Collaborating for the greater good

How a multi-year collaboration between 2 companies is furthering healthcare access for all in Mauritius and beyond

The saying ‘work smarter, not harder’ doesn’t quite ring true in the case of The Unisure Group and Smart Applications International’s collaboration. In fact, it’s been a matter of consistently working smarter and harder to get things off the ground and introduce Smart’s innovative technology to the Mauritian healthcare market.

The Unisure/Smart collaboration has been years in the making. Unisure, an international health and life insurance provider, saw a gap in the Mauritian market as far as direct settlement structures within out-patient services were concerned. In 2020, they approached Smart with the idea of introducing the market to Smart’s biometric cards, and now, more recently, the Smart Access app.

“Medical facilities in Mauritius charge medical insurance members upfront for out-patient medical treatment because there isn’t currently a formal direct billing structure to insurers that allows for seamless service delivery,” explains Unisure Head of IPMI in Mauritius, Daniel van der Merwe. “While we understood the facilities’ concern around the financial risks, we also felt that we owed it to our Unisure members to find a way to offer them a seamless engagement with the medical facilities within our network.”

And so, the hard work and collaboration between Unisure and Smart started to take shape.

“There are a few very large insurers in Mauritius, and even though it’s not as big a market as any of the other African countries, our conversations with Smart centred around the fact the country’s participation rate in insurance is much higher, largely because the population in general can afford to buy medical insurance,” Unisure’s Group Chief Risk Officer, Pierre Rossouw, explains. “Mauritius has one of the highest GDP per capita in Africa and it’s classified as an upper-middle-income economy. There are many lives on cover with insurers, and that certainly presents a great opportunity for Smart.”

Introducing the innovations behind the Smart Access app to Mauritian medical provider networks become a collective mission between Smart and Unisure, each team attending meeting after meeting to discuss the app and Smart’s innovative product offerings as a solution to the lack of direct settlement structures within local out-patient services.

The Smart Access app goes beyond biometrics to offer a virtual mode of medical access aimed at enhancing the patient experience, providing instant onboarding support to medical insurers, and ensuring provider transparency in healthcare administration.

It essentially issues members with a One Time Pin to allow the hospital to identify them and their level of cover and benefits, but in providing a seamless interaction between the medical provider and the insurer, it also acts as a facilitator of all data, effectively functioning as a full administration system for hospitals too.

After many discussions and engagements in Mauritius with numerous stakeholders, the Smart and Unisure teams recently got their first buy in from one of the country’s leading healthcare providers.

“This is a massive win, for Unisure and Smart,” van der Merwe explains. “Firstly, for Smart, this is the catalyst that will help them to start including other insurers into the structure as well. Large scale participation is vital, because that’s how this will benefit everyone who uses Smart, not just one particular entity.”

For Unisure, on the other hand, spearheading an initial proof of concept alongside Smart will of course benefit their members, hence their direct involvement. But in staying true to one of their seven company values – “We’re going far, together” – Unisure tackled this project with passion because the company equally wants the insurance market to thrive and for world-class healthcare, seamlessly delivered, to be available throughout Africa and beyond.

As Unisure Chairman Dr Graham Woolford says, “This collaboration creates a massive opportunity to make great shifts in the Mauritian medical insurance industry. Sure, this is a win for our competitors too, but at the end of the day it benefits everyone. At Unisure, we understand that in order to work effectively across the continent, we have to work together.”

At its heart, the Smart/Unisure collaboration is about creating an ecosystem for larger participation with multiple partners. Unisure is proud of the fact that their members will be the first to benefit from the Smart Access app, and it will no doubt lead to their members being offered access to an even greater network of medical providers over time, but truly the win is for each and every policy holder to be afforded greater access to the best medical care available.

The fact that a lot of companies set up principal structures in Mauritius, using it as a base to work with the rest of the continent, opens up new benefits to international private medical insurance plans. While many insurers may offer international cover, however, they do it on a pay-and-claim basis. Corporates now signing up with Unisure and within the Smart network will benefit from first-ever direct settlement advantages on their out-patient international cover.

“Smart currently has a presence in 11 African countries,” van der Merwe explains. “What that means for someone like myself, who lives permanently in Mauritius but travels to Kenya frequently, for example, is that should I need to access medical care and I’m on roaming cover, I merely need to present my Smart Access app to a medical provider within Unisure’s network and it identifies everything. It even has a ‘find a medical provider’ feature if I’m new to the country and not sure where my closest provider in the network is.”

At the end of the day, widespread medical services and ease of access is really what it is about, and thanks to the Unisure/Smart collaboration, ensuring that members don’t have to pay out of their pocket for medical treatment, this has truly revolutionised the industry and created an entirely different ecosystem for members to participate in.

For more information on The Unisure Group and Smart Applications International Ltd, visit www.unisuregroup.com and www.smartapplicationsgroup.com/kenya/ respectively.