PETER CHRISTOPHER
Senior multimedia reporter
peter.christopher@guardian.co.tt
Local insurance companies have experience an increase in health insurance claims, which has had an impact on their health plans.
Last month, the Guardian newsroom learnt that a health insurance policy offered by Evermed had been subjected back-to-back annual increases in premiums of 100 per cent in 2023, and 101 per cent in 2024. These increases prompted a customer to question the increase in the policy before opting to cancel it.
Guardian Media reached out the Guardian Group (GHL), who facilitate the Evermed policy. In response to the query, the company said, “Health insurance pricing is influenced by two main factors: the demographics of the insured group and its claims experience. Claims experience is shaped by a variety of elements, with medical inflation being a key consideration. This includes the rising costs of healthcare services, medications and consumables, compounded by challenges such as imported inflation. Another important factor is the overall health of the plan participants” said the company.
The response continued, “Since the COVID-19 pandemic, Guardian Life of The Caribbean has seen a steady increase in healthcare usage, which has impacted premiums. As a responsible insurance provider, the company must ensure that premiums are set sensibly to support the long-term stability and sustainability of the plan.”
However, the company stated in the case of the Evermed policy, low participation in the policy had impacted the premiums members who subscribe to the policy would pay.
“In the case of Evermed, previous rate adjustments, influenced by these factors, have led to a decrease in participation. This reduction has, in turn, affected the claims experience in the most recent policy year. As a result, Guardian Life has carefully considered all these factors in our premium renewal process, ensuring that the quoted premium reflects the current needs and dynamics of the plan,” said Guardian Group in its response to the Business Guardian.
The customer who had raised the concern to the Business Guardian, had similarly stated this reasoning was given to him by staff.
In GHL’s summary consolidated financial statements for nine months to September, 30 2024, Guardian Group chairman Robert Almeida acknowledged there had been a higher level of health claims.
“Insurance revenue grew by $363 million or 9 per cent over the prior year, mainly from continued growth in core business across the Group’s diversified product offerings in the English-speaking and Dutch Caribbean markets. The Life, Health and Pension (LHP) segment contributed insurance revenue of $2.2 billion, up from $2 billion in the prior year by $183 million or 9 per cent. Insurance revenue increased on all lines except Group Health, as clients continued to service their policies coupled with new business growth across all territories. This year-over-year increase in revenue was partially offset by increased insurance service expenses impacted by a higher level of health claims and directly attributable expenses. Total gross claims paid by the LHP Segment for the current period amounted to $2.2 billion compared to $1.8 billion in the prior year,” stated Almeida.
He said net insurance finance expenses increased by $58 million or 11 per cent over the prior year, mainly from its LHP segment.”
However, according to that report , the Group recorded unaudited profit attributable to equity shareholders of $598 million, which exceeded the prior year’s restated results of $464 million by $134 million or 29 per cent.
Almeida said of that performance, “This exceptional performance was mainly driven by improved net insurance service result, higher net investment income, higher insurance brokerage fees and commission income and lower other operating expenses partially offset by higher net insurance finance expenses and higher finance charges.”
Guardian Media had reached to two members of the board of directors Association of Trinidad and Tobago Insurance Companies (ATTIC) concerning the issue and if it was indeed symbolic of a trend with regard to health insurance. Neither could state definitively that the Evermed increase was a common occurrence, nor were they aware that there were wide surges as a result of the post COVID-19 trends.
However aside from health insurance, many with vehicle and property insurance have also noted a rise in premiums in recent years. Insurance companies said with regard to property, knock-on effects of several catastrophic events around the world had led to increased insurance costs for property owners in Trinidad and Tobago.
Similarly, it had been reported that an increase in accidents had pushed up the cost of car insurance premiums in the past year.
