Looking
out for the
future of health insurance

The health insurance market is undergoing a rapid growth phase. Figures from the Health & Protection Individual Private Medical Insurance Report put growth in membership purely in the retail sector for 2022 at around 13%.

Meanwhile anecdotal evidence and periodical insurer reports suggest that figure has been maintained or even increased throughout 2023.

But rapid growth, while generally welcome, brings its own challenges and demands to ensure it is sustainable and can support the new status quo.

As the Health & Protection Roundtable in association with Vitality heard, there are concerns across the sector that without taking measures to address these the services which underpin it may become truly unsustainable.

Take virtual and remote GPs for example.

These have been one of the most successful elements of the private healthcare sector, first booming during the pandemic when lockdowns prevented in-person appointments and then again as NHS access has become increasingly strained over the last 18 months.

However, some insurers have seen use of their virtual GP schemes soar from tens of thousands of appointments a year to tens of thousands a month.

This surge presents capacity issues of its own among the limited supply of doctors in the UK, but also acts as a more open gateway into private treatment where NHS GPs may have directed patients through NHS services first.

As a result, claims incidence is rising from the initial accessing of GP services and then further increasing as more private secondary consultations and diagnostics are taking place.

All of which puts pressure on costs and claims funds, pushing premiums higher.

As is generally the case with such situations, a range of carrot and stick interventions were suggested that could help alleviate some of this pressure.

These ranged from more visible initial guidance and increased use of dedicated treatment pathways for specific conditions by insurers to the possibility of mandatory excesses to protect claims funds and prevent overuse of GP services.

But these only tackle the issue once symptoms present and will struggle to stem the flow of people seeking treatment.

It is universally recognised that there is need among the country at large to take a more active role in keeping people healthy and improve their health – thereby reducing the incidence of illness and the severity when issues do present.

The insurance industry has been active in this area but the feeling from those gathered around the table was that it now must really focus the attention of the insured community on this element of their health.

Sustainability is one of the key issues facing the world at present, in how we live our own lives, undertake our work and interact across society.

Without addressing it within the health insurance industry the sector itself risks becoming unsustainable in terms of spiralling costs and ever lengthening waiting lists.