The Association of Medical Insurance Intermediaries (Amii) has warned that 2012 will be another tough year for the private medical insurance (PMI) sector.
It expects further mergers and acquisitions activity within the market including providers and intermediary firms.
Speaking at the organisation's autumn conference, Andrew Tripp, chairman of Amii, told brokers to batten down the hatches for the next twelve months.
"I wouldn't be at all surprised if there is some further consolidation not only in the provider market but also in the intermediary community," he said.
"We face challenging economic times, a very harsh economic climate and we have seen a decline in PMI business and I would expect that to continue in 2012 with all the economic uncertainty hurting confidence.
"So I think 2012 is going to be an extremely challenging year for us all," he added.
Tripp also called the past twelve months a "massive year of change".
"In 2011 we've had Pruhealth taking over Standard Life Healthcare, Simplyhealth and Groupama, Bupa's recently introduced open referrals and Aviva upgrading their cancer cover.
"And this week Permanent Health Company chose Axa PPP for its product underwriting and Pruhealth extended its vitality programme.
"So 2011 has been a massive year of change in our industry," he added.