Control over risk and related premium increases is possible!

2018 is no exception to the rule and mutual insurance premiums have again increased significantly. This happens every year, with average annual increases of 3%. Thierry Beaudet, the chairman of the mutual insurers federation, has announced increases of between 3% and 4% for 2018, a relatively modest rise compared with other such announcements: 4.5% on average at AXA, 4.80% at Generali, 4.9% at Malakoff Médéric, and jumps of sometimes 5% or 6% elsewhere. For income protection/incapacity policies, covering sick leave, incapacity and death, premium increases are less automatic and depend on the balance of the policy in question.


There is however an alternative to systematic premium increases. Businesses can apply a whole series of measures to improve control over their risks. “This starts with an analysis of consumption and cost data in relation to the territorial and sectoral benchmarks we have at our disposal, and continues with a clear summary shared with company management and employee representatives, who can support and partner best practices with employees,” says Jean-Marc Esvant, Head of Social Protection at Verlingue. “We are delivering data useful to the business and highly detailed P&L accounts, from which they can decide what steps to take,” explains Patricia Delaux, director of health and incapacity at AXA Health and Group.


There are not, however, thousands of drivers. If premium increases are removed from the equation, payouts, scope and the number of insureds remain as variables.


Careful policy drafting. “Close attention must be paid to the way policies are drafted and how they are coordinated when superannuation schemes are involved. For our part, we undertake engineering work on drafting cover, with very precise schedules of reimbursement based on medical need and the reality of medical billing to avoid unnecessary or excessive outgoings. We do this for all items of expenditure,” stresses Jean-Marc Esvant. To lower costs, businesses may also exclude employee spouses from their healthcare coverage, as they ought to be covered by their own employer from 2016 onwards.


The business can go further and decide to use healthcare networks. “Spending on opticians and dentists each account for at least 20% of complementary health insurers’ reimbursements. Attempting to control these expense items via healthcare networks has, when employees cooperate, real effects on the balance of policies,” explains Yanick Philippon. Businesses are increasingly taking this step, especially in eye care. “To convince them, we just provide them with a simulator of the savings generated by using healthcare networks. It is much more effective than giving big presentations,” Christophe Scherrer, deputy CEO at Malakoff Médéric, points out. “After a diagnosis phase, carried out on the basis of the healthcare barometer that we offer companies, we build a programme of prevention and adapted support, based on all or some of around thirty services (health e-coaching, absence calculator, back-to-work support, etc.). For companies that commit to implementing this type of programme, we can grant an upfront premium reduction of 8% to 10%. This also makes it possible to adjust increases for companies with loss-making schemes,” Christophe Scherrer continues.


Prevention measures targeting employees’ well-being have more impact on incapacity/income protection policies than on company health insurance schemes. A happy and physically fit employee takes much less sick leave. Here too, insurers are setting up a whole series of indicators to provide a clear snapshot of absence in the business, to identify the causes of sick leave and attempt to remedy the situation. Insurers are also making increasingly systematic use of checking up on employees’ sick leave. “A simple medical certificate requested from the attending physician and sent to our medical advisor is enough to limit abuse of the system. At Axa, all sick leave has been checked for about ten years. This can extend as far as a medical examination,” explains Patricia Delaux. “We are making checks standard practice at Generali,” says Yanick Philippon. Another effective measure is back-to-work support for employees on sick leave, which can limit the length of absence and provide a stress-free, perhaps gradual, return to the workplace.


Mireille Weinberg – L’Opinion