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News & Developments in International Health Insurance

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Feb 28, 2013

InterGlobal Clients Provided with Extra Protection via Red24 as Global Security Fears Rise

As insurance companies look to expand their services to stay competitive in the ever-expanding health insurance industry, InterGlobal have established a new partnership with Red24, an expert in providing international safety and security solutions. Pacific Prime customers under plans with InterGlobal now have access to even more services…

As insurance companies look to expand their services to stay competitive in the ever-expanding health insurance industry, InterGlobal have established a new partnership with Red24, an expert in providing international safety and security solutions. Pacific Prime customers under plans with InterGlobal now have access to even more services with their plans, as the new partnership allows InterGlobal customers free access to much of Red24's services.

Red 24 specializes in providing travel and safety advice for people all over the world, be it in the event of a natural disaster, political unrest or any other life-threatening event. Their top priority is providing information and resources for the general safety of clients while they are abroad. InterGlobal's new partnership with Red24 demonstrates the insurers' commitment to not only making sure customers are well covered medically, but making sure that their safety and overall needs are also being met.

Red24 is a global security assistance specialist providing security solutions to corporate or individual members that are looking to minimize the safety risks for themselves, their families and employees while they are outside of their home country. The crux of Red24's services can be found on the member website, which provides general safety advice for people whether they are residing at home or in a place away from home. In the event of a natural disaster, political unrest or other potentially dangerous situations, Red 24 provides support and assistance with their security network of more than 400 highly trained and multi-disciplined staff.

Along with providing their medical evacuation benefit, InterGlobal now offers all customers with access to Red24's extensive online resources with its international AdviceLine. This service provides some of the most up-to-date information in regards to travel safety in more than 180 countries. Customers will be able to log on to the site, enter their destination and receive a comprehensive report on any of the safety issues that may be affecting that area or country. The report's information includes crime, terrorism, conflict, political unrest, kidnap risk and general infrastructure. In addition, the reports provide current information about specific events or areas that may be of particular importance.

Another service from Red24 is their home security advice, which includes information on how to prevent identity theft, safety tips for online shopping, personal property and home security advice, conflict management, natural and environmental hazards, security advice for women and other areas that are closer to home.

Customers under InterGlobal's Comprehensive, Elite or Plus plans will also be able to access more advanced services with Red24, including the ActionResponse service. This service provides on-the-ground support from one of Red24's more than 400 specialists and also evacuation services, should customers be faced with a natural disaster, political unrest or other dangerous situations.

One example of how Red24 has assisted their clients was when two UK expatriate employees working in Valencia, Venezuela, were held at gunpoint in August 2010. In this high-stress situation, the pair had all their belongings stolen, including their passports. While they were startled by the event, they were unharmed. Upon first receiving a call from the employer, Red24 contacted the pair to make sure that they were safe and unharmed. Soon after, a Red24 specialist traveled to Valencia from a nearby city to assist the two employees with obtaining new emergency passports and arranging flights back to the UK. The Red24 specialist accompanied the pair throughout the ordeal, even up until they boarded the plane to go back home.

A more extreme situation where Red24 was able to come to the assistance of clients and non-clients was after the Mumbai terrorist attacks in November 2008. Immediately following the event, Red24 contacted their clients in the region by SMS and email asking them to contact Red24. From there, Red24 was able to provide the necessary services, including emergency evacuation to a safer city. This was an all-out international undertaking, with coordination from the head office in the UK. Red24 even provided non-clients assistance in ensuring others' safety and wellbeing. Clients who had plans to travel to the region were notified via SMS and email of updates of the situation and the safety status of the area.

There are four main ways in that Red 24 is able to provide the best in safety advice to their clients around the world. These include:

  • City Safety advice - Providing city guides with advice about dangerous districts of a foreign city.

  • Cultural Pointers - Comprehensive resources about social norms in differing countries, more specifically on what to wear in meetings and how to greet associates in specific countries, such as those in the Middle East.

  • Avoiding Major Natural Hazards - Updates and information about severe weather conditions in areas, including typhoon prone countries in South East Asia.

  • Assistance in Life threatening situations - On-the-ground assistance in the event of political unrest, kidnap, natural disaster or other dangerous and life-threatening situations.


The expatriate lifestyle is becoming increasingly popular and more and more companies are sending employees on international assignments. With this increase comes the need for more comprehensive assistance in the areas of safety and security, especially for those who may be living or traveling to areas where there is unrest, religious fundamentalism and general concerns for one's well being. InterGlobal is leading the way for health insurance companies as they look to expand their scope of coverage and services beyond medical needs and show concern for customers' overall well being.
Feb 27, 2013

Pacific Prime and InterGlobal Create New "Executive" Plan for Clients in Dubai.

Showing their dedication to the UAE market and capitalising on their depth of local knowledge in the country, InterGlobal has worked exclusively with Pacific Prime to create a product that is specifically tailored to meet the requirements of the…

Showing their dedication to the UAE market and capitalising on their depth of local knowledge in the country, InterGlobal has worked exclusively with Pacific Prime to create a product that is specifically tailored to meet the requirements of the growing demand for high level Individual Medical Insurance plans for expatriates in the United Arab Emirates.


The plan has been designed to match the needs of individuals in the UAE and to achieve this, a few crucial adjustments had to be made to InterGlobal's original individual plan. Firstly, InterGlobal needed to include the use of an outpatient direct billing network with enough geographical coverage to be made available to residents living in all areas of the Emirate. Regarding actual benefit changes, few changes were needed. Both the "Hospital Cash" and "Home Nursing" benefits were removed, as well as making Dental coverage optional. Finally, to make the plan more suitable in the UAE, per-conditions excess was removed and replaced with an outpatient co-payment option.


In growing expatriate communities such as in the UAE, with an equally growing number of international standard medical facilities, the requirement for benefits such as Hospital Cash and Home Nursing are not considered as necessary as other parts of the plan. To explain these benefits, the Hospital Cash benefit is a financial sum given to the insured member in the event of a hospitalisation that is not charged to the insurer; whereas the Home Nursing benefit covers the cost of a nurse to provide treatment at the patient's residence, as the name suggests.

The hospital cash benefit is designed to provide insured members with a cash incentive to utilise their home health system, or others, so that the insurer does not need to pay for the treatment. However, with the standard of international treatment rising, the tendency is weakening for expatriates to want to go home for treatment. Furthermore, seeing as costs will actually be more expensive for clients to pay for their journey home, the hospital cash benefit has become one of the most infrequently utilised benefits on the market as clients prefer to be treated locally in the private facilities.

The home nursing benefit is also something that has become less frequently used. The benefit is designed for patients to be treated in their own home after hospitalisation, rather than take up valuable hospital beds. In home government systems where there is a shortage of beds, this benefit can be very helpful to alleviate pressure on the need for bed spaces available. However, in expatriate hubs, where there is a larger quantity of private hospital beds available, the likelihood is that the patient will remain in the hospital until fully recovered thereby drastically reducing the need for home nursing. Furthermore, in cases where the patient may need home nursing, the costs for this would actually be much lower than in more developed countries with higher charges for nursing and travel.

Further to these benefits, InterGlobal and Pacific Prime chose to make the dental coverage on the comprehensive plan optional, as opposed to keeping it as a built in benefit. This helped to create significant savings on the premium as the costs for dental coverage are among the highest of any specific treatment type. The removal of this benefit alone will save clients 10% on the premium, helping to make the plan far more accessible.

The removal of the per condition excess and choosing to replace it with a choice of an outpatient co-payment has also helped to bring the plan more in line with the market standards in the UAE. In the UAE, local plans are more likely to have a per visit deductible, instead of per condition. The new option of choosing either a 10% or 20% co-payment for outpatient treatment will help clients save either 12% or 16% respectively on their premium.

For any inpatient treatment, InterGlobal will still cover this in full, so clients are protected against the extremely high costs for hospitalisation in the UAE. However, by agreeing to pay a portion of their outpatient treatment, clients will not only save on their premium, but will also help their insurer to control the increasing costs for outpatient treatment at some of the high cost facilities such as the American hospital or the Saudi German Hospital, which in turn will result in steady premium increases for the clients in the future.

The most significant benefit Pacific Prime clients will find on this plan is the inclusion of outpatient direct billing. With InterGlobal creating a wide network of facilities with locations in all major parts of the UAE, it is a major advantage to clients for them to be able to avail of this network. All the local providers in the UAE offer outpatient direct billing, and though InterGlobal offer excellent coverage on an international basis, it was previously unable to match the local market practice of having outpatient direct billing, proving to be a significant drawback for clients in this region. Now, however, InterGlobal have made all the necessary changes to ensure the plan is stable and accessible for the future in the Middle East.

Clients will still be able to enjoy all of InterGlobal's usual benefits, such as freedom of choice with full reimbursement at any facility (even if outside the network), the possibility of coverage for existing medical conditions, great family discounts (covering the 2nd, 3rd and 4th children for free) and a no claims discount on the renewal premium.

Pacific Prime is extremely pleased that it is able to offer InterGlobal's latest plan exclusively in the UAE and looks forward to being able to provide clients with comprehensive benefits in such a developing region for individual Medical insurance.
Feb 27, 2013

Bupa Worldwide Health Options Plan to See Higher Outpatient Insurance Costs

Bupa have just announced their first bi-annual premium increase from the 1st April 2013 on their international 'Worldwide Health Options' plan. The rate adjustment sees Outpatient health insurance costs rising faster than Inpatient or Evacuation costs.

Bupa have just announced their first bi-annual premium increase from the 1st April 2013 on their international 'Worldwide Health Options' plan. The rate adjustment sees Outpatient health insurance costs rising faster than Inpatient or Evacuation costs.


With the release of their bi-annual rates adjustments across all plans, clients on Bupa's Worldwide Health Options (BWHO) plan, specifically those who have chosen the "Medical Plus" module (outpatient consultations) will see an increase that is approximately 50% higher than the rest of the individual plans from Bupa. Though somewhat disappointing for those that do require the outpatient module, this targeted high increase is encouraging for clients who do not require the specific benefits included, ensuring their premiums remain steady.


One of the key components of the BWHO plan, when calculating the premium adjustments, is the ability to go into deeply specific details, drawing on complex data analysis to make targeted alterations.  Unlike most other companies, which typically use wider parameters when looking at the claims history of certain groups, Bupa's immense size and experience in the market allows them to use a premium adjustment matrix that is exceptionally detailed and factors in specifics regarding age, location, excess levels and the plan module.

In terms of premium adjustments regarding age brackets, most companies generally use wide age brackets of about 5 years. For example, ages 20-24 would fall under the same age bracket, 25-29 under the next bracket and so on. From an analytical point of view, this method makes it easier to calculate when making annual premium adjustments as the wide brackets allow for simpler calculation means. The drawback to this however, is that this method always impacts the client as they will typically see dramatic increases according to age when they reach the next 'step' in age bracket. For Example, at the beginning of an age group, someone aged 25 in a 25-29 age bracket will be paying relatively higher premiums than they should for their age to balance out those at the older end of the spectrum within that specific bracket. Furthermore, though clients will be paying relatively lower premiums at age 29, they will then see a sudden and large increase upon entering the 30-34 age bracket and this can quickly become a financial burden.  

To combat this issue, Bupa do not use wide age brackets but instead, the insurer calculates premiums according to every single year of age. Though this method is more time consuming when making adjustments, it does mean that every insured member is paying the correct premium according to their specific age and that each year, the adjustments made will be less severe resulting in a smaller financial burden for their clients to shoulder.

This specific analysis also rings true with Bupa when you look at the way they price different countries around the world. With 9 zones, this allows extremely specific data to be analysed according to the cost per regions. This array of different zones helps to protect clients' areas with lower, more stable costs for treatment from increased premiums caused by higher rising costs in other areas. This year's adjustment on the WMI module proves the accuracy of this system as all areas have relatively steady increases ranging from 6.24% to 6.74%. However, the WMP (outpatient) module has seen a much higher increase in the last 6 months with adjustments ranging from 9.56% to 10%. This has meant the total annual increase for the WMP module for the last 12 months is above 14%. This is counterbalanced on the other hand, by extremely minimal increases in the WME (medicines and equipment) and the WW (wellbeing and dental) modules that each saw an almost across the board increase of 0%, though some age groups increased by up to 3%. This brings the total annual increase to an average of just 4% for the last 12 months.

Further to location zones, Bupa also have a specific increase amount for each deductible chosen. In most cases, with other insurance companies a set 'standard' or 'basic' premium is issued and specific discounts exist for different excess levels. Whereas with Bupa, the performance of each specific deductible is reviewed then from this, the necessary adjustments can be made.

One of the methods Bupa use to try and keep annual adjustments fair relates to the actual modular design of the plan itself. Compared to most other companies whose plan designs are basic and inclusive of benefits such as Dental, annual health checks and medicines and equipment, Bupa have 5 separate modules that can be taken out individually, each with its own performance indications for the costs of treatment within that specific bracket.

These include; the WMI (Worldwide Medical insurance) that covers all inpatient treatment, the WMP (Medicines Plus) that covers outpatient consultations, the WME (medicines and equipment) covering prescription medication and equipment needed as an outpatient, the WW (wellbeing) that covers annual health checks and dental and finally the WE (Evacuation) module. These specific modules with specific treatments mean that if the costs for one treatment type increase, other non related treatment will not be affected. For example, other insurers may include dental as part of an outpatient plan, meaning that if the cost of a specific dental treatment increases, the costs for this entire plan will also increase and clients that do not use the plan for dental benefits will be negatively impacted.

This ability to show the specific performance of different types of treatment has helped Bupa to maintain generally steady increases over time. However, with this year showing a large premium increase for outpatient consultation modules, clients requiring this benefit will undoubtedly be disappointed.  Pacific Prime analysts expect that next year's adjustment for this particular plan will be minimal and if not, Bupa may need to reconsider the plan design if certain benefits within the WMP continue to cause high increases in premiums and affect clients not using those specific benefits within the WMP module.
Feb 20, 2013

Pacific Prime Clients with Bupa International Benefit from New Free Second Opinion Services.

With the amount of different health insurance plans and companies on the market these days, the difference between a good quality plan and a great one can no longer be determined simply by a list of basic benefits. To ensure their plans have an edge and remain competitive…

With the amount of different health insurance plans and companies on the market these days, the difference between a good quality plan and a great one can no longer be determined simply by a list of basic benefits. To ensure their plans have an edge and remain competitive in the market, many insurers today are strengthening their customer service and offering higher levels of added-value support. One of the leaders in this particular field is Bupa International.

Bupa International have recently improved the majority of their services to enhance their members' healthcare plans. These can be found on Bupa's 'Member's World',  an online facility created by Bupa so that live information can be provided for clients regarding their policy. Not only does the site give clients the status of their personal plan, such as claims assistance and access to the relevant documentation, but it also provides a Second Opinion service though Advance Medical, as well as Moving Abroad guides to living as an expat.

The Second Opinion service is particularly helpful for Pacific Prime clients as it allows them to remotely access expert, independent medical opinions if they feel it is necessary, or if they do not fully understand the initial diagnosis given by their local doctor.

If clients wish to make use of this service, they just need to access their Member's World portal and upload the diagnostic reports they have been given. After uploading these onto the website, they are then viewed by a clinical committee and if needed, the case will be evaluated and reviewed by medical experts from USA, German,UK,Spain,Switzerland and France, among other countries. Once the review is complete, the client will be sent a report that answers the following questions:

-  What does the diagnosis mean?

-  Is the diagnosis correct?

-  Is the proposed treatment correct?

-  Is there more information available about the condition?

-  Is there an alternative treatment that would be more suitable?

An interesting Case study for the Second Opinion service is regarding an insured member who had already had surgery twice for chronic Lumbosciatalgia (severe back pain) to no avail. Their doctor suggested that a third try at surgery might be able to return a positive result. Deciding to contact Advance Medical for a second opinion before going in for the surgery, the patient's case was forwarded to two separate orthopaedic experts, one located in the USA and the other in France. Each expert separately and independently warned against the third  surgery and both suggested a more basic approach to the problem, recommending lifestyle changes and specific exercise while supervised by a physiotherapist, as well as only taking pain relieving medication specifically for the condition when needed. This resulted in the patient being able to return to their daily life faster and with more ease than if they had the third surgery.

Always keeping the clients best interest at heart, Bupa outsource this Second Opinion service through a company called Advance Medical. Though seemingly unlike Bupa to outsource any of their client servicing, having a separate, completely impartial medical opinion means that the client can rest assured that any treatment suggestion made is not biased, thereby eliminating any possible worries that the suggestion may be made purely from a financial stand point. By offering this service, Bupa completely remove themselves from any part of the medical suggestion and encourage the international experts to suggest whichever treatment would be best for the patient, regardless of cost. By offering a completely impartial support network that provides round the clock free advice, Bupa is able to bring incredible relief for its expatriate clients, especially as it can often be a daunting experience to be hospitalised in a foreign country.

In many of the major expatriate-hub cities, where overwhelmingly high costs for both medical insurance and treatment alike are often present, along with an ever-growing choice of different insurance companies and plans becoming available, over-utilization fraud can commonly occur. This phenomenon involves doctors prescribing any treatment or surgery that may not actually be completely medically necessary, often as a way for the doctors or facilities to increase their revenue. By allowing clients to take advantage of Advance Medicals network of over 5,000 International physicians that provide unbiased and impartial opinions, Bupa is undoubtedly demonstrating their commitment to their clients living abroad.

This commitment is further proved by an array of expat guides that Bupa have made available on Members world for many cities around the world, namely the major expatriate-hubs such as Hong Kong,Dubai and Singapore. These guides provide clients with important tips and facts that are needed when living aborad, often including useful information that is not even medically related or insurance based, such as tax rules and advice about different international schools for expatriate families.

This kind of advice is essential as according to a recent study done by International relocation specialists, Bossom consulting, nearly 40% of expats are on assignment for 2 - 3 years, and nearly 30% are on assignment for 3-5 years. With this modern globalisation correlating with the numbers of expatriates, insurance providers need to take a more integrated approach to looking after their clients while on foreign assignment and turn their focus towards not only the clients' immediate health, but all aspects of life.

This holistic approach to helping clients while living abroad as expatriates has been a key factor in Bupa's success as clients clearly want to have more offered to them other than just coverage for medical treatment. It is becoming essential that insurance companies make their clients feel secure and safe whilst living in a foreign country to not only attract new clients, but to also maximise retention of their existing policyholders.

Feb 04, 2013

Now Health International Clients in the Middle East see Higher Premiums After February Adjustments.

Now Health International's semi-annual premiums adjustment was made on the 1st of February this year and resulted in an increase of either 5% or 6% for the majority of the countries the insurer works with. Premiums for clients based in certain…

Now Health International's semi-annual premiums adjustment was made on the 1st of February this year and resulted in an increase of either 5% or 6% for the majority of the countries the insurer works with. Premiums for clients based in certain Middle Eastern countries however, (namely Bahrain, Oman, Qatar and The United Arab Emirates) will see an increase of 8%. With a second increase due in August this year, if the rate of medical inflation in these Middle Eastern countries remains the same, it is possible that an annual increase of 16% could occur, resulting in a much higher figure than last years average of around 10% across the board of other insurers.

While the rest of the global average increase looks likely to only see an increase of 10% or 12%, the rising cost for medical treatment in the Middle East shows little sign of slowing as the area quickly and robustly rebuilds from the Global Financial Crisis that had such a big impact on the area in 2009 and 2010.

One reason for the higher costs for premiums in the Middle East is the inclination towards fraud in this area. Though insurance fraud has been stated as a victim-less crime in the past, ultimately the cost of this is shouldered by the paying clients. While only acted upon by a small percentage of patients or facilities, the loss from fraudulent claims is quite considerable as in 2009, the Saudi Arabian Newspaper Al-Hayat reported that an estimated $320 Million US Dollars was lost to fraudulent claims on an annual basis.

The fraudulent activity can actually be perpetrated by the both facilities and the paying clients alike. In January 2010, 39 doctors and patients were taken to court by the Abu Dhabi Health Authority (HAAD) for involvement in fraudulent insurance scams. There are 5 main categories of insurance fraud that can be done by the medical facilities:

Up Coding - When the charges for treatment are higher than what was actually performed. For example, a patient could just go for a basic consultation, though the facility will charge the insurer for actual curative treatment.

Unbundling - Unnecessary extra charging for a specific part of a surgical procedure, where that superfluous fee should have been covered by the total cost for the surgery anyway.

Duplicate Billing - Charging the insurer twice for the exact same treatment, though giving it a different name or motive to attempt to proceed undetected and gain reimbursement.

Over utilization - When the insurer provides more treatment than is actually necessary for the client, such as extended hospital stays  or prescribing drugs that are not specifically needed.

Phantom billing - Charging the insurer for treatment that never actually happened.

However, the facilities are not the only ones trying to milk the system. Patients themselves can try to commit fraud by one of two main methods, either using a fake card, or claiming for treatment they should not be covered for. Fake cards can actually be produced, though more often than not an insured member will give their card to someone who is not insured and commit identity fraud. Often clients on a medically underwritten plan will not disclose their full medical history and will claim for treatment that should rightly have been excluded by the insurer.

Nevertheless, it is not only fraudulent claims causing the increase in premiums in the Middle East region. The general boom of industry in the area has lead to an increasing amount of expatriates, as well a an ever growing amount of high net worth local nationals, resulting in an increasing demand for hospitals that will provide treatment at a western standard, meaning high costs for treatment.

A prime example of this is the recent opening of the Saudi German Hospital (SGH) branch in Dubaion the 19th of March 2012, being the 7th instalment, along with locations in Aseer, Hail, Jeddah, Madinah, Riyad and Sanaa, and the second instalment outside ofSaudi Arabia. The SGH group was established in 1988 and aims specifically to provide treatment that would equal the German healthcare standards. Easily considered one of the most expensive hospitals in theMiddle East, this expanding group of high end medical providers has expanded to match the increasing demand for such high levels of treatment
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