Expatriate Health Insurance

The idea of International Medical Insurance /Private medical Insurance traces its origins back to 1972, when a Danish sea pilot from Mauritius wrote to the Danish insurer: Sygeforsikringen “danmark” (the mutual health insurance “danmark”) complaining that recent legislative changes in Denmark meant that overseas health insurance was unavailable to expatriate Danes.

Sygeforsikringen “danmark” began then to provide international medical care to Danes, and later Scandinavians, living abroad and towards the end of the 1970’s began to provide international health insurance to other nationalities.

In August 1979, International Health Insurance (IHI) danmark a/s was founded in order to specialize in this growing market of expatriates abroad. IHI's vision was far reaching and non discriminatory. It offered medical insurance to any one who applied (outside the US) and it permitted anyone to continue cover once they returned 'home'. It also provided insurance to local nationals and guaranteed renewal.

Other companies soon joined in to compete, but generally preferred to compete on price, rather than the IHI hallmark, which was service.

Few were as brave as IHI to offer continued cover if you returned home to live. Few apart from those with a connection to Lloyds of London would offer cover to local nationals, preferring not to be seen as taking away business from the local markets.

Unlike IHI, few competitors envisaged needing to care for someone's health beyond retirement and among their clients, few clients took the time to review the possible costs of healthcare in their older age.

Cigna in the US was one of the first to actively enter the expatriate group market overseas.

Long established insurers were generally slow to move into the area of international medical insurance and so we have seen the rise of managing agencies, companies that do the marketing, selling, underwriting and claims handling on behalf of an insurer. William Russell from the UK was one of the first managing agents to emerge.

With a growing requirement for insurers to 'know their clients', it remains to be seen how well the managing agents can argue their dealings on behalf of their principals are done with full transparency.