the year to December.

AIA, which has over 789,000 members, provides life, health, trauma, and income insurance. Across all of AIA NZ’s different insurance categories in 2025:

• $21.35 million was paid out in total permanent disablement claims
• $108.69 million was paid out in income protection claims
• $142.45 million was paid out in trauma claims
• $177.31 million was paid out in health claims
• $257.73 million was paid out in life claims

AIA NZ accepted 91% of all claims received. The total claims paid out in 2025 is a decrease from 2024, which saw AIA NZ pay out $829.6 million in total claims and accept 92% of all claims received.

Releasing its latest Claims Compass report on Tuesday, AIA NZ found when it came to life insurance payouts, 43% were related to cancer, 16% were related to the heart, 11% were neurological and 7% were related to respiratory claims.

For health insurance claims, the AIA NZ report found 20% were connected to cancer, 22% were musculoskeletal related, 12% were digestive and 10% were heart related.

In the latest data from the consumers price index (CPI), health insurance saw a 20.5% annual jump. Last year, the Reserve Bank said it had "intensified its supervision" over the health insurance sector and the central bank noted that escalating claims cost had been a dominant source of strain in the sector.

AIA NZ chief customer officer Maddie Sherlock told interest.co.nz that across the industry, there had been a rise in premium costs, particularly for health insurance.

That was largely associated with medical costs and the value of those claims rising more than general inflation, which was an industry-wide reality and what the industry as a whole was experiencing, Sherlock said.

Of the total trauma claims, 53% were cancer related, 19% were for the heart while 12% were neurological related and 7% were musculoskeletal.

When it came to total income protection claims, 31% were musculoskeletal, 23% were for mental health, 15% were for neurological-related claims and 12% were cancer related.

Of the total permanent disablement claims, 27% were musculoskeletal, 24% neurological related, 22% were cancer related and 7% were for mental health.

Data from AIA NZ found at $221 million, customers aged between 50-59 had the highest amount of claims paid, followed by the 40-49 age group with $148 million.

Those below 20 had $11 million in total claims paid while those aged 20 to 29 received a total claims payout of about $22 million.

AIA NZ found that the total 2025 claims paid to males was $416.6 million while females received $287.8 million.

Growth in high-value medical claims

In its report, AIA NZ highlighted that $93.5 million in claims were paid to customers with heart-related claims.

Heart-related claims were most prevalent among men in the 40 to 69 age group, and they accounted for the largest share of heart claims in 2025, the report said.

Of the heart-related claims, 31% were for heart attacks, 24% were for heart disease, 6% for diagnostics, 5% for valve-related diseases and 3% for cardiac arrythmias.

"All medical claims costs are outpacing CPI inflation, but heart claims face some of the steepest increases. Treatment types such as scans, procedures and hospital stays are notably more expensive for heart-related conditions," the report said.

AIA NZ said it had continued to see growth in high-value medical claims, including chemotherapy and complex spinal procedures.

The report said there were several factors contributing to rising claims costs across the industry such as pressure on the public health system leading to people turning to private treatment, and improved diagnostic capability and treatment options.

Medical inflation was also contributing to rising claims costs with the cost of scans, procedures and hospital stays increasing faster than general inflation, the report said.

Different insurance options

Sherlock said AIA NZ’s focus was on balancing access and affordability, and it was hugely important to be innovative and to bring different options to the market as a way to meet different customer needs.

“There are some really good examples overseas with things like health wallets, people being able to opt into different benefits [and] opt out of different benefits depending on their circumstances and what is unique and will meet their needs.”

Over the next 12 to 24 months, that will be a big focus from them, she said.

Sherlock said when we look to other countries, New Zealand was underinsured when it came to things like life and health insurance.

“There is definitely an opportunity … to look at different types of insurance options. Insurance is about protecting future choices, providing access to care and financial stability," Sherlock said.

"I think there is really an opportunity to look to more innovation to meet more of the needs of New Zealanders.”