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Claims data from a major Australian life insurer for the period 1 April 2025 to 31 March 2026 provides valuable insight into the health conditions and events most likely to trigger an insurance claim for death or disability insurance. The findings reveal that while cancer and cardiovascular disease remain significant causes of claims, mental health conditions are now the leading reason for accepted claims overall.  The data includes claims for all distribution channels.

Understanding what drives claims can help Australians better appreciate the risks they face during their working lives and the important role insurance can play in protecting financial security when illness, injury or disability strikes.

Mental Health Conditions Top the List

Mental health conditions, including depression and post-traumatic stress disorder (PTSD), were responsible for 22% of all accepted claims, making them the most common cause of claims during the year.

When looking at how these claims were paid, 74% of mental health-related claims were Income Protection claims, reflecting the significant impact these conditions can have on a person’s ability to work. A further 23% were TPD claims, while 3% were Life Insurance claims.

The data highlights the growing importance of mental health as a cause of both temporary and permanent disability, particularly among working-age Australians.

Cancer Remains a Major Cause of Claims

Cancer accounted for 17% of all accepted claims, making it the second most common cause of claims overall. The insurer noted breast cancer and pancreatic cancer as conditions within this category.

Of all accepted cancer-related claims:

1. 43% were Life Insurance claims
2. 43% were Income Protection claims
3. 8% were Critical Illness (Trauma) claims
4. 6% were TPD claims

The spread across multiple insurance types demonstrates the broad financial impact cancer can have, from extended periods away from work through to serious illness and, in some cases, death.

Injuries and Fractures Continue to Impact Workers

Injuries and fractures, including joint dislocations and broken bones, made up 14% of all accepted claims.

The majority of these claims related to a temporary inability to work, with:

1. 77% paid under Income Protection
2. 21% paid under TPD insurance
3. 2% paid under Life Insurance

These figures highlight how everyday accidents, whether occurring at work, during sport or in daily life, can create significant financial pressure when they lead to time away from employment.

Musculoskeletal Conditions Drive Disability Claims

Musculoskeletal and connective tissue conditions, including back pain, arthritis and related disorders, accounted for 11% of all accepted claims.

Notably, these claims were concentrated entirely within disability-related insurance products:

1. 69% were Income Protection claims
2. 31% were TPD claims

Musculoskeletal conditions remain one of the leading causes of long-term work absence and disability in Australia, often resulting in lengthy recovery periods and ongoing treatment requirements.

Heart Disease and Stroke Remain Significant Risks

Conditions affecting the circulatory system, including heart attacks and strokes, represented 9% of all accepted claims.

Of these claims:

1. 52% were Life Insurance claims
2. 34% were Income Protection claims
3. 10% were TPD claims
4. 4% were Critical Illness claims

This category had the highest proportion of Life Insurance claims among the major conditions identified, reinforcing the serious and potentially life-threatening nature of cardiovascular disease.

Other Causes of Claims

In addition to the five major categories, accepted claims also arose from a range of other medical conditions and circumstances, including:

1. 5% from conditions of the nervous system
2. 4% from conditions of the respiratory system
3. 2% from conditions of the digestive system
4. 16% from other causes

Together, these categories accounted for the remaining 27% of all accepted claims.

The Bigger Picture

The data provides an important reminder that the most common insurance claims are often linked to conditions that affect many Australians during their lifetime. Mental health conditions, cancer, injuries and fractures, musculoskeletal disorders, and cardiovascular disease together accounted for 73% of all accepted claims.

Perhaps most striking is the significant role of Income Protection insurance, which featured heavily across almost every major category. This reflects the reality that the financial consequences of illness and injury often begin long before a permanent disability or death occurs, through the loss of a person’s ability to earn an income.

For individuals and families, these statistics reinforce the value of reviewing their insurance arrangements regularly to ensure they have appropriate protection in place. While nobody expects to suffer a serious illness, injury or disability, claims data continues to show that such events are far from uncommon, and having the right cover can make a substantial difference when life takes an unexpected turn.

This is general information and limited in its scope.  If you are considering buying or replacing and a Life Insurance policy then contact us to arrange a review for you. We can consider your individual circumstances, goals and needs and recommend a suitable insurer, product and structure to use. We work with several insurers and have extensive experience in helping to arrange claims.

At the time of writing, Life insurance and Financial Advice services are provided by Experien Insurance Services Pty Ltd (EIS) ABN 99 128 678 937 and Experien Financial Services Pty Ltd (EFS) ABN 32 631 346 757. EIS and EFS are a Corporate Authorised Representative (No. 320626 and No. 1274354) Count Financial Limited ABN 19 001 974 625, AFSL 227232. See our website for our Financial Services Guide and latest AFSL arrangements. Always read the Product Disclosure Statement issued by an Insurer before considering insurance.

17 August 2026