Discover the interview with Dr. Cornelia Röskau, Managing Director of Globality Health in Luxembourg, interviewed by Natalie Stevenson.
Dr. Röskau is a prominent member of the Luxembourg insurance community, leading the work of Globality Health within Europe and on an international basis. This is a complex industry which faces many logistical challenges in order to deliver such high-quality products and services to policyholders.
We are delighted to share our discussion with you.
👉 The different types of international health insurance products and some of the challenges faced in delivering a successful and timely response to policyholder needs;
👉 Reflection of the difficulties faced during the pandemic years and how Globality Health has adapted and advanced in their strategies;
👉 Between the numerous regulatory changes to come and the defence of the Luxembourg sector, Dr Cornelia Röskau shares her vision on the priorities of the ACA
Automatically generated transcript
You are listening to ACA voices. The podcast of ACA, the Luxembourg Insurance and Reinsurance Association. ACA is the voice of the Luxembourg insurance sector. To give you an overview of the main issues affecting the sector and to embody that voice, we give the floor to a number of key figures in our community. ACA Voices is aimed to all those interested in insurance development.
Hello everyone and welcome to this next edition of ACA Voices podcast. My name is Natalie Stevenson, advisor at ACA, the Luxembourg Association of Insurance and Reinsurance Companies. Today I have the pleasure to interview Dr. Cornelia Roeskau, managing director of Globality Health in Luxembourg. With 10 years specialising in health insurance, ACA is delighted to have you as a prominent member of our insurance community and as an alternate member to ACA’s Board of Directors. Thank you so much for joining us today.
Thank you so much for having me. It’s a big pleasure and I’m very excited to talk to you.
So, before we get into the details of your role at Globality Health, can you tell me a bit more about yourself and what inspired you to follow a career in insurance?
Yes, of course. So my name is Cornelia Roeskau. I’m German. I have acquired international background. I started my international background in Argentina, where I lived for a while, then in France, in Spain, Italy, and now in Luxembourg since 4 years. Indeed, it’s a good question how I ended up or how I find myself in insurances, because this is not what was my original intention when I started my university studies. I graduated in German and Spanish literature and then I did a PhD on 19th century Spanish literature. So I’m happy to say that I’m a real specialist in this topic. But then I continued, so I started working and continued a study on distance university, on business administration. So I have also a degree on business administration. This is also to reassure my team and colleagues and clients. So after a while working in France, where we stayed for 13 years, my family, I started working in a brokerage company, in a French family held brokerage company, which I felt very exciting as a job experience that I didn’t expect. I think we should talk more about insurances because insurances is such an exciting and really interesting topic which young people might not know enough about.
And from there I opened an office for this French brokerage company in Germany. And this is how I got in contact with Globality Health here in Luxembourg. I started working for Globality from Germany, from Berlin, as responsible for the German market. And after two years I was asked to join at the time, Board of Management with a broader sales responsibility. And since two years I’m now in charge of sales operations and legal as part of the Board of Directors.
So you really do have an international background which lends itself well, I think, to this industry, because I have to say, during our preparation discussion. It was the first time that I really got to understand a bit more about the international health insurance industry. And I find it really fascinating. So it is a huge privilege for me to be able to kind of interview you today just to set up. So for the next question, can you describe for us the types of products offered in the sector and the types of clients that you work with?
Yeah, absolutely. To go back to what you just said, I share your feeling. It is a passionating and fascinating topic because indeed I spent so many years living abroad and I think that there are several languages that I speak really very well for business purposes. But when it comes to explain that. I don’t know. My tummy hurts and what kind of pain this exactly is in my mother tongue. In German. I have a variety of words to describe if it is really I don’t even know how to say this in English if it’s a screaming pain. Or if it’s some pain. Or what kind of pain it is which helps the doctor to understand my suffering and then how to help me. And even though I have lived a lot of time abroad, I feel that it is extremely difficult to express body related topics in foreign languages. And there’s already what starts making our business so interesting. Of course, what we offer is international health insurance to both individual and corporate and SME clients. So the employer who sends people abroad for business purposes, I don’t know, maybe in order to develop a new market or to bring the corporate spirit to the foreign entities, or there are a number of reasons that make employers want to send their people to live abroad for a certain period of time.
It can also be career development and other elements. But in this case, if the employer sends the employees abroad, then there is the duty of care. So the employer has to make sure that if the person gets ill, that he or she is covered and taken care of at the same level as this would be taking place in the home country. Right? Of course, there’s one element which is the pure financial risk if you come from Luxembourg or Germany. So these Central European countries, we have an idea about what, for example, costs for delivery can be, right? I would say this is depending on if it’s a public hospital or private facility. It might be something between, let’s say, three and €10,000. If the same treatment takes place in an international hospital, let’s say in Singapore or in one of the big cities in China or in the US. You can add even zero at the end, right? So the costs will be by far more expensive. And this is the first thing. Right? So if it’s a small company, for example, who sends somebody to the US. Already from a financial perspective, I would very strongly recommend to take out a good international health insurance plan.
Because if there are complications, for example, something that happens all the time, right? Delivery, birth of a baby, this can really be very high costs and six digit amount is not surprising in the US. And if there are complications added or, I don’t know, premature baby or there can be so many things that can go wrong in this kind of action, then without a good health insurance cover, this can be really tricky for the employer. But then the second part is what is also very important, I think in the context of medical care, it’s knowledge and its language, right? I send somebody to a foreign country. Then the first question if this person detects symptoms that could be cancer, for example, the first question that this person will have in all cases is where do I find a good medical provider who can trust that my treatment will be an international standards and will be at the same high level of quality as this is in my home country? And then also we have the language barrier, right? It’s not everybody speaks perfectly English. And this goes for both for the employee who is abroad and for, of course, the medical practitioners.
It’s not in all places in the world that you will find somebody with whom you can communicate in English. So our role is broader than what we would expect here. Luxembourg from CNS, for example, or for my health insurer in Germany or in France. When we are in our home countries, I think we have all this context of knowledge that we can easily access, right? So we will ask for birth. We will ask our friends who already have children where did you give birth? Where’s a good birth clinic? I should go. I can ask my neighbors, my all time, all life medical practitioner, general practitioner, that I have to get advice if I’m in a place where I’m totally new and this is something that I have personally experienced in my past. It is very difficult to find a place where you trust that the medical treatment is up to date. And this is, for example, a service that we offer. So an insured member who is in, I don’t know, Kuala Lumpur covered with us, if they have a problem, they can call us. They can of course go on our website, but we rely very much on telephone calls.
It’s a bit old fashioned, but it is everything that is related to medical treatments. I think it is very much about the human touch, the human assistance that we can give. So people will call us and ask where to go or somebody who is already in hospital will call us and say hey, I don’t read Chinese. I was given this and that treatment. But I just don’t know. Is this good? Can you take a look? And then we ask them well. Take a picture, send it to our email address. We will take a look, we will translate and we will check with the medical practitioners that we have in our own medical team or with our network here in Europe. And I have seen cases where this already was very, very reassuring for the insured member just to say, just to hear the treatment that you got on the other side of the world in a, let’s say, public hospital in Providence, China. This is absolutely up to our medical standards. How you would be treated here in Kirchberg Medical Hospital or in Germany or in France or wherever here. This is what makes it so exciting.
It is not only that we reimburse costs, right? This is a part that we do, of course, but we do a lot more. And this is what makes I haven’t been bored one day since I started working in health insurances. And I can say I’ve been here for quite a while.
This is so complex. And I think just hearing you speak, it makes me appreciate the level of protection that is available out there, but also the kind of assurance that this would provide to your clients, knowing that it’s a fully comprehensive solution that you’re offering. Which kind of leads me into the next question what kind of infrastructure is required on the ground in these kind of countries in order to be able to drive this solution?
Yeah, good question. It’s also the one question that, without exception, all our corporate clients who decided over the past six years to join us, to choose us as their provider, asked me, you are a relatively small company based in Luxembourg. We have roughly 100 staff members. And how can you provide the service? And of course, we work with medical networks. So we have a sister company. So we belong to the Munich Re and Argo Group, so big German insurance group with a lot of different providers for different solutions. And we have a sister company which is called the Euro Centers. They’re headquartered in Prague and they are specialized in medical assistance. They have administrative platforms around the world in the main markets where expats tend to be. So in the US, in South America, in African countries, in Australia, in several Asian countries, and so forth. And together with us, they serve our intrude members in these markets. So they have developed medical networks, right? So a network of medical practitioners, mainly hospitals, but also outpatient facilities where we offer direct settlement. And something that was surprising for me when I joined from my former job as a broker, I had seen, of course, a lot of different IPMI international health insurance providers.
What was new for me in Globality is that we also give advice on quality. This was something that I had not seen and which I feel is great because actually one thing is to give a list to intro members to say, hey, these are the hospitals that are on the city. But I think with internet, more or less everybody can have access to this kind of information nowadays. But that we really say, okay, you have chosen one hospital which is okay, we have better experiences with another one. And if you want, dear patient, we can assist you and organize a meeting, an appointment with a very good doctor in a different facility. There is, of course, the quality aspect, but there’s also the pricing aspect. So our sister company has arrangements on prediscussed medical fees or fees for medical treatments. And this of course is important. Well, this is the part about insurances that maybe not all the clients understand directly. But of course, insurances, you ensure a risk that can come up as it also cannot appear in international health insurance, it is a little bit less of a risk. So we know if you have a population of 1000 employees in the same group, we know statistically that there will be a number of I’m just throwing numbers, right, between, I don’t know, maybe ten and 50 births per year and there will be one cancer case and there will be one heart attack.
It’s really not exemplary figures just to say we know in these groups that there will be medical treatments that will come up. So it is a little bit less of this real insurance, like in the fire insurance. We all have fire insurance for our houses and we hope that this will never be used, right? But in health insurance it is probable. And so, of course, if a corporate client ensures the 1000 experts that are assigned abroad, then they will know that they will have to pay a certain amount of premiums per year. And of course, what the clients are all interested in is financial stability. So they hope that the premiums will not increase massively from one year to another, which makes it important for us to handle these costs, right? Cost containment insurance is always very easy. You can just say no and not reimburse. This is, of course, in medical insurance, not the preferred way. So what we rely on very much is really looking into the cases of probably higher costs, medical case management. So one important element is to find network partners who agree reasonable costs with us. Not cheap, but reasonable and customary in the place where they are.
And then, of course, something what we also do is we look into every case of hospitalization. So always it’s not if you cut your finger, right, then it’s just reimbursed and there’s no discussion. But if there is a cancer case, for example, we would contact the insured member and discuss the options. And there are always options. The option can be to stay in the hospital where you are and get treatment over there. Another option can be to get a second opinion from a different medical provider in the same area options can be to change the hospital, to go to a hospital in the area. If we feel that the medical standards are not that high in the country where the expert is, then we would probably recommend to go to a different well, maybe there can be a different city, but can also be a different country. Or in very specific cases, we would also suggest to go home. And this can have several reasons. So I had one case that was quite interesting. It was for a hernia surgery. So I think this of course, I’m not a doctor, but I hear that this is not a very complicated medical treatment.
And we had somebody in Singapore who was scheduled for hernia surgery that was really very expensive. And so what our medical team did, they called me, it was a German. And our medical team also, the lady who took care of it is also German. She imagined that as a German patient, you would appreciate it if after surgery you wake up if you can communicate in German and not in English. She felt that there was a benefit for this person to be offered to get treatment in Germany. So she called him and offered that we could organize a treatment in the Charitae Hospital, which is the one big hospital in Berlin. It’s a very good reputation said, okay, we organize a flight, we organize an appointment for you. And some days after the surgery, when you are fit for fly, we will transport you back. How does it sound? And of course, it sounded great, right? And it sounded great also for the employer at the end, because instead of paying €30,000, the entire between surgery and flight and everything costed not even $10,000. So there were an economy of €20,000 made for the benefit of the employer who at the end did not have to pay over the years for premium increase.
And of course this was really WINWINWIN for everybody. So we also, of course, the insured didn’t have to pay the cost. And the insured member was super happy not only about the insurer, but mainly about the employer who had really well taken care of him by choosing such a great insurance company. And this is well, I could fill our minutes here with this kind of story because there are also other cases where we had another this was the nice and fun story. We had another case some years ago where somebody was in Saudi Arabia and had a very severe cancer and there was in Saudi Arabia. You can imagine medical treatments are absolutely on international standards. It’s extremely good doctors and hospitals and so forth. And it was not about costs or anything, but our medical team was under the impression that for this poor it was a young man. It was a really tragic story for this poor young man. The main question was not when will he be back to work for his expatriation job, but when will he survive the treatment? And so what they did in agreement with the insured, so with the employee, they contacted the employer and explained the situation.
So we feel from a medical point of view that his chances to recover fully after surgery will be better if he’s in his original surrounding, if he has family members coming to visit him, if he has friends seeing him and everything. So we suggested to end the expectation to organize a treatment in a specialized facility in Hamburg in this case and to bring the person back. And it was fun because some of our clients were so used to this kind of procedure with us that they directly say great, if we send somebody back, we end the costs for expatiation, we take the person out of the plan and so forth. So we will economize money. And in this case we said we would recommend to let this person still another week under our international plan before you switch him or her back to Social Security. Because this was a private facility where we felt he would be had best chances to recover fully. And of course there can be different waiting times depending on the kind of health insurance that you bring if it’s private or public. And this is what we did. So we transported him very quickly back to Germany, got him hospitalized and operated really the following day.
And then while he recovered, I don’t know if at the end he came, he was so fit that he could work again, but at least he survived. And this is what makes it so fascinating for me if I see what our medical team does. There are so many elements in health and health treatment, right? It’s not black and white. There can be little elements that can make the difference, right? If you give somebody who needs to be transported back on an assistance flight and I assisted to a call from our medical team to somebody who should be transported back after a heart episode. And the colleague said to the gentleman, yeah, okay, you will be transported on Saturday, you will be back in Germany on Sunday and please make sure that on Monday morning you call me. And after she hung up, I said, well, isn’t this a bit flirty, but you look him up on the Internet. Was he so good looking? And she said, well, actually, yes, he was, but this is not the reason, but there’s a medical reason. She said, well, the only thing that could go wrong is if he had another panic attack during the flight.
And she said, well, with this he had something to do, he had something to concentrate on. He knew that on Monday morning he would need to call me to give me feedback on how everything is. This gives me thumbs up. It was so great. So there, the flight also went well, and he came back to Germany and there was a business traveler who had an episode during a business trip to China. But this is really what makes it for me. And of course, we cannot do everything out of Luxembourg on our own, so we have these networks in some countries, we also work with external networks. In the US, there are some very specialized providers who have literally hundreds of medical providers in their network or pharmacy networks. We work with one pharmacy network in the US that you can see literally in New York in every corner of the street, where people then go with their insurance card, a bit like you would do in Luxembourg. Right. You go with your insurance card and you don’t have to advance costs. Everything is taken care of. It’s really very comfortable.
Wow. So international is a key theme. Travel is a key theme. You’ve mentioned various different continents within which patient care can take place. Moving on to the kind of the impacts of the COVID health crisis on the international health insurance industry, can you tell me a bit more about your experiences and how globality health has adapted in this new environment?
Yeah, this is indeed yeah. The Pandemic was, of course, was a horrible time for everybody for an international health insurance. It was a particular challenge because, of course, we all worked from home. We didn’t even go to the office. So I imagine that somebody who would be asked to go on expatriation to a foreign country would reasonably ask why, if the rest of the business works well from home, why would he or she leave the country and go elsewhere? And this is what we saw over the past year. Funny enough, in the first year of the Pandemic, we sold a huge amount of new policies to individuals. There were a lot of people who called and say, oh, I am a Chinese businessman. I came to Germany and with my travel insurance, I only intended to stay for two months, but now I’m stuck. What do I do? So, yeah, you did right in calling us. And so we covered a new client, so we made a lot of new clients that year, but then in our existing clients. So in the corporate world, there, as I said initially, the global mobility policies of our clients are all a bit different.
Right. In some cases, they say all our foreign entities are traditionally led by, let’s say, a German or somebody of Spanish nationality for a Spanish group. Others say we have specific positions that are always filled every three years by a new colleague, like a career development. Or others who say, who wants to go develop personally into the middle management function in our group has to spend at least three years in a foreign entity to learn about our group spirit elsewhere. And so there are a lot of different motivations in those cases where there’s a job rotation. We saw that those that for whom the expectations came to their traditional end, after three years, they would come back, but no replacement would be sent out, which really affected our business quite a lot. So there were a lot of contracts who have been drinking over the past years, not because clients are not happy, but because they just have difficulties in deciding on when they can send people abroad again. And then, of course, we have traditionally, I would say a third of our insured members go to China. So a really huge sum. The other day I read an article about expats in China and the number of how many Germans are currently on expedition in China was smaller than what we currently insure.
And of course, it’s not a secret. We are not the only international health insurance in the world, right? So I imagine that this must have been either the figures were wrong or indeed the population has decreased massively. And now China is indeed a bit of a topic. We see that there are still severe travel restrictions to enter China. I just had a conversation with a big client who said they are considering taking out all their experts from China and relocate them to other Asian countries due to this very restrictive latest lockdown that we re about in Shanghai and other places in China. And I’m very curious to see how the European or let’s say Western industrial clients will develop their strategy. Because I think we are so closely linked to China, it’s difficult for me to imagine what, for example, the German industry will do if they say, well, China becomes too difficult for us. But of course, also there’s the Russian war in Ukraine is a topic that affects us a lot. So, as I said, I belong to Munich, re and Ogo group. Our group has a very strict position towards Russia and says, well, we will withdraw or have withdrawn from the Russian market.
Totally. And of course, with this, indirectly, of course, we also position ourselves towards the clients. Right? If you say, well, it will be difficult for us to ensure your expats in Russia, then of course the employer also has to consider what they do, whether they find a health insurer who says, Well, I don’t care, I still do business in Russia, or they say, well, we also withdraw our experts and reassign them elsewhere. So I never expected my job becoming a political one. Actually, it is right. It’s a political statement that we are giving and it has an impact. It’s impressive, right, to see that with our work. We also say, well, this is what we can do, what we want to do, and what we cannot do anymore.
Yeah, there’s certainly a lot of changes at the level of ACA and our interactions at the European level. Not the parent organization, but our European association, I believe, withdrew the Russian membership or the russian delegation from their membership. So, yeah, we’re seeing the reverberations of these political developments throughout the industry. So thank you very much. Perhaps one last question. What would you consider to be priorities for ACA ? And what kind of feedback would you like me to give my colleagues?
Yeah, I’m actually very happy with the work and the assistance that ACA provides us, the insurance company based here in Luxembourg. One topic that I discovered not so recently, but what is really important for us is the assistance that we receive, for example, on HR topics. So there’s this work group where our HR director, for example, attends regularly when it comes to a lot of topics that concern the entire insurance industry here. Personally, I’m a very huge fan of Luxembourg, and living in Luxembourg, I feel that as a financial place, it is sometimes a bit tricky for us to attract workforce from the neighboring countries. Thinking about our staff, I don’t know if you have any Luxembourg, a real Luxembourg nationality, maybe two or three who have acquired the nationality with the time, but no born Luxembourg. So we have to find talents elsewhere. And in some cases, I feel it is a bit tricky to attract people here. They might fear the language barrier in case of the Germans not speaking French, for example, and not, let alone speaking Luxembourgish. But then also a topic where I know that ACA is involved in is this topic of taxes and Social Security for transporter activities.
So, of course, we have, I think, up to 60% of our workforce living in the neighboring countries. And then, of course, after the pandemic, the question of remote working is the hot topic that we have, of course, with our employees, but also when it comes to new regulations from the regulator. I feel that it’s extremely helpful to have this support from ACA and to be able to exchange on tricky topics. And I don’t say that to please you. It’s really hard for you, man, that’s.
Really encouraging to hear. And I can say, certainly on behalf of my colleagues, there is no shortage of things to do. We all work very hard. So it’s great to hear that it’s appreciated.
It is perfect.
Cornelia, thank you so much for joining me today and sharing your views. And we thank you to the audience for tuning in and listening to this podcast, and we look forward to welcoming you next time.
Thanks a lot. It was a big pleasure.
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