1 in 4 workers is owed an insurance payout -- some worth up to $20,000 -- that many will likely never claim

New Nayya analysis of 6.7 million medical claims finds a hidden gap in the benefits employees are already paying for, as the affordability crisis leaves half of Americans on the brink of debt from a $500 medical emergency

NEW YORK, Oct. 6, 2026 /PRNewswire/ -- At a moment when half of U.S. adults say they couldn't cover an unexpected $500 medical bill without going into debt, new data from Nayya shows that millions of American workers are leaving far larger sums on the table: money from benefits they've already bought and paid for.

According to a 2026 analysis by Nayya, an AI-powered benefits optimization platform, 1 in 4 employees enrolled in supplemental health benefits has a reimbursable claim sitting unfiled. These are payouts they're entitled to right now, tied to real events that have already happened, such as a hospital stay, an ER visit for a broken bone, or a cancer diagnosis.

The dollar amounts aren't small. Nayya's analysis found the average reimbursement opportunity is $1,080 for a hospital admission, $1,796 for a forearm fracture, and as much as $20,000 for a full cancer benefit — money that, in the middle of a health crisis, can be the difference between healing and financial freefall.

Supplemental benefits like accident, critical illness, and hospital indemnity insurance are the ones people think about least. Only 40% of eligible workers say they have a high level of understanding of their critical illness coverage, and just 35% for hospital indemnity. And filing a claim means remembering you're enrolled, decoding what's covered, gathering paperwork, and submitting it, all while managing a medical emergency. Faced with that, it's no surprise that most people don't follow through, and the claim goes unfiled.

"People buy this coverage precisely so they're protected when the worst happens," said Sarah Liebel, CEO at Nayya. "What's heartbreaking is that the system asks people to remember a policy, decode what it covers, and chase down paperwork in the exact moment they have the least strength to do any of it, right after an accident, a diagnosis, or a hospital stay. So they don't. And the coverage they paid for never reaches them."

And this isn't an edge case. Across 611,000 members and 6.7 million medical claims reviewed in the first half of 2026 alone, Nayya surfaced payout opportunities for roughly 300,000 people.

Nayya Claims closes the gap by connecting medical claims data directly to a member's supplemental coverage, automatically spotting every reimbursement opportunity when a qualifying event happens. From there, the process moves forward on the member's behalf, so people actually receive the money their coverage was built to provide while they focus on recovery.

For employers and brokers, the stakes are just as direct: the benefits packages they work hard to build only deliver their full value if employees can actually collect on them. Nayya gives them a clear, documented way to show those benefits are working, and their people are getting the money they're eligible for.

"In an affordability crisis, every penny counts," said Liebel. "It's on employers to make sure the money their employees have already earned is reaching them in their moments of need."

To learn more about Nayya Claims, visit https://www.nayya.com/claims. 

About Nayya
Founded in 2019, Nayya is on a mission to connect people's most important information, so they can thrive in their health and wealth. Nayya's platform is the first of its kind: agentic AI that doesn't just advise, it acts — transforming benefits from a once-a-year decision into an always-on advantage for every employee. As a trusted platform to leading employers, Nayya unlocks long-term value through helping employees live more resilient lives. Learn more at nayya.com.

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SOURCE Nayya