Health Insurance

in a post-pandemic & high inflation world

Life & Health

Reinsurance
Solutions
3 mega-trends affecting health insurers everywhere

Everything & everyone is international mindset and customer-

more and more globally centricity is new normal for hospitals,
interconnected doctors, workers, students, patients

Healthcare is ever more emergence of hyperspecialised medical

centres of excellence and personalized
complex, expensive and medicine, amid struggling public health
personalised funding systems

On average, we are growth of consumer class with rising

getting richer (and older) expectations of medicine and higher
year after year prevalence of lifestyle diseases
3 mega-trends affecting health insurers everywhere

Everything & everyone is international mindset and customer-

more and more globally centricity is new normal for hospitals,
interconnected doctors, workers, students, patients

Healthcare is ever more emergence of hyperspecialised medical

centres of excellence and personalized
complex, expensive and medicine, amid struggling public health
personalised funding systems

On average, we are growth of consumer class with rising

getting richer (and older) expectations of medicine and higher
year after year prevalence of lifestyle diseases
DIS-EVOLUTION
 Healthiest time in human history?

HOWEVER • Lowest child mortality

• Longest longevity
Rising incidence in middle aged people of: • Eradicated: smallpox, measles, polio,
plague
• Obesity • depression • Taller people
• Cancer • anxiety • No more dying from appendicitis, dysentery,
• Type 2 diabetes • insomnia broken limb, anemia
• Osteoporosis • fallen arches • Beyond “peak tobacco”
• heart disease • plantar fasciitis
• strokes • myopia
• kidney disease • arthritis
• lower back pain • constipation
• some allergies • acid reflux
• dementia • irritable bowel syndrome

Population
Health
Permanent
Energy
Surplus
 OR…

IMPROVE the overall SELECT the healthiest

health of the portfolio lives in the first place

• Targeted activities (step • Branding (e.g. Vitality

challenge, smoking program etc)
cessation, diet goals etc) • Health scores apps etc
• Incentives (gym • Premium incentives do
discounts, waiving not need to be backed by
deductibles etc) sound actuarial analysis
• Health coaching • Marketing to younger,
• Gamification more active customers
• Works best in corporate • “This is for me”
schemes with strong buy- Population
in from HR Health
BUT…
• Only reaching the already
engaged?
• Non-behavorial risk
factors (genetics &
environment)?
• ROI?
• Changing behaviors is
hard
3 mega-trends affecting health insurers everywhere

Everything & everyone is international mindset and customer-

more and more globally centricity is new normal for hospitals,
interconnected doctors, workers, students, patients

Healthcare is ever more emergence of hyperspecialised medical

centres of excellence and personalized
complex, expensive and medicine, amid struggling public health
personalised funding systems

On average, we are growth of consumer class with rising

getting richer (and older) expectations of medicine and higher
year after year prevalence of lifestyle diseases
MEDTECH
INNOVATION
WillisTowersWatson 2019 Global Medical Trends Survey
• Do what’s best for the patient • Wants to get better
• Optimise insurance coverage • Will trust doctor over insurer
(care setting etc) • Assume that latest
• Amortize expensive assets technology is always best
(MRI, Da Vinci, PBT etc) • Unrealistic expectations of
• Over-testing modern medicine
• Bias for surgery • “Google doctor”
• Worldwide talent shortage • Increasingly prepared to
pushing up doctors fees travel abroad to get best care
• Growth in regional medical
centres of excellence
SCOPE OF
COVERAGE

INSURER

• Keep the product affordable

• Evidence-based, effective, non-experimental
treatment or clinical trial
• Standardised practice (DRG), R&C charges
• Meet customers’ needs (e.g. TCM)
• Difficult to go against doctor’s advice
• Need to stay in line with competitors
• and ahead of the national health system
3 mega-trends affecting health insurers everywhere

Everything & everyone is international mindset and customer-

more and more globally centricity is new normal for hospitals,
interconnected doctors, workers, students, patients

Healthcare is ever more emergence of hyperspecialised medical

centres of excellence and personalized
complex, expensive and medicine, amid struggling public health
personalised funding systems

On average, we are growth of consumer class with rising

getting richer (and older) expectations of medicine and higher
year after year prevalence of lifestyle diseases
ALL TOGETHER NOW

21 | Global Health Reinsurance

Browse

Buy

Stay well

Feeling unwell?

See a doctor

Go to hospital

Claim

Get better

Stay better
Browse  Insurer touch point

Buy  Insurer touch point

Stay well

Feeling unwell?

See a doctor

Go to hospital

Claim  Insurer touch point

Get better

Stay better
Browse Social network recommendations – Brand image – Product features

Risk scoring – Pricing – e-sale – Employee flexible benefits / workplace

Buy marketing – Premium collection – Policy issuance

Health score – Lifestyle Coach – Nutrigenomics – Mental health support –

Stay well Stress Management program – Wearable devices

Feeling unwell? Symptom analysis - Primary care triage

Teleconsultation – e-prescription – Drug home delivery – Appointment making

See a doctor - Second Medical Opinion

Medical Concierge - Provider finder – Hospital reviews – Intelligent pre-

Go to hospital authorization – Medical travel arrangement (incl. Evacuation) – E-
membership card - Pharmacogenomics – e-health record

Cashless payment – Health blockchain - Fraud check – Claims adjudication

Claim – Provider contracting – TPAs

Get better Home care – Treatment adherence management

Stay better Chronic disease management – Patient support groups

 Core systems
+
Orchestration layer
+
Master App
+
AI-enabled
navigation
BACK TO
PRODUCT DESIGN

27 | Global Health Reinsurance

GATE 1 GATE 2 GATE 3
Promote Need

Telemedicine Platform
Inclusive Underwriting

healthy primary
choices

Care Coordinator
care?

Need
Outpatient
panel secondary
care?

Medically
necessary,
Outpatient,
Preferred effective,
Daycare or Recovery
Providers reasonable
Inpatient?
& customary
care?
Engaging with your customers

Pre-Existing Conditions Coverage

Wellness & Preventative Coaching Program

Medical Advice & Teleconsultation

Second Medical Opinion

Out-Patient Health Cash Card

 “Orchestrating an Ecosystem”
“Managing the Risk”
Platform & Partnerships
Coverage & Claim

Payer Partner
End-to end support for insurers around the world

Risk
Services
Transfer

reinsurance
Medical
Product
Network

Claims
Disclaimer
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Health Insurance
in a post-pandemic & high inflation world

Life & Health

Reinsurance
Solutions