Demand for international medical insurance is booming as the digital nomad trend fuels the yen to work overseas. This, coupled with an increased focus on health, brings opportunities for advisers looking to break into new territories.
It’s a growing space according to Megan Lewis, commercial lead at international insurers William Russell. “We’ve seen a change in expectation from employees around the healthcare their employers provide. Providing a comprehensive health package is regarded much more as a duty of care requirement,” she explains. “On top of that, there are still some parts of the world, such as Africa and SE Asia, where it can be really difficult if you don’t have an international medical insurance plan.”
Opportunity knocks
There are plenty of opportunities for corporate adviser firms looking to enter or expand their international footprint. “As workforces globalise and individuals seek more flexible lifestyles abroad, the demand for comprehensive, portable healthcare coverage is growing, particularly in regions like Asia, the Middle East, and Africa,” says Andy O’Cain, global head of distribution at Axa Global Healthcare
Existing clients can prove a valuable source of international business, whether that’s a UK company with overseas offices or an individual client who heads up a global business. “There are some big bits of business out there,” says Ed Watling, head of health and wellbeing at Mattioli Woods. “The pharmaceutical companies, as an example, can have large international workforces that need cover.”
There’s also more importance attached to comprehensive cover. “Employees have become more mobile with remote working arrangements so there’s an opportunity to provide cover to individuals who are looking to relocate to other countries while still wanting to maintain the level of cover they are used to at home,” explains Alexander Bender, head of key account management, health at Allianz Partners.
Sometimes there doesn’t even need to be an overseas assignment involved for a client to want to opt for international cover. Watling says he’s seen more people based in the UK trade up to an international plan for the richer benefits. “They want access to private maternity or to be able to nip over to Switzerland to get their medical treatment,” he explains.
As well as potentially representing a new business line, moving into international can also protect an adviser’s existing book. Just as there are opportunities to add clients’ international business to your remit, other advisers may also be eyeing up their UK business.
Familiar territory
For advisers considering taking the leap into international medical insurance, there are certainly plenty of similarities with the UK market. Although international plans are often richer to reflect the absence of the NHS overseas, benefits schedules are very similar with access to in and outpatient treatment as well as a range of additional services such as mental health support and counselling, virtual GP and cover for chronic conditions.
Recent product launches reflect market trends that UK advisers will recognise too. For instance, at the beginning of the year, Axa Global Healthcare launched its Global Health Adapt product. Aimed at SMEs, this is a modular plan that offers the flexibility that these companies need.
Other providers have taken a different stance on flexibility. As overseas assignments aren’t always a multiyear posting, short-term medical insurance is available from some providers. As an example, April International allows cover to be taken out for anything from one month, up to a maximum of 18.
Insurers also cater for the group risk needs of international clients. Earlier this year, William Russell revamped its life insurance plan adding in adult and child critical illness and a funeral costs benefit. “Covid has made everyone more aware of their mortality,” says Lewis. “The market is looking to diversify to meet customer needs, whether that’s group risk or medical insurance tailored to shorter assignments or a more limited spread of countries.”
International insurers share some of the challenges seen in the UK market too, especially around medical inflation. Aon’s 2025 Global Medical Trend Rates Report forecasts that medical plan costs around the world will rise on average by 10 per cent in 2025, with some regions, such as the Middle East and Africa (15.5 per cent) and Asia-Pacific (11 per cent), set to outstrip this. Controlling medical costs on
a global basis can be harder, particularly in regions where there’s little regulation around the cost of medical treatment. This has made it common for insurers to include a range of excesses and co-pays to help control costs and make premiums more sustainable.
Foreign affairs
In spite of the similarities, there are some significant differences. “The international market is considerably more fragmented and varied than the UK domestic market,” says Adam Harding, divisional director international at Howden Employee Benefits. “There are more insurers operating globally, offering a wider range of products, benefits, and pricing structures.”
Watling agrees. “There are around 10 times as many insurers in international compared with the UK market, each with several different plans. It gets even more complicated when you add on that they’re not all licensed for every country so a solution for a client may need input from several insurers,” he says.
As well as understanding the different regulations in each country, it’s also important to know what the health systems are like. While an employee may be able to take advantage of reciprocal arrangements in the EU, evacuation and repatriation will be priorities for postings in parts of Africa.
These complexities mean specialist expertise is essential. “International medical insurance is a high-risk, high-value segment of the market,” says Harding. “The financial exposure from large claims can be substantial, making accuracy and precision essential. This is not an area where firms can afford costly mistakes.”
There are also concerns that current global conditions might add a further barrier to advisers looking to enter the market. “It’s highly volatile at present given the current economic situation and trade wars. The reduction of open trade does reduce the numbers on assignment and we saw a reduction of around 2 per cent over the last 12 months,” says Bender. “There are high hurdles to enter the market and we would urge caution and careful consideration before doing so.”
Take the leap
Swotting up on the health and insurance intricacies of nearly 200 countries may not be for everyone. Where this is the case, working with another firm can be an option for an adviser wishing to extend their territory. “Strategic referral partnerships can be extremely valuable, especially for firms that lack the scale or client base to invest directly in in-house international medical insurance expertise,” says Harding.
Finding the right person to work with is key to the success of these partnerships. Watling says it could be a firm that’s licensed in the regions where clients send employees or one that specialises in international business.
There’s also plenty of support for those wanting global domination in their own name. Most of the insurers can provide training and information on the different products, regulatory issues and needs of the international market. “We’re more than happy to work closely with advisers,” says Lewis. “We can provide them with information on the technical aspects or help them identify where they should be targeting their attention, providing support with marketing campaigns and social media content while they build their confidence.”
Harding adds that while insurers can be supportive, often offering training, product
guidance and onboarding support to help advisers get up to speed, it’s important to engage with multiple providers. “Each insurer has its own perspective and approach, so it’s vital for advisers to engage with multiple providers to really understand the market dynamics.”
