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Still not enough integration in group health and protection – Middleton

by Mark Dunne
19 March 2026
AMII adds two advice firm members
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David Middleton has not seen enough integration in the private medical insurance and risk sectors since he became executive chairman of the Association of Medical Insurers and Intermediaries (AMII).

When Middleton (pictured) was appointed in April 2021, he called on those serving the health and wellbeing areas of the private medical market to work closer together in the post-pandemic environment.

As a trustee of a mental health charity, he said at the time that he was “staggered” by the amount of young people seeking help, and that the industry was working on silos.

Frustrating

Five years into his term, has his message been heeded?

“Integrated in terms of all the different strands of the world of health and wellbeing talking to each other? No, not really,” he told Health & Protection.

“It is still quite frustrating.”

Middleton gave an example of why greater integration is needed. In income protection, group life and private medical insurance there will be a bolt-on employer assistance programme.

“If the adviser never knows which individual to go to, then the employer has no chance,” he said.

This shows that the industry is talking to each other, which is the approach Middleton wants to see.

“The whole suite of employee benefits talking to each other with ultimately a benefit for getting people better when they are unwell or preventing them from being ill,” he added.

“There is still lots of work to do in that area of integrating the benefits to ultimately get people fit and healthy and staying in the workplace. That is the goal.

“There has been some progress, but ultimately, it is still very siloed,” he said.

Middleton admits that there are bigger issues in the industry, but it would be better if everything was integrated.

“In an ideal world would you like people to talk to each other and get the pathway being simple and straightforward and quick?” he asked.

Five-year review

So, five years into his term, how does Middleton believe that the private medical insurance market has changed.

He identifies two main issues here.

“Providers have come in with different propositions and there is more focus on prevention.

“Fewer claims mean fewer premium increases,” he said.

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