Swiss Health Insurance: Digitization Is Still in Its Fledgling Stages

Many Swiss health insurance providers have not yet embraced the trend towards all things digital. This is the conclusion of a study by unbiased comparison service moneyland.ch.

The functions of online portals and smartphone apps offered by 17 Swiss health insurance providers with customers bases of at least 30,000 compulsory health insurance policy holders were analyzed for the study.

Online portals and apps compared

Most Swiss health insurance providers now have websites. However, a number of insurance providers do not offer extended online portals which their customers can log into to access additional services. Even some providers with large customer bases do not provide customer portals. Examples of these include Agrisano, Aquilana, Concordia and ÖKK.

Insurance providers which scored highly with regards to online portal functionality include Atupri (35 out of 40 points), CSS (33 points), Sanitas (32 points), KPT (31 points) and Sanagate (29 points). You can get a detailed overview of the results using the request box at the foot of this article.

Health insurance apps compared

Apps for smartphones and tablets have become increasingly important for many applications. But some health insurance providers do not yet offer apps to customers. These include major insurers like Agrisano, Assura, Concordia and ÖKK.

The highest points for app functionality go to CSS and Sanitas (50 out of 60 points), Sanagate (43 points), Atupri (42 points) and Visana (41 points).

Other insurers like Swica scored poorly in this regard, but are in the process of upgrading their digital services. Concordia, which does not yet offer extended online services, is another such insurer.

 “Although there are a few exceptions to the rule, it is fair to say that Swiss health insurance providers have not yet fully entered the digital age,” says moneyland.ch CEO Benjamin Manz. It isn’t surprising then that a majority of health insurance customers do not use health insurance apps. Insurers either do not offer apps, have only recently launched apps, or offer apps with limited functionality.

Online access to documents

Most health insurance providers which offer customer portals let customers access documents, premium bills and health insurance statements, and view or download their insurance policies. Typically, archived older documents can also be accessed.

When apps are available, the same functions are normally included. Typically, policyholders can use apps to access their bills, statements and policies.

Filing claims via online portals or apps

When indirect claim settlement is used, policyholders must forward healthcare bills to their insurers for reimbursement. Many of the insurers which offer online portals let policyholders file claims and upload medical bills, pharmacy bills, therapist bills and invoices for other covered costs via their online portals. Not all customer portals include this function. For example, Assura policyholders must send invoices by mail.

Smartphones provide an ideal medium for claims filing, as invoices can quickly be photographed and submitted to insurance providers using a single device. All insurers which offer customer portal apps include this function. Even customers of Helsana, which only recently began offering a customer portal app, can now file claims via app.

The claims function offered by Swiss insurers is already widely used. Swica expects 500,000 claims – approximately 17 percent of claims by its policyholders – to have been submitted by app by the end of 2018. KPT says that around 229,000 documents have been submitted via its customer portal and app. Atupri says that around 10,000 invoices are uploaded every month.

Digital health insurance cards and vaccination certificates

Health insurance cards store important personal health insurance information, and facilitate healthcare billing. Because many policyholders now carry smartphones, the concept of virtual health insurance cards has become an increasingly realistic option.

The majority of Swiss health insurance providers do not include this function in their apps. However, the apps offered by Atupri, CSS, Sanagate, Sanitas, Sympany and Visana do let users display virtual health insurance cards. Virtual vaccination certificates are rare, with only the Sanitas app including a virtual vaccination booklet.

Deductible and coinsurance tracker

Keeping track of remaining annual deductible and coinsurance payments and remainders throughout the insurance year is difficult. Policyholders are often unsure exactly how much they must still pay out-of-pocket at any point within an insurance year. Being able to quickly see exactly how much of their annual deductible and coinsurance still applies at any time is a simple but useful function. Surprisingly, this basic function is not included in all customer portals. For example, the customer portals offered by Assura and Helsana do not currently provide a simple overview of deductible statuses.

Reporting accidents and hospital stays

The option to report accidents or hospital stays via customer portals is not yet widely offered. Only five insurers provide this option. Only the apps offered by Atupri and KPT let customers report accidents. Atupri, CSS and KPT give policyholders the option of reporting hospital stays via app.

Limited digital communication

Many of the insurance providers included in the analysis give policyholders the option of sending messages directly to insurer representatives via the customer portal. However, very few insurers offer live customer support chat functionality. Exceptions to this rule include Atupri (German only) and Groupe Mutuel. Swica and Sympany provide customer service chat lines on their websites.

The same rule applies to apps. Only CSS and Sanitas let customers communicate directly with representatives over their Smartphones via chat. “In an era in which instant messaging via Whatsapp and other communication services has long been the norm, the absence of chat services from Swiss health insurance providers is surprising,” according to moneyland.ch analyst Ralf Beyeler.

A direct connection to telemedicine centers via app is another key feature which is surprisingly absent. Only the apps offered by CSS, Sanagate and Swica (a separate app is required) provide this service.

Insurance coverage information

All of the customer portals offered by analyzed Swiss health insurance providers let customers access information about their insurance coverage. However, only CSS, Sanagate, Sanitas and Swica provide interactive insurance coverage checks. Only CSS, Sanagate and Sanitas provide this function in their apps. Insurance coverage checks let policyholders select various healthcare services and (ideally) automatically receive information about whether or not each selected service is covered by either their compulsory health insurance or by their supplemental health insurance policies.

Address changes

Reporting a change of address can be done using any of the analyzed customer portals. With the exception of Sanitas, all analyzed insurance provider which offer customer portal apps include this function in their apps. The option of changing deductibles, accident coverage or insurance models via online portals or apps is less widely offered.

Terminating insurance agreements

Only Atupri and KPT let their customers terminate their own insurance policies directly via their customer portals or apps with a few clicks or taps. Atupri only provides the policy-termination function for compulsory health insurance and not for supplementary health insurance policies.

Fingerprint login

Many health insurance customer portal apps can be logged into using finger print recognition functions like Touch ID. This is practical because policyholders only need to enter their password the first time they use the app. Of the analyzed apps, only those from KPT, Sympany and EGK do not let user log in via fingerprint recognition.

Additional functions and fitness apps

Various health insurance providers include addition functions in their apps. Some insurers like EGK, Groupe Mutuel, Helsana, Sanitas and Swica offer separate, specialized apps for specific functions. Health insurance providers particularly promote apps which track the lifestyle and fitness habits of policyholders, with some offering controversial incentives to encourage policyholders to adopt these apps. Step-counting apps and digital training assistants are examples of these data harvesting apps. “From a consumer perspective, Swiss health insurance companies could provide far more value by developing solid customer portal apps which let policyholders quickly and easily administrate their health insurance rather than promoting fitness-tracking apps,” says moneyland.ch CEO Benjamin Manz.

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