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Majority of medical claims for ‘routine’ treatment

by Emma Simon
28/10/2025
GP, fit note, mental health, PMI, private healthcare
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Employees are increasingly using private health insurance for routine medical problems, rather than serious conditions, according to the latest claims data from VitalityHealth.

Its 2025 Health Claims and Insights Report shows that ‘everyday care’ now accounts for 70 per cent of claims. This  covers its GP service, talking therapies, physiotherapy, and optical, dental and hearing.

The claims data also shows that more than seven out of 10 authorisations (71 per cent) are now started online. The company also reported that 64 per cent of GP consultations led to onward referrals or additional services, reflecting the growing role of digital healthcare pathways in speeding up diagnosis and treatment.

This report also shows how technology and AI are being used across the health sector, with VitalityHealth saying this trend is particularly evident when looking at cancer treatment and claims.

It says cancer treatment continues to evolve rapidly, with new biological and hormone chemotherapies being used to treat a growing number of cancers. 

According to Vitality, between 2019-2024, claims rates of biological and hormone chemotherapies to treat Vitality members each increased by 30 per cent respectively.  The health insurance says that while these treatments are improving outcomes for patients, it is also pushing up treatment costs. This it says reinforces the need for both prevention and early detection of such conditions. 

The report also highlighted the benefits of having a workforce that is active and encouraged to keep health. The report said healthcare costs costs for members who were highly active were 27 per cent lower, while those who were of a healthy weigh had a 35 per cent lower risk of hospitalisation.

VitalityHealth CEO Arun Thiyagarajan says: “The insights within this report underscore a pivotal shift in how consumers engage with and use health insurance. The surge in Everyday Care usage, and the widespread adoption of digital access and technology are signals of a fundamental transformation in customer expectations and the regular ongoing value and access to care and treatment members are now getting.

“With more of us turning to health insurance for accessible, preventative services or early, quick access to access, there is significant opportunity for the industry to embrace this and better serve customers now, and in their time of need.  By being proactive with health and treating people earlier in any health journey, we can deliver regular and ongoing value, enable healthier choices, and help people to live in better health for longer.”

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