Read the Conversation
Meeting highlights:
- AXA prioritizing International Markets as part of the new strategy: driving double-digit growth, looking to know how mature markets adapt to local markets.
- AXA as a health protector and provider: One Health clinics across Africa offering outpatient and inpatient services.
- AXA addressing unmet local needs: First and unique insurance company connected to the Social Security System in Morocco, investing in One Health clinics in Egypt to address lack of services, launched individual health in French-speaking Africa, etc.
- AXA collaborates with local stakeholders to provide inclusive and logical insurance.
- The importance of digital technologies and Big Data in health: improve distribution, increase access, take preventive action, and data-based decision-making.
- Meryem Chami is advocating for Africa and driving AXA’s mission to promote the health agenda through a diverse and skilled team.
EF: What are the AXA group's priorities, how is AXA Africa organized, and what businesses are they operating in the region?
MC: AXA is pursuing stronger global ambitions and focusing on renewed growth under its new strategy. International markets, including South America, Southeast Asia, and Africa, are key components of this strategy and are seen as significant growth engines for the group. These regions are critical areas where AXA aims to achieve rapid and substantial growth. The company’s first half-year figures, announced by the end of this week, will likely show double-digit growth in these international markets.
AXA's main challenge is reinforcing its presence by helping local populations protect what matters most to them. Our approach includes leveraging a strong balance sheet, thanks to being part of a large group, which is crucial in the insurance business where financial stability is vital. Moreover, AXA aims to bring expertise from mature markets and adapt it to local contexts to ensure success. Health insurance is a rapidly growing line of business globally.
In Africa, AXA is considering whether it is sufficient to offer insurance simply or if we should expand operations to include health services. This would position AXA not just as a payer of bills but as a provider of services and protection. An example of this strategy is its plan to accelerate developments in Egypt.
We already have 77 clinics and aim to increase that number to over 120 in the next few years. In the meantime, we plan to expand beyond outpatient services to include inpatient services.
EF: Could you elaborate on the role AXA envisions in Africa, the opportunities within the healthcare sector, and which regions you are primarily focusing on?
MC: First, I want to emphasize that health insurance is a highly localized business, influenced by each market's regulations and the strength of government health services. Our strength lies in our ability to learn, adapt, and provide appropriate responses tailored to each market's needs. A common point across markets is the strong demand for health services, but the challenge is unlocking and ensuring this demand through affordability. Wealthy Africans can afford international health insurance, and those working for corporations are typically covered by corporate insurance.
However, the real challenge is addressing the needs of everyone else. In different countries, we use various strategies to tackle this issue. For example, in Morocco, where the level of existing health services is already good, we focus on protecting self-employed individuals, who comprise at least 30% of the population. We have launched Assurance Maladie Obligatoire (AMO), a universal health insurance, and introduced an individual health plan complementary to social security. This product is affordable, distributed through our agent network, fully digital, and connected to the social security system, providing a seamless one-stop-shop service. This initiative, launched last year, has been well-received and continues to grow.
In Egypt, the main challenge is expanding the service offerings. Corporate health coverage is still not widespread, but business is growing rapidly. We invest heavily in OneHealth clinics to provide high-quality service and an excellent client experience within a fully integrated health system. ONE HEALTH Egypt has currently 8 medical centers and one inpatient unit and it is going to expand its footprint to have 14 medical centers as well as 5 inpatient units.
In other French-speaking regions, we have launched our Third-Party Administrator (TPA) to manage consumption affordably for our clients, ensuring that we can offer competitive prices and effective service management. By focusing on these tailored approaches, we aim to address the diverse health insurance needs across African markets.
We recently launched an individual health insurance plan priced to be genuinely accessible. One of our biggest discussions with the team before launching it was inspired by the telecom industry, drawing on my background in telecom. Imagine if telecom services required an annual payment upfront instead of monthly fees—it would be far less affordable. We are applying this logic to our health business, moving to a monthly fee structure. Utilizing technology and data, we are integrating with mobile payment systems to allow incremental payments in line with people's monthly incomes, making financing more manageable.
In Nigeria, where we are already the leading provider, we are developing OneHealth clinics with a different approach than Egypt. While Egypt focuses on outpatient services, in Nigeria, we are starting with fully-fledged hospitals that include both outpatient and inpatient services, complete with surgical facilities. This comprehensive approach aims to meet the full spectrum of healthcare needs. We are making significant progress, but I still have many dreams and ambitions to deliver even more for our population.
The concept that resonates most with me is inclusive insurance. For example, even our health plan in Morocco, priced at around 30 U.S. dollars a month, is too expensive for many Africans. Tragically, many still die from preventable diseases like Ebola or malaria. A life could be saved with as little as $9 for malaria treatment. To address this, we are collaborating closely with local stakeholders to develop an inclusive insurance model.
In some areas, the primary need might not be comprehensive health coverage. Instead, offering targeted micro-insurance, such as malaria coverage for a few cents, could make a significant difference. However, the challenge lies in the low premiums and the lack of extensive distribution networks. This model relies on full integration with telecoms, consumer distributors, and other channels to reach those in need. We are actively working with various industry players to create a viable ecosystem for this inclusive approach, aiming to offer meaningful and affordable coverage to underserved populations.
I would like to highlight another crucial topic: distribution. In many of these markets, brokers play a significant role, enabling us to reach large accounts effectively. However, to truly add value, we must focus on developing the retail segment, which requires a robust distribution network. One of the key challenges we face is accelerating and expanding our distribution networks to reach remote locations and underserved areas. To address this, we launched an innovative project last year called Open Insure. The goal is to enable local, educated individuals to sell insurance through mobile phones in their villages, with premiums paid via mobile money.
This approach enhances inclusion by leveraging local people who understand the community's language and needs. Our responsibility is to train these individuals and enhance their capabilities, allowing them to start this business effectively. So far, we have built successful selling channels, particularly in urban areas and cities. This model applies to motor, health, and individual health insurance. I am excited to share that we will soon offer the entire claims journey through these apps, enhancing our service capability.
While digital insurance is gaining traction in some emerging markets, it is not meeting initial expectations, largely due to low awareness of insurance in Africa. I believe the real disruptive channel will be a hybrid model, combining digital solutions with human interaction, as exemplified by Open Insure.
EF: What qualities do you look for in local partners?
MC: The first thing we look for is innovation. In Africa, some businesses are so focused on their core operations due to rapid growth that they overlook expansion and service improvement opportunities. Collaborating with innovative partners can make a substantial difference. We can collectively create value and bring meaningful change by aligning with these partners. This is not just about AXA; it is about a broader commitment to serving these communities effectively.
We can achieve much higher penetration rates by partnering strategically with key sectors. The first of these is telecommunications. Figures like Mo Ibrahim have revolutionized the telco industry by shifting from monthly fees to a prepaid model, which is now ubiquitous. While applying a prepaid logic to insurance might be challenging, telcos can leverage their advertising budgets for loyalty programs that educate people about basic insurance, creating touchpoints for potential customers.
The second type of partners are banks and other financial institutions with extensive branch networks, such as post offices. By collaborating with these entities, we can develop client journeys that utilize their existing branches to reach the broader population effectively. The third type of partner is unique to Africa: money transfer services. These services, such as Western Union and various local players, are widely used for money distribution. In countries like Morocco, these networks are well-established and frequently utilized. Partnering with them can facilitate insurance penetration by integrating insurance offerings into their money transfer services.
By working with these three types of partners—telcos, banks, and money transfer services—we can significantly expand our reach and make insurance more accessible to a larger portion of the population. This will be a game-changer if regulators approve.
EF: Do you have specific strategies at AXA for managing client data to enhance the entire customer lifecycle and foster long-term partnerships with clients seeking insurance beyond immediate needs?
MC: You are touching on a topic that is very close to my heart because I firmly believe it has the potential to change everything. First and foremost, technology enables business models that would be impossible without it. This is a crucial point; we need to leverage this opportunity in Africa to move forward.
The second topic is data. To effectively use data, we first need access to it, which is perhaps the biggest challenge we face. From our discussions, we must raise regulators' awareness of the importance of digitalizing not just the sales process but the entire client journey. This will allow us to capture data throughout the value chain with the appropriate quality. For example, we need regulatory approval in some markets to create the right products to underwrite effectively when interacting with clients.
In other markets, it would be beneficial if regulators and governments could provide us access to reliable data sources to ensure we have high-quality data for analysis. This is one of our main objectives. Data enables us to proactively manage operations, make informed decisions about service offerings, identify new trends, and help corporate clients better manage their employees' well-being. For example, in Morocco, we are quite advanced with some large accounts, utilizing dashboards to analyze data directly with them. This collaboration helps them detect trends within their populations, and we assist them in implementing preventative measures to be more proactive.
My ultimate vision for data at AXA extends beyond Africa. I aspire to use this data not just to be the insurer that pays out claims but to become the insurer that prevents diseases in the first place. This is a big shift.
The key point is that with data connected to AI, we can intelligently and efficiently identify emerging trends and determine how to address them. AXA genuinely cares for its employees, and I say this sincerely. For example, AXA has been proactive in launching health initiatives; every two years, we offer mammograms for all women over 40 and annual health screenings for all employees over 35. I was surprised by the number of early-stage health issues we detected through these initiatives, which could significantly impact employee well-being.
However, a challenge we face as insurers is that we need to approach prevention strategically and data-driven to protect our bottom line by mitigating future costs associated with untreated health issues. Finding a balance is important, especially in regions like Africa, where infectious diseases still pose a significant threat.
I have a personal example that deeply resonates with me. One of my children, who is now 17, has been diabetic for four years. He uses continuous glucose monitoring systems. Unfortunately, these sensors are unavailable in the African market, so we must buy them from abroad. The cost is prohibitively expensive for many Africans. Despite this, my son has never been hospitalized due to his condition.
In contrast, when I look at the local population of diabetics, the average hospitalization rate is twice a year. This means that the costs associated with those hospital visits far exceed the expenses of purchasing the sensors and educating people on how to use them effectively. Investing in preventive tools like these sensors can lead to significant cost savings and better health outcomes for the community, avoiding getting to the medical cost. Here, we are only discussing the direct costs; we have not even touched on the indirect costs, which could be significant due to the potential impact on other body parts in the future. This is the shift we need to address.
EF: Looking back at your first year as CEO, what are the things you are most proud of having accomplished?
MC: First, I believe our greatest asset is our people. The key is to inspire our employees, encouraging them to wake up each morning focused on the challenges they will tackle that day. This is especially crucial in the insurance industry, where one can either approach it as just a job or genuinely believe in the mission of protecting what matters to people.
The insurance penetration rate in Africa is below 1%, so we must find ways to increase it. We must embrace disruption and think outside the box to do this. Innovation and a spirit of creativity are essential, as is building diverse teams with various skill sets. By leveraging collective intelligence, we can develop the right solutions. While we certainly need actuaries and insurance experts, we also require data analysts, tech-savvy individuals, and sociologists who understand the societal context to implement inclusive insurance effectively. Collaboration in an agile environment is vital to our success.
I am pleased to say that being part of AXA is a significant advantage for us. AXA provides access to benchmarks and insights from other markets, allowing us to learn from their experiences and adapt those lessons to our local context. AXA believes in Africa, and I will encourage my team to continue believing in AXA and to strive to deliver the best possible solutions for our communities.
EF: What are you most proud of?
MC: First and foremost, I am proud to be African and thrive on challenges. If I had to summarize my profile, I would say I am a transformer across various industries. I began my career in telecommunications, then moved on to banking, and later worked in mining and chemicals. Before joining AXA, I was involved in engineering. Working in insurance is particularly meaningful for me because the level of insurance penetration in a society is a key indicator of its overall development.
I firmly believe that now is the time for Africa to harness this potential, and I’m convinced that achieving this will require significant disruption, like what we have seen in the tech sector.
