Health insurance payout for first year customer clears way for dream trek.

One week Shirley Thomas was suffering "severe, frightening" ovarian pain; the next she was in the Himalayas scaling a 3,200m peak in Nepal.

In between the 38-year-old Northland mother underwent a $16,000 emergency surgery - paid by health insurance even though she had had the policy less than a year - to remove a cyst in her left ovary. It was the cause of the pain which had been troubling her for weeks.

"I was in dire straits," she says. "The pain was severe and getting progressively worse. I was dragging myself to work because I'd run out of sick leave; it was frightening, I was beside myself."

At the time Thomas (not her real name) thought her dream of hiking in Nepal - a trip she had been saving for and planning for three years - would have to be abandoned.


"My surgeon told me the cyst was getting bigger and was unlikely to remove itself. So the decision was made to operate - the week before I was due to leave for Nepal."

It was successful and Thomas was cleared to travel last September: "the first words I heard afterwards were my surgeon saying 'Cinderella will go to Nepal'," she says.

But it was not to be the end of her misfortune. Throughout last summer after her return from Nepal, Thomas began to experience more pain, a result doctors said of the damage caused by the cyst.

A second operation to remove the ovary was carried out earlier this year in surgery costing another $17,000.

But this was the point at which some good fortune kicked in for Thomas.
In April 2016, just five months before her first operation, Thomas took out health insurance cover through giant insurer nib and, because the cyst was not known to exist at that time, the costs for both surgeries were fully met.

"Without the insurance I would have had to pay for it myself," she says. "I probably would not have got to Nepal either because I might not have had surgery so quickly, I'm very grateful."

Thomas spent nearly three weeks in Nepal climbing the 3,200m Poon Hill in the country's Annapurna Range with a group of friends.

"We hiked up to seven hours every day, it was a wicked experience," she says. "I want to go back and do the Mt Everest base camp in a couple of years, but next year we are planning a trip to Europe."


Ironically Thomas only took nib insurance because of another health issue she was facing.
"I joined nib when I found out they had only a two-year stand down for this issue," she says. "But I'm feeling good now," she says, "and I'm pain free."

Thomas is among a growing number of people who are realising it is possible to take advantage of health insurance in the first year of cover.

"I used to have health insurance but let it drop. When I took out the nib policy, I had been without cover for about four years," she says.

"When I realised I could claim for the cyst operation straight away I was very pleased. nib's service was incredible, the whole thing was arranged very quickly."

nib last year paid out more than $4m in claims to over 4,000 first-year customers, a figure equivalent to $948 per person.

The most frequent reasons were for visits to a GP (4,224 claims) and the dentist (2,275 claims). The highest first year claim was $51,660 paid out for a knee operation in November - this for a patient who took out the policy five months before in June.

nib CEO Rob Hennin, says people generally don't take out health insurance expecting to use it.

"You don't buy it to make claims, you hope you're not going to get sick," he says. "But if you do you know you have the financial capacity to cover the costs of treatment when you need it.

"But we see insurance as much about prevention or early detection as it is helping at times of sickness. It means people can go to their GP for regular check-ups, which we encourage people to do.

"We would be very happy paying out more money for claims for this reason," he says.

More people under 40 are opting for health cover. Figures produced by the Health Funds Association of New Zealand show a quarter of the 1.3 million New Zealanders with private health insurance are aged 20-39 (342,276 people).

A similar trend is apparent with nib's own customers. Of the 198,729 it has in New Zealand, 50,965 or 25.6 per cent are in this age group.