Dec
23
Bupa International Rolls Out Full Medical Underwriting Options
Filed Under BUPA, DKV, Expat Insurance, Health Insurance, IHI Bupa, IHI Danmark, Insurance Company, International Healthcare, Medical Insurance | 5 Comments
In December, Bupa International joined the ranks of international private medical insurers that offer insurance policies with full medical underwriting (FMU) options that cover individuals for pre-existing conditions.
Until recently, it has been very difficult for expatriates to obtain coverage of pre-existing conditions on individual insurance policies, as few insurers would cover them. Many group policies may be underwritten with medical history disregarded once the group is sizable enough, however customers seeking individual coverage are often left with little choice but to take up policies that either exclude coverage of any pre-existing conditions or policies which will provide coverage after a moratorium.
Bupa International will now offer customers the ability to apply for full medical underwriting when enrolling in the Worldwide Health Options product, an option that would provide coverage of a list of over 60 pre-existing medical conditions the customer may already have.
Although the list of pre-existing conditions already includes cancer, high cholesterol, hypertension and asthma among others, Bupa International’s Medical Director Dr. Sneh Khemka has said that Bupa will hope to include cardiovascular conditions and diabetes in the list in the near future. One eventual aim is to work towards setting up a system where brokers could add the premium loading themselves in clear-cut cases, in order to streamline the process.
However, Bupa International is hardly the first to pioneer international health insurance products with full medical underwriting, with companies such as DKV Globality, InterGlobal and ihi Bupa already having earned names for themselves as providers which are more flexible in covering pre-existing conditions. While InterGlobal has been offering cover for pre-existing coverage in January 2010, DKV Globality has been extending individual customers that option since 2008 leveraging its access to Munich Re’s knowledge, group expertise and scale.
The Group Underwriting Director and InterGlobal, Barry Remington, said that “It has been welcomed by the market and is an excellent means for expats to have certainty that they will be covered for pre-existing conditions which may have become excluded if they had a reoccurrence of their condition under a moratorium scheme.”
Despite the fact that ihi Bupa, previously IHI Danmark, already offered FMU options prior to being purchased by Bupa in 2005, Bupa International decided not to emulate the product in its lineup due to the fact that their IT systems and medical technology were insufficient at the time. Another reason for keeping FMU products distinct was the fact that each appealed to different markets, with Bupa International finding traction in European markets and ihi Bupa performing similarly in Asian Markets.
As one of the largest international medical insurance providers, the announcement that Bupa International will introduce full medical underwriting options could cause a change in the landscape of the international PMI industry, potentially forcing competing major insurance companies to begin offering similar products.
Insurance Companies Mentioned:
Bupa was established more than 60 years ago in the UK and is now has ten million customers in over 190 countries, and over 52,000 employees around the world. Bupa is a leading international healthcare provider, offering personal and corporate health insurance, workplace health services and health assessments. 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. Bupa has operations around the world, principally in the UK, Australia, Spain, New Zealand and the US, as well as Hong Kong, Thailand, Saudi Arabia, India, and China and across Latin America.
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.
Originally dubbed IHI Danmark, the company has 30 years of history as an innovative international health insurer. The company was purchased by Bupa in 2005, and became a branch in 2009 beginning to operate under the banner of ihi Bupa.
InterGlobal is an international health insurance company offering international private medical insurance to expatriates, frequently traveling business people and companies around the world. InterGlobal was founded in the UK in 1998 as a joint venture company between the UK-based Inter Group and New Zealand-based Mike Henry Group. Since their founding, InterGlobal has expanded to the point where it now handles policies for clients in more than 189 countries around the globe, operating from 10 regional offices in the UK, Singapore, Kuwait, China, Dubai, Thailand, Japan, South Africa, Qatar and Vietnam.
Dec
22
The Insurance Industry: Mergers and Acquisitions 2010
Filed Under AIG, Aviva, BUPA, China, Health Insurance, International Healthcare, Life Insurance, United Kingdom | 5 Comments
A number of Mergers and Acquisitions (M&As) between insurance companies have been implemented during 2010 in a bid to strengthen business activities in both mature and emerging markets. These developments have taken place as insurers strive to capture an increase in profitable markets and penetrate new markets to capitalize on shifting global demands.
The M&As implemented are planned to facilitate improvements in the quality and range of services which can be provided to clients, together with uplifting profit margins and share values for companies as rationalization processes are implemented.
An appetite for mergers and acquisitions within the global insurance industry has been re-activated in the last 18 months. These activities have occurred in the wake of the global financial crisis – which started in 2007/2008; the financial crisis originating in the USA with a knock-on impact worldwide.
With the economies in the western hemisphere still feeling the effect of financial instability into late 2010, growth has been focused on Asia, Latin American and the Middle East as these regions have emerged more quickly out of recession than the established markets in North America and Western Europe. Asia – particularly China and India – has become pivotal for the insurance industry offsetting lacklustre returns from established markets.
While the USA and Western European countries are suffering from the impact of austerity measures, the major reforms of state provided healthcare services proposed in these major nations could be beneficial for private sector insurers. There is an expectation that populations may switch to private insurance in bigger numbers as standards and waiting times worsen in public sector provision. The out-sourcing of state funded medical treatments and procedures to private facilities with spare capacity may also be adopted as a more cost effective process in countries such as the United Kingdom.
Additionally opportunities for private insurers in western hemisphere countries could emerge from an attempt to rectify a estimated shortfall amounting to trillions of dollars in the pension and savings sectors in these nations; this deficit has been building up over many years and will need to be satisfied.
In the emerging markets of Asia and Latin America, the increasing wealth of the large populations has resulted in a demand for a broad range of insurance products. Insurance companies are poised to penetrate the market for micro-insurance, which is estimated to be worth some US$ 40 billion (£26 billion:€30 billion) of new premium business. A report issued by Swiss Reinsurance in December 2010 highlighted the potential demand for microinsurance primarily for low income populations in Asia, Latin America and Africa countries; the fledgling market being assessed at 4 billion policies covering a diverse range of products – 2.6 billion for people living on US$1.25 to US$4 a day plus the capability of a further 1.4 billion policies with the help of financial support from governments and international aid agencies.
Another niche market ready for expansion covers the development of takaful insurance primarily to populations in Islamic countries. This is based on the issue of mutually beneficial protection policies distinctly geared to markets in Middle Eastern and Asian countries.
Recent mergers and acquisitions in the insurance industry indicate that the combination of multi-national and local insurers is well placed to take advantage of these opportunities:
* Resolution Ltd is set to acquire Bupa’s Health Assurance business in a US$164 million (£102 million:€ 122 million) deal. As part of Resolution Ltd’s strategy to build a substantial share of the UK life insurance market, the company has reached an agreement with Bupa to acquire its life, income and critical illness insurance business. This enhances the previous acquisitions by the Clive Cowdrey formed company – Resolution Ltd – and follows the purchase of Friends Provident in 2009 for US$3.04 billion (£1.9 billion:€ 2.28 billion), and the US$4.4 billion (£2.75 billion:€ 3.3 billion) acquisition of AXA’s UK life assurance and savings arm earlier this year.
* UK based multinational insurance company Aviva plc has recently entered into an agreement with PT Asuransi Wahana Tata to purchase a 60% share of PT Asuransi Winterthur Life Indonesia (WLI). This is the first time Aviva has entered the Indonesian insurance market. Once the deal is finalized and Indonesian regulatory approval is given for the venture, Winterthur Life will be renamed PT Asuransi Aviva Indonesia. Aviva also operates in China, Hong Kong, India, Korea, Sri Lanka, Singapore, Taiwan, Malaysia and Australia.PT Asuransi Winterthur Life Indonesia is one of Indonesia’s top three health insurance providers and holds gross assets of approximately US$22.7 million (£14.5 million:€17.2 million), managing pension funds valued at US$63 million (£40 million:€48 million).
* The second largest insurer in China, the Ping An Insurance Group Company (PAIGC) has joined with equity investment firm Newbridge Asia exchanging shares held by PAIGC with those held by Newbridge in the Shenzhen Development Bank.
* The inauguration of MaxBupa in February 2010 covered the joint venture between local Indian insurer Max India and global insurer and major healthcare provider Bupa, with an initial network of offices in six major metropolitan areas – Delhi, Mumbai, Bangalore, Hyderabad, Pune and Chennai.
* China Everbright formed a joint venture with Canadian owned Sun Life in 2002 resulting in a new company – Sun Life Everbright. The partnership generated 18 offices within China. A restructuring of Sun Life Everbright was approved in 2010 enabling additional investors to buy shares in the joint venture, which will ultimately turn the company into a wholly owned Chinese entity, although Canadian based Sun Life will continue to provide management and actuarial services.
* BNP Paribas entered into a joint venture with the Taiwan Cooperative Bank in April 2010 – split 49%, 51% respectively – in order to sell a diverse selection of life insurance products. The joint venture, named BNP Paribas Assurance TCB Life Insurance Co, uses the bank’s 300 outlets to distribute policies to clients in the difficult Taiwanese insurance market.
* In Malayasia, the Singapore listed company Great Eastern Holdings has acquired the Tahan Insurance Company in a transaction amounting to US$ 4.7 million (£3.3 million: €3.5 million); the takeover being completed by Great Eastern Holdings wholly owned Malaysia insurance company, Overseas Assurance Corporation Malaysia (OACM).
* The Danish Investment Bank FIH Erhvervsbank (FIH) has been taken-over by a consortium involving Danish based pension company ATP, PFA Pension, CPDyvig and Swedish insurer Folksam; the deal worth US$879 million (£567 million: €670 million) relieving FIH of liabilities incurred by its previous takeover of failed Icelandic bank Kaupthing.
* London based insurance company, Brit Insurance, is recommending acceptance of an offer by private equity groups Apollo Global Management and CVC Capital Partners Ltd, which would conclude an acquisition proposal under discussion since June this year. Brit Insurance – which specializes in the major insurance and reinsurance business – has decided to recommend to its shareholders acceptance of an approach by Apollo Management and CVC Capital Partners. The bid is valued at US$1.3 billion (£850 million:€900 million), with the potential for a further 2.3% increase in value if certain targets are achieved.
*.Prudential Financial Incorporated, one of American’s largest life insurers, raised US$2 billion (£1.3 billion:€1.45 billion.) through the sale of over 18.3 million shares of Prudential Financial common stock, together with public offering of senior notes to help fund the purchase of AIG Star Life Insurance Co and AIG Edison Life Insurance Co from its American rival AIG. The acquisition of the two Japan-based insurers increased Prudential Financial reach across the world’s third largest economy.
* The German based major insurer Allianz took control of Allianz Seguros its Brazilian subsidiary in January 2010, when it purchased the remaining 14 percent of the company from Ita’u Unibanco. The acquisition will provide Allianz with access to gross written premiums of approximately US$905 million ((£584 million:€689 million) per year primarily in the Brazilian property and casualty insurance markets.
*The private equity fund manager Horizon Capital has agreed the purchase of Fortis Life Insurance Ukraine, with Belgian based Ageas Insurance International. The transaction fits with Ageas continuing their portfolio restructuring and follows the sale of their Turkish life & pensions business to the insurance unit of France’s BNP Paribas in June 2010.
*The Industrial and Commercial Bank of China (ICBC) has agreed to buy a major stake in the French-Chinese joint venture AXA-Minmetals Assurance Company. The move by the Chinese Bank ICBC will make them the majority shareholder and add to its non-banking revenue stream. The initiative by ICBC to acquire the 60 percent share in AXA-Minmetals Assurance comes as the Chinese bank announced that it gained a 27 percent increase in profits during the third-quarter of 2010 with net income of US$ 6.4 billion (£4.1 billion:€4.8 billion) up from US$ 5.05 billion (£5.9 billion:€3.8 billion) in the previous year.
*Zurich Insurance Co. Ltd., a subsidiary of Zurich Financial Services AG, the Swiss insurer, announced the acquisition of Compagnie Libanaise D’Assurances (CLA), a privately-owned Lebanese insurance company founded in 1951, with branches in the United Arab Emirates, Kuwait and Oman. The Zurich Financial Services Group also announced that it has entered into an agreement with its Spanish partners Unnim to sell them its 50 percent stake in their Spanish joint venture life and general insurance operation. Zurich’s decision to sell its equal stake in the Spanish insurance venture follows the merger between Caixa Sabadell, Caixa Terrassa and Caixa Manlieu in July 2010 to form Caixa d’Estalvis Unió de Caixes de Manlleu, Sabadell i Terrassa – also known as Unnim.
The financial industry is predicting a growth in business mergers and acquisitions during 2011 as companies emerge from the 2007 – 2008 global financial tsunami, with cash reserves available for new transactions. The insurance industry is expected to continue to be involved in these initiatives.
Companies Mentioned:
Aviva
Europe’s fourth largest insurance company, with more than 300 years of experience in the global insurance industry, Aviva is committed to the safety and satisfaction of its customers. They sell a broad range of insurance products including motor and property insurance, protection and health insurance, business insurance, life insurance and pensions.
Bupa
Bupa was established more than 60 years ago in the UK and is now has ten million customers in over 190 countries, and over 52,000 employees around the world. Bupa is a leading international healthcare provider, offering personal and corporate health insurance, workplace health services and health assessments. 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. Bupa has operations around the world, principally in the UK, Australia, Spain, New Zealand and the US, as well as Hong Kong, Thailand, Saudi Arabia, India, China and across Latin America.
Prudential Financial Inc
Prudential Financial Inc. is a financial services leader, with approximately US$750 billion of assets under management as at September 2010. Prudential Financial operates in the United States, Europe, Latin American and Asia, with approximately 42,000 employees worldwide
AIG
The American International Group is a leading international insurance organization with operations in more than 130 countries and jurisdictions globally.
Zurich
Headquartered in Zurich, Switzerland, Zurich Financial Services Group is an insurance-based financial services provider with a network of subsidiaries andoffices in North America and Europe and also in Asia-Pacific, Latin America and other markets. Zurich is one of the world’s largest insurance groups, and one of the few to operate on a truly global basis. With 60,000 employees serving customers in more than 170 countries, our business is concentrated in three business segments: General Insurance, Global Life, and Farmers.
ICBC
By the end of 2008, ICBC had altogether 385,609 employees and 16,386 domestic and overseas branches, providing extensive and high-quality financial products and services to 190 million personal clients and 3.1 million corporate clients.
Ageas
Ageas is an international insurance company with a heritage spanning more than 180 years. Ranked among the top 20 insurance companies in Europe, Ageas has chosen to concentrate its business activities in Europe and Asia, which together make up the largest share of the global insurance market. They are grouped around four segments: Belgium, United Kingdom, Continental Europe and Asia. It is an undisputed leader in the Belgian market for individual life and employee benefits, as well as a leading non-life player, through AG Insurance. Internationally Ageas has a strong presence in the UK, where it is the third largest player in private car insurance. The company also has subsidiaries in France, Germany, Turkey, Ukraine and Hong Kong. Ageas has a track record in developing partnerships with strong financial institutions and key distributors in different markets around the world and successfully operates partnerships in Luxembourg, Italy, Portugal, China, Malaysia, India and Thailand.
Swiss Re
Swiss Reinsurance Company Ltd was established in 1863 and is present in more than 20 countries. Swiss Re provides reinsurance products and financial service solutions. It offers various reinsurance products covering property, casualty, life, health and special lines – such as agricultural, aviation, space, engineering, HMO reinsurance, marine, nuclear energy, and special risks.
Dec
22
Private Medical Insurance Set for Review in the UK
Filed Under Aviva, BUPA, Health Insurance, Healthcare, Medical Insurance, United Kingdom | 8 Comments
Following the British’s government’s announcement that it will be embarking on major reforms and an overhaul of its long established National Health Services (NHS), the country’s independent body responsible for ensuring fair competition is maintained – the Office of Fair Trading (OFT) – has announced it will investigate the private healthcare sector in the country.
The formal investigation by the OFT will commence in Spring 2011 and will examine the nature of competition and barriers to entry affecting the private healthcare market in the UK; a market which is worth some £5.5 billion (US$8.5 billion) a year. The private healthcare market in the UK is set to grow in importance, with the impact of changes to the NHS emerging in the period between 2011 and 2015. The healthcare industry in the UK is also being stretched due to the needs of an ageing population and higher life expectancy levels.
The UK is a country where the majority of the population are only used to paying a basic contribution from earned income for medical treatment, which entitles a patient to treatment through the NHS for any ailment or procedure required. The purchase of private healthcare is a discretionary option primarily available to the more affluent element of the population or for employees of companies through corporate schemes; the NHS is itself a significant user of private healthcare facilities. However, following the government’s decision to overhaul the public healthcare system, the private medical market has come under the spotlight with the expectation that it will play an increasingly important role in the provision of healthcare services in the UK.
The OFT investigation will focus of the level of competition in the private healthcare market in the UK at national, regional and local levels and the possible restrictions on companies seeking to enter the market or expand within the market thus preventing the market from developing.
A fundamental issue to be investigated by the OFT concerns the application of network agreements between private medical insurers and private healthcare providers in the UK. This has lead to patient referrals being limited to a selected number of independent hospitals in the UK, although, the argument in favor of this approach, is that it minimizes costs by higher utilization of selected facilities. The other concern is that some smaller healthcare providers not in network agreements are being disadvantaged.
A contention is that if the UK healthcare sector opens up with more players entering the market, Private Medical Insurance (PMI) coverage will expand and be able to offer the British public lower costs for private healthcare.
The benefits of PMI compared with treatment under the NHS are that policyholders are able to get treatment more quickly with a choice of private high quality medical facilities.
A separate issue concerns the general purchase of private medical insurance. In the USA healthcare is exceptionally expensive with a local PMI policy being critical for patients to meet medical costs. The NHS reforms in the UK are not expected to result in a USA style healthcare system, however, similarities could arise with PMI and private health coverage being adopted on a more individual basis.
When comparing local and international PMI the difference in the scope of medical coverage is considerable, with international policies being more flexible. Local policies will often have more restrictions attached to the policy such as age limits set at 65, annual limitations on claims, higher medical exclusions, more pre-existing medical condition exclusions, geographical limitations and limited healthcare provider availability. Also, current policyholders of a local PMI policy may be barred from renewing cover if an insurer feels the client has become high risk.
The alternative to a local PMI policy is an international policy which will have a more comprehensive range of cover provided for policyholders. Although the premiums are higher compared to local PMI policies, fewer exclusions will apply and pre-existing conditions can normally be included for an additional premium. There is also likely to be a larger network of hospitals and medical centres available to policyholders, along with a wider variety of treatment options and maximum policy limits. International medical policies are also transferable around the world, including the USA if necessary.
There will be a difference in the calculation of renewal premiums between local and international PMI, with local PMI policies’ renewal premium usually based on the previous year’s claims made by a client, while international policies are normally renewed on a community rated basis. The benefit of the renewal criteria on a community basis is that premiums will allow for worldwide cover rather than a specific country.
If there are changes within the UK healthcare market it could lead to PMI becoming more affordable at a local level in the UK. Currently PMI obtained in the UK is predominately to supplement healthcare services or medications which are not covered by the NHS. Currently PMI in the UK is dominated by Bupa, Aviva, PruHealth and AXA PPP.
The benefits of PMI is that it provides the policyholder the ability to avail themselves of treatment for acute medical conditions, private healthcare services, surgery and in / out-patient services, including dental and optical treatments if specified. A comprehensive PMI will offer the policyholder a wide variety of healthcare cover, although the insured does have options to tailor the policy to their specific needs, with optional levels of excess payments. The network of private healthcare facilities will speed up patients’ waiting times, particularly in circumstances such as surgical procedures, compared to the use of the NHS system.
A key factor in choosing a private medical insurer is that the cheapest rarely offers the best value for money.
Insurance Companies Mentioned:
Bupa
Bupa was established more than 60 years ago in the UK and is now has ten million customers in over 190 countries, and over 52,000 employees around the world. Bupa is a leading international healthcare provider, offering personal and corporate health insurance, workplace health services and health assessments. 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. Bupa has operations around the world, principally in the UK, Australia, Spain, New Zealand and the US, as well as Hong Kong, Thailand, Saudi Arabia, India, China and across Latin America.
AXA PPP
Originally known as PPP Insurance, the company 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.
Aviva
Europe’s fourth largest insurance company, with more than 300 years of experience in the global insurance industry, Aviva is committed to the safety and satisfaction of its customers. They sell a broad range of insurance products including motor and property insurance, protection and health insurance, business insurance, life insurance and pensions.
PruHealth
PruHealth is part of a joint venture named Prudential Health Holdings Limited, between Prudential Assurance Company of the UK and Discovery Holdings. The joint venture was started in 2004 and offers private medical insurance in the United Kingdom. Currently Discovery Holdings owns a 75 percent stake in the joint venture while Prudential Assurance holds the remaining 25 percent.
Dec
21
Critical Success Factors to Indian Health Insurance
Filed Under China insurance, Expat Insurance, Health Insurance, Healthcare, Medical Insurance | 9 Comments
In recent years India has become one of the fastest growing countries in the world. At present, there is a high demand for health insurance in India; this is driven primarily by the growing percentage of middle class citizens in the country, and the types of illnesses or diseases associated with their lifestyle. As India sees the wide scale emergence of illnesses predominantly associated with developed nations, the costs associated with healthcare in the country have started to increase. The disparity in Indian healthcare provision has also been highlighted by the development of privately funded Start-up hospital chains catering specifically to upper-middle class residents of the country. As India further develops over the next 5 years the growth of the country’s medical industry, in addition to the increased levels of lifestyle related illnesses will further increase demand for quality healthcare services, and consequently health insurance, in the urban areas of India.
The growth of the Indian economy, together with the increase of lifestyle associated illnesses has seen the cost associated with healthcare increase dramatically in the last decade. As a consequence of this Indian health insurance premiums have grown by an estimated 40% in the last 10 years as insurance providers seek to cover their risk. The Indian Government, together with non-governmental organisations and insurers, have recognised the need for quality low-cost healthcare and are jointly launching several different schemes to offer lower cost health insurance to all residents in India. Some of the insurers include General Insurance Corporation of India (GIC), National Insurance Company, Oriental Insurance Company, New India Assurance Company and United India Insurance Company.
Although the health sector in India continues to grow at a fast pace, it has not yet achieved its highest potential, as there are a few internal factors limiting widespread implementation of quality medical services throughout the country as a whole. First, the general public is unaware of the insurance products available to them and which products are best suited to address their needs. Moreover, they have the general perception that the claim and settlement procedures are so complicated that this has frightened the potential consumers from purchasing health insurance. The health insurance providers are also facing challenges due to high claims ratios. The deficiency in the availability of accurate consumer profile data and illness patterns have limited the insurance providers in coming up with optimal product pricing, as well as stunting the development of any new desirable products for the intended target group.
The tax-free policy in general insurance currently in place has failed to attract the interest of the majority population in purchasing health insurance. The core problem to the situation lies in the lack of new product ideas and designs. In the current marketplace Indian health insurance providers mainly offer customers traditional protection type insurance policies; in some cases there is the possibility of obtaining minimal extended coverage options, which are largely considered to be innovative when looking at the industry within India. When one talks about innovation on insurance products in India, it normally only refers to slight adjustments on the product features and charges, such as options to include dental coverage or to include daily cash benefits for hospitalisation to name a few.
In order to expand the health insurance market in India, the Insurance Regulatory and Development Authority (IRDA) can carry out a few radical changes; one option is to consider subsidising universal healthcare in order to help reducing individual’s spending on emergency, as well as day-to-day, medical treatments.
In mature markets around the globe, such as Europe and North America, it has been proven that product innovation within the health insurance industry is a key success factor. Gartner (an analyst firm) has noticed that insurers have placed a large portion of their investment towards improving their product development abilities and coming up with new innovative products. Recent international innovations include taking into consideration the product requirements of different potential customers, as well as reviewing and establishing the product life cycle strategies accordingly. Other alternative strategies such as managed care organisations (MCOs) and health savings accounts (HSA) have also proven to be successful in managing medical costs, as well as improving healthcare standards and quality.
Comparatively, China also faces similar challenges as India. There seems to be a shift in the China operation model. The “old” operation model focused more on protection and customer service, whereas the “new” operation model is more client oriented as it offers additional value-added services to its customers. In terms of products, China health insurance is now moving towards placing more weight on offering health protection plans to clients rather than just merely offering basic medical care plans.
The insurers in China have only recently included managed-care type of products in their portfolio. With their limited experience with these types of products, they are still trying to sort out the issues in terms of product design, claims handling and operations. To differentiate themselves from other competitors in the market and create a competitive advantage, the insurers in China have identified that offering managed care products is the approach they need to follow in the years to come.
In 1986, India introduced Mediclaim, a list of multi-tiered long term insurance products, designed to close the gap in their product portfolio. This product is required to develop further in order to differentiate from the long term insurance products offered by other health insurers. Other products available in the market are health savings account type products offered by non-life and life insurance companies in the public sector. Unfortunately, due to limited coverage of these insurance products, they are not very popular in the market.
The Indian health insurance market is unique; it has a number of specific requirements and challenges of its own. It is the hope that insurers, by learning lessons from the more experienced counterparts in the market, will eventually develop their own new set of competencies and abilities such as insight on buyer behaviour, rationalising product development and taking advantage of technology to differentiate themselves from competitors by offering tailor-made services. In order to be successful in the Indian insurance market, it is one of the top priorities that insurers develop innovative products for their potential customers and have an execution plan and strategy to serve the market efficiently and effectively.
Dec
20
EU Extends Support for Philippine Healthcare Program
Filed Under Healthcare, Philippines | 1 Comment
The Philippines Department of Health (DoH) and the EU have reached an agreement over the Philippine Health Sector Policy Support Program (HSPSP), with the EU having contributed a further € 36 million (US$ 47.8 million:PhP 2.12 billion) towards the second phase of the program on 17th December 2010. The focus of the second phase of the Health Sector Policy Support Program (HSPSP) is to try and ensure universal access to healthcare for all members of the population, especially disadvantaged members of society.
The second phase of the HSPSP will be overseen by the DoH working closely with other entities such as the provincial and municipal governments in the Philippines, which have the responsibility for delivering primary healthcare services in the country. The funding will enable further work to be undertaken and extend the benefits achieved under phase one of the scheme, while recognizing that considerable improvements to the access for fundamental healthcare is still required for the poorer members of society in this highly populated country.
The HSPSP is coupled with the Aquino Administration’s Health Sector Reform Agenda, with a combined focus on developing local healthcare systems and the reform of the hospital and health regulatory systems in the country. The strategy includes meeting Millennium Development Goals in respect to maternal and child health. Implementation of phase one of the HSPSP will be completed by the Philippine DoH by December 2010.
The second phase of EU funding will be used over two years to implement operational measures included in the Philippine healthcare reform proposals aimed at improving delivery of the Philippine state-run health services. The €36 million (US$47.8 million:PhP 2.12 billion) grant from EU funds follows their previous grant of €36 million (US$47.8 million:PhP2.12 billion) in 2006 and is part of the EU’s continuous support for the HSPSP in a bid to improve access to healthcare for the poor and disadvantaged population of the country.
A fundamental purpose of the HSPSP is to address the inequalities which exist in the Philippine public healthcare system, with phase two building on the lessons learned in phase one.
The Philippine DoH initially adopted the Health Sector Reform Agenda (HSRA) in 1999 as part of a major government policy action to address inequalities in the country’s healthcare system. In 2005, the HSRA adopted a program called FOURmula One for Health (F1) 2005-2010, which formed part of the HSRA’s framework to speed-up progress with the public healthcare reforms in order to eradicate the large scale divides between income levels and the urban and rural populations of the country. Since 2005, the approach to healthcare reform in the Philippines has gained momentum, with international bodies such as the World Health Organization (WHO) and UN backing the Philippines health project.
Although the Philippine healthcare sector has improved over the last decade, it still lags behind many of its Asian peers, especially in maternal mortality rates, which remain a health issue in the country.
Part of HSPSP reform agenda will be to address the challenges the Philippine healthcare sector has experienced in respect of financing and delivery of health services in the country. The proposals now allow for the devolution of responsibilities to local levels of government in an effort to achieve the prime objective of the program which is to improve inequalities and cut out inefficiencies which have existed in the Philippines healthcare system. These actions will strive to ensure all Filipino’s have fair and adequate healthcare coverage for curative and preventive services and achieve the overall goal of the Health Sector Development Project (HSDP) which is to improve the health status of the population.
The Philippines are taking a progressive approach to the healthcare reform process in the country by adopting a pro-active policy, with clear targets to eliminate shortcomings in the healthcare sector with valuable help from EU funding.
Dec
17
Potential in the Microinsurance Market
Filed Under Africa, China, Income Protection, Life Insurance | 5 Comments
The global microinsurance market is estimated to be worth US$40 billion to the insurance industry according to a report by Zurich based Swiss Reinsurance.
Swiss Re has highlighted the huge potential in supplying the massive populations in countries in the emerging markets of Asia, Latin America and Africa, with low cost insurance products. The report identifies the scope to expand the range of products, which could be made available to low-income groups in these continents.
The historic reason for the under-development of insurance products to low income segments in emerging market economies has been the inability to find commercial solutions to the supply of products for this market. However, the Swiss Re report estimates that there are approximately 2.6 billion people worldwide – living on US$1.25 to US$4 a day – requiring low cost insurance protection, which could be made available on a commercial basis; the potential earnings from this market is estimated to be US$33 billion.
Additionally, it is estimated that a market – totalling 1.4 billion people and US$7 billion in premium value – exists to supply insurance to individuals living on less than US$1.25 per day, with help from government support / international aid.
The author of the new sigma study, Amit Kalra, said: “For insurers, microinsurance creates an opportunity to tap into new markets and build a strong brand value that can be used for selling conventional insurance products in the future.”
The largely untapped microinsuance market provides global insurers with new opportunities to grow, and create a new source of premium income driven by the volume of sales involved. With the global economic conditions remaining challenging for multinational insurers – partly stemming from the demands in the mature insurance markets in Europe and Northern America being static – insurers recognize the opportunities presented with access to under-developed insurance markets.
The economies in Asian countries such as China, India and Indonesia have been able to buck the global trend of low growth by strengthening economic activity, and represent the optimum potential for microinsurance; the populations in China and India top 2.6 billion people.
In addition to the immediate commercial benefits mircoinsurance provides for insurers, there would potentially be longer term scope for business growth as new customers become accustomed to the benefits of insurance protection and saving schemes and expand the purchase of new products.
Amit Kalra said: ”The Asia-Pacific region is the fastest growing and the largest microinsurance market. Microinsurance has also grown considerably in African and Latin American countries despite these being relatively smaller microinsurance markets at present.”
The largest selling segment in the micronisurance market currently is credit life – a mortality cover coupled with a mircrocredit element. However, the need for better quality and a broader choice of insurance protection – to meet demand in the agricultural, saving, life and health microinsurance market – is recognized.
There are challenges in the microinsurance market needing to be overcome before the sector can fully develop, with clearer regulatory standards and improved infrastructure to be installed. There is also inadequate historical information surrounding risks and claims insurers may face in these new markets.
Multinational insurers embarking on the provision of microinsurance are faced with the challenge of establishing strong local partnership to distribute micro products and suitable channels for policyholders to make claims. Insurers also need to take into account the cultural element of local communities to ensure services and products meet the specific requirements of potential policyholders.
In July this year, the China Insurance Regulatory Commission (CIRC) reported that the world’s largest insurer by market value – China Life Insurance – had written nearly 4 million microinsurance policies, generating US$20.2 billion. China Life recently received regulatory approval by the CIRC to expand its microinsurance business in rural regions of China, which include Jiangsu, Hunan, Tibet, Zhejiang and Xinjiang – helping the insurer towards its goal of generating US$38 million in microinsurance premium income in 2010.
Allianz, one the world’s largest insurers, has been active in the microinsurance market for years and operates in countries such as India, Indonesia, Colombia, Egypt, Senegal and Cameroon. Allianz Indonesia has set a target this year to achieve 1 million policyholders by 2012. In India – Allianz’s largest microinsurance market – the insurer offers savings, property, life and health micro products and expects the market to continue to grow.
Non Government Organizations (NGOs), governments and local communities have been working on programmes across regions of the world where vulnerable communities and individuals require protection for their livelihood and well-being. Organizations such as the International Finance Corporation (IFC) recently committed US$4.1 million in grants for mircoinsurance in Eastern Africa. With the Swiss Re report highlighting the potential benefits of mircoinsurance on a commercial basis, insurers have the opportunity to develop policies to meet the protection needs of the more venerable element of the world’s population.
The fundamental basis for microinsurance to work for the insurer is a high volume of policyholders, coupled with low cost margins. Also, insurers will benefit from working with local partners with close ties to local institutions and communities to help mircoinsurance providers to establish a market presence.
Insurance Companies Mentioned:
Swiss Re
Swiss Reinsurance Company Ltd was established in 1863 and is present in more than 20 countries. Swiss Re provides reinsurance products and financial service solutions. It offers various reinsurance products covering property, casualty, life, health and special lines – such as agricultural, aviation, space, engineering, HMO reinsurance, marine, nuclear energy, and special risks.
Allianz
Allianz 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.
China Life Insurance
China Life Insurance Company Limited (China Life) is a People’s Republic of China-based life insurance company. The products and services include individual life insurance, group life insurance, accident and health insurance. The Company operates in four business segments: individual life insurance business, group life insurance business, short-term insurance business, and corporate and other business.
Dec
16
Merger Increases Bangkok Dusit Medical Services (BGH) Hospital Network in Thailand
Filed Under Health Insurance, Healthcare, International Healthcare | 11 Comments
Thailand’s hospital operator Bangkok Dusit Medical Services (BGH) has announced that it is to merge with the Health Network Group, which operates the Phyathai Hospital group and the Paolo Memorial Hospital group. The move is part of Bangkok Dusit’s move to expand its healthcare coverage in Thailand and Asia.
The proposed merger provides Bangkok Dusit with an additional 8 hospitals from the Health Network Group. This will consist of 4 hospitals currently operated by Phyathai Hospitals and 4 hospitals from the Paolo Memorial Hospital group – for approximately US$315 million. The deal will be comprised of cash payments and the issuing of new shares.
The acquisition is expected to be completed by the second quarter of 2011 and will add the 8 healthcare facilities to Bangkok Dusit’s existing network of 19 hospitals, bringing the Thai hospital operators network to 27 with a 20,000 a-day outpatient capacity when the merger is completed.
“The merger will reemphasize BGH’s leadership as the leading private hospital operator and will enable us to expand our patient portfolio to cover a wider demographic of Thai patients, foreign patients, and social security patients… We expect that our leading position in Thailand will enhance our capabilities to become a leading regional player as part of our plan to prepare ourselves for the competition as a result of the ASEAN Economic Community (AEC) agreements that includes liberalization of many sectors including the private healthcare sector,” said Dr. Prasert Prasarttong-Osoth, Group CEO & President of Bangkok Dusit Medical Services.
Earlier this year, Bangkok Dusit acquired ANB Laboratories (ANB) for US$27 million to expand into the pharmacy and medical laboratory business. This move by Bangkok Dusit was its first step into its non-core front-line medical business activities, with the takeover of ANB providing access to the Thai medicine and pharmaceutical manufacturing and distribution market.
BGH’s current client base is predominately foreign patients seeking treatment as part of the medical tourism industry and the more affluent local population seeking high quality private healthcare services through the Thai or Cambodian network chain. The acquisition of the 8 hospitals from the Phyathai Hospital and Paolo Memorial Hospital groups will enable BGH to capture a proportion of the Thai middle and lower income healthcare market, broadening their range of clients.
In addition to the high-income earners and foreign nationals seeking medical treatment within Thailand’s established private healthcare system, there is a growing middle income class in the country, creating a new client target for Thai healthcare providers. The expanding middle-class population across Asia is becoming more influential as the private healthcare industry aims to capitalize on the growing demand for a higher standard of medical treatment.
BGH has established a reputation as a key player in the medical tourism industry catering for foreign patients seeking private healthcare treatment – and is one of the original private healthcare providers in Thailand and the Asian region involved in competing in the lucrative private healthcare market.
Thailand was one the first countries to realize the potential in the medical tourism market and, after Singapore, lead the creation of a niche market for this medical sector. Asian countries have now established a strong reputation as a prime destination for relatively low cost medical treatment, with prominent private healthcare providers – including Bangkok Dusit hospitals Samitivej and BNH in the capital Bangkok – competing with market leaders Bumrumgrad in the Thai and Asian medical tourism industry.
The private medical market in Asia has become increasingly competitive, with India, Singapore and Malaysia, in addition to Thailand, being key destinations for medical tourism. Other Asian countries such as the Philippines and Taiwan have also emerged more recently as providers for medical tourism, which is predicted to be worth approximately US$100 billion in the short to medium-term; the regional leaders – India – reported that the healthcare market was worth US$38 billion in 2009.
Earlier in 2010, there was a fierce bidding war between Malaysia’s Khazanah and India’s Fortis Healthcare for Asia’s largest hospital group Parkway; Khazanah emerged the winner with a US$3.3 billion offer.
The medical tourism industry has developed in Asia, with Hong Kong and Singapore being the original providers. India has now become the market leader in Asia as it can offer a broader range of products for a fraction of the price of homeland treatment in European, USA, Middle Eastern and Japanese healthcare facilities. The attraction of Asia for medical treatment reflects the provision of quality facilities in exotic locations, with minimal waiting times for procedures at affordable prices.
As an example of cost comparisons, a heart by-pass operation in the USA is likely to cost a patient US$130,000 whereas the same procedure in Thailand would be approximately US$11,000, while in India it could be as little as US$10,000.
Other cost comparisons (shown in US$) – bottom end figures for treatment in Asia versus higher figures for USA for typical medical procedures – are:
| Medical Procedure | Thailand | USA | India | Singapore |
| Heart Bypass | 11000 | 130000 | 10000 | 18500 |
| Heart Valve Replacement | 10000 | 160000 | 9000 | 12500 |
| Angioplasty | 13000 | 57000 | 11000 | 13000 |
| Hip Replacement | 12000 | 43000 | 9000 | 12000 |
| Hysterectomy | 4500 | 20000 | 3000 | 6000 |
| Knee Replacement | 10000 | 40000 | 8500 | 13000 |
| Spinal Fusion | 7000 | 62000 | 5500 | 9000 |
As western hemisphere countries are faced with austerity measures, healthcare reforms, increasing medical costs and longer waiting periods for treatments, the alternative Asian equivalent offers Americans, Europeans, the Japanese and patients from wealthy Middle Eastern countries a desirable option for obtaining medical treatment – where capable, affordable and efficient healthcare facilities have been established.
Although the medical tourism industry in Asia has developed and evolved, some barriers still remain in terms of language particularly when complicated procedures are involved, but this issue is being addressed.
As BGH expands its customer base following the new merger to cater for market opportunities in Thailand, the optimism in the Asian medical tourism industry is for USA insurers to offer patients the opportunity to receive treatment from Asian private healthcare rather than US counterparts as a cost saving measure.
Asia is expecting the expansion of the private medical market to continue with healthcare providers enhancing positions across the region.
According to KGI Securities, there were 1.5 million medical tourists visiting Thailand in 2007, with forecasters estimating that by the end of 2010 the figure will be in the region 2 million medical visitors. Overall the medical tourism industry is set to boom in the coming years, with Asian nations leading the provision of services and, in this respect, BGH will be well placed to maximize opportunities.
Companies mentioned:
Bangkok Dusit Medical Services
Bangkok Dusit Medical Services was founded in 1969 and the Bangkok hospital started its operation in 1972. Bangkok Dusit Medical Services operates a private hospital network in Bangkok, other Thai provinces and in Cambodia. The Group’s private healthcare facilities include Samitivej hospital and BNH hospital.
Bumrungrad International
The Group’s principal activities are owning and operating hospitals. Its flagship hospital, Bumrungrad International, is a renowned medical centre attracting over 1 million patients annually and named one of the world’s top ten international hospitals by Newsweek International. The Company also owns a businesses in real estate and anti-aging and functional medicine.
Parkway Holdings Limited
Parkway Holdings Limited, is one of the region’s leading providers of healthcare services, with a network of 16 hospitals with more than 3,400 beds throughout Asia, including Singapore, Malaysia, Brunei, India and China.
Fortis Healthcare Limited
Fortis Healthcare Limited is a healthcare provider having a network of 28 hospitals, satellite centers and heart command centers with nearly 3,300 beds capacity.
Khazanah Nasional
Khazanah Nasional is the investment holding arm of the Government of Malaysia and is empowered as the Government’s strategic investor in new industries and markets.
Dec
15
UK’s National Health Service Required to Save Billions
Filed Under Healthcare, United Kingdom | 7 Comments
The British Government is asking for massive budget cuts in the wake of recently enacted austerity measures; as part of these measures the government, led by Prime Minister David Cameron, has called on the National Health Service (NHS) to become more efficient, in addition to providing more value-for-money. As a consequence the NHS is set to be tested to the limit, as the Government demands that the British Public Healthcare sector slash £20 billion (US$32 billion) in costs by 2015; an amount which equates to cost reductions of 4 percent per year.
The austerity measures, and drive for efficiency savings, are the largest ever seen in the United Kingdom. This has left the NHS in the challenging position of making drastic spending cuts while retaining current levels of services. Local Authority provided Social Services are also being affected along with public healthcare services, and both entities have been charged with delivering noticeable improvements in the quality of their services in certain problem areas.
The nation’s Health Select Committee – appointed by the House of Commons – is entrusted with the examination of health policies, administration, and expenditure by the Department of Health, and the Committee’s associated bodies have been in charge of the spending review covering the NHS and social service departments. The Select Committee recognized that the UK public healthcare sector is being set a significant challenge. The level of savings required is estimated at 4 percent per year – a level which has never been achieved by the NHS since its inception in 1948.
There has been no attempt to achieve efficiency gains of this magnitude within a national healthcare system anywhere in the world previously. The unprecedented measures being adopted by the UK’s Government have been criticized for being unclear and lacking significant information on how the quality of healthcare services will maintained, while achieving the financial cuts sought – although the need to maintain or improve standards of care is still necessary. It is seen as vital for the NHS to maintain the established standard of care provided to British nationals, but the government demand for improved financial management of the system is seen to be of paramount importance to the overall expenditure cuts being implemented in the country.
The NHS has already put in place measures to become more cost effective, with savings being found by reducing the length of patients stays in NHS hospitals, reducing hospital infection rates, and by cutting the number of unscheduled attendances at Accident & Emergency (A&E) departments. As government ministers and local authorities set out budgets in order to achieve the savings sought for the NHS and social services, there is recognition that the UK private healthcare sector may be able to benefit from the government’s plans for cost reductions in state funded healthcare.
According to research carried out by Laing and Buisson – an analyst and research company specializing in the independent healthcare sector in the UK – private hospitals increased the amount of medical procedures carried out for the NHS in 2008/9 despite the impact of the recession in the UK. Revenue from private hospitals within the country increased by 3.5 percent, to £421 million (US$673 million) for the year. The Laing and Buisson report highlighted that patients using private healthcare facilities funded by the NHS, under the waiting-list criteria, dramatically increased between 2008-2009 when 212,000 NHS patients were dealt with in this way; this accounted for 22 percent of private hospital treatments compared to 6.3 percent in 2007.
The recession in the UK dented the demand for private medical cover in 2009, with Laing and Buisson reporting that as the UK economy struggled there was a decline of 4.8 percent in private medical insurance and medical schemes funded by employers. At the start of 2010, there were 7,238,000 people holding British private medical insurance and self-insured medical expense schemes, representing 11.7 percent of the UK population.
Although the UK private healthcare sector has been vulnerable to the financial cutbacks by companies, and lower levels of personal disposable income, the reform of the NHS is likely to present increased opportunities for the private healthcare sector.
However, the private healthcare market in the UK – which is estimated to be worth £5.5 billion per year – is set for a review by the Office of Fair Trading (OFT). The OFT said that it will examine the nature of the market, in addition to the competition and the effectiveness of healthcare provision for private patients. The OFT highlighted that the private healthcare sector in the country is growing in importance as proposed NHS reforms are implemented, the demands from an ageing population increase and the overall need for better medical outcomes.
Sonya Branch, OFT Senior Director of Services and Public Markets said: ”We are keen to establish whether patients and buyers of private healthcare services, including the NHS, are getting the full benefit of choice and competition.”
The private medical insurance sector in the UK is dominated by Bupa, AXA PPP, PruHealth and Aviva.
The leading providers of hospital care in the independent UK healthcare sector include Netcare’s General Healthcare Group, Spire Healthcare, Hospital Corporation of America (HCA), Ramsay Health Care and Nuffield Health. There is the possibility that new independent hospital providers make seek to enter the market and meet demand from NHS patients.
UK independent hospitals could face a potential dilemma resulting from being called upon to provide more services under NHS conditions in the future. While the benefits from generating more business would be self evident, the attractiveness to privately funded patients may lose its appeal if it is seen that equivalent treatment can be obtained under state funding.
While the private medical insurance sector in the UK has declined with the impact of austerity measures following the global financial crisis in 2007-08, the measures being adopted to reform the public health system could result in an increase in demand for private medical insurance.
Companies Mentioned:
General Healthcare Group
General Healthcare Group (GHG) is leading health care services provider in the UK. GHG primary focus is treating private patients, while maintaining our position as a dynamic partner of the NHS. GHG has a network of 67 hospitals and treatment centres across the UK
Ramsay Health Care
Ramsay Health Care was established in 1964 and has grown to become a global hospital group operating over 100 hospitals and day surgery facilities across Australia, the United Kingdom, Indonesia and France.
Spire Healthcare
Spire Healthcare’s mission is to be the best private provider of quality healthcare. Spire Healthcare has 26 year heritage in the private healthcare sector.
The Hospital Corporation of America (HCA)
The Hospital Corporation of America (HCA) is the largest private operator of healthcare facilities in the world. HCA operates some 170 acute care, psychiatric, and rehabilitation hospitals in the worldwide.
Bupa
Bupa was established more than 60 years ago in the UK and is now has ten million customers in over 190 countries, and over 52,000 employees around the world. Bupa is a leading international healthcare provider, offering personal and corporate health insurance, workplace health services and health assessments. 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. Bupa has operations around the world, principally in the UK, Australia, Spain, New Zealand and the US, as well as Hong Kong, Thailand, Saudi Arabia, India, China and across Latin America.
AXA PPP
Originally known as PPP Insurance, the company 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.
Aviva
Europe’s fourth largest insurance company, with more than 300 years of experience in the global insurance industry, Aviva is committed to the safety and satisfaction of its customers. They sell a broad range of insurance products including motor and property insurance, protection and health insurance, business insurance, life insurance and pensions.
PruHealth
PruHealth is part of a joint venture named Prudential Health Holdings Limited, between Prudential Assurance Company of the UK and Discovery Holdings. The joint venture was started in 2004 and offers private medical insurance in the United Kingdom. Currently Discovery Holdings owns a 75 percent stake in the joint venture while Prudential Assurance holds the remaining 25 percent.
Dec
14
Allianz Asia Pacific Confirm Appointment of New CEO
Filed Under Allianz, Insurance Company | 2 Comments
Allianz Asia Pacific has announced the appointment of Kamesh Goyal as Chief Executive Officer of the Asian region; he will be based in Singapore. Kamesh Goyal will move from his current post as the Allianz Country Manager for India and MD & CEO Bajaj Allianz Life Insurance; in addition to his new role he will continue as Allianz Country Manager for India.
Kamesh Goyal became Chief Operating Officer (COO) of Bajaj Allianz General Insurance in 2001 changing rolls in 2004 to CEO, and was later appointed as Country Manager, MD and CEO of Bajaj Allianz Life Insurance in 2007; he originally joined Allianz in 1999.
The insurer has also confirmed that the current COO of Bajaj Allianz Life Insurance – Mr Varghese Philip – will take up the role of CEO in February 2011. This appointment is subject to final approval from the Insurance Regulatory and Development Authority (IRDA) – India’s insurance regulator. Varghese Philip also joined Allianz in 1999 and took part in Allianz’s Indian joint venture with Bajaj when it was first established in 2001.
The current regional CEO for Allianz Asia Pacific – Bruce Bowers – will take up the role of CEO Central and Eastern Europe, Middle East and the North Africa Region (CEEMA) for Allianz; the change will take effect in February 2011. Bruce Bowers succeeds Manuel Bauer, who becomes a member of the Board of Management of Allianz – as announced earlier in the year. Bruce Bowers has more than 30 years experience in the life and general insurance industry, holding a variety of CEO positions within the Allianz Group in the last 10 years.
Allianz is one the world’s largest insurers, providing insurance products and services which include life, health, property and casualty cover for individual clients and corporate businesses. Allianz is a German based financial institution, with approximately 100 subsidiary and affiliated operations sustaining the insurer’s global reach.
Allianz recently released its global results for the third quarter 2010, with the German insurer generating a 2.3 percent increase in operating profit – uplifting profit for this period from €2 billion (US$ 2.6 billion) to € 2.1 billion (US$ 2.8 billion).
Indian based Bajaj Allianz is one the leading private life and general insurers in India. Bajaj Allianz is a joint venture between Allianz and local Indian insurer Bajaj Finserv Limited. Since Bajaj Allianz’s inception in 2001, the Indian based insurer has generated a presence in approximately 1100 locations throughout the country.
Bajaj Allianz is currently in a strong position within the Indian insurance market, which is forecast to grow significantly as the Indian economy continues to expand. The demand for life, saving and healthcare products is set to increase in-line with improving individual financial prosperity.
The Bajaj Allianz product range includes home, motor, travel, business, life and health insurance. The private healthcare sector in India in particular is set to grow substantially as insurers design products to meet emerging health demands for a country with a population in excess of 2 billion people. Other major players in the Indian health sector such as Star Heath & Allied Insurance, Appollo Munich Health and the newly formed MaxBupa will provide Bajaj Allianz with tough competition.
Over the last five years Allianz has performed robustly in growth markets, with Allianz’s Asian operations reporting sound results. Business in Central and Eastern Europe and the Middle East is also reported to have performed well. Allianz state that premiums from the life and health sectors have been the driving force for income generation during 2010 and there are approximately 30 million Allianz customers located in growth markets in Asia and the CEEMA region. Since the global financial crisis, which started in 2007-2008, Allianz’s Asian operations have emerged as the pivotal basis for business growth, with the German insurer recording an average growth in gross written premiums of 24.4 percent between 2005 and 2010 in the the region.
All management changes are subject to approval of the respective regulatory authorities.
Insurance Company Mentioned:
Allianz
Allianz 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.
Dec
14
US Study: Low Compliance of Mammogram Screening Among Insured Women
Filed Under Health Insurance, Healthcare, USA Health Insurance, Uncategorized | 7 Comments
Breast cancer is the most common form of cancer among women, accounting for around 16 percent of all female cancers. It kills around 519,000 women every year, worldwide.
A recent US study, conducted by the Medco Research Institute, reveals that only half of insured women aged over 40 are claiming annual mammogram screenings, despite recommendations endorsed across the US and the world.
The Medco Research Institute is an evidence based clinical research organization that branch from the US privately owned pharmacy manager, Medco Health Solutions.
Health organizations worldwide, such as the US National Cancer Institute, agree that women aged 40 years and older should have screening mammograms every 1 to 2 years. The US National Cancer Institute states that age is the most important risk factor for breast cancer among women. Women aged 50 years or older will typically have the highest rates of breast cancer within a population.
The Medco Research Institute aimed to identify the prevalence of annual mammograms among women aged 40 years and over. This was achieved by calculating the number of annual mammogram claims between 2006 to 2009 among insured women. Data was collected using administrative records retrieved from Medco’s integrated database.
More than 1.5 million women qualified for the study. The target population were of females, aged 40 years and over with continuous insurance coverage between 2006 and 2009. Women with a previous history of breast cancer were excluded from the study, including those who had either a mastectomy, chemotherapy or radiotherapy.
Results indicated a low compliance of mammogram screening across the study group. Only a small group of women in the study achieved the recommended annual mammogram screening at 16 percent among the 40 to 49 age group, and 23 percent among the 50 to 64 age group. It was shown that approximately 50 percent of women aged over 40 received annual mammograms over the four year study. However, only 40 percent of women aged over 50 years received the recommended minimum of 2 mammograms during the study period. 78 percent of the entire study group received at least one mammogram over the four years.
The term mammogram screening refers to the routine check up among women, who are symptom free, for early detection of breast cancer. A breast cancer tumor, in its early stages, is likely to be small and confined to the breast, and undetectable by self examination. A mammogram is an X-ray picture of the breast that is able to pick up abnormal breast tissue including tiny mineral deposits of calcification, or a mass, which may be a tumor or a cyst. Any abnormal findings are referred for further investigations to determine whether they are cancerous. The size of the breast cancer tumor and how far it has spread are among the important factors used to predict the patient’s prognosis. Mammogram screening has therefore been regarded as a highly important early detection tool so that treatment can be started early, possibly before it has progressed and spread to other areas.
The cost for a mammogram screening varies from facility to facility, however the cost is typically between US$80 and $150, but can also be priced over US$200 at certain medical institutions. Women in the US who are eligible for Medicare coverage are entitled to an annual mammogram screening when they reach 40 years of age. Both the UK and Australian Governments offer free mammogram screening programs through the NHS Breast Cancer Screening Plan and BreastScreen Australia. UK women aged 50 years and over are offered a scan every three years, whereas Australian women aged 40 years and over are offered a scan every two years. The cost of mammogram screening in the UK is around GBP$45 or US$71, lower in comparison to US costs.
As part of Obama’s Health Reform, disease prevention is promoted through the Affordable Care Act, by improving access to clinical preventive services including mammogram screening. From 2014, all US citizens will be required to have private health insurance or otherwise pay an annual fine. Under the Affordable Care Act, insurance plans beginning on or after 23rd September 2010, must cover a range of preventative services, with no cost sharing by the patient. Prior to this law, insurance companies were able to share the costs and some patients were paying a gap fee between US$10 and $35.
Given the implementation of the US Health Reform, a larger number of women will be taking out health insurance from 2014 and will therefore have access to free annual mammogram screening services. Whether there will be a low compliance of mammogram screening among newly-insured women is yet to be determined. However, it is probable that newly-insured individuals will be seeking primary care services more than ever before, given the cost of healthcare was a major barrier prior to the reform.
Mammogram screening programs are a topic of recent debate in the media. A recent study, published in the New England Journal of Medicine, compares the rate of death from breast cancer among two groups; one who had mammogram screening and one without. Women aged between 50 and 69, living in Norway, were analysed over a period of ten years from 1996 to 2005. Data gained from the 40,000 women who had developed breast cancer, concluded that routine mammograms cut the breast cancer death rate by only 10 percent. An interview with the Norwegian researchers revealed that they were expecting at least a 30 percent reduction.
The US National Cancer Institute also lists the possible harms of mammogram screening, found through a meta-analysis of individual data from seven randomized controlled trials. The US National Cancer Institute revealed mammogram screening may lead to treatment of insignificant cancers resulting in over diagnosis. Mammograms can also be misleading due to false-positive and false-negative testing. Furthermore, the risk of radiation-induced mutations resulting in breast cancer are increased, especially among the younger population. However, it is important to note that the US National Cancer Institute concluded that mammogram screening is beneficial to women, resulting in decreased morbidity relating to early detection of breast cancer.
Although the Medco Research Institute revealed some interesting figures in it’s study, many questions are left unanswered. The study was restrictive in its findings, using quantitative methods there is little we can conclude without investigating the participant’s reasoning and attitudes towards the compliance of mammogram screening. It is possible that the study will be used as a pilot in preparation for an in depth case study; however, at this stage there is no indication of a further investigation. Reasons why women decide against mammogram screening are suggested in various media sources and can vary from discomfort during the screening exam, controversial debate as to whether mammogram screening is valuable, access to facilities, or breast screening awareness.
Further research needs to be conducted in order to find out the specific reasons as to why there is a low compliance of mammogram screening among insured women in the US. It remains to be seen whether this number will increase given the addition of newly-insured women that we expect to see in 2014, following implementation of the US Reform that will make health insurance compulsory. With new insurance laws, health preventative measures are becoming more accessible to the public, whether or not the public complies is another issue.
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