International private medical insurance (IPMI) is just as important, sometimes more so, for individuals as it is for people sent abroad by their employer.
This includes some workers who want tailored cover exceeding their employer’s offering.
Though the customer base for IPMI is also widening out to include cost-conscious digital nomads and retirees who are choosier about where they relocate to.
And despite continued challenges from ongoing tensions in the Middle-East, issues around service, and for some the Brexit vote, this is a market where demand remains strong as its customer base continues to broaden.
Nervousness among insurers
One particular challenge facing the sector relates to expats with pre-existing conditions, Amber Musson-Thorp, head of healthcare consulting at Louvre First Advisory in Qatar, tells Health & Protection.
“I don’t believe underwriting itself needs to change significantly, although I do see a nervousness from some of the big insurers about pre-existing conditions and how they manage the underwriting process,” Musson-Thorp says.
“The bigger challenge is geographical, compliant coverage and direct billing in locations my clients may be travelling to.”
Musson-Thorp says she is surprised at the lack of geographical coverage offered by the larger insurers for individuals.
“We’re seeing an increasing number of ‘closed’ or restricted markets where insurers are unwilling or unable to provide cover; recently these have included countries such as Thailand, Lebanon and Uzbekistan,” she continues.
“This creates challenges for internationally mobile clients whose work or lifestyle span multiple jurisdictions.
“Advisers and customers are looking for simplicity, flexibility and certainty. They want one insurer that can support them regardless of where they relocate, rather than having to change insurers every time they move to another country.”
Demand broadening beyond HNWs
Getting this right could help insurers further expand an ever growing market.
And Jodi Thomas, global head of retail, health and benefits at Allianz Partners, has certainly noted a broadening out of the market.
She points out that while high-net-worth individuals remain a core market, demand has widened to include retirees, digital nomads, freelancers and students who need flexible healthcare cover while living or working abroad.
And these expats are mindful of the cost of such cover.
“Medical inflation is bringing affordability into sharper focus, making it increasingly important for insurers to balance cost management with a strong customer experience,” Allianz’s Thomas says.
Though she also points to another growth area.
“One of the biggest growth areas is among retirees and early retirees, people aged 55 and over, relocating overseas, particularly to destinations such as Portugal, Spain and Italy, where the climate and cost of living are attractive,” she continues.
“Greece also continues to appeal to higher-net-worth individuals.
“We’re also seeing strong growth across Asia as rising wealth drives greater demand for private healthcare, while the Middle East remains a consistently important market due to mandatory health insurance requirements in many countries.”
Choosier about locations
For Joe Thomas, managing director at April International UK, he agrees established expat hubs such as Spain, Portugal and also Singapore are increasing in popularity.
“These markets combine attractive visa options, high-quality healthcare infrastructure and an excellent quality of life, making them particularly appealing to internationally mobile individuals,” he says.
But customers are also becoming much more selective about where they choose to relocate, Thomas says.
“Geopolitical instability, economic uncertainty, and changing visa or tax rules are making individuals think more carefully about committing to a long-term move,” he continues.
“Destinations affected by ongoing conflict, political uncertainty or sudden regulatory changes naturally create more hesitation, while some people are delaying relocation altogether until conditions become clearer.”
More diversity in people who want cover
Advisers have also picked up on this trend.
Matt Howells, founding partner at Vizion Group of Companies, tells Health & Protection.
“We’re seeing more diversity in the people interested in cover,” Howells says.
“High net worth is a growing market in the UK, where UK domestic coverage is simply too restrictive for some clients, and does not provide them with the flexibility they desire.”
Strong demand
Amanda Olore, head of strategic relationships at IMG, notes strong demand for ‘core’ plans within the individual IPMI market, with many individuals seeking limited outpatient benefits alongside robust inpatient coverage.
“That said, there remains a market for high-end IPMI plans, with some members continuing to value higher benefit levels and fully global coverage rather than Europe-only or worldwide excluding the US options,” she adds.
Furthermore, as the pandemic becomes a more distant memory, some public healthcare systems across Europe have started to recover, and this recovery has implications for the demand for private provision.
“We are seeing this trend in parts of Europe, where some members are increasingly looking for short-term cover until they can access local healthcare schemes,” Olore reveals.
“Previously, many would take out a full IPMI plan for added peace of mind, but there now appears to be greater confidence in government-funded healthcare systems.”
Brexit’s impact
While the pandemic may be fading, Brexit certainly is not, and its impact continues to be felt by IPMI advisers seeking cover for clients.
Peter Lurie, director at Proactive Medical and Life, tells Health & Protection: “The demand is static at the moment because I feel personally, just by way of dealing with international policies and specifically Europe, that we have a real problem with Brexit.
“This is especially with wanting to do international cover for expats going to Europe. We seem to be stuck with this whole Brexit scenario and having to find a local broker to be able to do business and service the policy.
“So from a European perspective it’s static, but from a Middle East perspective, it’s actually been okay. Although with the current situation with the war, there’s a lot less travel happening and a lot less security and uncertainty, so that’s difficult.”
Demand to remain strong
But for now at least, it seems that growth remains strong, according to IMG’s Olore.
“We see IPMI as a cornerstone of our overall growth strategy,” she continues.
“Given the ongoing political, environmental, technological, and economic uncertainty around the world, we expect demand for IPMI to remain strong and continue growing beyond our already established book of business.
“To meet this demand, the sector must continue evolving its products and distribution strategies to ensure coverage remains relevant, flexible, and accessible for globally mobile individuals and families,” she adds.