News

• A record 3.8m claims paid to members, up 16% from FY24.
• $1.706b paid out in claims to members, up 14% from FY24.
• $6.85m paid out in claims every business day.
• 94% of premiums collected paid back out to members in claims.
• The Group deficit of $51.8m is made up of the $56.9m deficit for Health Insurance offset by a $13.9m net surplus from subsidiary investments, less a $8.8m group accounting consolidation adjustment
• Southern Cross Health Insurance $56.9m deficit is a $42.2m improvement from FY24 financial results.

Southern Cross Health Society Group today announced that it had paid out a record 3.8m claims1  to members during the 12 months to 30 June 2025 (FY25).

CEO Nick Astwick said this represented a 16% increase in volume on the prior financial year, due to more members claiming, and more often.

“There is clear evidence our public health system remains under pressure, we’re seeing members of all ages using their policies more than ever to access the private healthcare treatment they need, when they need it.”

Astwick said the value of health insurance was becoming increasingly more relevant for individual policy holders and the more than two and half thousand New Zealand businesses who offer subsidised Southern Cross Health Insurance to their employees.

“Nearly 40% of our 950,000 members are part of a subsidised group scheme offered by 2,600 employers providing them and their families with timely access to the healthcare they need. This is not only good for their health and wellbeing but means they can get back to their day-to-day lives sooner.

“As New Zealand’s largest health insurer, and the third biggest funder of healthcare behind Health New Zealand and ACC, we have an important role to play in supporting the overall healthcare system, and we want to do more.”

Astwick adds “despite the economic climate, it’s heartening to see our membership remain stable with net membership sitting at 951,808, down slightly from 955,301 last year.”

Supporting our members when they need us most

Astwick said he was incredibly proud of how Southern Cross Health Society had supported its members during the financial year, which was reflected in a market-leading Net Promoter Score, and Southern Cross sitting in the top 10 trust ranking in the 2025 Kantar Corporate Reputation Index.

Astwick says while the Society is pleased to see members getting value out of their health insurance plans, the exceptionally high demand as more members claim more frequently, does result in increased claims costs, and this directly impacts premiums, which can be difficult for members.

“Our member services team has worked incredibly hard to support our members who may be finding it difficult to manage premium increases. This year 17,772 members were able to retain their cover by choosing to add or increase their excess.

“At the same time, looking at market prices across the health insurance sector, we know our annual base premium increases are lower. We’ve been able to achieve this through our Friendly Society status which means we don’t have shareholders to pay a return to, by keeping our operating costs down and because of our Affiliated Provider (AP) programme.

“We now have 2,500 contracted healthcare providers nationwide, adding 143 providers to our AP programme over the year. We were delighted this year to achieve a national price for imaging procedures such as x-rays, mammography, CT scans and MRIs,” he said.

Outlook

Looking ahead, Astwick says “for the year ahead (FY26), we have an active programme of work underway to manage our claims costs, ensure premium affordability and generate a surplus, while continuing to be the health insurer of choice for New Zealanders.

“While we will never be distracted from our reason for being, which is to fund private healthcare for our members, we want to do more to help our members. Every member, and every New Zealander, deserves to enjoy good health, but this is not the reality for many.

“Our average lifespan in New Zealand is around 82, but our health span is 70. This means the last 12 years of Kiwis lives are spent in ill health – New Zealanders deserve better than this.

“That’s ultimately what we’re trying to do at Southern Cross. We are heavily invested in shortening those 12 years, to claim that better health back for our members.

“We are looking at how we can support our members beyond paying for treatment when they are unwell, and how we can become the first-choice health partner for New Zealand.”

Key numbers:

• Out of every $1 received in premium, 94 cents was returned to members by way of claims
• $1.706 billion claims paid vs $1.811 billion premium income
• Record 3.8 million claim lines paid – 16% increase from FY24
• $43 million return on investments
• 951,808 members – decrease of 3,493 from FY24
• Health Insurance operating costs reduced by 3% over the year
• Southern Cross Health Society Group reported a $51.8 million deficit after tax
• Southern Cross Health Insurance reported a deficit of $56.9 million
• Society’s subsidiary investments generated a combined net surplus after tax of $13.9 million.

1 FY25 reported the highest claim line count on record, which represents singly billed items or services within a claim.