This year’s ITIC APAC event brought together representatives from all over the APAC region and beyond to talk about business challenges and opportunities, to network, and to learn more about exciting industry developments in the local travel and health insurance sphere. A packed agenda featuring engaging speakers and informative presentations, together with plenty of opportunity for social and business networking, made for an inspiring conference. Here’s ITIJ’s full review.
On the agenda … Day 1
ITIC APAC Hong Kong opened with a panel session looking at medical costs and inflation in the Asian region. First to speak was Thalia Georgiou, Managing Partner, Healthcare Advisory, Asia Care Group in Hong Kong, who said that there are clear challenges to healthcare in the region. She pointed out that although Southeast Asia’s health markets are dynamic and exciting, great caution must be exercised when investing. She added that there was a significant need for affordable care options with prevention and disease management at their core. Thalia said that due diligence is imperative for investors as assets often do not perform as expected. She also cautioned that corruption and fraud could easily account for 10-to 30-per-cent profit loss.
Next, Lynne Fung, Executive Director, Business Development at Matilda International Hospital in Hong Kong, stressed the importance of building trusted relationships as insurance payments were responsible for around 80 per cent of cases, with more than 50 per cent being direct billing. She said that trust begins before a patient arrives at a hospital and is built through engagement and measured in ethics, integrity and commitment. Lynne then went on to present details of a complicated case in which the hospital was repeatedly asked for discounts, including a request at the end of the patient’s treatment for 35 per cent off. She said that there was a need for transparency in pricing from the start and where there was a trusted system in place, trying to negotiate price reduction at the end could only damage the relationship.
Although Southeast Asia’s health markets are dynamic and exciting, great caution must be exercised when investing
Dr Zubin Daruwalla, Health Industries Leader with PwC South East Asia Consulting in Singapore focused on his country’s healthcare system, saying that medical expenses, surgical costs, critical illness treatments, disability and long-term care in the island state are covered by multiple layers of protection through four publicly funded healthcare insurance schemes, and complemented by private health insurance. He added that the public sector dominates acute care, while private sector providers focus on primary and specialist care. Dr Daruwalla said that, by 2020, healthcare expenditure in Singapore is expected to increase to even more than 2018’s budget of SG$10.2 billion due to its ageing population. He noted that the government has said that rising healthcare costs was not sustainable, meaning that the population must try and remain healthy. He quoted Singapore’s Health Minister, Gan Kim Yong, who said that a paradigm hift approach to ageing and health was needed ‘to move beyond the hospital to the community, to move beyond quality to value, and to move beyond healthcare to health’.
The second session of the day focused on some of the market challenges prevalent in the APAC region, and how these can be turned into market opportunities. Ben Loh, Chief Digital & Marketing Officer at Tune Protect Group in Malaysia, was up first with an engaging presentation about the way his company has digitised its insurance offering and is adapting to consumer demands for instant cover and a ‘friendly’ claims environment by working with eWallets and geo-apps. At the same time, the company is working with other providers, such as Air Asia, and monitoring data available from them to increase its reach further, using social media and dynamic websites powered by AI and machine learning to encourage purchasing.
Amy Villalobos, Head of International Benefits Management for nib Health Funds in Australia, followed with insights on the wider APAC market and insurers’ shift from ‘sick care’ to ‘health care’, where wearables and fitness programmes are giving customers greater value and providing an investment in their future. There is no ‘Asian market’, though, said Amy, just individual markets with individual needs. In China, for example, there has been a shift from group to individual travel, and customers are looking for ease of payment and ease of claim. They also want to able to operate within existing apps, such as WeChat. The key challenge is understanding individual consumers.
Brokers for Chinese tour groups are how most policies in the region will be sold in the coming years
Rounding off this session, Tan Chien-Wei, Director of Ulink Assist in Myanmar, took an enlightening look at the nascent healthcare landscape in Myanmar and emphasised the importance of Chinese travellers in the region. Thailand, he said, has overtaken France as the most visited country in the world due to Chinese travellers. Brokers for Chinese tour groups are how most policies in the region will be sold in the coming years.
Next on the agenda on Day One of ITIC APAC was a session on telemedicine for expats, with a focus on mental health support. David Thomas Boucher, Chief Business Transformation Officer for Bumrungrad International Hospital in Thailand, Myra Yu, Vice-President of Teladoc Health International & CEO APAC in China, and Laurent Pochat-Cottilloux, Global Head – Health Reinsurance Partnerships for AXA Global Healthcare in Singapore, shared their unique personal experiences of providing telehealth services in Asia, explained why the local market has seen impressive growth in telemedicine use in recent years, and gave insights into why access to care in this way is set to keep growing.
Myra told attendees that we’re going to see much more telehealth over the next five years. In Asia, a shortage of doctors, often short consultation lengths, and a significant proportion of incorrect diagnoses in the healthcare sector, together with a growing online commercial landscape, are fueling the growth of telemedicine. With telehealth giving better access to primary care in areas where it’s much needed, David explained how on-demand telemedicine is giving patients a better experience through the convenience, cost-saving and security it offers. Provider-sponsored telemedicine is the most effective, he said. Laurent rounded off the session with a couple of case studies that highlighted the importance of increasing awareness among expatriate employees around access to mental health services through virtual platforms.
Concluding day one was an insightful session on operating air ambulances within China and a look at the country’s evolving risk pool when it comes to health insurance. Dr Winston Jong, Group Medical Director of EMA Global in Singapore, took to the podium first to explain some of the issues faced by air ambulance crews attempting to repatriate patients out of China. Citing a particular patient case, he said it is often almost impossible to speak to a treating doctor, so in this instance the company was able to get the patient’s family to take photos of medications and monitor screens to get an idea of the patient’s health status. A photo of the treating doctor’s badge allowed them to call and ask to speak directly to that doctor, which eventually resulted in them receiving the medical statement – with the essential ‘red stamp’ – that is needed in order to obtain a landing permit to enter China. Other issues Dr Jong highlighted were understanding medical forms due to language barriers and medical jargon, the expense associated with landing in China, airport delays and having sufficient oxygen, sometimes not being allowed to remove oxygen tanks from aircraft, incompatible tank regulators, and the need to have a comprehensive equipment list to enter the country.
It is often almost impossible to speak to a treating doctor
Lily Chen, Managing Director of Essential Benefit Solutions Company Ltd in China, gave an interesting perspective on the health insurance landscape in China, explaining that the health status of employees in the country is getting worse, as they are ageing – the average age is now 35. Pollution is also very bad in the country, and together with long working days and weeks exacerbating health problems, plus the fact that a drop in the economy thanks to the trade war with the US has seen expats moving out of China, insurers are witnessing a shifting risk pool that includes a growing number of Chinese and fewer expatriates. The good news is that Chinese people are increasingly seeking out mid-and high-end medical insurance coverage, said Lily, and they are willing to pay more for this coverage for themselves and family members.
On the agenda … Day 2
Tony Ridley, CEO of Intelligent Travel in Australia, provided a presentation on ‘the travel revolution’ to kick off Day 2 of ITIC APAC. Over the last five years, said Tony, technology has played a major part in altering the risks and threats prevalent in the leisure and business travel booking landscape. The global penetration of mobile useage and social media, the use of digital wallets and cashless transactions, geolocation, as well as the proliferation of chatbots and voice activation via AI and machine learning, are all bringing hyperpersonalisation to the travel booking experience and have changed the way we plan and book travel. At the same time, the language of business has changed, with mobile technology allowing virtual offices to operate anywhere at any time. Aligning the old with the new is a major focus for corporates and the travel industry, while they are also having to tackle growing threats such as cybercrime. What they need to make sure they’re doing is understanding the wider risks inherent in today’s digitised travel sphere, and asking ‘what are the risks?’ and ‘how do I manage them?’
Following straight on from this session, attendees got to hear about the latest fraud detection and prevention practices from Dr Sunil Shanmuganathan, Head of Claims and Providers Network, Asia Pacific for AIG Travel in Malaysia and Maxime Paul, Lead Data Scientist for Shift Technology in Singapore. Dr Shanmuganathan shared interesting data from his company about helicopter evacuation cases, hospital admissions and associated costs in Nepal from 2013 to 2018. It showed how the company’s actions to revise policies and coverage over the period and develop standard operating procedures for evacuations had led to a significant decrease in backend claims in the last few years, helped save on average 22 per cent on helicopter evacuation costs, and led to a significant proportion of cases being directed to preferred helicopter and medical providers. By establishing tighter communication, case management and early engagement with involved parties in such cases, AIG Travel has achieved higher case visibility and cost control and lowered its exposure and susceptibility to coverage abuse and fraud.
Besides such vital human engagement, technology and big data are making important inroads in the fight against fraud. Maxime showed how, in the age where customer experience is king, automation is proliferating the claims process in order to provide customers with swift and accurate responses to their queries and to settle claims in minutes rather than days. But building in fraud detection to the digital claims process is vital. The accumulation of big data combined with AI allows technology to cross-reference insurers’ data and sort claims according to their fraud risk almost instantaneously, helping to detect fraudulent claims and even networks of fraudsters. Fraud detection has always been an important part of claims management, said Maxime; but with the inevitable arrival of claims automation, it will become critical.
Technology has played a major part in altering the risks and threats prevalent in the leisure and business travel booking landscape
Next up for discussion was what insurers expect from their service providers and how these expectations can be met. Alexandre Besson, Managing Director of Feti’a Assistance in Myanmar summarised an insurer’s objectives as maximising the collection of premiums and minimising the payment of claims. He added that an assistance company’s objectives were maximising the collection of memberships and minimising the payment to external providers. Likewise, a medical provider’s objectives were maximising the revenues generated by increasing the number of patients and/or the invoicing value, while a transportation provider’s objectives were maximising the revenues generated by increasing transportation and/or the invoicing value. Common to all, however, is an aim to offer the best possible service and keep patients safe. He said this can be done by constant communication, providing real empathy to put patients in a positive emotional state, and providing value-added services.
Lisa Fryar, Managing Human Resources – Medical Benefits, Emirates Airlines in the UAE, said that those in the insurance and assistance industry all have similar expectations from airlines: an upgrade, a discounted airfare, the most direct route, and a quick MEDIF turnaround. For many travellers, she said there was an expectation for insurance and assistance companies to arrange this and when it didn’t happen, they expect the airline to foot the bill. Lisa said that the traveller wants an upgrade, the insurance company wants a cheap deal, and the assistance company wants the fastest, most direct route. She also added that travellers who take out travel insurance don’t care about complex relationships between the insurance company, the underwriter, the assistance company, and the hospital. Summarising, she said the insured just wants to get assistance when they need it, the medical facility just wants to get paid, the family and travel companions just want their loved one looked after, and the airline just wants the least risk possible when transporting the patient.
The airline just wants the least risk possible when transporting the patient
Katy Youngman, APAC Regional Medical Provider Manager, Allianz Partners in Australia, said that positive outcomes were driven by ease of access to providers via a single point of contact that streamlines communications, and through international patient departments in hospitals. She also said that market insights can be gained through provider newsletters detailing new regulations or changes in the law. Stressing two-way communication, Katy said it was essential to understand timeframes and how they can have clinical and financial implications. She also said it was important to obtain medical reports to make quick cover and patient movement decisions.
Before the conference’s closing Provider Network Forum, attendees heard from Petar Denoble, Vice-President, Mission at Divers Alert Network (DAN), a non-profit membership-based association that maintains a database of hyperbaric chambers around the world, including their opening times, whether they are currently closed for maintenance, and the capabilities of each facility. Thus, they are able to match patients to facilities and, through establishing relationships with nearby medical facilities, assist with evacuations and repatriations. Around eight per cent of DAN members need repatriating, and most of these are between the ages of 50 and 70. ost such evacuations are from the Caribbean, then Southeast Asia, then Mexico. Diver preparation is key, emphasised Petar, to mitigating their risks, and DAN also helps with such pre-trip advice.
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