ITIC APAC 2026 | IPMI – what is driving increased utilisation of international health insurance?

The ITIJ team have been reporting from ITIC APAC in Singapore this week (15–17 June 2026), sharing the discussions that took place at the conference. Read all reports.

During the fourth session, Nir Kaminer, Director and Co-Founder, MedRev International, explored the growing challenge of utilisation within international health insurance, arguing that medical inflation alone does not explain the rapid increase in claims costs seen across Asia Pacific.

To illustrate the problem, Kaminer opened with the example of a helicopter evacuation scam in Nepal’s Everest region, where guides, hospitals, and helicopter operators allegedly collaborated to generate unnecessary rescue claims. In one example, four trekkers were transported on a single helicopter flight but billed to insurers as four separate evacuations, highlighting how fraud, waste, and overutilisation can significantly inflate costs. He noted that while such cases attract attention, they represent only part of a much larger challenge facing insurers.

Kaminer said that medical inflation across APAC was currently running at around 15–17%, significantly outpacing premium growth. However, he suggested that rising costs were increasingly being driven by everyday utilisation rather than major catastrophic events. Factors contributing to this trend include ageing populations, growing rates of chronic disease, post-pandemic demand for healthcare services, defensive medicine, and increasing patient expectations.

Particular attention was given to the role of overutilisation. Kaminer observed that many patients now arrived at consultations with strong expectations around tests, procedures, and specialist referrals, while providers often operate within fee-for-service environments that incentivise additional treatment. At the same time, anxiety, language barriers, and unfamiliar healthcare systems can lead travellers and expatriates to accept more interventions than may be clinically necessary.

A key theme throughout the presentation was the distinction between policy eligibility and medical necessity. Kaminer suggested that many authorisation systems were designed to determine whether treatment was covered, rather than whether it was required. Under pressure to deliver rapid decisions and positive customer experiences, insurers often adopt a “pay now, challenge later” approach, allowing unnecessary utilisation to pass through the system.

He argued that stronger clinical oversight was needed, particularly for high-volume claims. According to Kaminer, physicians are uniquely positioned to influence the behaviour of other physicians, making independent specialist reviews an effective mechanism for challenging treatment decisions and encouraging more evidence-based care. Drawing on behavioural science concepts such as the halo effect, sentinel effect, and nudge theory, he suggested that simply knowing that cases may be independently reviewed could alter provider behaviour and reduce unnecessary interventions.

To close, Kaminer emphasised that utilisation management should not be viewed solely as a cost-containment exercise. By placing medical necessity under greater scrutiny, insurers can reduce unnecessary treatment, improve clinical quality, and deliver better long-term outcomes for both patients and payors.