A repricing of risk is under way in life insurance, driven less by product design and more by how claims are emerging in practice.
Discovery Life’s 2025 claims statistics, released on 17 March, show that R11.5 billion was paid in claims and benefits, including R6.9bn in individual life claims, R2.4bn in shared-value payments, and R2.2bn in group risk claims, with 65% of individual policy payouts going to living benefits rather than death claims.
Discovery Life said this reflects how “life insurance is evolving to provide protection throughout a person’s life”. Mortality is no longer the dominant claims event; instead, morbidity, income disruption, and client behaviour are shaping both the frequency and nature of payouts.
“Life insurance is no longer just about what happens when someone dies. More and more, it’s about supporting people while they are still alive – helping them navigate severe illness, disability, or income disruption.”
The data points to a shift from event-based planning to a lifecycle model, where multiple, lower-severity, and often recurring events define outcomes.
Living benefits are not supplementary – they are core
The composition of claims reflects this shift. Of the R6.9bn in individual life claims, R3.2bn related to death benefits, while R1.8bn was paid for severe illness, R987 million for capital disability, and R684m for income continuation, with a further R268m paid through additional benefits such as funeral cover and education protection.
Discovery Life noted that while the industry typically sees 20% to 30% of payouts going to living benefits, “at Discovery Life, 52% of risk payouts now support clients during life”.
Once shared-value rewards are included, most value is delivered while clients are alive – often incrementally rather than through a single claim event.
This has implications for product structuring. The relevance of cover increasingly depends on its ability to respond across a range of events and severities, rather than a single high-value payout.
Income risk is becoming more prominent
Although severe illness remains a large contributor to claims, income continuation benefits point to a different type of risk.
Discovery Life highlighted that these claims provide ongoing support when clients cannot work, often starting earlier in their working lives and extending over time.
The longer duration and cumulative cost of income loss position income protection as a more persistent financial risk than once-off events.
Early detection is increasing claim frequency while reducing severity
One of the more notable trends is the rise in lower-severity claims, particularly in cancer.
Discovery Life reported that lower-severity cancer claims have been increasing at roughly twice the rate of higher-severity claims (22% annually compared with 11%). This is linked to increased screening and earlier detection.
Through Discovery Health’s Personalised Health Pathways, more than 18 000 screening actions were completed in 2025, including 9 476 cancer screenings, 5 469 health checks, 2 504 metabolic screenings, and 714 organ health screenings.
These led to 47 diagnoses that triggered claims, including 35 cancer cases – 32 detected at stage 1 or 2 – as well as 12 heart and artery conditions.
“AI is enabling highly personalised recommendations based on each client’s health profile and behavioural patterns,” said Dr Deidre Kotze, chief medical officer at Discovery Life. “By guiding clients toward the screenings most relevant to them, we are increasingly able to detect serious conditions earlier, when treatment options are broader, and outcomes are often significantly better.”
The result is a shift in the claims profile: more claims, but at earlier stages. This places pressure on product designs that focus primarily on severe events.
Repeat claims are becoming more common
The data also shows an increase in repeat claims. In 2025, 22% of severe illness claims were for second or subsequent events, amounting to R320m.
Discovery Life noted that many of these occurred within the same body system and often at similar or lower severity levels, with 64% of related claims at the same or lower severity.
“Health events don’t always happen just once,” the insurer said, adding that its cover is “designed to support clients for recurring or related conditions”.
This trend challenges product structures that limit claims for related conditions or do not reset benefits effectively.
Behaviour-linked incentives are influencing outcomes
Discovery’s shared-value model continues to shape both engagement and claims experience.
The insurer has paid R18.8bn in shared-value rewards to date, including R2.4bn in 2025. Of this, around R1.25bn was paid as premium paybacks and R1.16bn through cash conversion benefits.
Clients who reach higher engagement levels show a 73% lower mortality risk and a 45% lower disability risk.
“Engagement in Vitality … has been at the core of Discovery Life’s story,” the insurer said, noting that improved health outcomes contribute to the value returned to clients.
High payout rates, but disclosure remains key
Discovery Life reported a 99.3% claims payout rate, with declines mainly due to non-disclosure (0.4%), misrepresentation (0.15%), and fraud (0.15%).
“These figures reflect the strength of our underwriting process and our commitment to paying valid claims,” said Sylvia Steyn, head of claims at Discovery Life. She added that underwriting aims to ensure that cover “performs exactly as intended at the point of claim”.
Underwriting is becoming more dynamic
Together, the data shows how claims are shifting: more are linked to illness, disability, and income loss, often occurring earlier and sometimes more than once. The shift places greater weight on living benefits, income protection and sustained client engagement, aligning cover more closely with how risk is now emerging in practice.
Discovery Life indicated that underwriting is increasingly influenced by client behaviour, supported by data from health engagement and screening activity.
This shifts underwriting from a one-off assessment at policy inception to an ongoing process influenced by clients’ health engagement, while also extending the role of advice from initial cover placement to continuous client support over time.
