Southern Cross Medical Care Society has announced that it paid out a record $1.8 billion in claims to its members during the 12 months to June 30, 2026, up 5.5% from a year earlier.
In releasing its annual report, the society says that 88 cents of every dollar received in premiums was paid back to members in claims.
Nick Astwick, CEO for the society, says the result reinforces the important dual role it 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.”
Astwick says he’s 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.
Claims Cost Escalation Reduced
“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,” he says.
…we expect premium increases to moderate from the increases experienced over the past three years…
Astwick says that 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.”
Looking ahead, he says 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.
…we’ll begin introducing new ways to help members make healthier choices…
“Over the coming months, we’ll begin introducing new ways to help members make healthier choices and turn good intentions into lasting habits,” he says.
“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.”
Southern Cross Medical Care Society Group reported a group surplus of $146.9 million for the June 30 year, following a combined deficit of $140 million for the two prior financial years.
Click here to see the full annual report.
