The Private Medical Insurance Market in Ireland

Last week, iPMI Global reported that AXA Accelerates the Development of its Health Strategy in Europe with the Acquisition of Laya. This week global insurance and healthcare analyst Ian Youngman, gives us his take on the deal. Ian is a writer and researcher specialising in international private medical insurance, global healthcare and medical tourism. He writes regularly for a variety of magazines, newsletters, and online services. He publishes a range of market reports and undertakes research for companies and has London market management experience with brokers and insurers. To read Ian's reports, click here.

AXA has bought Laya Healthcare from AIG. The sale is expected to close in the fourth quarter of 2023, subject to regulatory approvals and other customary closing conditions.

• Laya Healthcare, Ireland’s second largest health insurance provider with offices in Cork and Dublin, and serves 28% of the Irish private health market.
• 690,000 customers.
• Revenue EUR 800 million.
• The company also offers life, dental, and travel insurance.
• Laya Healthcare acts as a MGA for Elips Insurance.
• AXA – Global Healthcare has a regional distribution hub in Dublin to cover all of Europe.
• AXA will acquire Laya for €650 million (US$712.7 million).
• Laya traces its roots back to the formation of Bupa Ireland in 1997, which ended VHI’s monopoly on the State’s health insurance market.
• The business was bought in 2007 by Quinn Insurance and restructured as Laya after administrators were appointed to Quinn Insurance in 2010.
• Laya was the subject of a management buyout in December 2011 with the support of an underwriter owned by Swiss Re.
• AIG acquired the business in 2015.

Analysis

• AXA affirms its ambition to grow its European franchise, by expanding its operations in a buoyant, fast-growing health insurance market.
• AXA Ireland is a market leader in motor insurance, holding more than 30 per cent of the market.
• It is also an active player in the home, commercial, and farm lines of business.
• AXA operates in the Republic of Ireland and Northern Ireland with 1450 employees and h 34 branches.
• AIG has almost completely left PMI and IPMI.
• Accident and Health insurance products within General Insurance include voluntary and sponsor-paid personal accident and supplemental health products for individuals, employees, associations and other organisations, as well as a broad range of travel insurance products and services.
• Health and international health insurance have always been a small part of the covers offered, and for decades it has been in and out, in and out etc. of both markets in various countries.
• AIG Global Benefits Network is a worldwide network of leading insurers providing customised employee benefits products and services to multinationals. There are 40 insurer partners for 100 countries. It uses captives and pooling for group PMI and group IPMI.
• AIG Direct offers health cash insurance in the UK but not PMI or IPMI.
• AIG Private Client is for the HNW market but does not offer health insurance.
• There are now very few countries that AIG is selling health insurance in.
• It offers IPMI in China and Singapore and that is about it.
• 48 per cent of the Irish population-2.5 million people- has some form of health insurance according to the Health Insurance Authority.
• Health insurance in Ireland is massively complex.
• Competitors subsidise the once state owned VHI.
• Apart from VHI and Laya the only other PMI insurer is Irish Health Life owned by Great-West Lifeco.
• VHI has a 49% market share and Irish Life Health has 20%.
• PMI is a complex legal minefield as Chubb and Bupa found to their cost.
• IPMI is probably illegal within the Republic of Ireland but the legal position is cloudy.
• Ireland has a booming economy.
• The country sees much inbound investment and new local businesses.

What is next?

• Axa ultimately plans to replace the Swiss Re units to underwrite Laya’s business itself.
• Ireland is within the EU and effectively Northern Ireland is in a free trade region with the Republic of Ireland.
• Perhaps not in my lifetime but it is almost certain that the two halves will join together.
• Axa could and should cross-sell other products into the Laya membership.
• It could offer discounts to customers on home or motor insurance- the two competitors cannot do this.
• Within a decade people born overseas will outnumber those born in Ireland.

The latest information, facts and figures on iPMI and international health insurance

• International Private Medical Insurance (IPMI) is a key global health insurance product for many insurance companies, brokers and MGAs.
• It is a dynamic market that is seeing major new partnerships, selling and buying of insurers or business books, technological changes and much more.
• New compulsory health insurance and universal health insurance affects demand in a positive as well as negative way.
• Brokers and insurers expect strong growth in 2023 and future years.
• Employers are shifting from traditional expat models to decentralised models that incorporate more virtual assignments and in-market hiring. 
• There are more short-term and flexible assignments but the number of long-term assignments is at pre-2020 levels.
• IPMI has new markets of HNW, digital nomads, temporary foreign workers, cross-border workers, local employees, contract workers plus international students.
• The publisher has been researching and studying the IPMI market for 30 years.
• His market reports are based on a daily updated database of 177 countries-83 insurance companies-47 insurance brokers, agents and MGAs/MGUs.
• The main IPMI is report is 300 pages and as well as the latest information this edition studies the many insurer-insurer IPMI partnerships that are changing the global market.

The 2023 edition includes:

• 177 country profiles
• 83 insurance companies 
• 47 insurance brokers, agents, MGAs and others

Download the full report, International Health Insurance 2023, click here.