Navigating Cancer in UAE

As a corporate insurance broker in the UAE, often we are the first point of call for an HR Manager when they learn  an employee has cancer. This can be a scary and difficult time for the employee, their family and their employer and it’s the role of a good insurance broker to help ease this process by providing timely, accurate information in a sensitive manner.  We will be able to advocate for the patient to ensure their best possible utilisation of the policy to provide optimum care and a speedy recovery.

Below is a recent client case showing how we worked with a client and the insurer to manage a breast cancer case. The group was with a local insurer and it was a claims-rated policy. The reason this is important is that with claims-rated policies the company can see exactly how much is being paid out by the insurer for a specific case.

This can also be scary because with the wrong insurer, they could increase the premium massively with no option but for the client to either pay the premium or seek medical care outside of the UAE. Every other insurer will ask for any ongoing cancer cases. Unfortunately, in this case, the news was given during the renewal phase and so the insurer could only predict what the total cost would be. 

 

Here is step-by-step what we did:

 

Meet with the insurer

Meet with the insurer, be upfront and tell them about the case, which hospital the member wants to go to and a treatment plan from the provider. You cannot under any circumstances move to another insurer and not inform them in the hope they cover it, this puts the member in jeopardy and the entire plan because of non-declarations. Always be upfront as it gives you the best opportunity to manage the case properly. 

Ask the insurer to negotiate with the provider

Ask the insurer to negotiate with the provider a treatment plan at a lower cost based on their footfall of clients going to that hospital. If a hospital is favourable to the insurer they are likely to be recommended for future cases because of their professionalism.

Move the member onto a separate category

Move the member onto a separate category. The reason you would do this is then it is an isolated case, if there is an increase of 100% then you want that premium to be on one member as opposed to increasing everyone’s premiums by 100%. This is important because for additions to a policy, they would be on the lower rates. For example, if the group medical insurance premium increased by 10% (as opposed to the individual’s 100% increase), if the case is in remission on renewal, then we can bring the member who was having treatment back onto the lower premiums.

Discuss a profit share agreement with the insurer

Discuss a profit share agreement with the insurer. If the insurer predicts certain claims, you can say that if the client performs well up to a certain amount of claims then they can share the profit with the company. This is important because it shows a longer-term partnership with the client, and the insurer doesn’t want to gain above and beyond because of an unfortunate case.

In this case, the client was covered at American Hospital, she had the treatment over the next 12 months, and the insurer covered everything. Upon renewal, we negotiated the premium back down following the larger increase. The client missed out on the profit-sharing agreement, but it was kept in place for a second year so that they could try and recover some of the additional premiums paid after looking after their employee. 

The above case would not be available with all insurers, so it is important to have a broker with close relationships with insurers and the ability to have frank conversations and give commercial reasoning on behalf of their clients. 

In some cases, companies don’t have the budget for the premium increases, and so the navigation of a cancer case is something that not only impacts the individual and their loved ones but also the whole company who now have an ethical and moral obligation to support their colleague. 

It’s important to look after your staff’s well-being and generally, it is well-documented that if you look after your people, particularly during a time of crisis, they will look after you.

If you would like further information, please reach out to us at Beneple.