Healthy living is at the top of the agenda for Daman which has 2.4 million policy holders. Its CEO, Dr Michael Bitzer, is a former German army doctor who served in Bosnia as a peacekeeper. Delores Johnson / The National
Healthy living is at the top of the agenda for Daman which has 2.4 million policy holders. Its CEO, Dr Michael Bitzer, is a former German army doctor who served in Bosnia as a peacekeeper. Delores JohShow more

Health insurer Daman proves a good fit for UAE



It would be difficult to accuse the Daman chief executive of not practicing what he preaches.

Healthy living is at the top of the agenda at the national health insurance company that has 2.4 million policy holders.

With chronic conditions from diabetes to cardio-vascular disease costing health authorities in the country billions of dollars, the Abu Dhabi-based insurer is fully focused on promoting a fitter and healthier nation.

But for the chief executive Dr Michael Bitzer it means more than eating his five-a-day and the occasional jog.

The former German army doctor who served in Bosnia as a peacekeeper has already run a half marathon on the treadmill before lunch in preparation for a 73km race in Germany.

The afternoon includes a session cycling through the dunes on a track on the outskirts of the capital.

When he is not in the gym or cycling he is running up and down Jebel Hafeet or cross-country skiing.

“I’m really in the wrong country for that one,” he reluctantly concedes. “I did try it with roller skis here once but people looked at me like I was an alien.”

Next year he plans to take a group of Daman employees to an endurance event in the Netherlands that involves walking 50km per day over four days.

An email sent out to staff to scope out potential interest generated 250 responses. That was whittled down to 45 who survived a series of Herculean fitness tasks such as running around Yas Marina and walking up and down 16 flights of stairs at the company’s old offices.

“I feel there is more of a discussion around healthy living in the country now,” says the former Munich Re executive, who has been at the helm of Daman for a decade.

The health insurer is 80 per cent-owned by the Abu Dhabi Government with the remaining 20 per cent held by Munich Re.

It exclusively manages the Government’s Thiqa health programme for UAE nationals as well as one for low-income expatriates.

The adoption of mandatory health insurance in Dubai means the company is now expanding out from its base in the capital and has already added some 150,000 mainly expat members living in the neighbouring emirate.

Its growth comes at a turbulent time for country’s crowded insurance sector where a large number of small operators offering multiple lines have accumulated huge losses as a result of cut-throat competition.

The latest crop of quarterly results from the sector revealed more losses for an industry struggling to achieve profitable premiums.

“Some competitors had problems that’s true,” he says. “Some did the wrong risk assessment or, to gain market share, dropped their premiums. Some burned their fingers and destroyed their shareholder capital.”

Because Daman only offers health insurance it is not exposed to the competition in other crowded insurance lines where the battle to win customers has led many companies to write so-called “toxic” or negative premiums where the cost of the policy does not cover its real cost. In such situations a rise in claims can wipe out profits and leave companies dangerously exposed.

Still, with the cost of providing healthcare spiralling in recent years, Daman has invested millions of dollars in technical analysis to keep on top of costs while also flagging up potential fraud or misuse.

The healthcare sector is expanding rapidly across the region, driven by population growth, the roll out of mandatory health insurance schemes and the increasing incidence of lifestyle diseases.

Regional health spending is projected to grow at 12 per cent a year to US$69.4 billion by 2018 from an estimated $39.4bn in 2013, according to Alpen Capital.

In the region, Saudi Arabia will remain the largest market while Qatar and the UAE are expected to be the fastest growing ones. That kind of growth is a challenge for health insurers seeking to keep a lid on costs in a region where free health and dental cover is seen as an entitlement.

“People expect health to be for free,” says Dr Bitzer. “In the past, governments have covered costs so it is difficult for people to accept that good health care costs. This is the case across the GCC,” he says.

The provision of free health care also means there is little to discourage people from overusing health services by, for example, seeking multiple “second” opinions or visiting doctors or emergency rooms unnecessarily.

“You hear a lot of anecdotal stories,” Dr Bitzer concedes. “Everyone knows someone who visits five or six providers or knows someone who consumes a lot for dental. But statistically it is not a big problem.

“The easiest way to reduce costs is to reduce access and make people wait for six months. But this would not be accepted by the community here. That is almost a no go.

“We cannot tell someone they cannot go to a hospital. We may in the future develop products with some limitations but currently the schedule of benefits has to be open.”

Daman’s investment in data analysis technology aims to capture not only the trends driven by the member but also those of the hospital.

It compares the cost and frequency of procedures undertaken by hospitals and other health providers against peers to flag up over-spending, misuse or even fraud.

“A provider can maximise the outcome through the legal framework. Fraud is different – it’s a criminal activity,” Dr Bitzer says. But he acknowledges there is sometimes a thin line that separates the two.

He says the company will continue to invest in data analytics to keep on top of such behaviour.

That should ensure that the company, like its chief executive and its stair-climbing employees, stays in shape.

scronin@thenational.ae

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