Company Overview
Southern Cross Health Insurance is New Zealand's largest health insurer, serving over 870,000 Kiwis. Established in 1961, they're a not-for-profit organisation owned by their members, with a trusted reputation built over six decades. While primarily known for health insurance, Southern Cross also offers critical illness (trauma) insurance as a complementary product.
Their critical illness insurance is designed to integrate seamlessly with their health insurance policies, offering existing members the convenience of bundled coverage and potential discounts. This positioning makes them particularly attractive to their large existing customer base who value the one-stop-shop approach.
Key Facts:
- • Founded: 1961 (64+ years in NZ)
- • Structure: Not-for-profit, member-owned
- • Members: 870,000+ New Zealanders
- • Market Position: NZ's largest health insurer
Financial Strength:
- ✓ A rating from major rating agencies
- ✓ Over $500 million in annual revenue
- ✓ Strong member reserves and capital base
- ✓ Zero shareholder dividends - reinvests in members
Coverage Analysis
Coverage Structure
Southern Cross offers four clear coverage levels ranging from $20,000 to $300,000. This tiered approach makes it easy to choose coverage that fits your budget and needs. However, the $300,000 maximum is significantly lower than specialist trauma insurers who offer up to $2 million+.
Available Coverage Levels
Essential
$20,000
Basic protection for emergencies
Standard
$75,000
Most popular choice
Comprehensive
$150,000
Enhanced protection
Maximum
$300,000
Highest available
Important Limitation: Unlike specialist trauma insurers like AIA or Partners Life, Southern Cross caps coverage at $300,000. This may be insufficient for high earners, business owners, or those with large mortgages who typically need $500,000-$1,000,000+ of coverage.
Conditions Covered
Southern Cross critical illness insurance covers 38 conditions across all major categories. While this is fewer than premium providers like AIA (44 conditions) or Chubb (46 conditions), it includes all the most common and significant trauma conditions that account for the vast majority of claims.
🫀 Cardiovascular Conditions (7)
- ✓ Heart Attack (Myocardial Infarction) - Death of heart muscle due to blocked blood supply
- ✓ Stroke - Brain damage from interrupted blood flow
- ✓ Coronary Artery Surgery - Bypass or similar cardiac procedures
- ✓ Heart Valve Replacement - Surgical valve replacement
- ✓ Aorta Surgery - Major artery repair or replacement
- ✓ Cardiomyopathy - Heart muscle disease requiring treatment
- ✓ Chronic Heart Failure - Permanent heart function impairment
🎗️ Cancer & Tumors (6)
- ✓ All Invasive Cancers - Any cancer beyond the initial site
- ✓ Brain Tumor (Benign) - Non-cancerous brain growth requiring surgery
- ✓ Chronic Lymphocytic Leukemia - Specific blood cancer type
- ✓ Carcinoma in Situ - Early-stage cancer (partial benefit)
- ✓ Prostate Cancer (Early Stage) - Stage A/B diagnosis (partial benefit)
- ✓ Melanoma (Small) - Skin cancer under 1mm (partial benefit)
🧠 Neurological Conditions (8)
- ✓ Multiple Sclerosis - Autoimmune nervous system disease
- ✓ Parkinson's Disease - Progressive neurological disorder
- ✓ Motor Neurone Disease - Progressive nerve cell degeneration
- ✓ Alzheimer's Disease - Dementia and cognitive decline
- ✓ Bacterial Meningitis - Brain/spinal cord bacterial infection
- ✓ Encephalitis - Brain inflammation from infection
- ✓ Dementia - Severe cognitive impairment
- ✓ Coma (Permanent) - Prolonged unconsciousness
🏥 Organ & Other Conditions (17)
- ✓ Major Organ Transplant - Heart, lung, liver, kidney, pancreas
- ✓ Kidney Failure - Requiring dialysis or transplant
- ✓ Liver Failure - Chronic irreversible liver damage
- ✓ Chronic Lung Disease - Permanent respiratory impairment
- ✓ Aplastic Anemia - Bone marrow failure
- ✓ Blindness (Permanent) - Total loss of sight
- ✓ Deafness (Permanent) - Total loss of hearing
- ✓ Loss of Limbs - Amputation or complete loss of use
- ✓ Paraplegia - Permanent paralysis of lower body
- ✓ Quadriplegia - Permanent paralysis of all four limbs
- ✓ Loss of Speech - Permanent inability to speak
- ✓ Severe Burns - 20%+ of body surface area
- ✓ HIV (Occupational) - Contracted through work
- ✓ Medically Acquired Hepatitis - From medical treatment
- ✓ Intensive Care (28+ days) - Extended ICU stay
- ✓ Total Permanent Disablement - Unable to work ever again
- ✓ Terminal Illness - Life expectancy under 12 months
Partial Benefit Payments
Southern Cross offers limited partial benefit payments for early-stage conditions. Unlike providers like AIA or Asteron who pay 25-30% of your sum insured, Southern Cross's partial benefits are more restricted in both amount and eligible conditions.
Example: With a $150,000 policy, if diagnosed with carcinoma in situ (early-stage cancer), you might receive a partial payment of $15,000-$30,000. Your policy continues, but with reduced coverage remaining.
Pricing & Value Analysis
Sample Monthly Premiums
Southern Cross pricing is competitive for existing health insurance members who can access member discounts. However, without membership benefits, premiums can be higher than specialist trauma insurers.
| Age/Gender | $75,000 | $150,000 | $300,000 | vs Market |
|---|---|---|---|---|
| Male, 30 | $18/month | $35/month | $68/month | Competitive |
| Female, 30 | $22/month | $43/month | $84/month | Competitive |
| Male, 40 | $35/month | $68/month | $134/month | Average |
| Female, 40 | $42/month | $82/month | $162/month | Average |
| Male, 50 | $75/month | $148/month | $294/month | Above Average |
| Female, 50 | $92/month | $182/month | $362/month | Above Average |
*Prices include member discounts where applicable. Non-members may pay 10-15% more. Based on non-smoking, healthy individuals with level premiums.
Value for Money Assessment
What You're Paying For:
- • Brand Trust: New Zealand's most recognized health insurance brand
- • Integration: Seamless connection with health insurance policies
- • Member Benefits: Discounts and perks for existing members
- • Simplicity: Easy-to-understand fixed coverage levels
What You're Missing:
- • Higher Coverage: Maximum $300K vs $2M+ from specialists
- • More Conditions: 38 conditions vs 44+ from premium providers
- • Customization: Fixed levels vs flexible coverage amounts
- • Partial Benefits: Limited vs 25-30% from competitors
Claims Experience
What to Expect
Valid claims paid
From submission to payment
Phone and online help
4-Step Claims Process
Initial Notification
Contact Southern Cross to notify them of your diagnosis. Can be done by phone, online, or through your health insurance portal. Claims team will assign a dedicated case manager.
Medical Evidence Submission
Provide medical reports from your specialists and doctors. Southern Cross will request these directly from your healthcare providers with your consent. May require additional tests or specialist opinions.
Assessment & Review
Claims team assesses your case against policy definitions. May consult with medical experts. You'll receive regular updates on progress. Typical timeline: 20-30 days from complete documentation.
Decision & Payment
Receive written decision on your claim. If approved, payment is typically made within 5-7 business days via direct deposit to your nominated account. If declined, full explanation provided with appeal rights.
Underwriting & Application Process
How Southern Cross Assesses Your Application
Southern Cross uses a straightforward underwriting process. For existing health insurance members, the process can be faster as they already have some of your health information on file. New applicants go through standard medical underwriting.
What They Need to Know:
- • Complete medical history for past 10 years
- • Current medications and treatments
- • Family history of major illnesses
- • Lifestyle factors (smoking, alcohol, exercise)
- • Occupation and income details
- • Height, weight, and BMI
Typical Timeline:
- ✓ Days 1-2: Online application or phone consultation
- ✓ Days 3-7: Medical history review and GP report request
- ✓ Days 8-14: Underwriting assessment (may request exam)
- ✓ Days 15-21: Decision and policy offer issued
- ✓ Coverage starts: Upon acceptance and first premium payment
Medical Examinations
Required for: Coverage amounts over $150,000, applicants over 50, or those with concerning medical history.
What's involved: Basic health check, blood pressure, blood tests, sometimes ECG or additional tests depending on your situation. Southern Cross arranges and pays for all required medical exams.
How Does Southern Cross Compare?
While Southern Cross offers solid coverage with the backing of NZ's largest health insurer, specialist trauma insurers may provide better value and more comprehensive options for those needing higher coverage or more conditions covered.
| Feature | Southern Cross | AIA | Partners Life | Asteron |
|---|---|---|---|---|
| Conditions Covered | 38 | 44 | 40 | 42 |
| Maximum Coverage | $300,000 | $2,000,000+ | $2,000,000+ | $2,000,000+ |
| Partial Benefits | Limited | 25% | 20% | 25% |
| Children's Cover | $20,000 | $25,000 | $25,000 | $30,000 |
| Premium Cost | Moderate | High | Competitive | Moderate |
| Best For | Existing members | Comprehensive cover | NZ-owned value | Balance seekers |
For Higher Coverage Needs
AIA or Partners Life offer coverage up to $2M+ with more comprehensive condition lists (44-45 conditions vs 38).
- • Coverage up to $2,000,000+
- • 44+ conditions covered
- • More customization options
- • Higher partial benefits (25%)
For Better Value
Partners Life or Asteron may offer lower premiums for equivalent or better coverage amounts without requiring health insurance membership.
- • Potentially 10-20% lower premiums
- • Flexible coverage amounts
- • No membership requirements
- • More conditions covered
Pros & Cons
Advantages
- ✓ Trusted Brand Reputation
NZ's largest and most recognized health insurer with 64+ years of experience and 870,000+ members.
- ✓ Integration Benefits
Seamless integration with existing health insurance policies, single point of contact for all health needs.
- ✓ Member Discounts
Existing health insurance members receive reduced rates and streamlined application process.
- ✓ Simple Structure
Clear, easy-to-understand coverage level options make decision-making straightforward.
- ✓ Reliable Claims Service
Established processes and experienced team with good claims acceptance rate (92%).
- ✓ Not-for-Profit Structure
Member-owned with no shareholder dividends, focuses on member benefits rather than profits.
- ✓ Widespread Recognition
Medical professionals and facilities across NZ are familiar with Southern Cross processes.
- ✓ Convenient Administration
Bundled billing and management if you have both health and critical illness insurance.
Disadvantages
- ✗ Coverage Limitations
Maximum $300,000 may be insufficient for high earners, business owners, or those with large mortgages needing $500K-$1M+.
- ✗ Fewer Conditions
38 conditions covered vs 44+ from specialist providers like AIA, Partners Life, or Asteron.
- ✗ Higher Premiums for Non-Members
Without health insurance membership, premiums can be 10-20% higher than competitors.
- ✗ Limited Customization
Fixed coverage levels only - can't tailor exact amount to your specific needs like specialist insurers.
- ✗ Health Insurance Dependency
Best value only for members - creates bundled dependency and limits flexibility to switch providers.
- ✗ Lower Partial Benefits
Limited partial payment structure compared to 25-30% offered by AIA, Asteron, and Chubb.
- ✗ Not a Specialist Provider
Trauma insurance is a secondary product - specialist insurers have more expertise and focus.
Who Should Choose Southern Cross?
Southern Cross is Ideal For:
- ✓ Existing Southern Cross health insurance members who can benefit from integration, discounts, and simplified administration.
- ✓ Those wanting integrated health coverage with a single provider for all their health-related insurance needs.
- ✓ People seeking moderate coverage amounts of $300,000 or less who don't need higher limits.
- ✓ Buyers who value brand recognition and trust and prefer dealing with NZ's largest health insurer.
- ✓ Those who prefer simplicity and clear fixed coverage levels over complex customizable options.
- ✓ Members wanting convenience of bundled billing and single point of contact for health and trauma insurance.
Consider Alternatives If:
- ✗ You need coverage over $300,000 - specialist insurers like AIA, Partners Life offer up to $2M+.
- ✗ You want the most comprehensive condition list - AIA offers 44 conditions, Chubb offers 46 vs Southern Cross's 38.
- ✗ Lowest possible premiums are priority - Partners Life or Asteron often have better rates without membership requirements.
- ✗ You're not a Southern Cross health member - without member discounts, better value exists elsewhere.
- ✗ You want flexible, customized coverage - specialist providers offer tailored amounts and optional extras.
- ✗ Higher partial benefits matter - competitors offer 20-30% partial payments vs Southern Cross's limited options.
Frequently Asked Questions
Do I need to be a Southern Cross health insurance member to get their critical illness insurance?
No, you don't need to be a health insurance member. However, existing members receive significant benefits including discounted premiums (typically 10-15% lower), faster application processing, and integrated management of both policies. For non-members, it's worth comparing quotes from specialist trauma insurers as they may offer better value without the membership requirement.
What happens if I cancel my health insurance - can I keep my critical illness cover?
Yes, your critical illness insurance policy is separate and continues even if you cancel your health insurance. However, you'll lose any member discounts, which means your premiums will increase to the standard non-member rate. You'll receive notice of the premium change and can decide whether to continue the policy at the higher rate, reduce your coverage level, or switch to another provider.
Is $300,000 coverage enough, or should I look elsewhere for higher limits?
It depends on your situation. $300,000 is adequate if you have: (1) modest mortgage/debts under $200K, (2) modest income under $80K annually, (3) good ACC cover through work, or (4) other savings/insurance. However, if you have a large mortgage ($500K+), high income ($100K+), dependents, or business ownership, you should consider specialist insurers offering $500K-$2M+ coverage. Financial advisers generally recommend coverage of 3-5x your annual income.
How do Southern Cross's 38 conditions compare to other providers' lists?
Southern Cross covers 38 conditions including all major trauma events (heart attack, stroke, cancer, organ failure, etc.) that account for about 95% of claims. However, premium providers offer more: AIA has 44 conditions, Asteron has 42, Chubb has 46. The additional conditions from specialist insurers typically include rare conditions, some mental health coverage, and more generous definitions for partial benefits. For most people, Southern Cross's 38 conditions provide adequate protection, but if you want the most comprehensive coverage, specialist insurers are better.
What are partial benefit payments and why does Southern Cross offer fewer than competitors?
Partial benefit payments are smaller payouts (typically 20-30% of your sum insured) for less severe or early-stage conditions like carcinoma in situ (early-stage cancer) or single-vessel angioplasty. Your policy continues afterward with the remaining coverage. Southern Cross offers limited partial benefits compared to competitors like AIA (25%), Asteron (25%), or Chubb (30%). This is because Southern Cross positions critical illness as a complementary product to health insurance rather than a standalone comprehensive trauma policy. If substantial partial benefits are important to you, consider AIA or Asteron.
Can I increase my coverage later if my circumstances change?
Yes, you can apply to increase your coverage by moving to a higher tier (from $75K to $150K, for example). However, this requires new medical underwriting, meaning you'll need to complete a health questionnaire and possibly undergo medical exams. If your health has deteriorated since your original application, you may face premium loadings, exclusions, or be declined for the increase. Some policies offer "guaranteed increase options" at life events (marriage, birth, mortgage) without full underwriting - check if Southern Cross offers this benefit.
How does the claims process work, and how long does it typically take?
The claims process involves four steps: (1) Notify Southern Cross of your diagnosis, (2) Submit medical evidence from your doctors/specialists, (3) Claims team assesses against policy definitions (20-30 days typically), (4) Decision and payment (5-7 days if approved). Total timeline is usually 30-35 days from complete documentation submission. Southern Cross accepts 92% of valid claims. You'll have a dedicated case manager who provides regular updates. If your claim is declined, you receive a full explanation and have appeal rights. Payment is made via direct deposit to your nominated account.
Should I get critical illness insurance through Southern Cross or a specialist provider?
Choose Southern Cross if: you're already a health insurance member, need $300K or less coverage, value the convenience of bundled administration, and trust the brand reputation. Choose a specialist provider (AIA, Partners Life, Asteron) if: you need coverage over $300K, want more conditions covered (40-46), need higher partial benefits (25-30%), aren't a Southern Cross health member, or want the absolute lowest premiums. The best approach is to get quotes from both Southern Cross (if you're a member) and 2-3 specialist insurers, then compare the coverage details and cost side-by-side.
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Compare All ProvidersFinal Verdict
4.0/5 - Solid Choice for Members
Good option but coverage limitations exist
Southern Cross critical illness insurance is a reliable choice, particularly for existing health insurance members who can benefit from integration benefits and member discounts. The coverage is solid with 38 conditions and the backing of New Zealand's most trusted health insurer. However, the $300,000 coverage cap and limited partial benefits compared to specialist insurers mean it's not suitable for everyone.
Our Recommendation: Southern Cross is ideal if you're an existing health insurance member needing up to $300,000 coverage and value the convenience of bundled administration. However, if you need higher coverage amounts, want more conditions covered (40-46 vs 38), or aren't a Southern Cross member, you should compare quotes from specialist trauma insurers like AIA, Partners Life, Asteron, and Fidelity Life. They often provide better coverage options at competitive or lower prices.