Healix reduce impact of High Cost Claims with new Stop Loss model

Healix Health Services are continuing to innovate with the introduction of a new Stop Loss model designed to protect clients’ corporate healthcare trust funds from the impact of High Cost Claims.

The whole of the healthcare market has seen a significant uplift in cancer claim costs over the last 27 months.  The average cost of a cancer claim three years ago was £50k, but now insurers are regularly seeing cancer claims breaching £100k, £200k and £300k.

These high claims can seriously affect the long term sustainability of any healthcare scheme so Healix has created a ‘future proofing’ model for our Healthcare Trust clients which reduces the impact High Cost Claims could have on their claims funds.

Healix already make Aggregate Stop Loss insurance available to its Healthcare Trust clients, providing insurance protection where total claims exceed the estimated claims fund.  This is usually activated when claims reach 100% or 125% of the fund although different levels can be agreed. To help protect clients’ funds against the impact of individual High Cost Claims, Healix have also added £100k Specific Stop Loss insurance to the contract. This means that for any individual claim exceeding £100k, costs above £100k will be met by an insurance policy rather than the trust fund.

This combination of Aggregate and Specific Stop Loss insurance, arranged by Healix Insurance Services and underwritten at Lloyds, means that our clients’ healthcare trust funds are not only protected from total claims exceeding the estimated claims fund but also from any individual high cost claims making a big dent in the fund. Furthermore, with the claims fund being less susceptible to spikes from high cost claims, the estimated claims fund required could be reduced for future years.

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