Regional profile: The UAE is buzzing but a hive of regulatory overhaul

Demand for private medical insurance across the UAE is very strong reflecting the region’s economic rebound from Covid, according to insurers and advisers.

However, regulation governing insurance providers is constantly evolving with new local mandatory health insurance requirements being a particularly significant change.

But despite this Tariq Siddiqi, commercial director at William Russell, believes after his latest visits that the UAE is a very attractive proposition.

“It was clear to me on my recent visits that Dubai is once again buzzing,” Siddiqi said.

“Demand for health insurance across the UAE is very strong, even in the Northern Emirates, which have yet to make health insurance mandatory for residents.

“The strong economic recovery from the Covid-19 pandemic, and the rapid repair to corporate balance sheets has seen clients returning to international insurance providers, having switched to local provision to reduce costs in 2020 and 2021,” he added.

 

Constantly evolving rules

This positive energy belies a hive of regulatory activity in the region.

The UAE implemented a local mandatory health insurance requirement which is being enforced, which Allianz Partners head of sales and distribution Middle East and Africa Cheryl Beattie warns could potentially pose an existential threat to international medical insurers.

“Cover can only be provided by local companies, which could mean the end of global insurance providers in these regions,” Beattie said.

“Foreign insurers can still issue offshore top-up policies to UAE residents as long as that resident also holds a locally mandated plan.

“In Dubai, the regulator the Dubai Health Authority (DHA), implemented mandated health cover in 2015. However, it then issued a regulation saying foreign insurers could issue health cover if they used the wording prescribed by the DHA.”

But the situation for global insurance providers is difficult as the whole of the UAE lacks a central regulator with rules, so far at least, prescribed by each emirate individually.

 

Corporate tax hit

One significant change coming is the pending introduction of a Corporate Tax in 2023.

The UAE has been tax free for many years but Beattie noted this could hit company finances and dull the appetite for cover.

“The implementation of corporate tax may place financial pressure on companies, which could have a direct impact on budgets in areas such as private medical insurance (PMI) and additional benefits. This is definitely a legislative change we will need to keep a close eye on over the coming year,” she said.

 

Soaring treatment costs

For those that do secure cover, treatment can be very expensive with medical inflation typically running at around 10% in the region and so it pays to shop around and trim unnecessary costs where possible.

Amber Musson-Thorp, group commercial director for Qatar, UAE and Kenya, at Lifecare International explained some of the more common situations this occurs.

“Dental can be expensive here and isn’t on a lot of plans. There’s always deals on if they’re prepared to move around,” Musson-Thorp told Health & Protection.

“A lot of families will hire full time nannies here. The nanny’s visas and therefore health insurance will be something that the family need to pay for.

“Families on a budget can ask for generic alternatives at the pharmacies to bring the cost of their prescriptions down.

“Generics have the same active ingredients and pharmacological effect as the brand name alternatives but can be 60% cheaper.

“Even for the over-the-counter products the pharmacists will pick out the most expensive option when there are two or three cheaper options on the shelf,” she added.

 

Visa rules paradox

On the subject of visas, there are very specific requirements in certain emirates around the health insurance requirements needed for the issuing of a visa to an expatriate.

Allianz’s Beattie highlights this can create a paradoxical and challenging situation where an expatriate holds a comprehensive and robust international health insurance policy which does not meet the specific visa requirements of that emirate.

But navigating the public system can be just as difficult for expats.

“The UAE government is working on improving this in the hopes of becoming a medical tourism hub,” she said.

“Expats intending to use the public system currently need to obtain a health card from the Ministry of Health, which can be sought online or by visiting a health centre.

“Private hospitals in the UAE are plentiful. Medical staff are well trained, are often expats themselves and generally speak excellent English.

“However, private hospitals do not always deal with major trauma, certain complex emergencies, and other specified pathologies, which remain largely in the public domain.”

 

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