In early 2019, the Voluntary Health Insurance Scheme (VHIS) was introduced in Hong Kong by the Food and Health Bureau to regulate indemnity hospital insurance plans offered to individuals, with voluntary participation by insurance companies and consumers. The VHIS was designed as a means of encouraging and supporting customers to purchase private healthcare services and for Koh Yi Mien, Managing Director Health and Employee Benefits at AXA Hong Kong, this scheme represents a broader transformation of healthcare and insurance services. “Currently, the demand on healthcare in Hong Kong in the public sector is incredibly high with very long waiting times and waiting lists,” she explains. “As a result, people just aren’t getting timely access to treatment. The private sector in Hong Kong, which is world-class, has capacity. So, if we can rebalance and shift some of the elective work from public to private, it will free up more people to use the public service in a timely fashion.”

Yi Mien also points to a global drive for greater transparency, accountability, use of data and technology as well as promoting customer choice as key drivers of change in the insurance space. “It’s no longer a case of simply providing reimbursement to people when they need treatment,” she says. “It’s about being the patient’s partner throughout their whole life so that when they need healthcare, whenever and wherever they are, we are there to help and support them in their times of need.” 

The modern-day insurance customer is very different from the customer of the past. We live in times of greater access to information through the advent of social media and the increasing influence of the Internet and this has resulted in insurance customers being more knowledgeable about their conditions and asking more questions of their doctors than ever before. As a result, the balance between the customer and the healthcare provider is becoming more equitable. “Customers and patients, as a result, are becoming more demanding,” says Yi Mien. “Gone are the traditional ideas that doctor knows best. It’s not uncommon for patients to see their doctor with a list of demands, while expecting to be serviced.”

Running parallel to becoming more knowledgeable and demanding is the use of smartphones and how it has created a culture of service in an instant. When customers purchase etiquettes or use banking services, they expect the ability to be able to access and complete these transactions and services via their smartphone devices. Fewer and fewer people are accessing physical bank branches and the healthcare insurance sector, despite being still very traditional, is feeling the effects of this instant demand. “Healthcare is a very traditional sector sure, but asking patients or customers to book weeks in advance and telling them they don’t really have any choice is becoming increasingly unacceptable and so healthcare becomes a commodity,” says Mie Koh. “They, like any other customer, vote with their feet and want 24/7 access to quality healthcare without waiting directly from us as the insurer.”

The informed customer and patient have also transformed the relationship between customer and doctor. It is no longer a bilateral relationship and the entire healthcare ecosystem works to provide services from prevention right through to treatment. The result? Insurers like AXA work with customers before they are sick and encourage them to maintain their health, but they also work with clients during their illness and even afterwards AXA will continue to treat them in their rehabilitation. “During their healthcare journey, customers want some handholding in order to navigate the very complex healthcare system, to make sure they get the right healthcare provider, doctor and hospitals that are best for them in their time of need,” says Yi Mien. “This can only happen if we are using digital so that it becomes more real time.”

AXA has been embracing technology for a number of years to be able to serve and effectively work with its customers. It achieves this by starting with the definition of a product, because the product sets the rules. Yi Mien highlights that the rules would often be how AXA would spell out the terms and conditions, the provisions, but these rules also set the customer expectations. Throughout late 2018 and 2019, AXA has invested in digital to enable its customers to buy online, service online, claim online and check-up online. The company also launched a servicing app called Emma, a ‘digital companion’ that enables even faster service. Yi Mien describes this app as a true “health companion”. She is also keen to highlight that the technology is only part of the story. AXA has built a vast medical network with some of the leading hospitals and doctors and customers simply having to log into their companion app to be able to access this network at the touch of a button. “All they need to show is their digital card, their e-card, and with the QR code, the provider just scans it. All of the data is downloaded and all they need to do is sign, get their treatment, and then when they discharge, just sign that they have received the treatment and off they go,” she says. “The hospital will bill AXA directly so there’s no out of pocket. The data is also transmitted to AXA which means that we have more comprehensive and more reliable data.”

Comprehensive and reliable data is crucial to the technology journey of AXA, but it is also integral to the customer journey. With a customer’s entire electronic medical records stored effectively and securely, as Yi Mien notes, why would they go anywhere else? The data that an insurer handles is often complex in nature, but this data is processed through artificial intelligence, with AI being used to process claims more effectively and interpret the information to allow AXA to create rules and algorithms to better serve its customers. AXA also utilises AI through its companion app Emma. “Emma is our chatbot,” explains Yi Mien. “Emma has been built up based on a multitude of Q&As that our customer services team have recorded and collected over many months and years. As we continue to build, and more people use Emma, then the quality of the responses she has in her arsenal will improve.” In the first two months of operations, Emma recorded an accuracy level of 50%. Yi Mien firmly believes that as more people engage with Emma and as a result, the chatbot will evolve and become more of a real-time navigator that can direct customers across the whole ecosystem.

In the global discussion around AI, the topic of transparency is often a key point of debate. With governments around the world shining a spotlight on exactly what data is collected and how it is used, AXA ensures that it maintains an open and transparent dialogue with its customers. As customers engage with Emma and the companion app, they can at any time request their transcripts. Should they choose to speak with a human adviser, all calls are recorded and again they can access those recordings should they wish. Not only is this an example of AXA complying with global governing laws, it also highlights that the customer is at the very heart of every decision it makes and it maintains this as it continues to implement new technologies. “If you look at banking as an example, we all are so used to accessing our bank accounts at any time, be it through our phones or online,” says Yi Mien. “If we want to speak to someone, we can. If we want to go into a branch, we can. I believe this is the way to go with insurance as well. We make it easy for our customers to contact us. We are doing everything we can to allow that.”

“Healthcare is quite personal, so we are doing what we can to allow customers to speak to people, should they not wish to use our chatbot. These are very personal journeys and digital is still in its early days, so we really have to provide different avenues and channels for our customers to contact us.”

As Yi Mien notes, AXA designs its customer journey by starting at the product and going through all the way to treatment. The company makes every decision with the customer’s perspective in mind. As a doctor by trade, Yi Mien sees that all new products are designed by doctors because they understand how the patients move throughout the whole healthcare ecosystem. When AXA designs new products, it does not operate within a vacuum. It has a customer insight group, where around 1,000 customers operate as a real-time focus group in which AXA can test its products with. “When I think about future products, we will test with this group of people and get feedback to see whether we are aligned with the current customer need. So, it’s not just technology per se, but actually meets a customer’s needs,” she says. “One other area to make sure that we are doing the right thing, because technology also costs money, is to make sure that we are very robust in what we do. AXA is unique in that we sell life insurance, health insurance, employee benefits, and we also have P&C. So, being a multi-line insurer, we have the opportunity of having one approach and cross-selling across the business lines, which is a fantastic opportunity. We can only do that through technology.”

Over the course of her career, Yi Mien has been a champion of the transformative effect of technology in becoming a greater enabler for healthcare and healthcare insurance providers around the world. One area in particular that is close to her heart is the mental health space. In Hong Kong, the waiting time to see a psychologist is close to two years and if patients were to seek private care, it is an expensive solution. “Look at a country like Hong Kong, or Australia, they are so vast that there just aren’t enough practitioners to cover the breadth of the geography. Digital is the solution,” she says. “Digital enables people to seek, support and care at the time that is most convenient for them.”

“In the past two to three years, there has been a proliferation of digital tools. Recent studies have shown that digital tools are as good as, if not better, than in-person therapy because customers prefer to talk to a robot rather than face-to-face because they feel that the robot is not judging them.”

Another example that Yi Mien highlights is in the UK, where a VR program has been developed by programmers that is therapy through gameification. The treatment is consistent every time and because of its mobile platform, it is accessible. “We can provide it where you work,” she says. “That’s just one example as to how we can destigmatise mental health through technology.”

AXA operates within a broad healthcare ecosystem, an ecosystem made up of partners, providers and doctors and Yi Mien stresses that in the future of insurance, it will be impossible for insurers to control the ecosystem. “I don’t foresee a future where that happens,” she says. “Partnerships are incredibly important. Things are moving so fast there’s no way we can catch up alone. We need to have partners, collaborators, who are working together to ensure we are at the top of our game and at the forefront of innovation.”

“Over the course of our lives, so many different things can happen and so people will need better care and support. By having a collection of data that represents our customer’s needs we are able to push or suggest services that better meet those needs. In order for us to do that, we need to have players collaborate in the ecosystem. It’s imperative.”

As AXA continues this digital growth journey, the next few years will be defined by improving the agility of the digital companion in order to improve the interaction with customers. AXA will also be looking at developing a digital marketplace in which customers can go shopping within an AXA owned digital platform. For Yi Mien, though, the future is clear for AXA and in order to be successful, she feels it’s down to one thing. “AXA has a clear digital strategy for sure, where it will transform its digital system and build new IT infrastructure to transform the customer experience,” she says. “But the technology is only one part of the story.”

“Unless we can transform the customer experience to deliver a service they truly value, then technology doesn’t do anything. It’s important to recognise that technology is enabling us to transform healthcare, to make it easier, faster, and cheaper for people to receive care. That means in the long-term, sustainable healthcare and health services, which fits into sustainable insurance.”