CALCULATING THE RISK

Dubai 2017 | HEALTH & EDUCATION | B2B

The healthcare sector represents a changing landscape for insurers specialized in ensuring Dubai is covered today and tomorrow.

Shadi Al Mahameed
SHADI AL MAHAMEED
Managing Director
Medgulf
Jacques Alouan
JACQUES ALOUAN
General Manager
GlobeMed Gulf Healthcare Solutions

How are your respective companies embracing the Emirate's enthusiasm for technology?

SHADI AL MAHAMEED In the health insurance sector most of the companies and third party administrators have developed platforms and mobile apps to make clients' lives easier. There has been a dramatic decrease in the amount of paperwork and most of the work can be dealt with via online portals and payouts can be made by bank transfer. Medgulf Group has decided to take this further to another level, so we developed our own advanced platforms. Becoming one of only two insurers currently applying a real online pricing tool, the rest of the players are still developing theirs. This is a substantial use of resources, and we believe it is the right investment in future technology. Online services and automation are coming into the insurance industry, and it is something we need to adapt to. Regulators have helped encourage the insurance companies to do this because the government is leading by example.

JACQUES ALOUAN We are experiencing an unprecedented rate of growth in new technological developments in the healthcare space, especially around mHealth initiatives. This is causing major disruptions in the industry in terms of the democratization of healthcare by empowering patients to participate in their treatment decisions. Specialist organizations are playing a major role in introducing a wide variety of tools to feed this change and no single organization will be able to efficiently introduce such a wide range of technology. This is why our strategy is to supplement our in-house development capabilities by partnering with organizations that are offering a unique value proposition to the market and are aligned with our mission to improve the health of our members. As innovation and cutting-edge technologies continue to lead our way in a demanding industry, we have developed Automated Medical Rules (ARC) Engine with a unique architecture based on expert dictionaries comprised of coding, medical, pharmacy, and dental rules to automate medical and cost control measures as well as to digitize the entire claims life cycle.

How are your products being tailored to the changing market?

SAM The Medgulf Group is known for its appetite across all lines of business. We are a company that wrote almost USD1.5 billion gross premiums across the region, and it is not favorable for us to be restricted to health insurance lines only in the UAE. We would definitely rather have a wider range of lines. We have established a solid relationship with the insurance brokers in the market, and we have reached out to around 45 registered insurance brokers in Dubai and intend to approach 25 brokers in Abu Dhabi since our recently attained HAAD approval. These brokers represent our sole distribution channel because we are not planning to build a direct sales force in the UAE. We intend to build special relationships with our strategic partners, and focus our attention on the service aspect of our business here. Instead of investing time and effort in building a sales force, we decided to divert both of them to focus on investment in technology to develop our level of service. Our brokers will be able to secure quotes online through our SME pricing tool, which in turn reduces the turnaround time so that companies can get an SME quote or a revision within a minute; also, a competitive turnaround time is pursued for large group pricing. Being the most recent company to join the market implies that we have to create a key differentiator from the rest of the players. We have focused on technology, our turnaround times, and deliverables that have put us on a separate preferred providers list with the brokers.

JA GlobeMed is a Third Party Administrator (TPA) operating in the UAE and a member of GlobeMed Group operating in 11 other countries in the Middle East and Africa, with 26 years of experience. As a TPA, we manage healthcare benefits of insured members through separate arrangements with each of the insurers and healthcare providers. GlobeMed handles the full claims cycle including checking members' eligibility, generating automated medical coverage decisions, claims processing, adjudication, and settlement. We also assist members to ensure swift delivery of health services from healthcare providers. In addition to our role as TPA, our business model as system vendor provides payers—including insurance companies, public administrations and other TPAs—with access to our system to manage their members' healthcare benefits on their own. Of course, we offer them all the necessary training, user guides, and manuals. Companies working with us are offered solutions that ultimately provide the necessary balance between cost containment and the quality of service.