This week it was Bupa Global’s turn to hold their first ever digital event, and they had some good news for the International Health Insurance market.

Bupa Global took the opportunity to make this a global event, attended by key intermediaries from all over the world from the comfort of their own home / office. I’m getting quite used to sitting down with a cup of coffee for these, rather than jumping on a train for half a day, although I do miss the chance to catch up with a few old faces and in this case, some of my previous colleagues.

Bupa Global speakers;

Paddy Watt, Commercial Director, Bupa Global – Dr Paula Franklin, Chief Medical Officer, Bupa Group – Sheldon Kenton, CEO, Bupa Global and GeoBlue – Rebecca Kett-Young, Head of Operations, Bupa Global

This event was the start of a new series called ‘Perspectives’, aimed to increase communication with the International Health Insurance market, and will be held regularly with the next session in September.

Session 1: Exploring our new reality

COVID-19 has, and will continue, to lead to disruption in the International Health Insurance industry and Bupa Global discussed three topic areas, showcasing how they have felt this impact and how they have dealt with it.

How Bupa Global are supporting customers through the crisis

Sheldon Kenton – CEO, Bupa Global and GeoBlue

  • The business stood up well to the immediate challenges created. It is a diverse organisation with many different operations and it saw the initial impact earlier than most other European headquartered businesses via its operations in in China and Hong Kong. This allowed Bupa to road test what would go on to become their global response and provided some advantages in maintaining their customer capability, allowing all 3,000 employees to work remotely while maintaining their turnaround times.
  • Despite the challenges faced, the NPS (Net Promoter Score) results, by which Bupa measure customer satisfaction, have continued to rise throughout this period.
  • With customers all over the world facing different access to, and capabilities of, care, Bupa worked hard to help steer members through this by creating a digital COVID-19 Hub. This is proactively supporting International Health Insurance customers with regular updates and is supported right across the Bupa Group.
  • Another response was to give every customer access to Global Virtual Care and they extended mental health benefits across all customers.
  • Between January and May Bupa Global’s Virtual Doctor service saw a 49% month on month registration increase
  • While International Medical Insurance claims have been suppressed during these month, core claims still continued, Bupa babies were still being born and cancer is still being covered as usual
  • A dedicated case manager has been assigned to every case of COVID-19, or which is suspected to be COVID-19 to help ensure the best support and clinical advice, as well as helping to manage some high cost International Health Insurance claims.
  • Bupa Global has also announced today that they are permanently removing the general pandemic exclusion from their International Health Insurance products moving forward.
  • Although they quickly announced that they would cover this pandemic in full, they wanted to reassure customers that this would continue, and that they would also now cover any future pandemic. This is good news for both their members and the market in general by removing uncertainty and bringing Bupa Global into line with the other major International Health Insurance providers.
  • There was an acknowledgement to the market feedback early on that Bupa Global didn’t come out to the market with their initial stance on COVID-19 as quickly as they might have done, however as a large organisation working through a lot of change, it was difficult to come out with an overview of their position, however they feel that now is the right time to make sure that they are providing more regular updates moving forward.
  • What can customers do if they are experiencing financial difficulties? Bupa Global already have processes and protocols in place for this scenario within their service team. They are sensitive to the issues and have had low levels of enquiries about ability to pay already. It will effective different customers in different ways and so a blanket statement isn’t possible, however Bupa are willing to try and support customers through this period where possible.

The Global Picture

Dr Paula Franklin – Chief Medical Officer, Bupa Group

  • Dr Franklin provided a recap on the symptoms of the virus and how it has emerged over the initial months, acknowledging that information and details of the disease are still evolving daily.
  • Reiterated that those at greatest risk are those
    • With an immune deficiency,
    • over 70,
    • under 70 with chronic heart, lung and kidney issues
    • with a BMI over 40.
  • Ethnicity and lower income populations are also reported to have had a worse experience with the virus, seemingly having experienced a higher risk of catching it, catching it more severely. Dr Franklin explained that this experience is driven by socio-economic factors, rather than clinical ones, with a range of reasons still being researched, but including;
    • Limited access healthcare
    • Densely populated living conditions
    • Cross generational housing
    • Populations with a higher level of chronic illnesses
  • Numerous government restrictions to reduce the spread of the virus have taken place around the world, mainly focused on restrictions on movement and increasing levels of testing.
  • The UAE and Saudi Arabia were two countries called out by Dr Franklin which had led the way, with establishing high levels of testing very early on.
  • By the 25th of January the UAE had already tested over 1 million people.  With two locations within the Emirate conducting door to door testing helping to identify, localise and contain the virus.
  • High levels of testing, used alongside contact tracing appears to be the most effective way to combat the spread of the virus.
  • The development of a vaccine, or vaccines, is being conducted at a pace truly unprecedented in medical history. A vaccine can usually take a decade, or longer to develop in normal times, even fast tracking is usually around 5 years. The aim of 12 – 18 months is extraordinarily fast and has been driven by high level of collaboration, not seen before, between both pharmaceutical companies and countries.
  • There are currently 150 vaccines in development and 19 already in clinical trials across the world.
  • Once, and if, a vaccine has been found, it then needs to be produced on scale, funded and distributed, so there is still a long way to go. How this further steps will be achieved remains to be seen
  • There will be ongoing consequences from the pandemic, not only economic, but broader health implications also. The delay in screening services, preventative treatment and potential chronic implications for some patients after having COVID-19 will all have an impact.
  • There is also a particular impact on mental health which is already starting to come through in research. The impact of being isolated and limitations on activities which people usually use to ‘decompress’ have had an impact and there is already clear evidence there will be a mental health burden due to the pandemic.  This will be have both a short term impact with stress and anxiety, but also longer term impacts where families and friends that have passed away and they are dealing with bereavement. People in the provision of care in general, not just hands delivery of care, are also expected to be impacted significantly. Experiencing trauma like this can often see a delay in mental health issues arising, sometimes an anniversary is a trigger, meaning we are likely to be dealing with this issues for a long while to come.
  • What happens to a vaccine if the virus mutates? This is common, the seasonal flu vaccine is annual for this reason and COVID-19 is being monitored and has already mutated, however these have not affected the behaviours of the virus so won’t impact the current vaccine work. If it does mutate significantly then yes, the vaccine would need to change and or adjust to respond to this.

Impact to services and operational highlights

Rebecca Kett-Young – Head of Operations, Bupa Global

  • Bupa Global experienced a sudden drop in International Health Insurance claims from February onwards, particularly in outpatient claims as private facilities shut around the world.
  • They saw a steady month on month decline, particularly in April which was 53% lower than March and 65% lower than January which was the last month with a normal claims trend.
  • Claims for May experienced a 35% increase compared to April, however were still 50% less than January.
  • Customers did still make claims and access cover, however, maternity and cancer claims were largely unaffected while some countries did continue almost as normal with no national lockdown.
  • To date, just under 250 Bupa Global members have been admitted into hospital with COVID-19, globally. All of which have been case managed and supported clinically.
  • All regions saw an increase in International Medical Insurance claims in May.
  • Most regions claims are still 50 – 60% down, other than China which is now back up to 95% of where it is expected to be.
  • During the pandemic 3,000 customers downloaded and accessed Bupa Global’s Virtual Doctor app and has proved a very popular tool from the feedback received.
  • Additional claims costs are expected moving forward as hospitals increase the use of PPE and cleaning regimes.
  • Uncertainty remains over what future claims will look like after they experienced a spike in claims in Beijing after the lockdown was eased there.
  • Bupa does expect a claims bounce back with many member accessing treatment which was delayed. They expect this could happen later this year or at the start of 2021 and are planning to ensure they have the employees in place to be able to maintain services levels at this time.
  • Bupa Global recorded a record score of +60 in their NPS claims feedback in June which has been consistently high, scoring +53 in March and April and +57 in May.
  • While some of the inpatient COVID-19 treatment has been expensive, this high claims impact is likely to be balanced out by a fall in claims elsewhere.
  • Bupa processes over £1Billion of International Health Insurance claims each year and this large scale helps in these scenarios and means the pandemic is unlikely to have a large impact on pricing moving forward.
  • The Bupa UK domestic business has offered members a financial rebate, however Bupa Global is unable to make the same commit at this time as their products and scope of coverage is very different. However they stated a clear priority to customers and will be fair and transparent with what they do commercially and are not looking to make any financial gains form the pandemic.

If you have any International Health Insurance needs, wish to discuss this article, or would like to discuss the broader International Employee benefits market in further detail, please get in touch.

Engage International is the specialist International division at Engage Health Group, supporting expatriates and high net worth clients with International Health Insurance uk, as well as offering a full range of broking and consultancy for businesses with an international footprint. This includes Company International Health Insurance, International Group Life, International Critical Illness, International Short Term Disability Insurance, International Long Term Disability Insurance, International Income Protection Insurance, Group International Travel, Kidnap & Ransom Insurance and International Employee Assistance programmes.