More than seven out of 10 medical insurance claims are not for ‘routine’ treatment according to new claims data from VitalityHealth
Its data shows 70 per cent of its health calcium were for its ‘everyday care’ services, which include GPs, talking therapies, physiotherapy and dental and optical options. This may prompt employer to rethink how how workplace health benefits are designed and the role of PMI and other healthcare products, such as cash plans, in their overall benefits package.
This data is contained in VitalityHealth’s 2025 Health Claims and Insights Report. It also shows the growing role of digital pathways, with 71 per cent of authorisations now started online. The company also reported that 64 per cent of GP consultations led to onward referrals or additional services, reflecting the growing importance of digital healthcare pathways in speeding up diagnosis and treatment — a trend that could help employers reduce absence and support wellbeing more effectively.
The report also shows how technology and AI are being used across the health sector, with Vitality saying this trend is particularly evident when looking at cancer treatment and claims.
It says cancer treatment continues to evolve rapidly, with new biological and hormone chemotherapies being used to treat a growing number of cancers.
According to Vitality, between 2019-2024, claims rates of biological and hormone chemotherapies to treat Vitality members each increased by 30 per cent respectively. The health insurer says that while these treatments are improving outcomes for patients, it is also pushing up treatment costs — reinforcing the need for both prevention and early detection of such conditions.
The report also highlighted the benefits of having a workforce that is active and encouraged to stay healthy. It found that healthcare costs for members who were highly active were 27 per cent lower, while those who were a healthy weight had a 35 per cent lower risk of hospitalisation.
VitalityHealth CEO Arun Thiyagarajan says: “The insights within this report underscore a pivotal shift in how consumers engage with and use health insurance. The surge in Everyday Care usage, and the widespread adoption of digital access and technology, are signals of a fundamental transformation in customer expectations and the regular ongoing value and access to care and treatment members are now getting.
“With more of us turning to health insurance for accessible, preventative services or early, quick access to care, there is significant opportunity for the industry to embrace this and better serve customers now, and in their time of need. By being proactive with health and treating people earlier in any health journey, we can deliver regular and ongoing value, enable healthier choices, and help people to live in better health for longer.”
