Voluntary VHI health insurance

Voluntary medical insurance (VHI) - a type of personal insurance. In particular, it allows you to receive assistance in medical and preventive institutions (LPU) that do not work under the program. COMPULSORY HEALTH INSURANCE

Voluntary health insurance is usually divided into individual (taking into account the complexity of a particular disease of a particular person) and collective (taking into account the risk of certain diseases in a group of people).

Policyholders are individuals (as a rule, according to individual programs - pregnancy, tick-borne encephalitis, etc.) and employers (as a rule, according to collective programs - outpatient care, inpatient treatment, dentistry)^[1].

2023

The Russian VHI market for the year grew by 19% to 253.5 billion rubles

In 2023, the volume of the Russian voluntary health insurance (VHI) market reached approximately 253.5 billion rubles. This is almost 19% more compared to 2022, when the industry's turnover was estimated at 213.7 billion rubles. Such data are reflected in the BusinesStat study, the results of which were released on June 25, 2024.

According to estimates, in 2019, the costs in the segment under consideration amounted to about 180.7 billion rubles. In 2020, due to a decrease in the number of appointments for VHI policies during the COVID-19 pandemic, turnover decreased by 2% and amounted to 177 billion rubles. After that, a period of steady growth began: insurance companies adapted to new conditions and were able to increase fees.

In 2021, the market volume reached 199.9 billion rubles, an increase of 13% on an annualized basis. And at the end of 2022, the increase was recorded at 6.9%. Insurers received the bulk of the premiums from legal entities that issued insurance for their employees. At the same time, the departure of foreign companies from Russia against the background of a worsening geopolitical situation led to a slight reduction in the number of contracts. In addition, individuals with low incomes refused to purchase an optional policy. As a result, the market turnover increased solely due to the rise in prices for VHI policies.

In 2023, an increase in demand for VHI from employers was recorded. The departure of foreign customers of insurers from the Russian market was compensated by an increase in interest in VHI among domestic enterprises. The increase in turnover was also facilitated by an increase in the cost of medical services. In general, during 2019-2023, the turnover of the Russian VHI market increased by 40.3%. Among the significant players in the industry are JSC Sogaz, SAO RESO-Garantia, JSC AlfaStrakhovanie, SPAO Ingosstrakh and PJSC IC Rosgosstrakh^[2]

40% of customers apply for medical services on VHI through mobile applications

On average, 41% of voluntary (VHI) consumers medical insurance insured against an employer are ready to recommend their insurer to friends and acquaintances. This is evidenced by the results of a study conducted by the research company ORO. This was announced on December 8, 2023 Insurance by a public examination.

As part of the study, 1,800 interviews were conducted among clients of insurance companies who applied for services under the VHI policy over the past 4 months. The NPS (Net Promoter Score) index of insurance companies participating in the study providing VHI insurance services ranges from 28 to 57. The NPS index shows how satisfied customers are with the services of the insurance company and are ready to recommend it.

In the expert community, an NPS above 30% is considered good. This means that the brand is recognizable, most customers trust it and are not looking for alternative solutions. VHI - voluntary insurance. The main convenience of the service is that the insurance company provides the client with a ready-made pool of clinics with addresses at which such a patient will be admitted by appointment without queues and financial obligations (within the framework of services under an insurance contract). If you have a VHI, then any questions can be answered to you by official phone or in a special application of your insurance company, - said Ekaterina Ryazantseva, Ph.D., associate professor, head of the law department of the Institute of Economics, Management and Law.

The main driver of high NPS ratings, as noted in the study, is speed and high quality of service, including the speed of connecting to the operator and negotiating services.

Most often, clients of insurance companies apply for approval of services under the VHI policy (67% on average) or for admission to a medical institution (59% on average). At the same time, on average, 40% of customers apply for services through the insurance company's mobile application, including chat. More than 50% of users of these applications praised the competence of the chat operator, the stability of the application, as well as the convenience and ease of use of the application.

How Russia is digitalizing the VHI system

In voluntary health insurance, artificial intelligence is the engine of automation of many business processes, as a result of which it is possible to solve the client's issue without the participation of company employees with medical education. Dmitry Popov, Deputy General Director for VHI - Executive Director of Ingosstrakh, spoke about this in early September 2023.

According to him, automation of business processes allows you to optimize the timing of work on simple appeals, allowing doctors to concentrate on complex insurance claims. Ingosstrakh itself, as part of digitalization, uses chatbots for online customer service via VHI, which allows you to direct the client immediately to the necessary doctor or employee of the insurance company to respond to the request. The chatbot advises on the VHI policy, sends it to the right specialist to coordinate medical services or see a doctor, and also prompts how to sign up for an online consultation with the Virtual Clinic service.

In VHI, artificial intelligence is the engine of automation of many business processes

The digitalization of VMS was also told in the VSK Insurance House. This company has launched a digital clinic, which allows, through a combination of classical and telemedicine methods, to significantly reduce the cost of VHI while improving the quality of services, said Oleg Vitko, head of the Medicine unit.

Health care programs are included in the services of the digital clinic. They help develop continuous health care skills for our clients. We organize webinars conducted by professional psychologists, nutritionists, specialists in a healthy lifestyle. We get very good responses, "he said.

Dmitry Popov stressed that artificial intelligence technologies are gradually expanding their application area in medical insurance. Digitalization of key stages is increasingly covering both the main stages of the client path and the reference points of interaction between the insurer and the medical institution.^[3][4]

Foreign citizens can apply for a VHI policy on Public services

February 27, 2023 Ministry of Digital Development reported that foreign citizens can issue a VHI policy for. Public services The VHI (voluntary) policy medical insurance is a mandatory document for foreign citizens in. It Russia is necessary for obtaining medical care and employment in the territory. countries

The VHI policy is mandatory for obtaining a patent for work for foreign citizens. It can be issued for a period of 3, 6, 9 and 12 months. The document will go to Public services 's personal account electronically after payment on the insurance company's website.

How to issue a VHI to a foreigner

• go to the portal under the State Public services account, it must be confirmed
• fill out the application
• when the application is accepted, follow the link from your personal account and pay for VHI on the insurance website

If everything is correct, within 2 working days the electronic policy of VHI will come to the personal account of Public services.

2022

Reduction in the number of insured by 5 million people

In Russia, the number of VHI insured in 2022 decreased by 5 million people compared to 2021 and amounted to 31.8 million. Such data are given in the materials of the Central Bank of the Russian Federation, which were disclosed at the end of March 2023.

As Izvestia writes with reference to the materials of the regulator, the demand for VHI policies from individuals in 2022 continued to grow, and the main decline fell on corporate clients - by 5.6 million people.

The main decrease in the number of insured fell on corporate clients

Ingosstrakh confirmed that in general, there are fewer employees to whom employers provide VHI policies. This is due to the departure from the Russian market of some companies that insured their employees, as well as a decrease in demand for voluntary medical insurance for employees from small and medium-sized businesses, a company representative explained. Another reason is a decrease in the purchasing power of retail customers who purchase such policies on their own.

Olga Rumyantseva, chief underwriter for personal types of insurance at Absolute Insurance, agrees with this. She added that the share of foreign business in the VHI market was quite high, foreign companies considered such policies to be a mandatory part of the social package of their employees, and bought rather expensive programs. The Russian owners who replace them either refuse protection or reduce the cost of policies.

One of the co-founders of the BestDoctor insurer, Mark Sanevich, believes that the decline in the number of insured was also affected by the drop in sales of travel policies, which occurred against the background of flight restrictions and rising air ticket prices.

Against the background of a decrease in the number of insured, an increase in the total volume of fees on VHI was recorded. This is due to an increase in tariffs, market participants explained to Izvestia. Prices in clinics for the year increased by about 15-20%, and the average cost of the policy in the market - by 10-15%.^[5]

Market growth by 6.9% to 214 billion rubles due to an increase in tariffs

In 2022, voluntary insurance (VHI) contributions in Russia amounted to 214 billion rubles, an increase of 6.9% compared to the previous year. The market growth rate decreased - in 2021 they were measured at + 13%. This is evidenced by the data of the Central Bank of the Russian Federation, which were published in March 2023.

According to the statistics of the regulator, fees for VHI in the Russian Federation at the end of 2022 increased more than the volume of insurance premiums as a whole (by 0.5% - to 1.8 trillion rubles). The reason for this trend is an increase in tariffs due to an increase in the cost of medical services. At the same time, the offer of programs with a limited set of risks has expanded, the Central Bank notes. Corporate clients began to choose more often, for example, VHI with a franchise. Payments also increased: against the background of uncertainty and rising prices, patients tried to have time to take the maximum from their policies.

As Vedomosti writes with reference to the insurers themselves, in 2022 they recorded an increase in payments in the voluntary health insurance segment. Demand has also grown due to uncertainties about the extension of VHI programs - this forces the insured to "get better," experts interviewed by the newspaper say. High rates of insurance payments reduce margins and force businesses to become more technologically advanced by setting up loss control processes.

As insurers note, the average check for service in medical clinics has also grown - this affects the acceleration of medinflation. The cost of services under the policy increased in January-September 2022 by an average of 10-15%, noted in Rosgosstrakh and Consent. Dental services have risen the most - immediately by 10-30% per year. "Medical inflation" in 2022 exceeded 12% -14% and its growth will continue in 2023, according to representatives of insurance companies.

Overview of Key Performance Indicators of Insurers

2020: HeadHunter: 41% of Russians are dissatisfied with the VHI policy

41% of Russians are dissatisfied with the VHI policy - the results of the HeadHunter survey. The company announced this on December 10, 2020.

The survey was conducted from September 29 to November 9, 2020 among 3,824 Russian applicants.

According to the survey, 46% of working VHI applicants are provided by the employer, of which 79% have used the policy over the past six months. The study reflects the opinion of users of insurance products of Alfa-Insurance, Alliance Insurance, BestDoctor, VSK, Ingosstrakh, Renaissance, RESO, Rosgosstrakh, SOGAZ, Consent.

As the survey showed, Russians as a whole are not satisfied with the services of insurance companies - on average, only 21% to 35% of respondents spoke positively about the services provided under the VHI policy for each of the insurance companies. 41% of respondents are unhappy with the VHI programs of their insurance company. The average level of NPS for the group of insurance companies received a rating of -13. Most companies have NPS either below or at 0.

The most vulnerable places in terms of customer satisfaction for all insurance companies: support in solving "non-insurance" cases and the presence of bonuses and special discounts on what is not covered by the program. This is also confirmed by the distribution of answers to the question about the difficulties faced by users of VHI policies: the need to coordinate services with insurance and the insufficient volume of services provided are the most popular options.

The study also revealed the attitude of Russians to the services provided under the VHI policy as a whole. Respondents consider the main difficulties in using the VHI program to be the need to coordinate the assigned services with the insurance (43%); insufficient volume of services included in the program (41%); lack of available clinics and places in them (29%), opaque approval criteria and lack of feedback (26%), as well as a long approval process (20%), lack of dentistry (19%) and incompetence of doctors in clinics (19%). Persistent recommendations to make paid research in clinics and a poor level of service were noted by 14% and 11% of respondents, respectively.

The most important characteristics of the ideal VHI program, respondents called the presence of dentistry (50%), transparency of program conditions (39%), direct access to clinics and the ability to sign up independently (27%), high level of service in clinics available under the policy (27%), convenient location of available clinics (25%), the ability to include close relatives in the VHI program (23%) and the presence of services in the healthy lifestyle program that are usually not covered by the VHI policy (13%).

See also

• Compulsory medical insurance (Compulsory health insurance)

Notes