Pricing & Underwriting

Beyond the base factors, premiums vary by the specific risk a person or group presents:

• •Age — claim frequency and severity differ across age bands (a 50-year-old typically needs a longer recovery than a 30-year-old).
• •Gender — women generally make more medical claims, so a female pays more than a male of the same age for cover such as Long-Term Care and Critical Illness (though MediShield Life and Integrated Shield Plan premiums depend on age, not gender).
• •Health status — a pre-existing condition can attract special terms or even a decline.
• •Lifestyle — hazardous sports (e.g. recreational flying, mountaineering, scuba diving) draw extra premiums or exclusions; smoking is the single most important lifestyle factor, so non-smokers pay less than smokers.
• •Occupation — jobs are grouped into risk classes; the higher the occupational hazard, the higher the premium.
• •Persistency — how long customers keep renewing; it usually improves as policies age and varies by age band (younger insureds, e.g. 20–29, often persist worse than older insureds, e.g. 50–59, who value cover more). High expected persistency lets the insurer charge less.
• •Portfolio claims experience — collected premiums must be enough to pay expected claims; total claims comprise paid, pending and IBNR (incurred but not reported) claims, for which reserves are set.
• •Claims-based pricing — premiums adjusted to the individual's own claims (e.g. a renewal discount for no claims, or no penalty where the insured kept costs low by using a public hospital).
• •Group participation level — for voluntary group plans, low participation raises anti-selection risk, so rates vary by participation.