Mar
10
British Government tired of picking up bill for medical tourists, mulls changes
Filed Under Expat Insurance, Health Insurance, Healthcare, International Healthcare, Medical Insurance, United Kingdom | 1 Comment
The British Government is looking at a number of proposals that would attempt to curtail the number of medical tourists who leave without paying the bill, such as forcing visitors to show proof of medical insurance before entering the country.
The British Home Office has put forward ideas on ways to curtail the abuse of the National Health Service (NHS) system by visitors as the Department of Health is seeking to recover £22 million (US$32.9 million) in debt from foreign nationals that have received NHS services in the last 2 years without paying for them.
Numerous individual NHS Trusts are said to be seeking repayment of over £1 million in outstanding medical costs, including: London’s Imperial College Healthcare which is seeking £1.4 million including two £50,000 unpaid bills, one for a patient from the United Arab Emirates and one from Egypt; Pennine Acute Trust in Manchester has £1.2 million in outstanding bills, of which £34,000 is owed by a Malawian national with HIV; and Barts and the London NHS Trust is seeking repayment of £1.3 million, including a £52,000 surgery bill for a Chinese citizen.
On average, unsettled bills are £1,000, while numbers from the British Department of Health show that 50% of outstanding bills are not settled within one year of receiving treatment and 5% of overseas patients have three or more invoices that haven’t been paid. In total the NHS has to swallow £5 million in medical costs owed by foreigners every year.
At the moment, immigration laws only allow for barring people that already have an outstanding balance with the NHS from coming into Britain specifically for medical treatment. However, the proposals would seek to prevent abuse of the NHS system by making changes to immigration laws including making non-resident foreign nationals show proof that they have health insurance when they go through immigration, and extending the amount of time British expatriates can spend overseas before losing access to NHS services.
Any foreign visitor who already owes money to the NHS would be barred from entry into Britain, while any already in the country would be refused an extension of their visa until the debt has been settled. Also, any migrant seeking British citizenship will have their application delayed until any money they owe the NHS has been repaid. However, the proposals do allow free health care for failed asylum seekers who cannot be returned to their home nations at that time.
The proposals would not cover people who are from countries in the European Economic Area or those nations where Britain has reciprocal healthcare agreements. There are however, some concerns due to the fact that the proposals would mean sharing information on non-paying individuals with the Border Agency, which may be in conflict with patient confidentiality rules.
Mar
8
ING Asia Business attracts interest from European Insurers
Filed Under AXA PPP, Allianz, Insurance Company, United Kingdom | 1 Comment
The high-growth of Asian markets is proving to be a tempting proposition for some European Insurers currently making unsolicited bids for the business of ING in that region. As per comments made by industry analysts it is thought that Zurich Financial Services Group, Allianz and Axa may be among the potential suitors for ING’s Asia insurance unit.
As part of the restructuring deal mandated by the European Union, ING is splitting off of its global insurance operations and an IPO had been the initial preferred route, although they would keep their options open as communicated by a spokesman.
The bailout deal reached by ING with the authorities in the Netherlands was valued at more than GBP 7 billion back in 2008. Under the terms of the bailout package the European Commission regulators demanded ING to sell its insurance business within four years and focus on its banking operations.
There seems to be a growing number of trade buyers interested in targetting plans for IPOs. The announcement of Prudential Plc buying AIA from AIG is a good example of the type of interest some European companies are demonstrating, playing their role as industry consolidators, after emerging relatively unscathed of the financial crisis in insurance.
According to a recent comment by ING’s CEO, there have been several companies interested in acquiring their Asia business, although Zurich Financial, AXA and Allianz all have declined to comment whether they are prospective purchasers.
Insurance Companies mentioned:
ING is a global financial institution of Dutch origin offering banking, investments, life insurance and retirement services serving more than 85 million private, corporate and institutional customers in Europe, North and Latin America, Asia and Australia. ING Group is active in banking, investment management, life insurance and retirement services across 14 major economies in the Asia Pacific region, employing over 23,000 staff.
With nearly 155,000 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. In fiscal 2009 the Allianz Group achieved total revenues of over 97.4 billion euros. Allianz is also one of the world’s largest asset managers, with third-party assets of 926 billion euros under management at year end 2009.
AXA Group is a worldwide leader in Financial Protection. AXA’s operations are diverse geographically, with major operations in Europe, North America and the Asia/Pacific area.
Zurich Financial Services Group is an insurance-based financial services provider with a workforce of approximately 60,000 people. Founded in 1872, headquartered in Zurich, Switzerland, and serving their customers in more than 170 countries. Aims to become one of the top five global insurers.
Mar
3
Lloyds Banking Group Sells 70% Of Insurer Esure
Filed Under Insurance Company, United Kingdom | 1 Comment
Lloyds Banking Group plc (LBG) of the UK has sold 70% of its stake in esure, an Internet-based insurer, for approximately US$289 million. With this sale, LBG intends to regain focus on its core general insurance business through its brands of Halifax and Lloyds TSB.
The buyer of esure’s 70% stake is esure Group Holdings Ltd., a buyout vehicle of esure’s chairman and co-founder, Peter Wood. Using the Internet as the main sales channel, esure offers home, motor, travel and pet insurance.
Lloyds had originally inherited esure after its takeover of home mortgage bank HBOS early last year. The disposal of the 70% stake in esure by LBG forms part of the disposal of UK assets as per a state-aid ruling from EU regulators late in 2009, since Lloyds is now 43% owned by the state.
The impact of this sale on the accounts of LBG is not expected to be material.
Companies mentioned:
Lloyds TSB Group plc was renamed Lloyds Banking Group plc on 19 January 2009, following the acquisition of HBOS plc. This makes us the largest retail bank in the UK with a number of leading market positions. Our goal is to be the best financial services provider in the UK. We believe this means we must build a leadership position not on the basis of scale but on the foundations of reputation and recommendation.
esure was founded in 2000 by Chairman, Peter Wood, to offer competitive insurance cover by using the Internet as a primary sales channel. Mr Wood pioneered the direct selling of insurance over the telephone back in 1985, when he launched Direct Line. With esure, his aim was to go a step further and harness the efficiency of the Internet to give a better deal to responsible drivers and careful homeowners.
Feb
23
British MP’s report says Homeopathy should not be funded by NHS
Filed Under AXA PPP, BUPA, Health Insurance, Medical Insurance, United Kingdom | Leave a Comment
British parliament’s science and technology committee, headed up by chairman Phil Willis, has finished a new report on National Health Service funding for homeopathic treatments and come to the conclusion that the funding should stop.
The committee of MPs said that since there is no evidence that homeopathic treatments work better than a placebo, the NHS should cease providing funds for homeopathic hospitals and that doctors in the NHS system should not refer patients to homeopaths.
The chairman of the committee held that prescribing placebos like homeopathy in the NHS is ethically dubious and may destabilize relationships between doctors and patients.
The committee also forwarded the idea that the Medicines and Healthcare products Regulatory Agency (MHRA) should bar homeopathic treatments from displaying medical claims on their labels. The report came out against further funding for homeopathic research as well.
On top of the NHS currently providing funds for homeopathic treatments, certain insurance plans from AXA PPP and Bupa as well as other private medical insurers and cash plan providers will cover homeopathy, although the extent of coverage may vary between insurance plans as well as on a case by case basis.
Companies Mentioned:
Originally PPP Insurance, it became part of the Global AXA Group in 1999 and changed its name to AXA PPP in 2002. AXA PPP is now an international health insurance company with over 2 million customers around the world.
BUPA is an international health insurance company that provides health insurance for individuals and companies all over the world. This company has offices on three continents and over 7 million customers’ world wide. As a provident association BUPA has no shareholders, because of this it uses its profits to invest in healthcare and medical facilities around the world.
Feb
9
Spanish Doctors Call for Reevaluation of EHIC Scheme
Filed Under Expat Insurance, International Healthcare, Medical Insurance, Spain, Switzerland, United Kingdom | 6 Comments
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 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.
Jun
5
More Than 180 Million Customers Served: The European Health Insurance Card
Filed Under Health Insurance, International Healthcare, United Kingdom | 1 Comment
The European Commission recently announced that the number of Europeans using the European Health Insurance Card (EHIC) has topped 180 million people. The card was introduced back in 2004 to replace the somewhat cumbersome E111 form and then phased in over a year and a half. In January 2006 the E111 form was dropped completely.
The card allows anybody insured by a member state of the European Union to easily obtain free or discounted healthcare while on a temporary visit to another member state, although some countries will require the patient to pay towards their treatment. The card was intended to simplify the process that was originally fulfilled by the E111 form, as well as other E forms. The E111 form previously required people to request one every time they made a trip to another state in the European Union whereas the EHIC has an expiry date, much like a credit card, but more helpful.
The card now allows access to state provided healthcare to all European Union countries as well as countries in the European Economic Area (EEA) and Switzerland, bringing the total to 31 participating countries. It is important to note however, that the EHIC is only of use if you fall sick or injured while on a temporary visit, but prohibits people from traveling for the singular purpose of receiving healthcare. The European Health Insurance Card will thankfully cover maternity care and managing symptoms of chronic medical conditions, including renal dialysis.
There are however some issues. At the end of 2006, there were approximately 150 million Europeans walking around with the EHIC, and even now the EHIC is only carried by about 30% of the population. While some countries have incredibly high numbers of the population carrying the EHIC, such as Liechtenstein, Switzerland and Austria, all of which have over 95% of the populace holding the EHIC, people in other countries have not been rushing to get the card. One example would be Greece, where only 1% of the population holds the card. The fact that only 30% of Europeans have the card has prompted the European Commission to both engage in a information campaign as well as warn people going on summer vacation in Europe not to leave home without their EHIC.
Despite promoting the EHIC in time for the summertime, they have also warned people to make sure they take private travel insurance with them, as there are occasions and services that the EHIC will not cover. One of the main things to take note of is that the European Health Insurance Card will not cover the costs of any flights if you happen to be in a medical situation where you may need to be repatriated to your home country.
In addition, there are a number of countries such as France, Spain, Switzerland and Portugal that will require you to pay either a percentage of the costs or a fixed charge for different medical services, even if you present your valid EHIC. These may include costs for any prescriptions you receive, visits to the doctors and hospital stays. To clarify how important travel insurance would be should you fall ill while traveling; in France you may be required to pay for up to 45% of prescription costs, 30% of out patient visits to the doctor and a daily fixed charge for stays in French hospitals as well as having to pay a non-refundable 25% of the treatment costs in hospital. So even with your EHIC in your pocket, a quality travel insurance plan is still the best way to protect yourself from the costs of any unforeseen circumstances.
Please note that the European Health Insurance Card itself is FREE from your local government’s health authority. Do not be fooled by any websites you stumble across which are offering the EHIC for money. Bonus points for reporting possible scams to the appropriate authorities.
Jan
9
The Recession and Insurance
Filed Under Expat Insurance, Health Insurance, Healthcare, International Healthcare, Medical Insurance, UAE Insurance, United Kingdom | 2 Comments
With news outlets broadcasting dire predictions about the financial downturn like a frothy-mouthed preacher on the apocalypse, we feel it’s time to take a look at how people think the recession will affect insurance. With this in mind, we’ll take a look at projections about how insurers may fare, how your premium could shape up, and other worries and notable points to keep in your head moving forward.
Views on how the insurance industry will deal with the financial climate are a decidedly mixed bag. Larger, more established insurance companies are expected to do well, such as more diversified health insurers. Their size, balance sheets, and diversity of both product and geography are believed to allow a degree of protection from the need to boost operating earnings during the down times. Considering that the international private medical insurance market posted growth rates of around 20% or more for 2008 it’s hard to imagine some of the larger companies needing to start penny-pinching policies which would drive away customers. Combining their growth rates with their long-running operational stability and ratings agencies’ inclination to keep decently performing insurance companies at a favorable rating, and we will hopefully see some benefits for policyholders, not just shareholders. After all, the acceptable balance sheets and relative operating stability mean that your insurer stays in business and keeps offering your plan, plus there’s always the hope that with less of a need to increase earnings and squeeze margins, there may be less pressure to increase your premiums. However, given that insurance premiums have gone up 119% in the last 9 years, don’t hold your breath.
There are also those who believe that the world’s financial nose dive will be a boon to insurers in the international health insurance markets, and their reason is that during recessions, people are more open to traveling to other countries in order to find job openings. With more and more businesses extending their operations into new geographic areas, not only are people more willing to travel to foreign countries for jobs, but companies embracing globalization are increasingly opening branch offices and sending out local staff to manage new operations. This is seen as a potential spike in demand for expatriate insurance products both for individuals and companies. If this is indeed the case, then there are a number of ways this could affect your current policy or your plan to get one. One worry is that the increased demand for international health insurance will lead to increased premiums due to a burgeoning number of clients and the need to cover the increase in claims. I find this assertion extremely dubious, but resisted the temptation to file it under wild conjecture and speculation.
Most international health insurance products are community-rated, which means that their premiums are based on your age and area of cover, and the factors calculated for your premium such as medical inflation, claims ratios from the previous year’s age group are not linked to the number of policyholders in the plan. Simply put, an increase in people paying premiums does not alter the cost of care, or your likelihood of making a claim, and therefore is a highly unlikely reason for an increase in your premiums, so you can rest easy on that count.
Another issue that was raised by some spectators, such as those at the web publication for expatriates, Shelter Offshore, also think that with increased demand for insurance products geared towards expatriates, insurers may become a little choosier about who they will accept for coverage. In contrast with the other claim, this may actually be possible, but then again with tighter budgets all around it would be hard to imagine insurers becoming overly-picky and denying coverage to reasonable applicants who can always look for another policy.
So if the insurance companies seem to at least be lurching by in these troubled days, what about the prospects for your ever increasing premiums? One piece of good news is that with the recession in full swing, it has effectively put a damper on the inflating cost of care. With costs for medical treatments, tests and drugs falling in line with the downward turn in the economy, it should mean that these items won’t be consuming an increasingly large chunk out of insurers’ margins, alleviating some of the need to push up the cost of premiums. Although one problem in at least some sectors has been that during the financial debacle some private insurers’ more risky investments have taken a hit in the market downturn, effectively reducing the amount of cash and assets they have on hand to help pay out claims.
For example, Australia’s private medical insurers have put in a request to the government to allow them to raise their premiums on private health policies. Some of the investments made by the private health funds took a large hit, and the funds now say they will need to find $600 million Australian dollars to make up for the losses, and the plan is to do it through premiums. One firm, HBF is said to have lost approximately $56 million Australian dollars, while another company, MBF, lost about half of that. While this just highlights one geographic sector’s issues, it is seen to be fairly widespread given that at least some private insurers from every walk of life around the globe have taken a hit on their investments with AIG probably being hit the hardest. All in all it’s hard to say for sure whether or not the recession will have a direct and immediate effect on premium rates. While investments were hit, it’s difficult to see how much the decreased rate of medical inflation will contribute to staying the rise of premiums. Add into the equation the fact that many countries are deciding to invest large amounts of money in their public health systems and infrastructure could have interesting effects on premium rates as well.
One thing that has been made clear from reading recent news and stories is that healthcare systems and rules around the world are in a state of change. Highlighting the cases of Bahrain and the UAE, there is a growing trend in some countries to consider enacting rules that make health insurance for expatriates compulsory, meaning that if you are traveling into the country, you must have health insurance. If you do not, you must buy an insurance policy on the spot or possibly be refused entrance into the country, and standing in an airport is not the optimal place to shop for insurance. Additionally, in some countries like Germany, if you do not have health insurance, you may not be able to receive treatment. With this in mind, it is important that even in the tough times it is, at best, inadvisable to neglect paying your health insurance premiums. While the payments may be hard to part with if money is tight, should your cover lapse and there is an accident or an illness, depending on where you are, the best case scenario may end up being financial bankruptcy from medical bills. As for the worst case, it really is no fun having your health disintegrate and possibly die because your lack of insurance precluded you from receiving treatment.
Should you be looking for insurance, I cannot possibly stress the importance of shopping around for the best comparison in quotes. With the shifting sands of business and finance, there are subtle changes in the major insurers which will affect how they will be pricing their insurance products, so it is in your best interests to either canvas the major insurers to find competitive quotes and coverage details or contact a broker who deals with a wide variety of insurers’ products.
May
16
Private v.s. Public Healthcare: The UK Question
Filed Under Health Insurance, Healthcare, Medical Insurance, United Kingdom | Leave a Comment
The
While the National Health Service still has the biggest share of the healthcare services in
This comes as the British government is considering tax reforms that would see young British workers contribute to a new social security initiative benefiting the nation’s elderly. Following on from this comes the fact that a growing number of young professionals in the
So what’s going on?
Younger people in the
According to the Association of British Insurers (ABI) more companies than ever before are taking out private medical insurance in a bid to offer competitive benefits packages to prospective employees, and if the national service was all that it is cracked up to be, then this would not be a serious issue.
However, the fact that BUPA, the
In addition to the NHS’ bureaucracy there is a serious lack in qualified medical professionals, such as nurses, large amounts of overcrowding, poorly maintained treatment facilities and a virtual mountain to climb for treatment access. Is it any wonder that more and more individuals are choosing to go private over this public behemoth? And the situation won’t improve for the NHS, especially if a proposed imitative to give tax credit to organizations that provide private medical coverage to their employees goes through; a proposal remarkably similar to one made by Representative Ron Paul in the
And all of this comes at the same time as politicians on the other side of the
There are no hard and fast answers when considering health. However the trends in recent years, especially in countries like the