Global regulations in international health insurance are constantly evolving.
Recently, GDPR (General Data Protection Regulation), Covid-19 and telemedicine have posed a variety of challenges to insurers navigating the global regulation landscape.
In general, an insurer must be licensed to write business in a country.
For example, AWP Health & Life SA is incorporated and regulated in France and is permitted to write insurance on a freedom of services basis throughout the 30 EEA Member States, as well as in European Free Trade Association (EFTA) countries, Iceland, Liechtenstein and Norway.
There are also several countries outside the European Economic Area (EEA) whereby global insurers partner with locally authorised insurance companies.
These local insurers issue the policies, with the risk reinsured by the global insurance provider.
GDPR and data privacy
Data privacy and GDPR surrounding health data is under the microscope following the implementation of GDPR regulations across Europe and the removal of the safe harbour agreement in the US.
China and the UAE also have stringent measures in place. Health data must be stored in these countries, rather than offshore.
When new regulations are announced, insurers must wait for implementation regulations as they are open to interpretation in places such as China, which provides unique challenges.
In recent years, insurance providers had to invest heavily in IT and data infrastructure to ensure regulations were being met.
This also makes things challenging when trying to provide international health cover as there are lots of regulations to be followed if data needs to be transferred for medical reasons to another region.
Visas
In the wake of Covid-19, authorities became more stringent on visas.
If an individual was applying for a work visa and needed health insurance alongside this, visa authorities required confirmation that applicants were covered for Covid or Covid-related illness.
Additionally, while some health insurance is robust and covers cross-border travel, some of the visa authorities are now looking for local cover.
We are beginning to see a bit of leeway in this area, but this is an example of the challenges of cross-border regulation.
Telemedicine
The availability of cross-border telemedicine and access to medical professionals ensures that insurance members get access to care when they need it.
This is particularly useful for those travelling or working abroad, as they can access healthcare in their country of origin. However, it also poses challenges.
For example, in Italy the law around telemedicine is quite strict, with a local doctor being the only professional allowed to perform specialised prevention, diagnosis, cure and therapy meaning advice via telemedicine is not permitted.
With no single global regulation surrounding telemedicine, this provides complex challenges to global insurance providers.
Local mandatory health insurance requirements
Several countries such as UAE and Qatar have introduced local mandatory health insurance requirements.
Cover can only be provided by local companies, which could mean the end of global insurance providers in these regions.
The Dubai Health Authority (DHA) implemented mandated health cover in 2015 resulting in global providers scrambling to update policies.
However, they then issued a regulation saying foreign insurers could issue health cover for local residents, as long as local cover is also in place.
Despite the merger of the former UAE Insurance Authority with the UAE Central Bank with effect from 2 January 2021, separate health insurance regulators still exist with no central point of regulation in the UAE making things difficult for global insurance providers.
Global regulation is an ever-changing landscape made more complex by changes in power.
In the US, former president Donald Trump said he was getting rid of Obamacare, but he never did.
The future of global regulation can be a guessing game for insurance providers, depending on who comes into power.