Australia Private Health Insurance Market

TABLE OF CONTENT

TABLE OF CONTENTS
1 INTRODUCTION 17
1.1 OBJECTIVES OF THE STUDY 17
1.2 MARKET DEFINITION 17
1.3 OVERVIEW OF AUSTRALIA PRIVATE HEALTH INSURANCE MARKET 17
1.4 LIMITATION 19
1.5 MARKETS COVERED 19
2 MARKET SEGMENTATION 21
2.1 MARKETS COVERED 21
2.2 GEOGRAPHICAL SCOPE 22
2.3 YEARS CONSIDERED FOR THE STUDY 22
2.4 CURRENCY AND PRICING 22
2.5 DBMR TRIPOD DATA VALIDATION MODEL 23
2.6 AGE GROUP LIFE LINE CURVE 26
2.7 MULTIVARIATE MODELING 27
2.8 PRIMARY INTERVIEWS WITH KEY OPINION LEADERS 28
2.9 DBMR MARKET POSITION GRID 30
2.10 DBMR MARKET CHALLENGE MATRIX 32
2.11 VENDOR SHARE ANALYSIS 33
2.12 SECONDARY SOURCES 34
2.13 ASSUMPTIONS 35
3 EXECUTIVE SUMMARY 36
4 PREMIUM INSIGHTS 39
4.1 SOUTH EAST ASIA PRIVATE HEALTH INSURANCE MARKET- PESTEL ANALYSIS 40
4.1.1 OVERVIEW 40
4.1.2 POLITICAL FACTORS 40
4.1.3 ENVIRONMENTAL FACTORS 41
4.1.4 SOCIAL FACTORS 41
4.1.5 TECHNOLOGICAL FACTORS 41
4.1.6 ECONOMICAL FACTORS 41
4.1.7 LEGAL FACTORS 42
4.1.8 CONCLUSION 42
4.2 PORTERS FIVE FORCES: 43
4.2.1 THREAT OF NEW ENTRANTS: 43
4.2.2 THREAT OF SUBSTITUTES: 44
4.2.3 CUSTOMER BARGAINING POWER: 44
4.2.4 SUPPLIER BARGAINING POWER: 44
4.2.5 INTERNAL COMPETITION (RIVALRY): 44
4.3 SOUTH EAST ASIA INSURANCE SCENARIO VS GLOBAL 44
4.4 CUSTOMIZED DELIVERABLE 45
4.4.1 HOW ARE INSURANCE CLAIMS EVALUATED (I.E., PROCESS FOR FILING FROM HOSPITALS, PHYSICIAN JUSTIFICATION) 45
4.4.2 DATA INTERPRETATION 46
5 INDUSTRY INSIGHTS 59
5.1 DEMOGRAPHIC TRENDS:- 59
5.1.1 AGE 59
5.1.2 GENDER 59
5.1.3 OCCUPATION 59
5.1.4 FAMILY SIZE 59
5.2 NUMBER OF CLAIMS BY TYPE 59
5.2.1 CASHLESS VS. REIMBURSEMENT CLAIMS 60
5.3 EXTRA CARE/TOP-UP INSURANCE OFFERINGS BY COMPANIES 61
5.4 INVESTMENT & FUNDING 61
5.5 PENETRATION OF PRIVATE INSURANCE & DENSITY 62
5.6 INTERVIEWS WITH KEY HOSPITALS AND INSURANCE COMPANIES 63
5.7 POLICY SUPPORT FOR LIFE INSURANCE IN SOUTH EAST ASIA 64
5.7.1 MALAYSIA 64
5.7.2 PHILIPPINES 64
5.7.3 THAILAND 64
5.7.4 VIETNAM 64
5.8 PUBLIC VS PRIVATE HEALTH INSURANCE 66
5.9 OTHER KOL SNAPSHOTS 67
5.10 PREMIUM/COPAY/COINSURANCE 68
6 REGULATORY FRAMWORK 69
7 MARKET OVERVIEW 70
7.1 DRIVERS 72
7.1.1 INCREASING COST FOR MEDICAL SERVICES 72
7.1.2 GROWING NUMBER OF DAY CARE PROCEDURES 72
7.1.3 MANDATORY OPTING FOR HEALTH INSURANCE IN PUBLIC AND PRIVATE SECTOR 74
7.1.4 INCREASING OLD AGE POPULATION 74
7.2 RESTRAINTS 75
7.2.1 HIGH COST OF PREMIUM 75
7.2.2 STRICT DOCUMENTATION PROCESS FOR CLAIM REIMBURSEMENT 76

7.3 OPPORTUNITIES 76
7.3.1 INCREASING AWARENESS ABOUT THE BENEFITS OF HEALTH INSURANCE 76
7.3.2 INCREASING HEALTH CARE EXPENDITURE 77
7.3.3 GROWING MEDICAL TOURISM AMONG COUNTRIES 78
7.4 CHALLENGE 79
7.4.1 LACK OF AWARENESS REGARDING HEALTH INSURANCE 79
8 AUSTRALIA PRIVATE HEALTH INSURANCE MARKET, BY TYPE 81
8.1 OVERVIEW 82
8.2 INDIVIDUAL HEALTH INSURANCE 83
8.3 FAMILY HEALTH INSURANCE 83
8.4 CRITICAL ILLNESS INSURANCE 83
8.5 DISEASE-SPECIFIC INSURANCE 84
8.6 OTHERS 84
9 AUSTRALIA PRIVATE HEALTH INSURANCE MARKET, BY HEALTH PLAN CATEGORY/METAL LEVELS 85
9.1 OVERVIEW 86
9.2 BRONZE 87
9.3 SILVER 87
9.4 GOLD 87
9.5 PLATINUM 88
9.6 OTHERS 88
10 AUSTRALIA PRIVATE HEALTH INSURANCE MARKET, BY PROVIDER TYPE 89
10.1 OVERVIEW 90
10.2 HEALTH MAINTENANCE ORGANIZATIONS (HMOS) 91
10.3 PREFERRED PROVIDER ORGANIZATIONS (PPOS) 91
10.4 EXCLUSIVE PROVIDER ORGANIZATIONS (EPOS) 91
10.5 POINT-OF-SERVICE (POS) PLANS 92
10.6 HIGH-DEDUCTIBLE HEALTH PLANS (HDHPS) 92
10.7 OTHERS 92
11 AUSTRALIA PRIVATE HEALTH INSURANCE MARKET, BY AGE GROUP 93
11.1 OVERVIEW 94
11.2 MIDDLE ADULTHOOD (45-64 YEARS) 95
11.3 YOUNG ADULTHOOD (19-44 YEARS) 95
11.4 OLDER ADULTHOOD (65 YEARS AND ABOVE) 95

12 AUSTRALIA PRIVATE HEALTH INSURANCE MARKET, BY DISTRIBUTION CHANNEL 97
12.1 OVERVIEW 98
12.2 DIRECT INSURANCE COMPANIES 99
12.3 INSURANCE AGGREGATORS 99
12.4 OTHERS 99
13 AUSTRALIA PRIVATE HEALTH INSURANCE MARKET, BY COUNTRY 101
13.1 AUSTRALIA 106
14 AUSTRALIA PRIVATE HEALTH INSURANCE THERMAL INSULATION PACKAGING MARKET, COMPANY LANDSCAPE 108
14.1 COMPANY SHARE ANALYSIS: AUSTRALIA 108
14.2 MERGER & ACQUISITION 109
14.3 EXPANSIONS 110
14.4 NEW PRODUCT DEVELOPMENT 110
14.5 PARTNERSHIP 112
15 SWOT ANALYSIS 115
16 COMPANY PROFILE 116
16.1 AETNA INC. (A SUBSIDIARY OF CVS HEALTH) 116
16.1.1 COMPANY SNAPSHOT 116
16.1.2 REVENUE ANALYSIS 116
16.1.3 PRODUCT PORTFOLIO 117
16.1.4 RECENT DEVELOPMENTS 118
16.2 CIGNA 119
16.2.1 COMPANY SNAPSHOT 119
16.2.2 REVENUE ANALYSIS 120
16.2.3 PRODUCT PORTFOLIO 120
16.2.4 RECENT DEVELOPMENTS 122
16.3 AIA GROUP LIMITED 123
16.3.1 COMPANY SNAPSHOT 123
16.3.2 REVENUE ANALYSIS 123
16.3.3 PRODUCT PORTFOLIO 124
16.3.4 RECENT UPDATE 124
16.4 HCF 125
16.4.1 COMPANY SNAPSHOT 125
16.4.2 REVENUE ANALYSIS 125
16.4.3 PRODUCT PORTFOLIO 126
16.4.4 RECENT UPDATES 126

16.5 ALLIANZ 127
16.5.1 COMPANY SNAPSHOT 127
16.5.2 REVENUE ANALYSIS 127
16.5.3 PRODUCT PORTFOLIO 128
16.5.4 RECENT UPDATES 128
16.6 SUNCORP GROUP 129
16.6.1 COMPANY SNAPSHOT 129
16.6.2 REVENUE ANALYSIS 129
16.6.3 PRODUCT PORTFOLIO 130
16.6.4 RECENT UPDATES 130
16.7 MEDIBANK PRIVATE LIMITED 131
16.7.1 COMPANY SNAPSHOT 131
16.7.2 REVENUE ANALYSIS 131
16.7.3 PRODUCT PORTFOLIO 132
16.7.4 RECENT DEVELOPMENTS 132
16.8 DAI-ICHI LIFE VIETNAM 134
16.8.1 COMPANY SNAPSHOT 134
16.8.2 PRODUCT PORTFOLIO 134
16.8.3 RECENT UPDATE 134
16.9 HSBC GROUP 135
16.9.1 COMPANY SNAPSHOT 135
16.9.2 REVENUE ANALYSIS 135
16.9.3 PRODUCT PORTFOLIO 136
16.9.4 RECENT UPDATE 136
16.10 ACCURO HEALTH INSURANCE 137
16.10.1 COMPANY SNAPSHOT 137
16.10.2 PRODUCT PORTFOLIO 137
16.10.3 RECENT UPDATE 138
16.11 AIG ASIA PACIFIC INSURANCE PTE. LTD 139
16.11.1 COMPANY SNAPSHOT 139
16.11.2 PRODUCT PORTFOLIO 139
16.11.3 RECENT UPDATE 139
16.12 ASSICURANZIONI GENERALI S.P.A. 140
16.12.1 COMPANY SNAPSHOT 140
16.12.2 FINANCIAL ANALYSIS 140
16.12.3 PRODUCT PORTFOLIO 141
16.12.4 RECENT UPDATES 141

16.13 AXA 142
16.13.1 COMPANY SNAPSHOT 142
16.13.2 REVENUE ANALYSIS 142
16.13.3 PRODUCT PORTFOLIO 143
16.13.4 RECENT UPDATE 143
16.14 BNI LIFE 144
16.14.1 COMPANY SNAPSHOT 144
16.14.2 REVENUE ANALYSIS 144
16.14.3 PRODUCT PORTFOLIO 145
16.14.4 RECENT UPDATES 145
16.15 BUPA GLOBAL 146
16.15.1 COMPANY SNAPSHOT 146
16.15.2 PRODUCT PORTFOLIO 146
16.15.3 RECENT UPDATE 146
16.16 ETIQA 147
16.16.1 COMPANY SNAPSHOT 147
16.16.2 PRODUCT PORTFOLIO 147
16.16.3 RECENT UPDATE 148
16.17 GREAT EASTERN HOLDINGS LIMITED 149
16.17.1 COMPANY SNAPSHOT 149
16.17.2 PRODUCT PORTFOLIO 149
16.17.3 RECENT UPDATE 149
16.18 HONG LEONG ASSURANCE BERHAD 150
16.18.1 COMPANY SNAPSHOT 150
16.18.2 PRODUCT PORTFOLIO 150
16.18.3 RECENT UPDATES 150
16.19 INCOME 152
16.19.1 COMPANY SNAPSHOT 152
16.19.2 PRODUCT PORTFOLIO 152
16.19.3 RECENT UPDATES 152
16.20 MANULIFE HOLDINGS BERHAD 154
16.20.1 COMPANY SNAPSHOT 154
16.20.2 REVENUE ANALYSIS 154
16.20.3 PRODUCT PORTFOLIO 155
16.20.4 RECENT UPDATES 155
16.21 NIB NZ LIMITED 157
16.21.1 COMPANY SNAPSHOT 157
16.21.2 PRODUCT PORTFOLIO 157
16.21.3 RECENT UPDATE 157

16.22 NOW HEALTH INTERNATIONAL 158
16.22.1 COMPANY SNAPSHOT 158
16.22.2 PRODUCT PORTFOLIO 158
16.22.3 RECENT DEVELOPMENTS 159
16.23 PACIFIC CROSS 161
16.23.1 COMPANY SNAPSHOT 161
16.23.2 PRODUCT PORTFOLIO 161
16.23.3 RECENT UPDATE 162
16.24 PARTNERS LIFE 163
16.24.1 COMPANY SNAPSHOT 163
16.24.2 PRODUCT PORTFOLIO 163
16.24.3 RECENT UPDATES 163
16.25 PRUDENTIAL ASSURANCE MALAYSIA BERHAD 164
16.25.1 COMPANY SNAPSHOT 164
16.25.2 PRODUCT PORTFOLIO 164
16.25.3 RECENT UPDATE 164
16.26 RAFFLES MEDICAL GROUP 165
16.26.1 COMPANY SNAPSHOT 165
16.26.2 REVENUE ANALYSIS 165
16.26.3 PRODUCT PORTFOLIO 166
16.26.4 RECENT UPDATE 166
16.27 SOUTHERN CROSS 167
16.27.1 COMPANY SNAPSHOT 167
16.27.2 PRODUCT PORTFOLIO 167
16.27.3 RECENT UPDATES 167
16.28 THE ROYAL AUTOMOBILE CLUB OF WA (INC.). 169
16.28.1 COMPANY SNAPSHOT 169
16.28.2 PRODUCT PORTFOLIO 169
16.28.3 RECENT UPDATES 169
16.29 TOKIO MARINE 170
16.29.1 COMPANY SNAPSHOT 170
16.29.2 PRODUCT PORTFOLIO 170
16.29.3 RECENT UPDATE 170
16.30 UNIMED 171
16.30.1 COMPANY SNAPSHOT 171
16.30.2 PRODUCT PORTFOLIO 171
16.30.3 RECENT UPDATES 171

16.31 ZURICH 172
16.31.1 COMPANY SNAPSHOT 172
16.31.2 REVENUE ANALYSIS 172
16.31.3 PRODUCT PORTFOLIO 173
16.31.4 RECENT UPDATES 173
17 QUESTIONNAIRES 175
18 RELATED REPORTS 178