Claims-Based Pricing Insurance: Should I Buy? [2023]

Should I Opt for Claims-Based Pricing Insurance in Singapore?

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At Dollar Bureau, we’re committed to providing you with reliable, unbiased financial guidance. Our content is crafted by everyday Singaporeans who are trained in finance and insurance, ensuring relatable and practical guidance. We uphold strict editorial independence, regularly update our reviews, and value your feedback to keep our information accurate and relevant.

Discover more about our editorial guidelines here.

Should I Opt for Claims-Based Pricing Insurance in Singapore?

Ever wondered why your insurance premiums fluctuate?

Well, there’s a new kid on the block that’s shaking up the traditional insurance pricing model: claims-based pricing.

This innovative approach to insurance pricing is gaining traction, and it’s essential for you to get the low-down on it.

At its core, claims-based pricing is pretty straightforward.

Think of it like a reward system.

The fewer claims you make, the lower your premiums could be. It’s a bit like those no-claims discounts you might have heard about in car insurance.

The principle is simple: if you don’t make a claim, you’re rewarded with a discount on your next premium.

But where did this idea of claims-based pricing originate?

Delving into the annals of insurance history, claims-based pricing isn’t exactly a brand-new concept.

It’s been around in various forms, especially in the motor insurance sector.

However, its application in health and life insurance is relatively recent, and it’s causing quite the buzz.

Now, before you jump on the bandwagon, it’s crucial to understand the objective behind introducing claims-based pricing.

Insurance companies aren’t just rolling this out on a whim.

The primary goal is to encourage policyholders like you to maintain good health and make informed decisions about medical treatments.

After all, if you’re in tip-top shape and don’t need to make a claim, why shouldn’t you benefit from lower premiums?

It’s a win-win, right?

But, as with all things, there’s more to the story.

While the premise sounds enticing, it’s essential to delve deeper and understand the nuances.

After all, knowledge is power, and you want to make sure you’re making the best decisions for your future.

Remember, insurance isn’t just about the here and now.

It’s a long-term commitment, much like an investment.

And just as you wouldn’t dive headfirst into an investment without understanding the ins and outs, the same applies to understanding claims-based pricing.

So, buckle up and get ready for a deep dive into the world of claims-based pricing.

By the end of this journey, you’ll be well-equipped to navigate the ever-evolving landscape of insurance with confidence and clarity.

How does claims-based pricing work in insurance?

Insurance can sometimes feel like a maze, with its jargon and complex terms.

But fret not, I’m here to guide you through the intricacies of claims-based pricing.

Let’s break it down, shall we?

First off, let’s talk basics.

At its heart, claims-based pricing is all about adjusting your premiums based on your claim history.

Made no claims in the past year?

Bravo! You might just see a delightful dip in your next premium.

On the flip side, if you’ve made a claim or two, you might notice an uptick in your premium. It’s a bit like a seesaw, balancing out based on your claims.

Now, you might be wondering, “How do insurers decide on these adjustments?”

Great question!

Insurers use a combination of factors, including the number of claims you’ve made, the amount claimed, and even the nature of the claims.

It’s a bit like a recipe, with each ingredient (or factor) playing a crucial role in the final dish (or premium).

But here’s where it gets interesting.

Unlike traditional insurance pricing, where your premiums are primarily based on a fixed set of criteria, claims-based pricing is more dynamic.

It evolves with you.

Think of it as a dance, with both you and the insurer adjusting your steps based on the rhythm of your claims history.

However, it’s not all sunshine and rainbows.

There are caps and limits to how much your premium can be adjusted, both upwards and downwards.

So, even if you’ve been the picture of health and made zero claims, don’t expect your premium to plummet to rock-bottom levels.

Similarly, if you’ve had a year of medical challenges, there’s a limit to how much your premium can spike.

It’s all about balance, ensuring that you’re rewarded for good health but not penalised excessively for unforeseen medical issues.

In essence, claims-based pricing is like a dynamic dance, adjusting and evolving based on your unique journey.

It’s a fresh take on insurance pricing, offering a more personalised approach. But as with all dances, it’s essential to know the steps, understand the rhythm, and be prepared for any twists and turns.

Pros and Cons of Claims-Based Pricing in Insurance

Ah, the age-old debate of weighing the pros against the cons.

Every decision, especially one as crucial as insurance, comes with its set of benefits and drawbacks.

And claims-based pricing is no exception.

Let’s dive in and dissect the good, the bad, and the in-between.

Pros of Claims-Based Pricing

  1. Rewards for Good Health: It’s simple – the healthier you are, the less likely you are to make a claim. And with claims-based pricing, this translates to potentially lower premiums. It’s a pat on the back for all those gym sessions and healthy meals. Well done, you!
  2. Transparency and Fairness: With claims-based pricing, what you see is what you get. Your premiums are a direct reflection of your claims history, ensuring a transparent and fair pricing model. No hidden surprises or convoluted calculations.
  3. Encourages Informed Decisions: Knowing that unnecessary claims could lead to higher premiums, you’re more likely to make informed decisions about medical treatments. It’s all about being proactive and taking charge of your health.


Cons of Claims-Based Pricing

  1. Potential for Higher Premiums: Life is unpredictable. And sometimes, despite our best efforts, we face medical challenges. With claims-based pricing, a string of unfortunate events could lead to higher premiums, adding financial strain.
  2. Deterrence from Seeking Medical Care: The fear of premium hikes might deter some from seeking necessary medical care. After all, no one wants to be penalised for prioritising their health. It’s a delicate balance, and one that requires careful consideration.
  3. Uncertainty: With traditional insurance, you have a clear idea of your premium structure. But with claims-based pricing, there’s an element of uncertainty. Your premiums can fluctuate, making it a tad challenging to budget and plan for the future.


In the grand scheme of things, claims-based pricing is like a double-edged sword.

On one hand, it offers rewards and transparency, but on the other, it comes with its set of challenges.

The key is to weigh the pros and cons, understand the nuances, and make an informed decision that aligns with your unique circumstances.

Remember, insurance is a journey, not a destination.

And as you navigate this journey, it’s essential to arm yourself with knowledge, ask the right questions, and seek guidance when in doubt.

After all, it’s your future, and you deserve the best.

How Claims-Based Pricing Compares to Traditional Insurance Pricing

Navigating the world of insurance can sometimes feel like you’re deciphering a complex puzzle.

With various pricing models and terminologies thrown into the mix, it’s easy to feel a tad overwhelmed.

But fear not, for I’m here to shed light on the key differences between claims-based pricing and traditional insurance pricing.

Let’s embark on this enlightening journey together, shall we?

Traditional Insurance Pricing: At its core, traditional insurance pricing is like a trusty old recipe passed down through generations. It’s tried, tested, and familiar. Here’s what it entails:

  1. Fixed Criteria: Traditional insurance premiums are primarily determined based on a set of fixed criteria. Think age, medical history, lifestyle habits, and so on. It’s a one-size-fits-all approach, with little room for personalisation.
  2. Stability: One of the hallmarks of traditional insurance pricing is its stability. Your premiums remain relatively consistent, barring any significant life changes. It offers a sense of security, knowing that there won’t be any unexpected spikes or dips.
  3. Less Influence on Behaviour: With traditional pricing, there’s little incentive to alter your behaviour. Whether you lead a healthy lifestyle or not, your premiums remain largely unaffected. It’s a static model, with premiums set in stone.


Claims-Based Pricing: On the flip side, claims-based pricing is the new entrant, bringing a fresh perspective to the table. Here’s the low-down:

  1. Dynamic Adjustments: As the name suggests, claims-based pricing adjusts premiums based on your claims history. It’s a fluid model, evolving and adapting to your unique health journey.
  2. Rewards and Penalties: This model operates on a system of rewards and penalties. Stay healthy and make fewer claims? You’re rewarded with potentially lower premiums. Face medical challenges and make multiple claims? Your premiums might see an uptick. It’s all about balance.
  3. Encourages Proactivity: With claims-based pricing, there’s a clear incentive to take charge of your health. After all, your actions directly impact your premiums. It promotes a proactive approach, nudging you to make informed health decisions.


The Verdict: Both models come with their set of merits and drawbacks. Traditional insurance pricing offers stability and predictability, while claims-based pricing provides personalisation and adaptability.

The choice ultimately boils down to your preferences, needs, and circumstances.

Remember, insurance isn’t a one-size-fits-all solution.

It’s a deeply personal decision, influenced by myriad factors.

So, take your time, weigh the pros and cons, and choose a model that aligns with your vision for the future.

After all, it’s your journey, and you deserve to chart your course with confidence and clarity.

Real-world Implementation: Insurance Plans with Claims-Based Pricing

Stepping out of the theoretical realm, let’s dive into the real-world application of claims-based pricing.

After all, theory is one thing, but seeing it in action?

That’s where the magic truly lies.

So, buckle up as we explore the insurance landscape and uncover how claims-based pricing is reshaping the industry.

  1. The Pioneers: A handful of forward-thinking insurance companies have taken the plunge, introducing plans with claims-based pricing. These trailblazers are setting the pace, offering policyholders a fresh take on insurance premiums. Curious about who’s leading the charge? AIA, Great Eastern, Prudential are doing it in Singapore.
  2. Features and Benefits: At first glance, claims-based pricing plans might seem like any other insurance policy. But delve deeper, and you’ll uncover a treasure trove of unique features. From dynamic premium adjustments to rewards for healthy living, these plans are packed with perks designed to cater to the modern policyholder.
  3. Feedback from the Frontlines: Wondering how these plans fare in the real world? Well, the feedback has been a mixed bag. Many policyholders appreciate the transparency and potential for lower premiums. However, some voice concerns about the unpredictability of future premiums. As with all things, it’s essential to sift through the noise, gather feedback, and make an informed decision.
  4. The Road Ahead: With the insurance industry in a state of flux, claims-based pricing plans are poised to play a pivotal role in shaping the future. As more insurers jump on the bandwagon, we can expect a surge in innovative features, competitive pricing, and enhanced user experiences. The future looks bright, and it’s an exciting time to be a policyholder.


In a nutshell, claims-based pricing is more than just a buzzword.

It’s a movement, reshaping the insurance landscape and offering policyholders a fresh perspective.

As the industry evolves, it’s crucial to stay informed, understand the nuances, and make decisions that align with your long-term vision.

So, choose wisely, stay informed, and embrace the exciting possibilities that lie ahead.

The Future of Claims-Based Pricing: Trends and Predictions

The world of insurance is ever-evolving, with new trends and innovations constantly emerging.

And claims-based pricing, being the dynamic model that it is, isn’t immune to these changes.

So, what does the future hold for this intriguing pricing model? Let’s don our prediction hats and gaze into the crystal ball.

  1. Growing Popularity: As more and more policyholders become aware of the potential benefits of claims-based pricing, its popularity is set to soar. The allure of potentially lower premiums, coupled with a more personalised approach, is hard to resist. So, don’t be surprised if you see a surge in insurers offering plans with claims-based pricing.
  2. Technological Integration: With the rise of wearable tech and health apps, insurers are poised to tap into this goldmine of data. Imagine your fitness tracker syncing with your insurance plan, adjusting your premiums based on your daily steps, heart rate, and overall health. The future of claims-based pricing is set to be intertwined with technology, offering a seamless and integrated experience.
  3. Enhanced Flexibility: The rigid structures of traditional insurance plans might soon be a thing of the past. Claims-based pricing plans of the future are likely to offer enhanced flexibility, allowing policyholders to adjust their coverage, premiums, and benefits with ease. It’s all about putting you, the policyholder, in the driver’s seat.
  4. Regulatory Changes: As claims-based pricing gains traction, regulatory bodies might step in to ensure fairness and transparency. This could lead to standardised guidelines, ensuring that policyholders are protected and insurers maintain ethical practices.
  5. Holistic Health Focus: The future of claims-based pricing isn’t just about claims. Insurers are likely to adopt a more holistic approach, focusing on overall health and well-being. From wellness programs to mental health support, the scope of claims-based pricing plans is set to expand, offering a comprehensive health solution.


In essence, the future of claims-based pricing is bright, filled with exciting possibilities and innovations.

As the landscape shifts, it’s crucial to stay informed, adapt to changes, and make decisions that align with your long-term goals.

Expert Opinions on Claims-Based Pricing

  1. Claims-Based Pricing Concerns: The article references the chairman of the Health Insurance Task Force, who expressed concerns about claim-based pricing. The task force had discussed and rejected this pricing model because it might incentivise policyholders to avoid seeking medical treatment for fear of a premium increase. Untreated medical conditions could lead to more severe and costly health issues later on. Source.
  2. Rising Health Insurance Premiums: The root cause of increasing health insurance premiums can be attributed to advancements in medical care, increased use of diagnostic testing, and higher demand for medical procedures due to greater consumer health awareness. Claim-based pricing is seen as a solution that aims to alter consumer behaviour without addressing the root cause of rising medical costs. Source.
  3. Undermining the Insurance Principle: The article suggests that claim-based pricing undermines the fundamental principle of insurance, which is the pooling of similar risks of a group of similar individuals. The writer’s personal experience does not support the claim that this pricing model would benefit healthy policyholders. Source.
  4. Addressing Rising Medical Costs: The Monetary Authority of Singapore and the Ministry of Health are urged to disallow claim-based pricing to uphold the fundamental insurance principle and maintain public trust in the insurance industry. Source.
  5. Purpose Behind Claims-Based Pricing: The writer’s note at the end of the article mentions that the main purpose behind claim-based pricing is to discourage policyholders from seeking treatment at private hospitals with substantially higher charges. The policies aim to be fairer by rewarding those who exercise prudence in choosing reasonable healthcare providers. Source.


These insights provide a comprehensive view of the concerns and considerations surrounding claims-based pricing in the insurance industry.

It’s essential to weigh these expert opinions when making informed decisions about insurance policies.

Our Thoughts on Claims-Based Pricing Insurance

At Dollar Bureau, we’ve always believed in the power of foresight, especially when it comes to financial planning.

And when we cast our gaze upon claims-based pricing, our stance is clear: we’re not fans. Here’s why:

  1. Predictability is Key: Financial planning is as much about the present as it is about the future. It’s about anticipating costs, preparing for uncertainties, and ensuring that surprises are kept to a minimum. With claims-based pricing, this predictability is thrown out of the window. We can never truly know when we’ll need to make a claim, and the subsequent premium hikes can be a rude shock.
  2. The Appeal of Levelled Premiums: There’s a certain allure to knowing exactly what you’re getting into. With levelled premiums, you’re locking in a rate from the get-go, ensuring that future costs are predictable and manageable. It’s a commitment to stability, and in the unpredictable world of health and wellness, this stability is invaluable.
  3. Feedback from Our Readers: We’re not alone in our reservations about claims-based pricing. Many of our readers have reached out, sharing their frustrations about the spiralling costs post their initial claims. What’s even more disheartening is that these increased premiums often surpass those of levelled plans. It’s a bitter pill to swallow, especially when they’ve been diligent about their health and financial planning.
  4. The Trap of Surrendering: The idea of surrendering a policy and starting afresh might seem tempting, especially when faced with skyrocketing premiums. But here’s the catch: having made a claim, there’s the looming shadow of pre-existing conditions. This can be a significant roadblock, preventing them from qualifying for a new plan. It’s a classic case of being stuck between a rock and a hard place. In fact, some of them can’t lower their premiums anymore due to their pre-existing medical conditions.


In conclusion, while claims-based pricing might seem attractive on the surface, the long-term implications are far from rosy.

At Dollar Bureau, we advocate for foresight, stability, and predictability.

And as always, we’re here to guide you, offering insights, opinions, and potential solutions for different needs.

But these are just our opinions. What we think is good might not be the best solution for everyone, so make sure to always consult with a financial advisor for a second opinion.

Why Trust Us?

At Dollar Bureau, we’re committed to providing you with reliable, unbiased financial guidance. Our content is crafted by everyday Singaporeans who are trained in finance and insurance, ensuring relatable and practical guidance. We uphold strict editorial independence, regularly update our reviews, and value your feedback to keep our information accurate and relevant.

Discover more about our editorial guidelines here.

Firdaus Syazwani
Firdaus Syazwani
Twenty years ago, Firdaus's mother bought an endowment plan from an insurance agent to gift him $20,000. However, after 20 years of paying premiums, Firdaus discovered that the policy was actually a whole life plan with a sum assured of $20,000, and they didn't receive any money back. This experience inspired Firdaus to create, so that others won't face the same problem of being misled or not understanding what they are purchasing – which he sees as a is a huge problem in the industry.

Disclaimer: Each article written obtained its information from reliable sources and should be purely used for informational purposes only. The information provided by Dollar Bureau and its affiliated parties is not meant to be construed as financial advice. Dollar Bureau shall not be held liable for any inaccuracies, mistakes, omissions, and losses incurred should you act upon any information listed on this website. We recommend readers to seek financial planning advice from qualified financial advisors. 

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