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Writer's pictureLewis Price-Milne

How Does Trauma Insurance Work in NZ?

Trauma insurance, also known as critical illness insurance, is designed to provide financial support when you're diagnosed with a serious medical condition. In New Zealand, this type of insurance helps cover unexpected costs associated with major health issues, such as heart attacks, cancer, or strokes, which can significantly impact your ability to work and maintain your usual income.


trauma insurance nz

While it’s not the same as life insurance, trauma insurance provides a lump sum payment when you're diagnosed with one of the covered conditions, helping you focus on recovery instead of financial stress. Let’s break down how it works and how it might benefit Kiwis considering their insurance options.


What is Trauma Insurance?


Trauma insurance provides a tax-free lump sum payment if you're diagnosed with a specific, serious illness or injury. The conditions covered can range from cancer, heart attacks, and strokes to other significant health events such as major organ transplants or severe burns.


This lump sum can be used for any purpose, including:


  • Covering medical expenses not covered by ACC or private health insurance

  • Paying off debts such as a mortgage or credit cards

  • Covering lost income while you're unable to work

  • Funding home modifications or rehabilitation services


Unlike health insurance, which usually covers direct medical costs, trauma insurance is more focused on providing financial flexibility during a challenging time.


How Does It Work?


Trauma insurance kicks in when you’re diagnosed with one of the specified medical conditions outlined in your policy. Once diagnosed, you can make a claim, and if it’s accepted, you'll receive a one-off lump sum payment. The payout amount is based on the level of cover you've chosen.


Conditions Covered

Most trauma insurance policies in New Zealand cover around 40 to 50 medical conditions. These typically include:


  • Cancer (including early-stage cancers)

  • Heart attack

  • Stroke

  • Multiple sclerosis

  • Alzheimer’s disease

  • Major organ transplant


However, not all policies are the same, and the exact list of covered conditions will depend on the insurer and the specific policy you choose. Some insurers may also provide partial payouts for less severe conditions, such as early-stage cancers or heart issues, which may not be life-threatening but still require treatment and recovery time.


Payout Timing

Once you're diagnosed with a covered condition and your claim is approved, you’ll receive your payout as a lump sum. The timing can vary, but most insurance companies process claims quickly to ensure you get the financial support you need when you need it most.


Who Should Consider Trauma Insurance?


Trauma insurance is particularly beneficial for individuals and families who rely heavily on their income to meet financial commitments, such as mortgages or loans. For many Kiwis, the inability to work due to a health crisis can place a significant strain on their finances, and trauma insurance can help bridge that gap.


It’s also valuable for those who may need to access treatments not covered by public health services, as the lump sum payment can be used for alternative therapies, overseas treatments, or non-medical expenses like hiring a caregiver or taking time off work to recover.


trauma insurance nz

Key Considerations


Before taking out a trauma insurance policy, there are a few key factors to keep in mind:


Level of Cover

The level of cover refers to the amount of money you’ll receive if you make a claim. It’s important to choose an amount that will cover not only immediate medical costs but also any potential loss of income, ongoing expenses, and lifestyle changes that may arise from a serious illness. Many policies allow you to choose cover amounts ranging from $50,000 to over $1 million, depending on your needs and budget.


Exclusions and Waiting Periods

As with any insurance, it’s important to be aware of exclusions. For example, pre-existing conditions are generally not covered, and some illnesses may require you to survive for a certain period (usually 90 days) after diagnosis before the payout is made. Make sure to review the policy’s terms to fully understand any limitations or waiting periods that could affect your claim.


Standalone vs Bundled Insurance

Trauma insurance can be purchased as a standalone policy or bundled with other insurance products like life insurance or income protection insurance. Bundling can sometimes offer a cost-effective way to get comprehensive coverage, but it’s important to compare policies to ensure you’re getting the right level of cover for your specific needs.


Is Trauma Insurance Right for You?

Trauma insurance in New Zealand offers peace of mind by providing financial support during one of life’s most challenging times – when you're facing a serious health condition. While it's not a replacement for comprehensive health insurance, it can provide crucial financial assistance, helping you and your family manage unexpected expenses or take time off work to focus on recovery.


If you’re considering trauma insurance, it’s worth reviewing your personal financial situation and understanding how this type of cover fits into your overall insurance plan. To explore more about trauma insurance and how it might benefit you, visit our personal insurance page.


 

Disclaimer: The information in this article is general information only and is not intended as financial, medical, health, nutritional, tax or other advice. It does not take into account any individual’s personal situation or needs. You should consider obtaining professional advice from a financial adviser and/or tax specialist, or medical or health practitioner, in relation to your own circumstances and before acting on this information.

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