Health insurers are developing past traditional coverage models as consumers increasingly demand preventative care and digital services, according to a new report.
VitalityHealth’s 2025 Claims Insights Report found that everyday care services now account for 70% of all claims, marking a shift from hospital-focused coverage to broader healthcare access. The insurer reported that 71% of authorisations began online through digital platforms in the first seven months of 2025.
“The insights within this report underscore a pivotal shift in how consumers engage with and use health insurance,” said Arun Thiyagarajan, chief executive of VitalityHealth. “The surge in Everyday Care usage, and the widespread adoption of digital access and technology, are signals of a fundamental transformation in customer expectations and the regular, ongoing value, and access to care and treatment members are now receiving.”
The report revealed that 64% of virtual GP consultations resulted in onward referrals or services, with 27% leading to specialist referrals, 19% to prescriptions, and 18% to everyday care services. Survey data showed that 39% of customers used their cover to access private GP appointments in the past year, with 75% expressing concern about access to NHS primary care.
Younger consumers drove higher usage rates, with 93% of 18- to 34-year-olds reporting that they had used their health insurance in the past 12 months, compared with 46% of those aged 55 and older. GP appointments, optical and dental services, and screening and diagnostics were the most commonly used benefits among younger members.
Technology integration extended to cancer treatment, where claims rates for biological and hormone chemotherapies increased by 30% between 2019 and 2024. However, average cancer claim costs rose by 23% over the same period.
The report emphasised the role of prevention in managing costs. Members recording high levels of physical activity had 27% lower average in-hospital claim costs than inactive members, while those maintaining a healthy weight faced a 35% lower hospitalisation risk than members living with obesity.
Mental health and musculoskeletal conditions emerged as common claim types, with 92% of members seeing a therapist within five days of initial assessment and 81% reporting measurable improvement after completing treatment.
The findings indicate that 87% of health insurance customers believe insurers should support them in staying healthy beyond claim payments, suggesting that consumer expectations continue to evolve beyond traditional coverage models.
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