The increasing number of expats in the Middle East has led to some important changes to healthcare legislation. Magda Koval looks at how this has affected intermediaries selling into the region
The Middle East is one of the fastest growing markets for international private medical insurance (IPMI) today. The primary reason for this is a growing number of expatriates in the region due to investment in the infrastructure of countries like the United Arab Emirates (UAE) and Bahrain, which has resulted in increased external investment and businesses setting up in these areas. This influx of expatriates has led to a tightening up of legislation surrounding healthcare provision in an attempt to ensure public healthcare remains accessible to local nationals.
The result of this is increased opportunities for intermediaries selling into the region, particularly for group healthcare schemes.
While many Middle East-based businesses seek advice from local advisers, some will work with advisers based in the UK. If you are advising a Middle East-based company about health insurance for its employees, you need to make sure you are fully up to date with the latest legislative requirements in the country in question and that you are authorised to deal with an insurance company that is licensed in that country.
Local legislation is a major consideration for expatriates, intermediaries, providers and insurers in the Middle East and varies from country to country. Residents in Abu Dhabi are now legally required to show evidence of ownership of a medical insurance policy approved by the Abu Dhabi Health Authority (ADHA). If companies buy health insurance for their employees that is not approved by the ADHA, these employees will not be issued with a residence visa, meaning they will not be able to open a bank account, rent a property or get their children into a local school.
While the most recent and high profile, Abu Dhabi shows only one example of the legislative requirements in the Middle East. Kuwait and Saudi Arabia have their own rules and regulations that mean expatriate residents must purchase private medical insurance before they will be granted a residence or employment visa, with Dubai and Bahrain expected to follow shortly. There are also rumours of change in Qatar and Oman. Jordan has some of the most stringent insurance regulations in the region.
Much of the legislation relates to licensing and authorisation. You must make sure the plans you sell to your clients are locally licensed and approved. In some countries, this means an international PMI provider must partner with a local company, for example InterGlobal Insurance Company partners with Al Ain Ahlia Insurance Company in the UAE and Warba in Kuwait, among others, to sell fully regulated plans.
Aside from legislation, you need to consider which provider will best match your clients' needs. The support structure is a critical component of any medical insurance policy and, thanks to the burgeoning market for IPMI in the Middle East, service has become paramount to ensure providers remain competitive.
The most commonly asked question of a medical insurance company concerns the existence or otherwise of a direct billing network. Direct billing is where the provider pays the hospital direct for a member's out-patient treatment. This avoids the member having to go through a potentially time-consuming reimbursement claim process, where they need to pay for their treatment then claim the costs back from the insurance company.
It is beneficial for members if the insurance provider has a local office and local knowledge. This can be useful in cases such as dealing with government hospitals, which may generally be unwilling to deal with insurance companies but can be persuaded to do so if they have met a representative of the company face to face. A representative of an insurance company with local knowledge may be able to assist a member with deciding on the best medical treatment provider to go to for a certain procedure.
There are, of course, the usual areas to check to ensure you match your clients to a plan with the right benefits; age, medical history, budget, expectations and the country of residence will all affect this. For example, a client moving to a remote area or somewhere adequate medical treatment is not available, for example Iraq, will need a good emergency evacuation benefit. An insurance provider should be able to talk you through its portfolio and provide you with a 'checklist' to help you find the right cover for your clients.
This article has primarily focused on the growth markets of the richer states in the Middle East. However, as is all too apparent in the news today, some countries in this region are suffering as a result of war, terrorism and political unrest.
These countries still offer opportunities for sales of IPMI as government and aid workers will need quality healthcare cover. Not all insurers will cover some of the more risky territories while some, like InterGlobal, may charge a premium loading to offset the increased risk.
With these areas, it is, as always, vital to check the small print of the plan, especially that relating to emergency evacuation and cover for treatment needed as a result of acts of war and terrorism. Make sure you choose a provider that will cover your clients if they need treatment as a result of being a passive victim of an act of war or terrorism.
The Middle East is a diverse region with many opportunities for intermediaries but also a minefield of legislation. If you are looking to sell into the region, there is a lot to be gained from speaking with insurance providers who have plenty of experience in the area and who have a local presence, so understand the culture and are up to date on current legislation and market requirements. n
Magda Koval is sales and administration manager for InterGlobal's Middle East office
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