There are signs that older high net worth individuals (HNWs) are increasingly choosing to leave the UK and relocate abroad.
When they do, these individuals need a robust international private medical insurance (IPMI) policy that effectively serves them should they fall ill in their new home.
But there are also indications that these policies are replacing the care public health systems provide across the globe.
However, with a higher number of claims as customers make greater use of insurance, cost concerns abound.
This all means offerings need to provide greater flexibility around more cost effective options as well as exploiting technological advances to meet continued demand from an ever growing number of digital nomads.
Exodus of HNWs
“We’re seeing a rise of older HNW clients leaving the UK and moving to countries where they are required to have health insurance,” Chantal Leprêtre, client advisor at SIP Medical Family Office, tells Health & Protection.
“So they’re looking for IPMI to ensure cover in both their new country of residence and keeping cover in the UK as well.
“They may have concerns over the local healthcare system, such as wait times and general lack of appointments,” Leprêtre continues.
“So they’re looking towards an IPMI as it allows them to completely avoid using the local system and move directly into the private sector as opposed to PMI which often works in conjunction with the local system.”
Superior offering
This desire to discard local health systems extends across the world, as David Capote, president of LATAM at Trawick International, points out.
“Economic conditions in various countries continue to drive demand for IPMI products,” Capote explains.
“Customers are seeking access to world-class medical treatment that is often unavailable in their country of residence or that carries long wait times or capacity issues within any local authority provided services.
“Trawick has a large individual book in LATAM, using this as a reference point, historically residents have preferred access to the US healthcare system.
“However, recent changes to visa processes have led to growing interest in accessing European healthcare, which is made possible through an IPMI product.”
Switch from local PMI
But customers are not just switching from domestic public healthcare systems.
Devash Shah, head of individual sales at Axa Global Healthcare, tells Health & Protection that the provider has witnessed a “marked” increase in demand for clients choosing to make the change to an international package from their current local private medical insurance cover.
“We’ve seen this happen much more post-Covid and this is down to increased strain many local networks find themselves under,” Shah says.
“This has encouraged individuals to seek wider access and the ability to bypass waiting lists, while staying based in their home market.”
Shah maintains this trend is causing a reshaping of the IPMI audience, expanding it from a traditional expat base to include local market consumers.
“Not only that, but we’re finding that our entry-level international plans are popular, as they provide that wider access but remain relatively affordable,” Shah adds.
Preference for Individual IPMI
Advisers have also noted the switch to individual PMI offerings.
Adam Harding, divisional director for international at Howden Employee Benefits, says: “We’re seeing a growing number of individuals – both expats and local nationals – turn to international private medical insurance as public systems struggle under increased strain.
“For many, it’s about gaining faster access to care and navigating healthcare systems with greater ease, particularly for services like physio or private GPs.
“The shift is especially visible in Europe, where post-Brexit requirements and tightening visa processes are accelerating this demand.”
Rising number of claims
However, with accelerating demand, comes an increase in claims.
For Bupa, this has resulted in a 67% rise in total claims, while claims per customer are up 39% since 2021.
“This isn’t a short-term spike – it’s a sign of changing behaviour,” Anthony Cabrelli, managing director of Bupa Global, maintains.
“People are more proactive and health aware than ever and they’re looking for support that goes beyond emergencies.
“Our customers want cover that helps with prevention, mental health and managing long-term conditions.”
According to Harding, rising costs remain a growing challenge, pushing insurers to introduce smarter cost-containment strategies such as network restrictions.
“AI is likely to play a role – particularly in fraud detection and operational efficiencies that help keep premiums manageable,” he adds.
“Longer-term, there’s a clear opportunity for true ‘top-up’ products that complement public healthcare and offer global flexibility at a sustainable price point.”
And Joe Thomas, managing director of April International UK, expects the sector will need to adopt more flexible underwriting approaches and maintain sustainable premium levels amid rising medical inflation.
“Cost containment will remain a critical focus,” he continues.
“This will require smarter use of data, enhanced digital services, and greater localisation to deliver personalised, affordable, and accessible IPMI solutions.”
Shorter term cover
Cost containment strategies can also extend to providing more flexible cover insuring customers for shorter durations.
Kevin Melton, global head of IPMI at IMG, tells Health & Protection: “We recognise people may no longer require an annual policy and often travel for shorter periods of time but still need cover that provides more robust benefits than travel insurance.”
This trend has led the insurer to develop a range of short-term plans which are sold online and designed to be flexible, Melton explains, and customers can even incept a policy after their journey has started.
“The increased focus on mental wellness, overall wellbeing, and telehealth benefits that can be seen across the IPMI market right now is a reflection of how providers are adapting to the expectations and requirements of brokers and customers,” Melton adds.
Meeting individual needs
But Chloe Pullan, broker manager at Gibralta-based Sovereign Insurance Services, maintains that flexibility needs to extend to meeting individual needs.
“These needs can change from year to year, whether that be changing location so needing to meet different visa or residency requirements or changing personal medical needs and priorities,” Pullan says.
“Brokers need to stay engaged with their clients to ascertain these needs; the ‘point of sale’ isn’t just when the client signs their application for the first time, it’s at every renewal too.”
Pullan adds she loves the fact that some insurers such as April International and Axa Global have moratorium underwriting for individual clients.
“It can make the onboarding process so much easier for the client and has helped me find a solution for clients with complex medical history who would otherwise be declined,” Pullan continues.
“However it is essential to ensure the client understands how this can affect their ability to claim.”
Responding to rise of digital nomads
As customers become more mobile, Bupa Global’s Cabrelli reveals the insurer has invested £55m in its digital health capabilities.
“We’ve launched flexible plan designs across multiple regions and are expanding our provider network to ensure customers have access to trusted care wherever they are,” Cabrelli continues.
“The way people live and work has changed dramatically and our industry needs to keep pace.”
Cabrelli maintains hybrid working, short-term international assignments and the rise of digital nomads have created a new type of customer.
“We’re also seeing more employers move away from traditional expat packages in favour of local contracts,” he adds.
“That shift means IPMI products need to be more modular, adaptable across geographies and easier to tailor to individual needs.”
Digital services now an expectation
Edd Stowe, senior international business development manager at William Russell points out that customers now expect a digital offering.
“Digital access is now an expectation not a luxury, which also applies to international PMI,” Stowe says.
“Quoting, customer applications, underwriting, treatment approvals, claims submissions are now all expected to be done online in just a few clicks.”
Megan Lewis, commercial lead at the insurer, agrees, adding: “As people become more mobile or remote, such as digital nomads or overseas staff, there’s definitely a move to digital services like telehealth and virtual GP. which are simply viewed as expected services now and not as anything extra.
“There also seems to be more push for simple claims such as pre-pay cards or direct settlements for all claims and for policies to be multilingual,” Lewis adds.
Advancements in telehealth ahead
And it looks as though this increased investment in technology is set to continue as Trawick’s Capote predicts continued advancements in telehealth, with a particular focus on mental health and overall wellness.
“IPMI providers will need to offer integrated solutions that empower customers to take a more proactive approach to their health and, when possible, reward them for doing so,” Capote continues.
“Encouraging clients to engage in maintaining and optimizing their personal health will be key.
“Of course, AI will also continue to evolve within the IPMI space and is expected to have a significant impact on all aspects of the business, including the overall customer experience,” he concludes.
