News

• A record $1.8 billion paid out in claims to members, up 5.5% on FY25.
• Claims cost escalation at 7.1%, down from 12.2% in FY25, considerably lower than the rest of the health insurance sector.
• 88 cents of every dollar received in premiums paid back to members in claims.
• Group surplus of $146.9 million, following a combined deficit $140.0 million for the two prior financial years

Southern Cross Medical Care Society (the Society) today announced that it had paid out a record $1.8 billion in claims to its members during the 12 months to 30 June 2026 (FY26).

Nick Astwick, CEO for the Society said the result reinforced the important dual role the Society plays in supporting its members while also contributing to the broader New Zealand health system.

“As the largest health insurer and third largest funder of healthcare delivery after Health New Zealand and ACC, Southern Cross paid out an average of $7.2 million or 15,000 claims every business day.

“We supported hundreds of thousands of New Zealanders with timely access to healthcare when they needed it most, including thousands of Kiwi businesses who provide Southern Cross Health Insurance to their employees.”

Managing costs to protect affordability for members

Astwick said he was pleased with the Society’s performance over the past year as it continued to respond to the rapid rise in healthcare demand and costs to better manage pressure on premiums.

“Our claims cost escalation reduced to 7.1% in FY26, down from 12.2% the previous year, considerably lower than the rest of the health insurance sector. This matters because lower claims cost growth helps reduce pressure on premiums and supports the long-term affordability of cover for members.

“Importantly, while healthcare inflation remains a long-term challenge, healthcare demand and claims cost escalation are returning towards more normal levels, and we expect premium increases to moderate from the increases experienced over the past three years.”

Supporting members in more ways with their health and wellbeing

Looking ahead, Astwick said the Society’s stronger foundations would support the next stage of its evolution, broadening the value it provides to members while maintaining its focus on access to healthcare.

“Our role will always be to help members access the healthcare they need, but we also have an opportunity to support them well before they need to make a claim. Over the coming months, we’ll begin introducing new ways to help members make healthier choices and turn good intentions into lasting habits.

“This is what it means to become a health partner as well as a great health insurer. By supporting members more often and in more meaningful ways, we can help create the outcome that matters most: more healthy years, with greater independence, confidence and time to enjoy the things that matter to them.

"Healthspan, which is how long we live in good health, will become an increasingly important focus for New Zealanders, and Southern Cross has a meaningful contribution to make towards helping achieve that."