The Top Ten Mostly Costly Health Claims

July 12, 2017

 A new study was recently published by Sun Life Financial which documents the top stop loss claims paid by Sun Life to self-insured health funds between 2012-2015. More than half (53%) of the stop loss claims paid were attributable to the top 10 claims.


The following are the top ten stop loss claims and the amount paid for each type of claim between 2012-2015:

  1. Malignant Neoplasm: $429 million

  2. Leukemia/lymphoma/multi myeloma: $188 million

  3. Chronic renal disease: $156 million

  4. Congenital anomalies: $96.3 million

  5. Premature births/ low birth weight: $75 million

  6. Transplants: $62.2 million

  7. Congestive heart failure: $57.8 million

  8. Cerebrovascular disease: $57.4 million

  9. Respiratory Failure: $55 million

  10. Septicemia: $54.7 million

By comparing claim history to this list, plans can predict potential large claims and potentially protect themselves with stop loss insurance.

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