Data release
AIA paid 4.8% less in claims in the year insurers blamed surging claims for premium rises
Source: AIA NZ, AIA NZ pays $790M in total claims in 2025
AIA NZ paid $790 million in claims in 2025, down from $829.6 million in 2024. That fall came in the same year official figures put health insurance price rises near 20%. AIA's release never mentions the drop, and the share of claims it accepted slipped a point to 91%.
By Henry Smith · Insurers · 2026-05-12
What this means for you Health insurance prices rose almost 20% in a year when the country's largest life insurer paid out 4.8% less in claims and turned down a slightly bigger share of them. The claims surge insurers talk about is real, but it sits in some products and not others. AIA's health claims grew 6.2% while its life payout fell 13.5%, so the explanation fits some policyholders far better than others.
New Zealand's largest life insurer paid out less in claims last year, not more. AIA NZ paid $790 million in calendar 2025, down from $829.6 million in 2024. That is a fall of 4.8% (AIA NZ, 12 May 2026, and AIA NZ, 8 May 2025, both retrieved 20 August 2026).
The same year, health insurance premiums jumped. Stats NZ tracks the prices households pay in the Consumers Price Index. That index put health insurance premiums up almost 20% in the year to September 2025, and some individual increases reached 50% (RNZ, 29 October 2025, retrieved 20 August 2026).
AIA's release never mentions the previous year's total. Its acceptance rate slipped too, from 92% to 91%. That rate is simply the share of the claims it received that it agreed to pay (Claims Compass #3 and Claims Compass #2, retrieved 20 August 2026).
What did AIA announce?
On 12 May 2026 AIA NZ published the third edition of its Claims Compass, the yearly report where it adds up what it has paid out. It reports $790 million in claims for the year to 31 December 2025, helping more than 789,000 New Zealanders (AIA NZ, 12 May 2026, retrieved 20 August 2026).
The theme AIA chose is heart disease. More than $93.5 million went to heart-related claims, and they were most common among men aged 40 to 69 (same source).
AIA says it accepted 91% of the claims it received. It splits the payout across five products (same source):
- Life cover, which pays out when the insured person dies
- Health cover, which pays for private medical treatment
- Trauma cover, a lump sum if you are diagnosed with something serious, such as cancer or a heart attack
- Income protection, a monthly payment while you cannot work
- Total permanent disablement, or TPD, a lump sum if you can never work again
The dollar figures for each product are in the table below.
On costs, the release points one way. It blames "rising claim volumes and medical inflation across the industry". It gives three reasons: the public system is under strain, so people go private sooner; diagnosis and treatment have improved; and medical costs are rising faster than prices in general (same source).
A year earlier, when the total went up, AIA led with the comparison. The opening line of the second edition reported $829.6 million paid in 2024, "a $95M increase on the previous year" (AIA NZ, 8 May 2025, retrieved 20 August 2026).
What did the release leave out?
When the total rose, the year-on-year comparison was AIA's first sentence. When it fell, that comparison vanished. The sum takes one line: $829.6 million minus $790 million is a drop of $39.6 million, or 4.8%.
The number of New Zealanders covered also fell, from over 797,000 in the 2024 edition to over 789,000 in the 2025 edition (Claims Compass #2 and Claims Compass #3, retrieved 20 August 2026).
Which products fell, and which rose?
The release lists the 2025 totals for each product, but never compares them with 2024. The 2024 figures sit in AIA's own earlier report (Claims Compass #2, retrieved 20 August 2026). Put the two years side by side and the story changes shape.
Chart: QuoteHub comparison of AIA Claims Compass #2 and AIA Claims Compass #3, both retrieved 20 August 2026.
| Product | 2024 claims paid | 2025 claims paid | Change |
|---|---|---|---|
| Life | $298.1m | $257.73m | down $40.37m, 13.5% |
| Health | $167m | $177.31m | up $10.31m, 6.2% |
| Trauma | $139.5m | $142.45m | up $2.95m, 2.1% |
| Income protection | $97.2m | $108.69m | up $11.49m, 11.8% |
| Total permanent disablement | $23.9m | $21.35m | down $2.55m, 10.7% |
| Sum of the five products | $725.7m | $707.53m | down $18.17m, 2.5% |
| Headline total | $829.6m | $790m | down $39.6m, 4.8% |
2024 figures from AIA Claims Compass #2, 2025 figures from AIA Claims Compass #3, both retrieved 20 August 2026. The change column and both sum rows are QuoteHub arithmetic.
Three things stand out from that table. The release mentions none of them.
First, the whole decline sits in life cover. Life claims fell $40.37 million, which is more than the $39.6 million fall in the headline total. Health cover is where premium rises have been steepest, and health claims grew 6.2%. Income protection grew fastest, at 11.8%. It is the one product where the payout data genuinely matches the industry's cost story.
The life fall is not just a settling down after one unusually big year. AIA's 2025 release said life claims rose $34.6 million in 2024. That puts 2023 at $263.5 million (AIA NZ, 8 May 2025, retrieved 20 August 2026). The 2025 payout of $257.73 million is below even that.
Second, the five named products add up to $707.53 million. That leaves $82.47 million of the $790 million headline unexplained, and the table shows the same gap in 2024. Roughly a tenth of the payout went to products the release never names.
Third, health is not the main thing AIA pays for. Health claims were 22.4% of the headline total. Life, trauma and income protection together were 64.4% (AIA NZ, 12 May 2026, retrieved 20 August 2026). AIA is mostly a life insurer, and the life side is where its payout shrank.
What does one point off the acceptance rate mean?
Accepting 91% of claims means turning down 9%. Accepting 92%, as AIA did in 2024, means turning down 8% (Claims Compass #3 and Claims Compass #2, retrieved 20 August 2026). So nine claims in every hundred were declined, where the year before it was eight. That is a 12.5% increase in the rate of declines.
AIA does not publish how many claims it received, so nobody outside the company can turn that slip into a number of people. We can say this much: in a year when the dollar payout fell, the share of claimants who walked away with nothing rose.
How does AIA's health payout compare with Southern Cross?
Southern Cross Health Society is the country's biggest health insurer. Its latest reported year looks nothing like AIA's:
| Southern Cross, year to 30 June 2025 | Figure |
|---|---|
| Claims paid to members | $1.706 billion, up 14% on the prior year |
| Number of claims | 3.8 million, a record, up 16% |
| Members | 951,808 |
| Share of premiums paid back out as claims | 94% |
All figures from Southern Cross, 30 September 2025, retrieved 20 August 2026.
AIA's $177.31 million of health claims is 10.4% of Southern Cross's payout. Put another way, Southern Cross pays out about $9.60 in private health insurance claims for every health dollar AIA pays.
That contrast is the honest shape of the "surging claims" story. At Southern Cross, claims really did surge. At AIA, health claims grew 6.2%, about a third of the near 20% rise in health premiums (RNZ, 29 October 2025, retrieved 20 August 2026), and the total payout fell 4.8%. The industry version fits in one sentence. The numbers, insurer by insurer, do not.
What does this mean for your cover?
If you hold health cover, the claims pressure is real. It just sits mostly with the insurer that carries most of the load. Southern Cross can point to its own surging claims to explain its price rises. The industry-wide story does not do that job for every other insurer. So when your renewal letter blames rising claims costs, the question worth asking is what your own insurer paid out, not what the industry did. AIA's answer for 2025 is on the record: total payout down 4.8%, health payout up 6.2%.
If you hold life cover, the country's largest life insurer paid out 13.5% less on life claims in 2025 than in 2024, and less than it paid in 2023. Most life policies use stepped premiums, the common type where the price rises each year as you get older. Those rises happen whatever claims did.
Whatever you hold, the acceptance rate decides whether you ever appear in the payout figures at all. A one-point slip looks small until you are one of the 9%. Claims are won or lost on paperwork, on what you told the insurer when you applied, and on following the right steps. A claims readiness check is worth doing before you claim, not during.
What we could not check
AIA does not publish how many claims it received, so we cannot see the count behind the 91% acceptance rate. We cannot say how many people the one-point slip represents, only that the rate of declines rose.
AIA's material never explains the $82.47 million gap between the five named products and the $790 million headline. Workplace schemes and smaller benefits are likely candidates, but the release does not say, and we did not guess.
The Southern Cross and AIA reporting periods do not line up. AIA reports the 2025 calendar year. Southern Cross reports the year to 30 June 2025. They overlap by six months, so the 9.6 times figure is a rough guide to scale, not an exact comparison.
We took the Stats NZ price figure for health insurance from RNZ's reporting of it, not from Stats NZ directly. The 2023 life figure of $263.5 million is our own subtraction from the $34.6 million increase AIA stated, not a number AIA published.
AIA's release gives no premium income figure, so we cannot work out how much of the money it took in came back out as claims. Nothing here shows what AIA itself did to its own prices in 2025. The near 20% rise covers the whole health insurance market, not AIA alone.
Sources
- AIA NZ pays $790M in total claims in 2025, AIA New Zealand, 12 May 2026
- AIA NZ Claims Compass #3, Spotlight on Heart Claims, AIA New Zealand, 2026
- AIA NZ pays $829.6M in total claims in 2024, AIA New Zealand, 8 May 2025
- AIA NZ Claims Compass #2, Spotlight on Mental Health, AIA New Zealand, 2025
- Delivering for members more than ever, Southern Cross Health Society, 30 September 2025
- Healthy, young, but medical insurance premiums rise 25 percent in a year, RNZ, 29 October 2025
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Explore related pages: Life Insurance, Income Protection, Health Insurance, Trauma Insurance, For Brokers.