It has emerged within international private medical insurance industry that A+ International Insurance may not offer policyholders the option of renewing their medical insurance policies in the future.

A+ International Insurance’s decision to not offer clients a renewal on their IPMI policies may be due to Cigna’s purchase of Van Breda International; Van Breda International was integral to A+ International’s plan offerings and policy administration.

Cigna, a leading US based international insurance provider, purchased Vanbreda International in August 2010 in order to access the Belgian insurer’s international reach.

A+ International’s partnership with Vanbreda International is through Justitia NV. Justitia, an independent insurance company within the Vanbreda Group of companies, is responsible for underwriting A+ International’s international health insurance plans.

Justitia NV generated premium collections of EUR 18.5 million (US$ 26.3 million) in 2008.

While A+ is a relatively new entry to the global health insurance market, the company does have a significant number of policyholders worldwide; the potential denial of renewal terms to existing customers may leave a substantial number of consumers without adequate medical insurance coverage.

A+ policyholders are advised to contact the company, or their intermediary, in order to understand their health insurance options in the event that they are not offered a renewal of their current policy.

At present there has been no official confirmation from A+ International Insurance regarding future business, but policyholders who have contacted the company have been informed that there may not be renewal terms on their policies.

Swiss Life Group, a leading life insurance and pension provider in Switzerland, reported a 94% increase in net income for the first half of 2010. This was due to growth in premiums and newly implemented efficiency measures aimed at cutting operating costs. The revenue increase was reported in all of the major regional markets where the group operates, including Switzerland, France and Germany.

During the first half of this year the net income of Swiss Life increased to US$253.3 million (EUR 200.4 million) from US$131 million (EUR 103.6 million) for the same period in 2009. The combined amount of gross premiums, policy fees and deposits increased 20% year-on-year to US$11.5 billion (EUR 9.1 billion).

The strong performance by the company in the first half of 2010 was summarized in a statement released by Bruno Pfister, CEO of Swiss Life, by saying: “The improvements we achieved in client relations and distribution confirm that we have made sustainable progress in our pursuit of profitable growth. The measures introduced last year as part of our group-wide Milestone program have started to pay off.”

Last year, Swiss Life started the implementation of their new efficiency-enhancing policy, known as the “milestone” program, under which the company aims to increase new business within their “modern insurance and risk products” by more than 70%. The program can be considered a success for the company, as Swiss Life has achieved the 70% growth targeted by the policy – illustrated by the high returns the company experience during the first half of 2010 – in addition to reducing overall company-wide operating costs by 8%.

All that is left for Swiss Life is to realize their margin management target, which remains at 0.9%, unchanged from 2009. Analysts speculate that the target set by the company in this regard may be difficult to reach, due to the prevailing low interest-rate environment in Europe and pressure from competition across the region.

Citing low interest rates as a primary concern, Swiss Life has taken steps to limit their exposure to market risks, and have launched a new time-frame for the achievement of their margin management target – now aiming to see improvement by 2012. During the past 12 months the company has launched approximately 30 insurance products, conformed by a mixture of new and revitalized policies, and are still continuing their approach of achieving profitability before growth.

Insurance Company mentioned:

Swiss Life

Swiss Life was founded in 1857 as Schweizerische Rentenanstalt. The Swiss Life Group is committed to openness and transparency in management and actively supports good corporate governance. Swiss Life is a leading life and pensions provider in Switzerland and it is one of the top 10 European life insurance providers. As at the end of 2009, the Swiss Life Group employed a staff of around 8200.

Baloise Insurance Group of Switzerland has recently announced their acquisition of Belgian insurance company “Avéro Schadeverzekering Benelux N.V.” (Avero) in a deal valued at US$97 million (EUR 75 million). Avero is a subsidiary of the Dutch Eureko Group.

With this acquisition Baloise strengthens its market position, becoming the sixth-largest non-life insurance business in Belgium. With a share of around 5 percent Baloise is gaining a foothold in the French-speaking region of Belgium. The expected completion date for this acquisition is towards the end of 2010, once the corresponding approval by the regulatory authorities is obtained.

Baloise intends to gradually remove from the Belgian market the brand name Avero. Currently, Avero trades in the non-life insurance segment, with focus on the property and transport insurance markets. Using exclusively a network of brokers, Avero sells its products to over 100,000 private and corporate customers. It is estimated to hold a 13 percent market share in the transport sector.

With a 177-strong staff, Avero recorded a US$160 million (EUR 124 million) premium volume in 2009.

For Baloise, this acquisition represents another step towards the expansion of their international business.

Insurance Companies mentioned:

Baloise

Headquartered in Basel, Switerland, the Baloise Group is a European provider of insurance and pension solutions. In Switzerland Baloise operates as a focused financial services provider, combing insurance and banking. Further markets are Germany, Austria, Belgium, Luxembourg, Croatia and Serbia. The sales network comprises the company’s own sales organisation, brokers and further partners. Baloise operates its business in innovative pension products for private customers all over Europe and has competence centres in Luxembourg and Liechtenstein. The Baloise Group employs approximately 9,400 people.

Avero

Avéro Insurance is a member of the Eureko group, a major financial services provider, fully expanding in quantity in European markets. Avéro is active in the nonlife sector and focuses primarily on the property and transport insurance areas. It holds a market share of 13% in the transport sector. It sells its products to more than 100,000 private and corporate customers exclusively via a network of brokers. Avéro has 177 employees.

Perils AG, an insurance industry initiative which aims to improve the availability of catastrophe insurance market data, has released a loss index suggesting that the latest US$63.25 million (EUR 50 million) reinsurance transaction between Allianz Risk Transfer and Munich Re, for coverage of European wind risk, has contributed to the US$250 million (EUR 198 million) total placements of insurance transactions during the first six months of 2010. The deal between Allianz Risk Transfer and Munich RE was brokered by Willis Re, a leading reinsurance broker.

For the deal, Perils provided an independent estimate of the potential insured property industry loss in the event of a severe wind storm. This loss estimate is used as a trigger for the transaction.

Using the Perils index in this transaction, the loss estimates have been used as the index base in all main forms of industry loss-based and catastrophe insurance risk transactions, according to a recent statement released by the company. Reaffirming the value of the data provided by Perils for such transactions, the head of the insurance-linked market at Allianz Risk Transfer, Brian Kirwan, commented that it “greatly improves deal execution”.

As one of the founding members of Perils AG, the Allianz Group believes that the increasing use and acceptance of the Perils index plays a central role for the future growth of trading in the European wind-storm market.

In addition of Allianz, the other shareholders that took part in the founding of Perils AG include Axa, Generali, Groupama, Guy Carpenter, Munich Re, Partner Re, Swiss Re and Zurich Financial Services.

Companies mentioned:

Allianz

Allianz LogoAllianz Group is one of the leading global services providers in insurance and asset management. With approximately 153,000 employees worldwide, the Allianz Group serves approximately 75 million customers in about 70 countries. On the insurance side, Allianz is the market leader in the German market and has a strong international presence.

Munich Re

Munich Re LogoMunich Re stands for exceptional solution-based expertise, consistent risk management, financial stability and client proximity. This is how Munich Re creates value for clients, shareholders and staff. It operates in all lines of insurance, with around 47,000 employees throughout the world. Especially when clients require solutions for complex risks, Munich Re is a much sought-after risk carrier. The primary insurance operations are mainly concentrated in the ERGO Insurance Group. ERGO is one of the largest insurance groups in Europe and Germany and 40 million clients in over 30 countries place their trust in the services and security it provides. In international healthcare business, Munich Re pools its insurance and reinsurance operations, as well as related services, under the Munich Health brand.

Perils AG

PERILS is an insurance industry initiative aimed at improving the availability of catastrophe insurance market data. PERILS’ industry data are based on information exclusively received from insurance companies writing business in the territories covered by PERILS. The data provided are quality controlled and aggregated, and subsequently extrapolated to industry (or market) level. The resulting industry benchmark data are available to all interested parties via a subscription service.

Aimed at a segment of the world population termed as “global nomads” SwissLife has launched a new product that matches the health and protection needs of highly mobile expatriates worldwide. SwissLife designed the ExpatSelect product based on the notion that the needs for local employees differ from the ones of expatriates.

The plan, which is a global group benefits product marketed as ExpatSelect, is made up of five components covering retirement, death, disability, health and assistance benefits. Customisation of the plan is achieved by selecting any number of the five components, plus tweaking of the degree of cover within the particular component. Employers would benefit from the administrative advantage of having to complete one application per scheme, whilst the employees are also required to fill-in only one application form, regardless of the number of components selected.

With a worldwide population estimated at 20 million international workers, SwissLife believes there is market potential for their latest offering, especially considering that the families of these global nomads often receive benefit provisions from the employer as well.

More often than not, the expatriates falling into this global nomads category end up travelling away from the original destination their employers deployed them to, facing additional risks as well. Although this product has no geographical exclusions set, coverage in war zones and other high-risk areas would need to be reviewed at a later stage.

Given that the international medical insurance market is peaking in maturity, this latest product offering from SwissLife would support the maturity of the risk part of that market.

Insurance Company mentioned:

SwissLife

The Swiss Life Group is one of Europe’s leading providers of life insurance and pension solutions. In Switzerland, France and Germany, the Group offers individuals and corporations comprehensive advice and a broad range of products through its own sales force as well as brokers and banks. Swiss Life provides international corporations with employee benefits solutions from a single source, and is one of the global leaders in structured life and pension products for international high net worth individuals.

Issuing of the European Health Insurance Card (EHIC) will no longer be the responsibility of the state of residence of a person linked to the Social Security System of an EU Member State. This change in the European Law becomes effective on 01 May 2010.

The European Commission (EC) has as one of its objectives the free movement of people within the European Union (EU). Workers and pensioners who are linked to the Social Security System of any State can receive healthcare in any other Member State at the cost of the home State. Holders of the European Health Insurance Card EHIC are entitled to necessary healthcare in the public system of any EU/EEA (European Economic Area ) Member State and Switzerland, should they become ill or injured whilst on a temporary stay in that country.

Up until now, an entitled person would be issued with an European Health Insurance Card (EHIC) by the state of residence. Once the new law takes effect, the State where a person is paying to or benefiting from the Social Security System will be responsible for issuing the EHIC in cases where that person resides in another EU/EEA State.

As an example of this upcoming change, from 01 May 2010 the Health Service Executive (HSE) will have to issue the European Health Insurance Card (EHIC) for all Irish insured persons or pensioners and their dependants resident in other member States. Meaning that a retired person receiving a contributory pension from the Department of Social Welfare living in Spain will have the EHIC issued by the Irish authorities, and not by the Spanish authorities as it is the case now.

Relieving the issuance of the European Health Insurance Card (EHIC) by the state of residence of an entitled person may help resolve misunderstandings related to the entitlement of services in other countries, such as the case of Spanish Doctors calling for a re-evaluation of the EHIC scheme.

Organisation mentioned:

Health Service Executive

With an annual budget of over €15 billion, the HSE is one of Ireland’s largest purchasers of supplies and services. The HSE produces a wide range of reports and publications on health issues and developments, including Annual Reports, Guidelines for Nursing Home Subventions and Local Health Office Guides. The HSE also operates a major online repository of health-related reports, research and official publications from the HSE, former Health Boards and other health agencies.

Politicians and Doctors in Spain have recently joined forces to speak out against certain British ‘health tourists’ who are receiving free-of-charge medical treatment which is ultimately being paid for by taxpayers.

The SiMAP Union, representing public health doctors in Spain, criticized travelers holding the European Health Insurance Card (EHIC) for misusing the provision of emergency care and treatment destined for troubled holidaymakers. This criticism is not directed to expats with rightful residency who pay taxes.

Out of the thousands of British expats and tourists alternating residence between UK and Spain there is a percentage who time their visits to coincide with their needs for medical treatment. An approximate estimate by SiMAP puts this figure at 20 percent of all hospital admissions in Alicante, a favoured tourist destination.

Health professionals for years have kept silent about what politicians labeled as “freeloading” by these expats, and it’s possible that this rare support is instigated by the Doctors’ first-hand perception of the issues; issues which include  ‘medical tourists’  jumping queues, draining the Spanish healthcare system of their limited resources and depriving local people of medical attention they are rightfully entitled to receive.

One point of contention is the definition of ‘emergency treatment’ which has meant that in most instances Doctors do not question the alleged illnesses claimed by these foreign patients.

Addressing the above issue from a different angle, UK-based International healthcare and insurance firm PMI Global recently found that up to 20 per cent of companies are not procuring the correct health insurance for their expat employees in long-term foreign assignments.

In a report compiled by PMI Global, it was also revealed that up to 48 percent of companies didn’t carry the appropriate health assessments for the destinations their expat employees are sent to, and almost 50 percent of the companies neglect organizing the necessary vaccinations. Other problems identified include the level of access to psychological assistance and proper advice on where to receive medical attention.

According to comments by the operations director for PMI Global, too many employers are relying on the European Health Insurance Card (EHIC) in lieu of a proper international health insurance cover to ensure the medical attention their staff may require whilst on overseas assignments.

“While the EHIC entitles any resident in the UK to receive emergency healthcare treatment while traveling in the European Economic Area (EEA) and Switzerland, restrictions mean it isn’t a substitute for standalone international health insurance,” Rachael Floyd, operations director for PMI Global stated.

Given the looming healthcare budget shrinkage for both Spain’s SiMAP and the UK’s NHS, a possible target for cost-cutting measures would be the resources currently allocated for non-essential treatments and such action could potentially solve the perceived ‘medical care freeloading’ problem.

Insurance company and union mentioned:

PMI Global

PMI Global is a pioneering service offering an integrated package of insurance and healthcare support for employees abroad. The service is operated by PMI Health Group, the UK’s largest independent specialist provider of employee healthcare and insurance services.

SiMAP (Spanish)

SiMAP is a union of doctors in Valencia working in the public healthcare sector, covering the 3 provinces in the community. With essential presence in the Health Sector Roundtable, without favouritisms, to achieve greater quality of care and decent working conditions.

A cooperation agreement has been signed between SWICA and DKV Globality. As one of the biggest health and accident insurance companies in Switzerland, SWICA aims to jointly market with DKV Globality the international health insurance cover Globality CoGenio in the Swiss market, as well as providing a local continuation of insurance option in Switzerland. DKV Globality is a leading international health insurer with a special focus on expatriates. This joint approach closes a gap in corporate health and accident plans for global companies.

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More often than not, the staff of international companies and organizations on temporary overseas assignments have to fend for themselves or are inadequately insured when falling ill or suffering an accident. Another concern is whether they can resume the same level of cover provided by their plan upon their return to Switzerland. The partnership between SWICA and DKV Globality aims to eliminate the risk to expatriates when overseas.

Corporate clients benefit from the cooperation since it allows policyholders to switch from SWICA’s national inpatient and outpatient private health insurance solutions to DKV Globality’s international expat solutions, without the need for medical underwriting.

Globality CoGenio is an integrated, worldwide insurance solution for corporate clients in the Swiss market. This insurance solution offers the best of both worlds, since it has a wide range of assistance services and other benefits in addition to comprehensive healthcare services, ensuring comprehensive protection whilst maintaining individual local support.

Furthermore, this cooperation meets the needs of international companies by providing even wider cover. Swiss companies with international operations can now be offered by SWICA the market-leading DKV Globality products, supplementing its existing product range, whilst corporate clients in Switzerland of DKV Globality can enjoy the continuation of insurance option for staff returning to Switzerland.

A win-win situation for both companies and their clients.

Insurance companies mentioned:

SWICA
SWICA is one of the largest health and accident insurance companies in Switzerland, with a high-quality range of products and services comprising health, accident and daily allowance insurance for individual and corporate clients. Over a million people and more than 22,000 companies rely on premier service, financial security and competent assistance in the event of illness or accident. With its decentralised organisation, SWICA serves clients at over 50 locations in Switzerland.

DKV Globality
DKV Globality is a leading international health insurer with a special focus on expatriates, i.e. people working or studying abroad. Global companies and their expatriate staff as well as individuals and their families place their trust in DKV Globality’s expertise. The company stands for more than 80 years’ experience in health insurance and the proven competence of an international network of assistance and service partners. It is a member of Munich Health with more than 5,000 experts at 26 locations worldwide, providing its clients and partners around the world with innovative healthcare solutions. DKV Globality is a subsidiary of Munich Re, offering the financial strength and security of one of the world’s leading (re)insurers.