AXA PPP healthcare's decision this month to withdraw private medical insurance (PMI) cover for caesa...
AXA PPP healthcare's decision this month to withdraw private medical insurance (PMI) cover for caesarean sections has been met with resistance from its closest rival BUPA, which says it has no plans to follow suit.
With half of all deliveries in private hospitals now carried out by caesarean, costs are climbing for insurers. Many women are now electing to have a caesarean and it is getting tougher for insurers to distinguish whether it is medically necessary. As Dr Adrian Bull of AXA points out, insurers can only cover risk, not choice.
On the other hand, where does that leave policyholders who do require an emergency caesarean? Dr Natalie-Jane Macdonald of BUPA says cover for caesareans is a valued benefit and the procedure can be monitored, with claims costs controlled accordingly. But can the market afford to take this risk on in the form of premium hikes if claims do surge?
As this month's Cover survey of the individual market reveals, PMI sales are still steadily declining. In short, the market is not in the best position to absorb any sudden increase in claims.
AXA's move certainly does not do much to boost consumer confidence or promote PMI as value for money in the short term. However, it is the responsibility of all insurers to consider the long-term effects of cover on all their policyholders.
If other insurers decide to keep caesarean cover in place and claims keep rising, it could be policyholders who end up picking up the bill.
Kirstie Redford, editor
