10 costliest claims conditions account for $1.3B from 2013 to 2016

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Sun Life has released its fifth annual “Sun Life Stop-Loss Research Report," outlining the top 10 catastrophic claims conditions. The report provides data from 53,000 claimants and $4.5 billion in stop-loss reimbursements to project changes over time in costs of medical conditions.

The study included Sun Life Stop-Loss claims data from over 100,000 employees around the U.S. from 2013 to 2016.

Results included:

  • The top three conditions (malignant neoplasm, leukemia/lymphoma and chronic/end-stages renal disease) accounted for 32.3 percent of total payments.
  • The top 10 medical conditions accounted for 51.7 percent of all catastrophic claims.
  • Cancer remains the costliest illness and continue to increase, accounting for 26.7 percent of all stop-loss claims reimbursements.
  • While kidney disease remained at No. 3, overall average costs are declining.
  • Transplants continue to climb the list, although only moving up one stop to No. 10 in this report. Costs are increasing overall.
  • Million-dollar claimants increased 26 percent from 2012 to 2015.
  • While million-dollar claimants represented 2.2 percent of total claimants, they encompassed 23 percent of all stop-loss claims reimbursements.