The global nature of international PMI means providers have to be on top of their game and get the claims process right first time, every time. Tim Mutton delves into the detail.
When customers buy an international health insurance policy, they buy a promise. It’s as simple as that. It’s a promise that their healthcare requirements will be taken care of, up to the limits of their chosen cover.
It is the job of providers and brokers to help them understand exactly what they are entitled to and, most important of all, to deliver on the promise, to the highest standards, when a claim comes along.
That isn’t easy, because managing claims in the international private medical insurance (PMI) market is fraught with challenges. First, it stands to reason that in a global market, where the policyholder may be anywhere in the world at the time of the claim, there is no one script for a standard solution.
There are a whole series of individual parts that need to be built, managed, maintained and run smoothly, and in unison at the time of a claim to deliver for the customer: a medical network, a sophisticated IT infrastructure, repatriation services, languages and culture solutions, a regional office infrastructure and customer education.
A provider’s medical network delivers the most important part of the promise: the treatment itself. Networks consist of approved hospitals, clinics and consultants – often several thousands of them globally – each with a signed service level agreement (SLA) for handling the healthcare needs of policyholders.
These service standards are designed to enable customers to use a medical facility anywhere in the world and receive a consistent level of care each time. They take a significant amount of time to negotiate and set in process. So much so that some providers resort to using pre-established networks of larger insurers and rely on the existing SLAs in place, rather than negotiating their own bespoke agreements.
The right technology
Today, particularly in view of the global nature of this business, technology has a huge part to play in driving a consistent and reliable service. And because of the frequent need for rapid response, the right technology can make the difference between success and failure.
For instance, communication between all parties involved in the claims process needs to be accurate and swift to enable full and immediate servicing of a claim, no matter where the claimant is. And because expatriates move around different parts of the world, a provider’s claims handlers should be able to view the same client details wherever they are based.