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Analysis: International PMI: insurer networks – getting it right

Sam Barrett reports on a new brand of thinking
15th June 2012
 

Managing costs and delivering excellent customer service is difficult enough in domestic health insurance. Sam Barrett reports on how different insurers are taking on the challenge on a global basis

International private medical insurance (iPMI) providers must ensure they offer their customers a good level of service while also controlling costs. But, with customers potentially anywhere in the world, keeping an eye on these elements is not always easy.

“You might be offering worldwide cover but, when it comes to the individual customer’s experience accessing healthcare, this is immaterial,” says Alison Massey, marketing and ecommerce director at Now Health International. “As they don’t necessarily know what healthcare is available where they’re based, they need to be confident their medical insurer can help them access the most appropriate care.”

As well as ensuring this customer confidence, keeping tabs on price is also important. This can ensure that policies are priced to reflect the cost of healthcare in the area but will also prevent fraudulent and exaggerated claims pushing prices up.

Many iPMI providers recognise that overcharging can be a major problem in the international medical insurance market. For example, Andrew Apps, director at ALC Health, says it can often be subtle but it is essential to look out for it.

“It’s rare that we see extreme examples of overcharging but you do see plenty of cases where someone has been kept in hospital for an extra day or they’ve had three x-rays when they only needed two,” he says. “It can add hundreds of dollars to a bill.”

As an example, he says that he recently saw a bill for a customer who had been treated in the US for a headache. Among the items included on the bill was a chest x-ray.

GLOBAL NETWORKS

Insurers have developed a number of ways to address these issues, with DKV Globality the latest to launch an initiative with its Globalites service. This is a global network of carefully selected partners, which include third party administrators as well as insurers, to give customers a seamless service wherever they are in the world.

“This is designed to create trust with our customers,” explains Jeroen van de Velde, chief operating officer at DKV Globality. “There are lots of ways to do this but we believe this is the best way to deliver on both service and price.”

Through the network a customer requiring medical treatment calls the number on their service card and is put through to their local Globalite office which will be able to provide information on healthcare providers that might be appropriate.

Because all the partners are on a common IT platform and follow the same processes, wherever the customer is, they will receive the same level of service. But, as van de Velde adds, while there may be the strength of a global brand there is also the touch of a local provider.

“Our local partners have a better set-up than iPMI providers so they can provide much more in-depth and useful information to our customers,” he says. “This enhances their experience.”

Benefits also stem from the volume of business being placed. By joining up with a partner, greater discounts can be achieved. This benefits both parties but also leads to more sustainable premiums through reduced claims costs.

It is too early to see the financial results as Globalites was only rolled out earlier this year but the concept has been well-received.

Chris Beardshall, global account executive for the PMI Health Group, the advisers, says it is a very exciting proposition.

“It offers clients a global product with a local offering,” he says. “If it also harnesses better rates, it will be attractive to many of our clients.”

Insurers are also pleased to see this sort of innovation in the market. Massey says it is a good concept.

“You have to put the customer first and think about their experience,” she says. “People don’t want to call up someone on the other side of the world just to be read a list of hospitals from a database. It’s the right thing to do.” 

But, although the unified branding is a new approach, other insurers also use a network strategy to deliver customer confidence and drive savings. Cigna Global Health Benefits has been running its Cigna Links network for the last six years. Like DKV Globality it links with partners around the world to give customers a local service and the potential for lower claims costs that volume business can deliver.

Rather than operate under a common brand, customers receive a Cigna card but also a card for the partner in the country they’re based in, for example Grand United in Australia.

“It does deliver benefits,” says Mark Coleman, international sales director at Cigna Global Health Benefits. “We’re able to show our clients how much they save on claims costs by going through Cigna Links and the local knowledge really enhances the customer experience. It also helps with legislation and compliance issues as our partner will be able to ensure this is in place.”

But while this network approach has clear benefits, Coleman cautions that it is not the easiest service to implement. IT has to be up to scratch to enable easy transfer of claims data and it is also important to manage the relationship with partners to ensure it is mutually beneficial.

OTHER APPROACHES

Given the hurdles to building a network, other insurers have taken a different route to their service delivery, with many recognising the importance of a local presence. As a result, many international medical insurers have built up a network of offices to support customers and enable them to build relationships with healthcare providers.

As examples, Now Health International has four regional centres, in the UK, Dubai, Hong Kong and Shanghai and InterGlobal has 11 offices around the world.

“It’s difficult to know what’s happening somewhere when you don’t have someone based there,” says Paul Weigall, group sales and marketing director at Interglobal. “We also run our own assistance company so the chances are, wherever a customer is, we’ll have someone with experience there who can help.”

These local bases can also improve ongoing negotiations with the healthcare providers.

“We have a medical provider manager in each of these offices who is responsible for building relationships with the local healthcare providers,” says Massey. “You can arrange deals from the other side of the globe but, unless you’re in the region, it’s very difficult to understand the culture. This can often be key to building a successful relationship.”

While a local touch has its benefits, for some, operating a centralised service is key to delivering the right customer experience.

Several insurers have a headquarters in the UK and run their customer support 24/7 from there, says Beardshall.

“For some of our clients, being able to get through to a UK call centre, wherever they might be in the world, is really important,” he explains.

ALC Health is among these, running its customer service in the UK. Apps says that its customers like to be able to ring the insurer and feel they are talking to someone who can make a decision rather than a third party or worse, an electronic answering service.

William Russell also runs its claims service out of the UK, with support from a couple of offices in key locations such as Dubai and Hong Kong.

James Cooper, sales director at William Russell, says: “We do most of the claims from the UK as, by offering a centralised service, it makes it easier to control costs. A lot of claims involve direct billing and we’ll also accept scanned receipts for lower value claims.”

KEEPING COSTS DOWN

In addition to using direct settlement wherever possible, international insurers will also turn to repricing companies to help control costs. Apps says that where a large claim is made it may be referred to a repricing company to see if there is any room for negotiation.

“We don’t accept a claim at face value,” he says. “The repricing company takes a share of any savings it makes so it has an incentive to negotiate the costs.”  

Centralised insurers also argue that even without someone on the ground they can provide sufficient information to help their policyholders access healthcare wherever they are in the world. ALC Health has a comprehensive list of doctors selected according to criteria including whether or not they speak English and William Russell can provide customers will details of hospitals that have a direct billing arrangement in place.

“It’s not like a Yellow Pages,” says Apps. “Every doctor and hospital included in our database has been checked out. We can’t recommend them but we can tell our customers who we’re worked with on a regular basis.”

Although there is a variety of services, with some offering more financial or customer experience benefits than others, Beardshall says this is supported by the market.

“Different clients have different expectations,” he says. “For some being able to get through to a UK call centre will be a key priority while others will want to know their insurer is doing as much as possible to keep claims costs under control. It’s not a commoditised market and it’s good that it can provide options to all these customers.”

 

 



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