Capital Markets, Insurance and Savings Division Annual Report 2011 Insurance
Table of Contents 4.1 Non-life Insurance 76 4.1.1 Introduction 76 4.1.2 Insurance Premiums 77 4.1.3 Concentration Indices and Market Share 79 4.1.4 Selected Lines in Non-life Insurance 81 4.1.5 Non-Life Insurance Activity 85 4.2 Health Insurance 87 4.2.1 Introduction 87 4.2.2 National and Private Health Expenditure 87 4.2.3 Main Health Insurance Data 87 4.2.4 Concentration Indices and Market Share 93 75
4.1 Non-life Insurance 4.1.1 Introduction Non-life insurance includes all insurance lines that are not life insurance or health insurance. Non-life insurance focuses in three main areas: a. Property insurance: vehicle-property, loss of property, comprehensive home, comprehensive business, engineering insurance, etc.; b. Liability insurance: compulsory vehicle, third party liability, professional indemnity, employers liability, etc.; c. Financial insurance: credit insurance, guarantees, etc. There are currently 18 insurance companies in Israel, active in 15 non-life insurance lines. Most of these companies operate in the following insurance lines: motor vehicle, home, employers liability and loss of property. Besides insurance companies, two unique bodies operate in the compulsory vehicle line: a. Karnit Road Accident Victim Compensation Fund which compensates victims entitled to compensation for bodily harm under the law, and who are unable to claim compensation; b. The Managing Corporation of Compulsory Vehicle Insurance Pool (The Pool) Ltd. is responsible for insuring each applicant who was unable to obtain insurance coverage with commercial insurance companies. 76
4.1.2 Insurance Premiums Table D-1 Gross insurance premiums in non-life insurance by lines, 2007-2011 1 Year (in NIS millions) Rate of change in insurance premium in % Distribution by line 2007 2008 2009 2010 2011 2009/2010 2010/2011 2010 2011 vehicle insuranceproperty 5,385 5,499 5,655 5,641 5,776-0.2% 2.4% 33.3% 33.1% Compulsory vehicle 4,234 4,429 4,738 4,415 4,582-6.8% 3.8% 26.1% 26.2% Business insurance 1,620 1,604 1,735 1,748 1,800 0.8% 3.0% 10.3% 10.3% Comprehensive home 1,152 1,220 1,265 1,330 1,435 5.1% 7.9% 7.9% 8.2% Mortgage banks 305 273 256 248 240-3.2% -3.4% 1.5% 1.4% Professional indemnity 1,097 1,067 1,025 2.7% -3.9% 6.3% 5.9% Third party 637 667 695 4.7% 4.3% 3.9% 4.0% 1,716 1,808 Product liability 220 215 210-2.4% -2.5% 1.3% 1.2% Other surplus lines 21 20 18-4.1% -11.7% 0.1% 0.1% Other risks 563 535 540 564 581 4.3% 3.2% 3.3% 3.3% Employers liability 326 335 368 384 406 4.3% 5.8% 2.3% 2.3% Engineering insurance 326 323 317 335 378 5.8% 12.9% 2.0% 2.2% Freight in transit 172 167 156 160 173 2.5% 8.5% 0.9% 1.0% Credit insurance 77 84 88 94 97 6.3% 2.9% 0.6% 0.6% Marine hull & aircraft 39 40 44 43 41-2.0% -4.5% 0.3% 0.2% Total 15,915 16,318 17,136 16,930 17,458-1.2% 3.1% 100% 100% The data in Table D-1 - indicate that in 2010 the compulsory vehicle insurance line fell by 6.8% in total insurance premiums, mainly due to the transfer of the medical liability to road accident victims to Sick Funds, against a transfer of 9.4% of compulsory premiums collected from insurers to the funds. In 2011, total insurance premiums in the compulsory vehicle line increased by NIS 135 million, or about 3.8%, compared to 2010. 1 From 2009, the report on other liability lines was split into four sectors: third party liability, professional indemnity, product liability and other insurance. The mortgage bank line includes building insurance, sold through agencies owned by mortgage banks in the context of housing loan secured by mortgage. The comprehensive homeline includes building insurance and contents insurance that were not sold through agencies and mortgage banks. 77
Table D-2 Gross insurance premiums in non-life insurance by insurance groups and companies 2007-2011 (NIS millions) Gross insurance premiums Market share Percentage change in insurance premiums 2007 2008 2009 2010 2011 2007 2008 2009 2010 2011 2009-2010 2010-2011 Harel 2,467 2,660 2,777 2,862 2,847 15.5% 16.3% 16.2% 16.9% 16.3% 3.1% -0.5% Clal 2,767 2,688 2,756 2,681 2,660 17.4% 16.3% 16.1% 15.8% 15.2% -2.7% -0.8% Menorah 2,062 2,127 2,248 2,253 2,323 13.0% 13.0% 13.1% 13.3% 13.3% 0.2% 3.1% Phoenix 1,630 1,657 1,807 1,927 2,033 10.2% 10.2% 10.5% 11.4% 11.6% 6.6% 5.5% Migdal 1,486 1,513 1,441 1,390 1,435 9.3% 9.3% 8.4% 8.2% 8.2% -3.5% 3.2% Ayalon 1,153 1,164 1,205 1,218 1,165 7.2% 7.1% 7.0% 7.2% 6.7% 1.1% -4.4% IDI 653 740 823 868 907 4.1% 4.5% 4.8% 5.1% 5.2% 5.5% 4.4% Hachshara 767 724 740 827 909 4.8% 4.4% 4.3% 4.9% 5.2% 11.9% 9.9% Eliyahu 813 763 733 778 810 5.1% 4.7% 4.3% 4.6% 4.6% 6.1% 4.1% AIG 458 467 485 487 506 2.9% 2.9% 2.8% 2.9% 2.9% 0.4% 3.7% Shirbit 530 592 474 418 486 3.3% 3.6% 2.8% 2.5% 2.8% -11.7% 16.0% Bituah Haklai 514 456 490 360 366 3.2% 2.8% 2.9% 2.1% 2.1% -26.5% 1.5% Shlomo 0 153 526 268 386 0.0% 0.9% 3.1% 1.6% 2.2% -49.0% 43.9% Kanat 169 161 231 247 275 1.1% 1.0% 1.4% 1.5% 1.6% 6.9% 11.0% Karnit 193 196 191 189 190 1.2% 1.2% 1.1% 1.1% 1.1% -1.0% 0.5% ICIC 97 109 105 115 119 0.6% 0.7% 0.7% 0.7% 0.7% 8.8% 3.8% Ashra 50 25 23 22 25 0.3% 0.2% 0.1% 0.1% 0.1% -2.2% 13.7% Inbal 0 14 20 16 16 0.0% 0.1% 0.1% 0.1% 0.1% -20.2% 3.6% Emi 106 109 61 0 0 0.7% 0.7% 0.4% 0.0% 0.0% Total 15,915 16,318 17,136 16,930 17,458 100% 100% 100% 100% 100% -1.2% 3.1% Table D-2 shows the total amount of insurance premiums by insurance groups. Harel Group insurance premiums also include insurance premiums collected from insureds with Dikla, and Menorah Group insurance premiums include insurance premiums collected from insureds with Shomera. The data in Table D-2 indicate that in 2011 the market share of the five largest companies fell by about 1% - compared to the previous year, when it stood at about 65.6% of the total non-life insurance lines. 78
4.1.3 Concentration Indices and Market Share Table D-3 Concentration indices in Non-life insurance by insurance lines, 2000, 2010, 2011* Herfindahl-Hirschman CR3 CR5 2000 2010 2011 2000 2010 2011 2000 2010 2011 Compulsory vehicle 0.29 0.09 0.09 49% 40% 38% 60% 57% 56% Vehicle insurance - property 0.16 0.11 0.10 35% 44% 43% 49% 49% 64% Comprehensive home 0.25 0.13 0.12 47% 50% 49% 63% 73% 73% Mortgage banks 0.26 0.24 75% 75% 95% 94% Employers liability 0.22 0.14 0.14 46% 53% 53% 62% 79% 80% Comprehensive business 0.22 0.15 0.15 47% 59% 58% 62% 80% 81% Engineering insurance 0.58 0.15 0.15 68% 56% 56% 81% 78% 78% Other liability lines 0.22 0.18 0.17 47% 62% 61% 62% 81% 81% Credit insurance 0.63 0.56 0.55 95% 100% 100% 100% 100% 100% Total 0.12 0.11 0.10 31% 46% 45% 43% 66% 64% * For an explanation on how concentration indices are calculated, see Section 3.4, in Long Term Savings chapter. The two lines of vehicle insurance, compulsory and comprehensive, are the largest (about 60% of total premiums) and most competitive of the non-life insurance lines. The compulsory vehicle line is the more competitive of the two, and its three largest companies alone represent 38% of total premiums in this line. The credit insurance line continues to be centralized, with only two active companies. Nonetheless, total premiums in this line amount to NIS 97 million, representing only about 0.6% of the total insurance premiums in all non-life insurance lines. Table D-4 Concentration indices and competition in Non-life insurance for 2000, 2010, 2011* 2000 2010 2011 CR3 56.0% 46.1% 44.6% HHI 0.12 0.11 0.10 *For an explanation on how concentration indices are calculated, see Section 3.4, in Long Term Savings chapter. Table D-4 shows that in 2011 the trend of increasing competition continued and there was a decline in the market share of the large companies in favor of the smaller companies. 79
Table D-5 Market share of gross premiums in Non-life insurance by groups and insurance companies, 2011 Comprehensive business Comprehensive home Mortgage banks Compulsory Vehicle Vehicleproperty Employer liability Third Party Professional indemnity product liability Other Surplus lines Marine hull & aircraft Freight in transit Engineering Credit Other risks Total to company Harel 22.7% 14.2% 15.7% 12% 15% 18.6% 21.9% 41% 14.7% 0 8.2% 8.5% 10.4% 0 0 16.1% Clal 20.2% 18.3% 40.6% 12.3% 12.2% 18.3% 20.1% 14.2% 14% 29.2% 3.7% 26.6% 21.9% 65.5% 13.9% 15.2% Menorah 9.8% 16.6% 8.4% 13.9% 15.7% 12.5% 9.6% 7.2% 9.9% 27.7% 37.5% 18.6% 13% 0 5.6% 13.3% Phoenix 12.4% 13.1% 18.8% 8.2% 12.6% 16.3% 14.4% 13.3% 15.4% 0 28.3% 23.2% 20.6% 0 1.7% 11.6% Migdal 15.6% 10.6% 10.2% 5.6% 6.4% 14.1% 13.0% 7.5% 16.5% 0 17% 18.9% 11.7% 0 0.9% 8.2% Ayalon 5.7% 5.5% 3.3% 7% 7% 7.3% 8.4% 10.4% 5.4% 0 0 1.5% 11.1% 0 0.7% 6.7% IDI 0.2% 6.9% 2.4% 6.6% 8.5% 0.1% 0.5% 0 0 0 0 0 0 0 0 5.2% Hachshara 3.0% 3.8% 0 8.5% 5.7% 4% 4% 0.9% 1.6% 0 0 0 3% 0 1.8% 5.2% Eliyahu 1.9% 3% 0 9.1% 4.9% 1.6% 1.8% 0.4% 0.9% 0 0 2.7% 0.1% 0 0.1% 4.6% Shlomo 0 0.4% 0.6% 4.8% 2.7% 0.04% 0.1% 0 0 0 0 0 0 0 0 2.2% Bituah Haklai 5.6% 0.4% 0 1.4% 1.7% 4.3% 3.6% 0.4% 11% 27.5% 0 0.02 3.7% 0 0.9% 2.1% AIG 1.7% 6.1% 0 2.3% 3.2% 2.1% 2.3% 4.5% 10.3% 15.5% 0 0 1.6% 0 0 2.9% Shirbit 0.3% 1.2% 0 4.2% 4.4% 0.7% 0.3% 0.1% 0.3% 0 5.4% 0 2.9% 0 0 2.8% Kanat 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47.5% 1.6% Karnit 0 0 0 4.2% 0 0 0 0 0 0 0 0 0 0 0 1.1% ICIC 0 0 0 0 0 0 0 0 0 0 0 0 0 34.5% 14.8% 0.7% EMI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7.8% 0.3% Ashra 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4.3% 0.1% Inbal 0.9% 0 0 0 0 0 0 0 0 0 0.01% 0 0 0 0 0.1% Total 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 80
4.1.4 Selected Lines in Non-life Insurance Table D-6 Number of claims insured cars in the vehicle insurance property line, 2007-2011 2007 2008 2009 2010 2011 Percentage change 2008-2009 2009-2010 2010-2011 Claims in the vehicle insurance- property line with the exception of third party Claims in the vehicle insurance- property line, third party only Total claims in vehicle and property lines Number of cars insured in the vehicle insurance- property line with the exception of third party Number of cars insured in the vehicle insurance- property line, third party only Total number of cars insured Total vehicles in market 253,145 317,294 325,365 272,910 284,905 2.5% -16.1% 4.4% 64,039 60,857 68,345 66,884 60,871 12.3% -2.1% -9.0% 317,184 378,151 393,710 339,794 345,776 4.1% -13.7% 1.8% 1,291,737 1,435,197 1,477,344 1,478,922 1,584,925 2.9% 0.1% 7.2% 678,072 758,324 723,051 713,636 748,322-4.7% -1.3% 4.9% 1,969,809 2,193,521 2,200,395 2,192,558 2,333,247 0.3% -0.4% 6.4% 2,284,000 2,391,000 2,458,700 2,566,200 2,683,187 2.8% 4.4% 4.6% Source: Central Bureau of Statistics and CMISD analysis of annual reports of insurance companies. 81
Financing compulsory motorcycle insurance in The Pool Damage costs of motorcyclists with compulsory motorcycle in the framework of The Pool, amounted in NIS 488 million in 2011, compared to NIS 574 million in 2010. Figure D-1 shows the three sources of financing insurance payments for motorcyclists: 1. Insurance premium from insured motorcyclists In 2011, the total insurance premiums 2 from insured motorcyclists in The Pool fell by about 20%, from NIS 255 million in 2010 to about NIS 204 million in 2011. At the same time, there was an increase in insurance company premiums from motorcyclists, from NIS 59 million in 2010 to about NIS 93 in million in 2011. 2. Division Order The total amount of funds that the insurance companies are expected to pay The pool under the Division Order, 3 as a result of motorcycle accidents in 2011 involving another vehicle, dropped to NIS 126 million compared to NIS 132 million in 2010. 3. Subsidy by the public The general public of drivers in Israel insured under Compulsory Vehicle insurance has been subsidizing The Pool deficit year after year. In 2011, the motorcycle insurance subsidy in the pool was NIS 158 million compared to 187 million in 2010, a decrease of about 16%. Subsidy of the cost of motorcycle accidents by the other drivers in Israel means that every person insured under compulsory vehicle insurance has in effect paid a kind of motorcycle tax. A detailed breakdown of the composition of the payment to The Pool to cover injuries to motorcyclists shows that the insurance premiums of the motorists themselves covered only 42% of the damage, while the remaining 58% was covered by the other drivers in Israel. It should be noted that in 2011 there was a decline of 19% in the number of persons insured under The Pool compared to 2010 when 37% of all motorcyclists were insured by insurance companies not in The Pool. Figure D-1 The source of financing the cost of claims due to motorcycle accidents in The Pool, 2011 Public subsidy NIS 158 million Insurance premiums NIS 204 million 32% 42% 26% Division Order NIS 126 million Source: CMISD process of annual reports of insurance companies. 2 Premiums and fees earned. 3 On 1 June 2008, Amendment 20 of the Road Accident Victims Compensation Law, 1975 came into effect. This amendment provided that in a road accident involving a motorcycle and another type of vehicle, the insurer of the other vehicle will pay the motorcyclist s insurer 75% of the compensation in respect of bodily injuries to the motorcyclist, instead of 50% prior to the revision. 82
Figure D- 2 The deficit and total financing for claims with respect to motorcycle accidents in The Pool by other Israeli drivers 4 250 231 200 188 209 209 205 216 187 150 149 158 100 106 111 105 98 102 96 50 80 73 59 0 2003 2004 2005 2006 2007 2008 2009 2010 2011 The Pool deficit Subsidy level to insured person Source: CMISD process of the Pool annual report and statistical database. Figure D-2 presents the annual deficit of The Pool and the average subsidy rate paid by an insured in compulsory vehicle insurance each year. In 2011, an average of about NIS 59 was added to the average compulsory vehicle insurance tariff, compared with an average of NIS 92 paid in the last nine years. For example, a purchaser of compulsory vehicle insurance costing NIS 2,000, actually paid NIS 1,941 for his own insurance, and another NIS 59 as claims coverage to The Pool on account of motorcycle accidents. In 2011, the number of insureds in The Pool fell by about 19%, compared to 2010. This decrease explains the decline in The Pool s deficit and a decline in the subsidy paid by regular insureds with compulsory vehicle insurance. 4 Measured for December 2011. 83
Figure D-3 Number of homes with comprehensive home insurance and home insurance sold via agencies, mortgage banks, 2011-2010 1,200,000 1,000,000 980,501 990,721 1,048,829 800,000 600,000 400,000 387,436 369,966 364,096 200,000 0 2009 2010 2011 Comprehensive home Mortgage banks Figure D-3 shows that the number of homes insured by the mortgage banks agencies fell by about 5,870, compared with an increase of 58,000 homes that are not insured with mortgage banks, so that the total number of homes insured in the comprehensive line and in mortgage banks rose by about 6% during 2011. 84
4.1.5 Non-Life Insurance Activity Figure D-4 Percentage of non-life insurance premiums -GDP 2004-2011 3.20% 3.10% 3.00% 2.80% 2.94% 2.82% 2.60% 2.40% 2.20% 2.00% 2.32% 2.26% 2.24% 2.08% 2.01% 1.80% 2004 2005 2006 2007 2008 2009 2010 2011 Source: Central Bureau of Statistics data and CMISD analysis of annual reports of insurance companies. The premium-gdp ratio and the premium ratio per capita represent the degree of market penetration of non-life insurance services. Despite the increase in premiums collected, the growth rate is lower than the GDP growth, and therefore there is a significant downward trend in the rate of premiums-gdp. 85
Figure D-5 Percentage of premiums-gdp in non-life and health insurance Israel and the OECD, 2010 7% 6% 5% 4% 3% 2% 2.5% 3.1% 1% 0% Mexico Turkey Greece Chile Hungary Slovakia Japan Poland Estonia Finland Norway Australia Portugal Czech Republic Italy Sweden Israel Belgium Spain Iceland Source: OECD data and CMISD processing. Luxembourg Total OECD Netherlands France Austria Slovenia Ireland Korea Canada Switzerland US Figure D-6 The rate of premiums from GDP in non-life and health insurance Israel and the OECD, 2010 (US dollars) 3,500 3,000 2,500 2,000 1,500 1,278 1,000 500 0 734 Mexico Turkey Hungary Poland Slovakia Greece Czech Republic Portugal Japan Israel Italy Spain Finland Korea Iceland Australia Sweden Belgium Total OECD France Austria Germany Norway UK Denmark Netherlands Ireland Canada US Switzerland Luxembourg Source: OECD Statistics Portal and CMISD processing. 86
4.2 Health Insurance 4.2.1 Introduction Health insurance covers the entire range of health treatment in the life of the insured, such as surgery, transplants, medications, long term care, criticalillnesses, and more. 5 In Israel, Sick Funds and insurance companies offer a variety of health insurance services and coverage which are composed of three layers: A. Basic layer a basket of services provided by the Sick Funds to which all Israeli residents are eligible. These services are financed from the state budget and health insurance premiums collected by the National Insurance Institute. B. Supplementary health services (SHS) additional health services that the Sick Funds offer their members and which are not included in the basic layer of services. Each Sick Fund member can purchase additional health services of his choice. C. Commercial health insurance three types of health insurance coverage that insurance companies offer can serve as a substitute, supplement or addition to coverage provided in the basic package and SHS plans. Services provided by Sick Funds are supervised by the Division of Supervision and Control of Sick Funds and SHS in the Ministry of Health, while the health insurance of insurance companies is supervised by the Capital Market Insurance and Savings Commissioner. 4.2.2 National and Private Health Expenditure In 2011, the national health expenditure (public and private expenditure) in Israel stood at NIS 67.4 billion. In 2011, private expenditure, including inter alia, direct household payments, premium payments to insurance companies and Sick Fund payments for the SHS plan was 37.8% of the total national expenditure. 6 In 2011, premium payments with regard to health insurance to insurance companies was about 10.4% of the national health expenditure and about 27.4% of private health expenditure. 4.2.3 Main Health Insurance Data Health insurance includes two main lines: illness and hospitalization, which constitutes most of the insurance companies activity, and personal accident insurance. Illness and hospitalization line includes the following sub-lines: Medical expenses insurance (such as surgery, medications and transplants), long term care insurance, critical illness insurance, dental insurance, disability insurance, travel insurance and health insurance for foreign workers. 5 Data in this chapter do not include PHI (Permanent Health Insurance), which is reported as part of the life insurance report in the Long Term Savings chapter (see table C-2) 6 Based of Central Bureau of Statistics data. 87
Figure D-7 Total gross health insurance premiums, 2003-2011 7 (NIS billions) 7.0 6.37 6.0 5.61 5.0 4.53 5.15 4.0 3.39 3.70 4.09 3.0 2.63 2.96 2.0 1.0 0.0 0.64 0.47 0.54 0.22 0.23 0.26 0.30 0.29 0.34 2003 2004 2005 2006 2007 2008 2009 2010 2011 Personal accident Illness and hospitalization In 2011, the total gross insurance premiums in the illness and hospitalization line continued to rise a cumulative increase of about 142% from 2003, and an average annual increase of 12% in the last eight years. 7 Data in this chapter do not include PHI (Permanent Health Insurance) which is reported as part of the life insurance report in the Long Term Savings chapter (see Table C-2). 88
Table D-7 Gross health insurance premiums in the illness and hospitalization line, divided into individual and group insurance according to sub-lines, 2003 compared to 2011* (NIS thousands) 2003 2011 Individual Group Total Market share of Percentage of change 2003 2011 Percentage of change 2003 2011 Percentage of change sub-lines, 2011 (in %) Medical expenses 539,670 1,417,466 163% 272,545 751,105 176% 812,214 2,168,571 167% 34% long term care 180,230 766,613 325% 360,612 1,618,351 349% 540,842 2,384,964 341% 37% Critical illnesses 278,752 534,271 92% 21,044 53,643 155% 299,796 587,914 96% 9% Dental 11,034 3,875-65% 315,154 472,025 50% 326,188 475,900 46% 7% Travel 201,508 228,646 13% 11,023 111,532 912% 212,530 340,178 60% 5% Disability 189,219 195,797 3% 13,251 19,290 46% 202,470 215,087 6% 3% Foreign workers 90,592 133,318 47% 0 13,609 N/A 90,592 146,927 62% 2% Other 132.636 18,011-86% 12,854 28,978 125% 145,490 46,989-68% 1% Total illness and hospitalization 1,623,641 3,297,997 103% 1,006,481 3,068,533 205% 2,630,122 6,366,530 142% 100% * In 2003 there was no information about personal injury according to individual and group categories, therefore a comparison in this sub-line cannot be made. Table D-7 indicates that in the last eight years there have been significant changes in the scope of activity of insurance companies in the sub-lines. For example, there has been a significant increase in the sub-lines of medical expenses, long term care and critical illness - both in individual insurance and in group insurance. 89
Table D-8 Health insurance data divided into individual insurance and group insurance by lines and sub-lines, 2011 (NIS thousands) Insurance premiums Insurance premiums in Reinsurance Gross claims* Reinsurance claims Loss ratio** Individual Group Individual Group Individual Group Individual Group Individual Group Medical expenses 1,417,466 751,105 230,965 68,649 534,672 629,013 115,069 46,102 38% 83% long term care 766,613 1,618,351 119,600 223,728 191,459 888,205 65,809 142,002 N/A Critical illnesses 534,271 53,643 131,992 807 269,520 43,589 83,399 302 50% 81% Dental 3,875 472,025 0 13,206 3,966 338,326 0 9,238 89% 71% Travel insurance 228,646 111,532 28,946 610 133,868 52,768 16,460 275 58% 46% Disability 195,797 19,290 17,019 255 147,625 13,686 16,588 139 75% 71% Foreign workers 133,318 13,609 10 7 71,099 8,284 0 0 58% 68% Other 18,011 28,978 0 0 16,125 19,346 0 0 N/A Total illness and hospitalization Personal accident 3,297,997 3,068,533 528,532 307,262 1,368,334 1,993,217 297,325 198,058 462,261 175,644 48,990 29,202 164,381 154,071 39,463 26,040 36% 89% Total health 3,760,258 3,244,177 577,522 336,464 1,532,715 2,147,288 336,788 224,098 * Gross claims claims that were paid, a change in pending claims, indirect expenses for settlement of claims that were paid and change in indirect expenses that were paid. ** Loss ratio the ratio between claims actually paid with the addition of change in pending claims, and insurance premiums and change in reserves for valid risks. 90
Figure D-8 Total gross insurance premiums in the medical expenses sub-line, divided into individual insurance and group insurance, 2003-2010 (NIS billions) 2.50 2.00 38% 36% 35% 38% 1.50 37% 65% 1.00 0.50 34% 66% 34% 66% 33% 67% 35% 65% 63% 62% 62% 64% 0.00 2003 2004 2005 2006 2007 2008 2009 2010 2011 Individual Group In 2011, the total gross premiums in the medical expenses sub-line amounted to about NIS 2.17 billion, compared with NIS 1.97 billion in 2010. This indicates a continued upward trend in premiums in this sub-line - a cumulative increase of 167% since 2003, and an average annual increase of 13% in the last eight years. It can be seen that this increase is due to an increase in the volume of individual insurance and group insurance when the ratio between them remains almost constant. 91
2.50 Figure D-9 Total gross Insurance premiums in long term care sub-line, divided into individual insurance and group insurance, 2003-2010 (NIS billions) 68% 2.00 66% 1.50 64% 61% 1.00 0.50 0.00 59% 58% 60% 32% 62% 34% 67% 36% 41% 39% 40% 42% 38% 33% 2003 2004 2005 2006 2007 2008 2009 2010 2011 Individual Group In 2011 the total gross premiums in the long term care sub-line amounted to about NIS 2.38 billion, compared with NIS 1.97 billion in 2010. This points to a continued upward trend in premiums in this sub-line, a cumulative increase of 341% since 2003, and an average annual increase of 20.4% in the last eight years. The number of insureds under long term care insurance in 2011 amounted to about 5.42 million, of which about 0.4 million were insured under individual long term care insurance and about 5 million under group long term care insurance. The majority of insureds in group long term care insurance are insured in a framework within the Sick Funds (about 3.98 million). 92
4.2.4 Concentration Indices and Market Share Table D-9 Concentration indices in health insurance, divided into sub-lines, 2003 and 2011* (By insurance premium) Individual Group Herfindahl-Hirschman CR3 Herfindahl-Hirschman CR3 2003 2011 2003 2011 2003 2011 2003 2011 Medical expenses Critical illnesses 0.21 0.20 68% 68% 0.32 0.40 87% 97% 0.23 0.19 71% 66% 0.24 0.45 81% 84% Travel insurance 0.42 0.37 96% 86% 0.55 0.98 100% 100% Long term care 0.20 0.22 69% 74% 0.40 0.39 93% 99% Disability 0.22 0.19 72% 67% 0.73 0.44 100% 97% Dental insurance 0.32 0.51 96% 100% 0.55 0.45 96% 91% Foreign workers 0.40 0.33 95% 89% N/A 0.51 N/A 100% Total illness and hospitalization Personal accident 0.20 0.20 66% 66% 0.38 0.35 89% 96% N/A 0.26 N/A 81% N/A 0.37 N/A 90% *For an explanation on how the concentration indices are calculated, see Section 3.4 in Long Term Savings chapter. 93
Table D-10 Market share in gross insurance premiums in health insurance, divided into individual insurance and group insurance, according to sub-line, 2011 (in NIS thousands) Medical expenses Long term care insurance Critical illnesses Dental insurance Travel insurance Disability insurance Foreign workers Other Harel Group Clal Group Phoenix Migdal Menorah Group AIG Ayalon Eliyahu IDI Hachshara Shirbit Total according to sub-line Individual 376,689 212,691 360,388 231,367 186,227 0 16,957 5,136 24,323 3,211 477 1,417,466 Group 401,440 87,428 238,012 3,139 13,736 0 7,350 0 0 0 0 751,105 Market share 36% 14% 28% 11% 9% 0% 1% 0% 1% 0% 0% 100% Individual 257,684 135,764 103,904 170,590 57,433 0 7,387 32,117 0 1,735 0 766,613 Group 757,749 639,927 204,223 9,915 724 0 5,813 0 0 0 0 1,618,351 Market share 43% 33% 13% 8% 2% 0% 1% 1% 0% 0% 0% 100% Individual 93,248 116,624 65,567 141,717 78,319 14,133 8,609 6,763 6,117 3,175 0 534,272 Group 32,174 4,940 8,160 2,430 177 0 4,863 0 898 0 0 53,642 Market share 21% 21% 13% 25% 13% 2% 2% 1% 1% 1% 0% 100% Individual 1,673 0 0 0 2,202 0 0 0 0 0 0 3,875 Group 295,667 14,672 107,587 24,081 14,771 0 15,247 0 0 0 0 472,025 Market share 62% 3% 23% 5% 4% 0% 3% 0% 0% 0% 0% 100% Individual 128,232 32,323 36,497 2,288 588 12,994 2,660 0 965 0 12,099 228,646 Group 0 110,160 0 0 0 1,372 0 0 0 0 0 111,532 Market share 38% 42% 11% 1% 0% 4% 1% 0% 0% 0% 4% 100% Individual 43,673 37,780 25,566 49,804 29,723 0 3,164 4,025 1,985 78 0 195,798 Group 0 0 10,365 7,393 955 0 350 0 227 0 0 19,290 Market share 20% 18% 17% 27% 14% 0% 2% 2% 1% 0% 0% 100% Individual 58,604 46,511 6,414 0 13,314 0 8,475 0 0 0 0 133,318 Group 0 0 0 0 7,959 0 5,650 0 0 0 0 13,609 Market share 40% 32% 4% 0% 14% 0% 10% 0% 0% 0% 0% 100% Insurance premiums 13,019 0 15,959 18,011 0 0 0 0 0 0 0 46,989 Market share 28% 0% 34% 38% 0% 0% 0% 0% 0% 0% 0% 100% Total according to 2,459,852 1,438,820 1,182,642 660,735 406,128 28,499 86,525 48,041 34,515 8,197 12,576 6,366,530 company Market share for company 38.6% 22.6% 18.6% 10.4% 6.4% 0.4% 1.4% 0.8% 0.5% 0.1% 0.2% 100% Individual 183,691 58,319 17,560 19,136 10,331 132,174 9,294 823 28,544 1,605 784 462,261 Personal Group 38,560 96,337 0 3,603 3,546 11,247 22,351 0 0 0 0 175,644 accident Market share 35% 24% 3% 4% 2% 22% 5% 0% 4% 0% 0% 100% 1. Harel Group - Harel, Dikla 2. Clal Group - Clal, Clal Health 3. Menorah Group Menorah, Shomera 94