South Africa’s other big five

By: Sanlam Chief Medical Officer Dr Marion Morkel and Sanlam Product Actuary Petrie Marx

Dr Marion Morkel

Cardiovascular disease is back as the leading cause of death and funeral claims among South Africans, based on Sanlam’s 2022 claims statistics, after Covid-19 temporarily unseated it. Noting the return of heart disease as first among the ‘Big Five’ causes of Sanlam claims for the year, Sanlam Chief Medical Officer, Dr Marion Morkel says renewed awareness of health and lifestyle realities, with a commitment to prioritise regular check-ups and screenings, may well save lives.

Sanlam Product Actuary, Petrie Marx, says non-communicable diseases certainly didn’t disappear during the pandemic, but their return affirms the rationale to focus on the realities of high blood pressure, diabetes, smoking, obesity, unhealthy diet and sedentary lifestyle as leading contributors to serious health challenges.

Petrie Marx

The main causes of Sanlam’s death and funeral claims:

Cardiovascular disease was the leading cause of death and funeral claims (21%) for both men and women in 2022. Dr Morkel says the increase in claims for cardiovascular disease is something they will watch closely in the coming years. “The challenging economic conditions have also resulted in increased levels of financial stress, which can impact not only people’s mental health but also their physical wellbeing. Left unchecked, chronic stress can impact your heart health,” says Dr Morkel.  


Diseases of the respiratory system – including Covid-19 – were the second biggest cause of death claims (17%) in 2022. Covid-19-linked claims decreased dramatically in 2022, with Sanlam paying out R108.84m in confirmed death and funeral claims linked to the virus, versus R2.64bn in 2021. Of the total R6.38bn in benefits paid, just R139.9m comprised confirmed Covid-19 claims. However, Covid-19 still accounted for the most sickness income claims (41% / R31.07m) in 2022.

The main cause of Sanlam’s severe illness claims:

The overwhelming majority (52%) of Sanlam’s severe illness claims were for cancer and tumours, followed by heart attacks (8%), angioplasty (8%) and strokes (5%).

When considering severe illness claims for women, 63% were for cancer, of which almost half (48%) of all cancer claims paid were for breast cancer, usually affecting women aged 45 and up.
Cancer was less prevalent in men, accounting for 42% of total severe illness claims. 36% of these claims were for prostate cancer – an 11% increase from 2021. Dr Morkel says, “Prostate cancer is the most frequently diagnosed cancer for males in 112 countries and the continued increasing incidence has been reflected in clinical research globally. Our significant increase in prostate cancer claims highlights the ongoing need for regular screening for all men.”

Similarly, she encourages all women to perform regular self-checks of their breasts, follow the recommended guidelines for mammogram screening and to consult a health practitioner if there are any concerns.

The main cause of Sanlam’s disability claims

Cardiovascular disease was also the primary cause (23%) of disability claims for both sexes, accounting for 25% of women’s and 21% of men’s claims.

After claims for cardiovascular disease, disorders of the bones, back, joints and connective tissue accounted for the second highest amount (19%) of all disability claims. This includes back and neck problems, spinal surgery and various fractures. It’s also an important reminder to consider work-space ergonomics – whether working from home or at the office – and to get up and stretch frequently.

A cause to watch closely in coming years

While mental illness did not take first place in any of the claim categories, it accounted for 11% of disability claims (the third biggest cause), 9% of disability income claims, and 5% of sickness claims.

Mental illnesses are frequently stigmatised and taboo to talk about, which means people may suffer unseen, in silence. A recent Wits/ Medical Research Council DPHRU’s paper reported that over a quarter of South Africans suffer from probable depression. The 2022 World Mental Health Report ranked our nation low on mental health, estimating that an overwhelming 75% of people needing critical care do not receive it.

Dr Morkel adds, “The pandemic increased the global prevalence of depression and anxiety by as much as 25%. It’s critical to provide early, accessible interventions to ensure all South Africans can get care and support. There also needs to be much more conversation around mental health, so people feel safer sharing more about their emotional wellbeing.”

Marx concludes that Sanlam is committed to paying on its promise and helping to protect people from the financial impact of these and other curveballs. “This is our north star. We have promised to protect our clients and their families. That is always our priority. Our claim statistics give deep insights into what is jeopardising the health of our nation. During Covid-19, many people missed their routine check-ups. We urge individuals to resume these. Having your heart health checked, along with annual cancer screenings, may well save your life.”

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Visit the official COVID-19 government website to stay informed: sacoronavirus.co.za