With preventive healthcare and mental health concerns rising, where are we steering as a society dependent on healthcare insurance?
Illness > Risk > Life > Health > Security > Care > Insurance
The above mental map is a quick reflection of the fragility of life and its association with healthcare. If you live in a Middle Eastern country offering no national health scheme, you would know how expensive healthcare can get without insurance.
Most countries in the GCC have mandated private health insurance for all citizens and residents, which has increased the onus on employers. Countries such as UAE and KSA have made healthcare a national priority by increasing pressure on insurance providers through healthcare bodies.
From the all-inclusive premium insurances that cover dental and physiotherapy to mental health and coverage for several dependents to more basic healthcare schemes that cover the bare minimum, the landscape has a far way to go. However, it’s questionable if insurers have kept abreast of industry dynamics to tailor more customer-oriented healthcare plans at even a basic level.
“The pandemic has impacted every sector in one way or another, and the insurance industry has not been an exception to the rule. Over the past two years, several adjustments insurers have had to make,” says Mufazzal Kajiji, CEO, Zurich International Life (Middle East).
“In terms of claims, our latest customer benefits paid report showed that in the last three years, COVID-19 was the second highest cause for life cover claims—illustrating the wide-reaching impact the pandemic has had on the insurance industry,” adds Kajiji.
Preventive Health-Tech Needs
“Insurance companies tend to overlook the customer experience. We’re in the people business, and in addition to giving sound, unbiased advice, we must ensure that our customers are getting a hassle-free, convenient service in terms of turnaround time and efficiency,” says Kajiji.
One area that provides an opportunity for insurers is preventive care tools. Think of the number of Vitamin C tablets you’ve popped over the last two years to boost immunity. COVID-19 made conversation around self-care and preventive care normal. A study explored how global insurers can embed self-care products into benefit plans. Globally, self-care solutions, as part of basic health plans, include wearable technology (18%), home testing kits for common conditions (8%), virtual care solutions for self-care (8%), and apps and devices to self-manage conditions (18%).
The benefits are innumerable, with one in two employees swearing by wearable technology to manage health conditions such as diabetes and heart failure. However, only one in five insurers covers wearable technology’s cost to self-manage well-being issues.
For a region that ranks high on obesity, diabetes, and cardiovascular illnesses, health-tech is a preventative solution that insurers should tackle on a mass scale.
“Many insurance companies ignore the importance of creating awareness around life insurance and critical illness cover and how it’s directly linked to financial preparedness. The onus is on us to make it easy for customers to understand life insurance by breaking down the industry jargon and complex terminology,” Kajiji says.
Dealing With Health Equity
“Both life and general insurance products have had a different experience during the pandemic, where insurance claims for both [life and health] soared. The pandemic proved to be a disruptive catalyst for many insurers, pushing them to speed up their digital assets and make it more accessible to customers at all times,” Neeraj Gupta, CEO, Policybazaar.ae (Policybazaar UAE).
“Telehealth services saw a huge jump during the pandemic, as policyholders avoided visiting hospitals and clinics and preferred to get diagnosed from the comfort of their homes,” Gupta added.
“Insurers also started to look for opportunities and partners that helped them reduce cost and build strategic partnerships wherein they could access customers quicker. However, claim incidents in some lines, for example, motor, reduced significantly due to government-imposed lockdowns,” he adds.
There are 62 registered insurance companies in the UAE, 34 in Saudi Arabia, 12 in Qatar, 20 in Oman and below in Bahrain, Kuwait, and the rest of the GCC. While governments have pushed for health insurance coverage as part of national health policies, affordability remains a critical factor in determining the lack of access to a large population.
In a recent report by health provider William Russell, Qatar ranked third worldwide; Lebanon, UAE ranked 39th place and Oman and Bahrain at 59th position, and Turkey the 73rd for the highest costs for health insurance claims. The most common claim among Arab countries was “GP and specialist consultations.” Despite the impact of the pandemic, a study found that just 1% of insurers see preparedness planning for high-risk events, such as future pandemics and natural disasters, as a top medical insurance priority.
Adding to the woes, even though mental health was flagged as the second-biggest risk to employee health, just 3% of insurers see mental health provision as a key priority.
“Insurers should look at it from a customer service perspective. It must make sense from the bottom line if it’s for a profit; however, deals can be for wellness benefits with professionals to help with mental health coverage and online assistance. This is an opportunity for insurance and wellness companies to be creative and add value to society,” adds Ghurani.
Mental Health Ddemands
“This conversation between the customers and insurers has intensified since the pandemic struck, and policyholders are now more aware of the inclusions and exclusions in their respective policies,” adds Gupta.
Office yoga, extra pay for extra hours, and comp offs are all great incentives to boost morale. Still, several workplaces in the Middle East are falling short in ensuring employee well-being without providing mental health insurance. Why? To cut a long story short – affordability.
In the case of employees without mental health coverage, the onus lies with the employer to apply for a group policy that covers counseling and cognitive aid. Last month, the Ministry of Human Resources and Emiratisation issued a new resolution that mandated establishments in the UAE to provide either a bank guarantee or insurance coverage for employees in high-risk jobs.
While it is unclear who can avail of this bank guarantee, the region’s lack of mental health providers adds to the high cost of services. “The exclusion of mental health in insurance plans is mainly due to high cost and access to certified practitioners,” says Gupta.
“Your mental health matters more than 1,000 dirhams per hour,” says Chris Haill, founder and CEO, MindForce DXB, a platform dedicated to raising awareness on mental health.
“The issue of insurance coverage remains a big barrier to access, we know from first-hand experience that most patients pay out of their pockets. The tricky thing is that it’s not captured in the data. Hence the data we collected underestimates the consumption of mental health care and burden,” says Farah Saad, Senior Consultant at PwC Middle East. She worked on a report that quantifies the socio-economic impact of untreated mental illness. The report found that due to the lack of access to mental healthcare for citizens in the GCC, nearly $3.5 billion is lost per year.
“When talking about increased access to mental health. We need to look at it from a societal point of view and consider the wider benefits for the larger population – improved quality of life for people with mental illness, including their caregivers, reduced expenditure in terms of criminal justice cost, reduced mortality associated with self-harm and attempted suicide. Hence the benefits will definitely outweigh the cost spent on including mental health cover at a basic level,” adds Farah.
She cites the Mental Healthcare Parity act passed ten years ago and how that was a breakout moment for the US. “The intention was to ensure that mental healthcare is covered at par or equal to physical health in all insurance plans.”
“It’s not that there won’t be any challenges,” she says. “Insurers need to make informed decisions based on feasibility studies that assess the impact of coverage on the overall well-being of the people, including a reduction in the suicide rate.”
Toward An Inclusive Mental Health Scheme
“Mental health coverage is an essential aspect of everybody’s life,” says Ramzi Ghurani, Managing Partner, Petra Insurance Brokers.
“Usually, mental health coverage is on more robust and comprehensive policies due to the cost implications of mental health care professionals in the region and globally. It is, by nature, an expensive type of treatment,” he adds.
However, while affordability remains a limiting factor to a region-wide rollout, inclusive mental health would also have to be more varied. The issue only worsens with a shortage of mental health professionals in the region. With a diverse population such as the Middle East, UAE is home to nearly 200 nationalities, cultural nuances play a big role. Raising awareness regarding community tools available outside of coverage is also picking up speed with initiatives such as MindForce DXB.
“There is a stigma in the workplace even if you’re battling mental health issues and have coverage or allowance. I know people who hesitate to tell their managers about their mental battles out of fear of judgment. Would a boss deem an employee unfit for the job if she spoke openly about her issues?” asks Haill.
A truly inclusive mental health scheme would require players from the public and private sectors to unite. “Ideally, local governments should subsidize benefits so that they can be included in the medical insurance for basic coverage,” Ghurani adds.
With the World Economic Forum’s Global Risk Report 2022 citing that mental health deterioration will become a critical threat to the world, Gupta says, “Insurers are looking at ways to provide cover for mental health conditions at economical costs.”
Note to readers: Oman Insurance, Bupa Arabia, AXA Insurance, and Qatar Insurance were contacted to comment on the evolution of customer needs and the importance of mental health coverage, but we didn’t receive their responses at the time of publishing.
RAMZI GHURANI
Managing Partner