Low claims discount
The low claims discount gives a 10% discount for members who have claimed under $500, or a 5% discount for members who have claimed between $500 and $1,000 and is based on a two year claims period. The premium discount applies for up to 12 months from renewal.
Eligibility for the low claims discount
Members are eligible for the low claims discount if they are paying adult premium rates and have had their Southern Cross health insurance for at least two years continuously, unless they are:
- in a subsidised work scheme
- under 21 years old.
It does not apply to Cancer Cover Plus, Critical Illness, Cancer Assist or HealthEssentials plans.
How the low claims discount works
If an eligible member has claimed between $0 and $499 over the two year claims period, a 10% discount is applied to the member's premium at their policy renewal.
If a member has claimed between $500 and $1,000 over the two year claims period, a 5% discount is applied to the member's premium at their policy renewal.
Qualification for the low claims discount is based on claims paid over the two year calculation period, rather than the date of the healthcare service or the date a claim is submitted.
We offer the low claims discount at our discretion. We may change or remove it upon giving reasonable notice to policyholders.
Low claims discount FAQs
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What is changing?
The current low claims reward is being gradually replaced with a low claims discount from 1 June 2018 as policyholders renew.
The low claims discount is a 10% discount for members who have claimed under $500, or 5% discount for members who have claimed between $500 and $1000, over the two year calculation period. The discount applies for 12 months from policy renewal. -
Why are you changing the low claims reward?
The low claims reward had a complex set of thresholds depending on age and plan type. Members told us that the reward was not well understood and it was difficult to know the impact of a claim on the ability to retain the reward.
Regular reviews of plans, benefits, rewards and discounts help us to ensure we can continue to offer the best value health insurance for all our members. Changing the low claims reward to the new, simpler, low claims discount recognises that members want to use their policies, and have a straightforward discount when their claims are at a lower level. -
Is there a new discount?
No there will be no new discount, just changes to the existing Low Claims Reward - members will still get access to all the great member offers by being a Southern Cross member.
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What isn't changing?
The discount still does not apply if you're under 21 years old, part of a subsidised work scheme or haven't had an active policy for 2 years or more.
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When will this change take effect?
The low claims discount will be applied to members on policies with a renewal date of 1 June 2018 onwards.
Members on policies with a renewal date up to 31 May 2018 will have the low claims reward applied until their next annual renewal. -
Will premiums still increase?
Premium levels necessarily reflect claims paid (i.e. the use that is made of the Society's health insurance benefits). The premium charged for different plans and for members in different age groups, takes into account current claims levels and costs, as well as the predicted use of benefits in the coming year.
In the last calendar year, across our membership as a whole, the Society returned on average 90 cents in claims for each premium dollar it received.
Rising claims costs reflect a number of factors. These include increasing medical costs, the introduction of cover for new technologies and treatments, and the increasing levels of use of policy benefits by members.
The main cause of premium increases is claims cost escalation.
The top three contributors to this escalation in 2016/17 were:
- More members claiming more benefits (accounts for 50%*)
- Procedure price inflation (accounts for 40%*)
- Newly added benefits (accounts for 10%*)
Source: SCMCS 2017 Annual Report
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I don't claim very much. Is this reflected in my premium?
We offer a healthy lifestyle reward for the first two years of your policy, members who qualify will have the reward applied when they sign up. After two years of continuous membership a low claims discount (previously the low claims reward) is available to certain members. The low claims discount is based on claims over the two year calculation period, and is a 10% discount for members who have claimed under $500, or a 5% discount for members who have claimed between $500 and $1000. The discount applies for 12 months from your policy renewal. -
If ACC decides to reimburse the costs for a treatment that Southern Cross funded due to ACC's original decline, will my low-claims discount be reviewed?
If the claim has been included in determining your eligibility for the low claims discount, your eligibility will not be reviewed regardless of the ACC outcome. We will, however, adjust your policy limits as applicable. -
Why is the low claims discount assessed over 2 years?
We use a two year period so there is sufficient time to even out your usage of policy benefits. If we only used on year, the threshold would be much lower and it would be harder for members to get the discount. -
When does my policy renew?
Your policy renews each year on your policy anniversary date. You can find this date on your membership certificate and also on your 'Membership details' page of My Southern Cross.