Product Family


Underwriting Manager, Healthcare

For US healthcare systems that are covered by wholesale insurance underwritten in London, the pandemic has exacerbated or highlighted several other areas where a dialogue and risk management and transfer will be key. 

The first of these is in the supply chain. 

The COVID-19 pandemic, and the restrictions on the movement of goods and people put in place by governments around the world, caused an effect on supply chains. Given the time-and-condition sensitive nature of many components and goods used by the healthcare sector this was a concern for healthcare executives. 

Our risk engineers worked closely with clients to help them better understand the intricacies of those supply chains and pinpoint those areas of bottlenecks, for example. The increased use of scanning and sensors has been an important way to help clients to gain a better understanding of where goods are, and in what conditions, at any time. 

In March 2021, the blockage of the Suez Canal, one of the world’s busiest trade routes, brought this issue into focus once again with billions of dollars of trade affected.

Healthcare executives were reminded again of the need to understand their supply chains – how long they are, who their second and third tier suppliers are – and to put in place measures to mitigate the risks should supply chains fail. 

Our risk engineers and innovation experts have been working with clients to use a powerful combination of risk engineering expertise and data science and digitalisation to give clients a better picture of these potential pinch points.

Climate change

Climate change is one of the most pressing issues facing society as a whole, and for the healthcare sector there are some very real challenges. One of the risks posed by climate change is the potential for an increase in the spread and severity of communicable diseases; increased temperatures can expand the areas in which certain diseases such as dengue fever or malaria can thrive, for example. In addition, changes in climate and the environmental implications, are an emerging risk when it comes to physical and mental wellbeing.

A recent articlei in the British Medical Journal (BMJ) reiterated calls made by other experts for the World Health Organization to consider climate change a “public health emergency of international concern”. The same article states that, at a conservative estimate, climate change will likely account for an additional 250,000 deaths between the years 2030 to 2050, while associated issues such as food insecurity, could also cause hundreds of thousands of deaths in the coming years.

This looming crisis may put additional pressure on healthcare systemsii, many of which will have been hugely impacted by the ongoing COVID-19 pandemic, and which already are being asked to focus on the socio-economic factors behind health as well as on preventive medicine and community health management. 

For risk professionals in the healthcare sector there are clearly some big issues to tackle here. Talking to risk engineers about the potential future impacts of health-related risks caused by climate change is a good place to start. As these risks emerge, we need to continue to have robust dialogue to try to understand their impacts and to find strategies to put in place to try to mitigate them.

Healthcare systems also need to manage their own footprint. Emissions resulting from energy consumption, transportation, and product manufacturing and use account for a large proportion of the healthcare sector’s footprint, with about 70% of all emissions arising in the supply chainiii.

This is a serious concern for healthcare executives and many in the healthcare sector are taking steps to find ways to reduce emissions. Some are, for example, seeking to align their operations with the Paris Agreement on Climate Change and to work with manufacturers and suppliers of healthcare goods to try to get net emissions to zero by 2050.

Clearly this is a huge challenge – and not just for the healthcare sector. Insurers too are making strides to reduce their own climate footprints. Acting on climate change is one of the core values of AXA Group and as well as making efforts to reduce our own carbon footprint. Our experts are working hard to devise risk transfer mechanisms and financial instruments to support clients’ efforts to reduce their carbon footprints. 

Again, a dialogue is key here; as risks evolve and business practices change to try to reduce carbon emissions, insurers and risk engineers can work with clients to find ways to transfer those risks and support healthcare executives’ move towards a greener model. 

As well as traditional insurance coverages, solutions such as parametric coverages, which pay out swiftly when a pre-agreed trigger is met, can be useful in transferring some of the risks associated with climate change and the efforts being made to combat it. 

Business travel

Business travel is an important cog in the UK economy. According to the Business Travel Association, in a normal year, business travel contributes more than £220 billion to the UK’s gross domestic productiv. The COVID-19 pandemic meant that work travel all but dried up in 2020. The number of business trips slowed drastically as the effects of the pandemic took hold across the world; according to the Global Business Travel Association, business travel fell by about 90% last yearv

But while the discovery of COVID-19 variants has meant that some countries have re-imposed travel restrictions and lockdown rules, the phased rollout of COVID-19 vaccines, coupled with governments’ and businesses’ desire to kickstart economic recovery, has given hope that business travel will resume in earnest later this year. And when it does, traveller safety is likely to be companies’ biggest concern. 

The Institute of Travel Management, which represents businesses in the travel management industry in the UK and Ireland, surveys its members each year about their top priorities.  Every year for the past ten years, traveler safety has ranked number one.  

Once business travel resumes it will likely look quite different for some time. There are things which employees can do to be prepared for these changes and ways in which they can increase their comfort and safety. For example, when traveling by plane, employees should download boarding passes to eliminate paper contact. Travelers should wear masks – and change these every four hours – and take their own snacks and drinks on board, among other things.

Once travellers arrive at the destination airport, they should allow extra time for temperature checks and other processes that may be required by the host country; extra time for airport transfers should be considered. 

If possible, travellers should download the app of their hotel to a mobile device to minimise contact. They also should bear in mind that some areas of the hotel, such as gyms, may be closed or have restricted access.  

Companies that deploy colleagues on business trips can take steps to try to minimise the risks travellers may face. When businesses are sending colleagues on business trips, communication is key. The unfolding COVID-19 situation has underlined the importance of providing to all employees clear, consistent advice based on real-time developments. 

Security managers must ensure they monitor the situation - daily - to have up-to-date information on the areas where employees are working or may be asked to work. Employees should be given advice on how to reduce their exposure to COVID-19, how to recognise symptoms, and what they should do if they develop symptoms.

Companies that send significant numbers of employees on business trips should have dedicated resources to monitor the latest developments and cross-check information from sources such as the World Health Organization as well as local media outlets.

All travel plans should be risk-assessed, taking into account the traveller’s unique risk profile as well as medical and logistical concerns, for example. 

Before any business trip, companies should review the evacuation plans in place should a situation develop. Those plans should include specific triggers and the steps that should be taken if a repatriation is unfeasible for any reason, among other things. Evacuation plans should also include not only access to supplies and equipment but take into consideration factors such as mental wellbeing and the psychological impact on travellers due to any change in circumstance. 

Any evacuation requires a coordinated approach between different areas of an organisation, such as HR and legal, and clear communication with affected employees is also vital.

Moving forward

These three topics are likely to remain high on the agenda of healthcare executives for some time. Supply chains are becoming ever more global and complex, climate change is perhaps the biggest challenge of our generation, and the pandemic has highlighted more than ever the duty of care that employers have towards their colleagues who travel for work. 

There are no quick fixes to these issues, but we believe that through communication and gaining a deeper understanding of risks, there are steps that healthcare executives can take to reduce their exposures.  

As underwriters and risk experts we want to gain and share deeper insights into these risks and continue to devise solutions to help better manage and transfer them. 

This article has been produced by our Healthcare and Life Science Industry Practices Group. Find out more here:

i. Harmer, A.; Eder, B.; Gepp, S.; Leetz, A.; & van de Pas, R., 'WHO should declare climate change a public health emergency' in The BMJ 2020, available at 30 March, 2020.
ii. Tennison, I.; Roschnik, S.; Ashby, B.; Boyd, R.; Hamilton, I.; & Oreszczyn, T., 'Health care's response to climate change: a carbon footprint assessment of the NHS in England' in The Lancet, vol. 5, iss. 2, E84-E92, available at February, 2021.
iii. Ibid.
iv. Business travel association unveils plan to get business travelling again. Business Travel Association, available 7 May, 2020.
v. Ibid.


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