Making a Claim Should Be Quick and Easy
Health insurance is there to help cover the cost of healthcare. Whether it’s claiming for a dental check-up, a new pair of glasses or treatment in hospital, you want to know your claim will be processed quickly and accurately.
At Phoenix Health, we measure different parts of the claims experience, from how quickly claims are processed to how members rate their experience. Together, these measures help us understand how we’re performing and where we can continue to improve.
How Phoenix Health Measures Claims Experience
There are different ways to measure the claims experience. We use these three measures to understand how quickly claims are processed, how easy it is for members to claim and how they rate their claims experience.
Claims Processed Within 24 Hours
The percentage of manual extras claims processed within 24 hours.
On-the-Spot Claiming
How often extras claims are processed on the spot at the provider.
Claims Satisfaction
How members rate their claims experience in our annual satisfaction survey.
Claims Performance Snapshot
These are our latest claims results, showing how quickly extras claims are processed, how often they’re completed on the spot and how members rate their claims experience.
94.5%
Claims Processed Within 24 Hours
July 2026
82.5%
On-the-Spot Claims
July 2026
95%
Claims Satisfaction
FY26 Member Survey
Claims Performance Over Time
Claims happen every day. Looking at our results over time shows how consistently we’re processing claims and paying benefits back to members.
Claims Processed Within 24 Hours
Jul-Sep
87.1%
Oct-Dec
88.9%
Jan-Mar
90.5%
Apr-Jun
93.2%
Source: e5 System Reporting
Over the past 12 months, more manual extras claims have been completed within 24 hours, increasing from 87% to 93%. That means, more members are receiving their benefits sooner.
On-the-Spot Claiming
Jul-Sep
82.5%
Oct-Dec
82.9%
Jan-Mar
82.1%
Apr-Jun
81.9%
Source: HAMBS
Around 82% of all extras claims are paid instantly, giving members immediate access to their benefits while claiming with their healthcare provider.
Claims Satisfaction
FY24
95%
FY25
94%
FY26
95%
Source: Ipsos Member Satisfaction Survey
Claims satisfaction has remained consistently high over the past three years. Because when it’s time to make a claim, the last thing members want is a complicated process.
Benefits Paid
Health insurance is about being there when members need it. Every benefit paid represents support for healthcare, whether that’s a routine dental check-up, specialist treatment or a hospital stay.
Jul-Sep
$15.8m
Oct-Dec
$17.3m
Jan-Mar
15.6m
Apr-Jun
$17.5m
What Members Tell Us
Our claims experience results tell part of the story. Hearing directly from members tells the rest. Read what our members have to say on ProductReview.com.au