Stomach-turning surgery claim cost insurer $165,222

Stomach-turning surgery claim cost insurer $165,222 | Insurance Business

Stomach-turning surgery claim cost insurer $165,222

Insurer Southern Cross Health Society has revealed its list of highest claims by cost over the past six months, and topping the list was a claim of $165,222 it paid to a customer who underwent gastrectomy.

In its latest Pulse Report, Southern Cross Health Society detailed two instances of spinal fusion make up its top three highest claims by cost, costing $128,958 and $128,201 each.

The insurer recorded orthopaedic ($101 million), general surgery ($88.5 million), and imaging and tests ($55 million) as its top three specialties by cost. The firm also revealed its top three most surgical procedures claimed for including skin lesion excision (31,498 claims), colonoscopy (10,169 claims), and nasendoscopy (4,622 claims).

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Overall, Southern Cross Health Society paid out $544.1 million in claims to customers. These include 122,877 surgical procedures, 353,749 GP visits, 246,857 specialist consults and 301,507 prescriptions.

As of March 31, Southern Cross Health Society has 870,584 members, including its oldest member of 107 years. The insurer added 297,942 of its members are registered to My Southern Cross, an online service that allows customers to manage their health insurance policy.