The role of insurance is expanding from 'post-coverage' to 'preventive care and health management.' With an aging population and an increase in chronic diseases, traditional methods of providing insurance payouts after illness are becoming insufficient to meet diverse health management needs. Insurers are increasingly broadening their business areas to include health screenings, lifestyle management, chronic and severe disease management, and senior care.
Samsung Fire & Marine's healthcare team consists of over 30 professionals, including rehabilitation physicians, nurses, and experts in gerontology, financial engineering, and demography, working together to bridge the gap between insurance and healthcare.
Lee Hae-sung, head of the healthcare business team at Samsung Fire & Marine, emphasized in a recent interview with Aju Economy that the core of the healthcare business is to connect the customer's treatment journey. He stated, 'Insurers must act as 'care navigators' or 'care coordinators' to ensure that customers receive the necessary services in a timely manner throughout the process of prevention, diagnosis, treatment, post-care, rehabilitation, and long-term care.'
Below is a Q&A with the executive.
- What does the Samsung Fire & Marine healthcare team do?
'The Samsung Fire & Marine healthcare team is composed of over 30 members, including rehabilitation physicians, nurses, and PhD-level experts from various fields such as gerontology, financial engineering, and demography. We are creating a business model that integrates insurance, healthcare, and services while also researching how data can be effectively utilized.'
- What is the biggest challenge in transitioning from post-coverage to preventive care?
'Insurance can be likened to an umbrella. While an umbrella is needed when it rains, it is also necessary when it snows. Insurers must provide value to customers while also creating value within the insurance itself. The biggest challenge is how to deliver both simultaneously. Even if we create a prevention-focused healthcare model, customers must actively use it and change their lifestyles for it to be effective. Creating good services and changing customers' health habits are two different issues. The time factor is also important. Insurance payouts can be measured immediately, but the effects of prevention or lifestyle changes manifest over a long period. We need to look at not just short-term usage rates but also long-term changes in health habits, delays in disease progression, treatment continuity, reduced readmissions, and customer retention rates.'
- How can we encourage customers to use healthcare services habitually?
'First is hyper-personalization. Each customer has different ages, genders, health screening results, existing conditions, and lifestyles, so providing the same health information to everyone will not encourage sustained use. Second is immediacy. For example, using a continuous glucose monitor (CGM) allows customers to see how their blood sugar changes based on their meals in real time. Customers need to be able to immediately see the relationship between their actions and health changes to adjust their behavior. Third is motivation. We need rewards that go beyond simply giving points for walking. For instance, analyzing the nutritional content of meals through photos or providing coupons for healthy behaviors like walking for a certain amount of time can be effective. Considering the aging population and the increase in single-person households, family-based care is also important. There may be a growing demand for services that manage the health status of parents living separately.'
- How can health data be utilized in actual business?
'Health screening data is crucial for understanding customers' health statuses. Lifestyle data includes information collected through smartphones or wearables, such as sleep patterns, eating habits, exercise, blood pressure, and blood sugar levels. Smart scales can also provide insights into body composition and hydration. The recent expansion of the medical MyData system has laid the groundwork for individuals to take a more proactive role in utilizing their medical information. In the future, if we can safely connect medical and health data with insurance and financial data, we believe it will enable more sophisticated personalized health management. These data must be combined to create personalized and immediate services.
However, various regulations, including privacy laws, medical laws, and financial regulations, are intertwined. While we are exploring various initiatives through regulatory sandboxes, a more sophisticated structure based on trust among customers, insurance companies, and data providers must be established. It is more important to safely utilize data within the scope agreed upon by customers and to return the results to better health management services or insurance experiences.'
- What services can be offered by combining financial MyData and health data?
'Financial MyData allows customers to view their spending, financial status, pensions, insurance subscriptions, and assets. Medical MyData provides information on hospital usage, diseases, treatments, and medications. When these two are combined, we can assess both health risks and financial risks for customers. For example, analyzing income, medical expenses, insurance status, and health conditions together can lead to personalized coverage analysis, health management based on disease risk, medical expense predictions, senior care, and management of medical expenses after retirement.
In the long term, we envision using artificial intelligence (AI) to analyze both health and financial assets, considering health risks as well as expected medical expenses and income gaps in the event of illness, coverage, and retirement assets. This represents one aspect of Samsung Fire & Marine's vision for a 'hyper-personalized care navigator.' However, since both financial and health information are sensitive, clear customer consent and transparency regarding the purpose of data utilization are essential.'
- What is the ideal collaboration structure with hospitals, startups, and big tech companies?
'In one word, the ideal structure is 'separate yet together.' Hospitals provide medical expertise, tech companies offer technology, pharmaceutical companies focus on new drugs and treatments, and startups specialize in innovative services. Insurers excel in managing the entire customer journey and risk. Customers prefer a connected experience rather than using each service separately. I believe insurers should act as care navigators or coordinators to facilitate organic connections among all players.
In particular, Samsung Fire & Marine can leverage infrastructure such as startup incubation programs for strategic partnerships and investments. We are also considering various collaborations with institutions like Samsung Medical Center, Gangbuk Samsung Hospital, and Catholic University Medical Center to enhance research and improve customers' quality of life. Our goal is to provide a unified experience while respecting each party's expertise.
* This article has been translated by AI.
Copyright ⓒ Aju Press All rights reserved.