12th Release

Transcription

12th Release
COOPERATIVE
HEALTH INSURANCE
January 2011, Issue 12
Medication Outside the Realm of Insurance
Vitamins and Psychiatric drugs not covered
Dr. Rashid Al-Rashid Alhomaid:
Healthcare services in KSA at par with
those in developed countries
ICD-10 Medical Coding
Towards Increased Efficiency
and Cooperation
Editor’s note
Editor-in-Chief:
Dr. Abdullah Bin Ibrahim Al-Sharif
Secretary General of the Council of Cooperative Health
Insurance
asharif@cchi.gov.sa
Asst.Editor In Chief
Mohammed S. Al Hussain
Asst. Gen.Secretary of Admin & Finance
of the Council of Cooperative Health Insurance
The General Secretariat of the Council of Cooperative
Health Insurance
PO Box 94764 Riyadh 11614
Phone: 920001177
Fax: 014870071
www.cchi.gov.sa
Publisher:
CEO: Rabih El-Amine
rabiha@alefinternational.com
Editor-in-Chief: Mustafa Shehab
mustafas@alefinternational.com
Associate Editor: Amira Hamadeh
Editors: Said Al-Hasanieh
Syed Noori Mohammed
Yasmeen Hinnawi
Jehad Abou Hashem
Group Editor (English) Afifa Jabeen Quraishi
Senior Graphic Designer: Hussain Mohamed Al-Bakri
Distribution:
P.O. Box: 301292 Riyadh 11372, Phone: 0096614623632
E-mail: info@alefinternational.com
The reproduction or reprinting of any part of this magazine must have
the express permission of the publisher, who reserves the right to
initiate legal action against any violation.
Since the launch of the Cooperative Health Insurance Magazine as a voice of the
Council on the one hand, and an incubator for the health insurance sector, on the
other hand, we took upon ourselves the responsibility of reflecting the reality of
this sector by deliberating on each and every insurance issue and researching all
matters related to this important sector.
To achieve this, we are fully committed to transparency and objectivity, and we
are keen to include all that matters in this sector, and in particular, the beneficiaries
of health insurance services.
In line with this aim, we discuss in this issue a range of subjects that have never
been covered before. In our Hot Topic segment, we highlight the issue of the
medications covered and uncovered in the insurance policy and the main reasons
for this difference.
Our Cover Story this month focuses on the medical coding system, adopted
in the Kingdom, in terms of its importance, benefits and role in improving and
advancing health services.
The topics discussed in this issue are many and varied. As in every issue, in this
edition also we profile a company operating in the insurance sector – SALAMA
Takaful Insurance and Reinsurance Co – reviewing its history and insurance
programs. In this context, we also shed light on the social responsibility programs
carried out by BUPA Arabia, and highlight its efforts in the training of staff and
Saudi nurses to provide home health care, in addition to other activities designed
for the service and benefit of the society.
In keeping with the magazine’s vision of enhancing general awareness of the
insurance culture, we conducted an opinion poll to find out if policyholders are
aware of their rights guaranteed by their insurance polices as well as the reasons
for uncertainty that cause major problems between insurance companies and
customers.
We also reviewed the financial results of insurance companies during the
first nine months of the year, and the successes achieved in the performance of
companies in general. In our Finance and Investment section, we discuss the ways
insurance companies can deal with losses and the options available in this area.
As part of our efforts in understanding the experiences of other countries in the
field of health insurance, we review in this issue, the Australian experience.
In Tourism, we are off to Jordan, where we share with our readers some of the
archaeological treasures of this brotherly Arab country, while also touring the city
of Petra, one of the most fascinating wonders of the world.
In the end, we answer your questions and comments in our Insurance Forum.
We hope you enjoy reading the magazine. See you in the next issue.
Editor-in-Chief
In the Spotlight
6
News
Finance & Investment 14
CCHI meets with insurance
companies, discusses developments
Controlling deficit and dealing with losses
Borrowing, merging or innovating
are the options
The Council of Cooperative Health
Insurance (CCHI) recently met with
health insurance companies and
claims management companies to
discuss the latest developments in
the health insurance sector after the
comprehensive application of the
cooperative health insurance system to
all targeted segments.
Snippets
1818
The insurance sector is considered as the
main pillar in the global economy and
equity markets. However, it continues
to witness difficulties in the Arab
market, specifically in Saudi Arabia,
mainly because of the modest capitals
and the recent entry in the Saudi stock
market.
Islamic Arab Insurance Company,
the first Shariah-compliant insurance
solutions (Takaful) provider in
the world, was founded in the
United Arab Emirates, and began
its operations in 1979.
Hot Topic
20
Social Responsibility
Medication Outside the Realm of
Insurance
Vitamins and Psychiatric drugs
not covered
24
Reports and Analysis
Under the guidance of the Minister
of Health Dr. Abdullah Al-Rabiah,
President of the Council, Saudi Arabia
implemented a medical coding system in
order to benefit from modern technology
in managing health insurance.
Interview
In this issue of the
Cooperative Health Insurance
Magazine, we meet with Dr.
Rashid Bin Suleiman Bin Rashid AlRashid Alhomaid, Vice Chancellor
of King Saud bin Abdulaziz
University for Health Sciences Postgraduate Studies and the former
Secretary General of the Council
of Cooperative Health Insurance
(CCHI).
Around the World
48
28
32
Tech World
40
Interactive TV, or ITV, a term we often
hear these days, is a technology that
allows the viewer to interact with the
television set in ways other than simply
controlling the channel.
Lifestyle
52
Fragrances are tantalizing enough to delight
one’s senses, take the breath away and make
you fall in love with them.
Health Insurance in Australia:
Establishing Equality and Excellence
The health insurance system of
Australia, which is known for its
tolerant and diverse society composed
of many races, ethnicities and cultures,
is characterized by its unique concept.
The participation of companies and
institutions in social responsibility
programs has become one of
the main prerequisites of human
development.
28
44
The Saudi market recorded good financial
results during the first nine months of
2010. One hundred and two companies
achieved a net profit of SR61.32 billion,
while 27 companies suffered a loss rate of
SR2.63 billion.
Dar Al-Takaful launches world’s first
bloodstock Takaful product
Cover Story
36
Travel & Trourism
56
Jordan: The Land of Civilization
Visiting a country that is rich in tourist
sites – from ancient historic castles and
forts to magnificent wildlife reserves
and other attractions – is always a
splendid experience. Choosing where
to go or which place to visit becomes
a difficult task, especially in a country
that abounds in geographical diversity
and is considered to be a magnet for
tourists from all around the world, as is
the case with Jordan.
Survey
60
How informed are insurers about their health
insurance policy?
News
CCHI meets with insurance companies, discusses
developments
The Council of Cooperative Health Insurance (CCHI) recently met with
health insurance companies and claims management companies to discuss
the latest developments in the health insurance sector after the comprehensive
application of the cooperative health insurance system to all targeted segments.
The meeting started with a speech by Dr. Abdullah bin Ibrahim Al-Sharif, Secretary
General of the Council, who welcomed the attendees and talked about the objectives
of the meeting, which the Secretariat organizes periodically, stressing on the need to
expand training courses and workshops. He also stressed on the importance of communication between the various
insurance parties to understand their needs and come up with solutions for the
insurance industry. Al-Sharif said: “The secretariat of the Council has taken important
steps, which in partnership with insurance companies have contributed positively to
the health insurance sector.”
“The number of qualified insurance companies has reached 26, in addition to
five claims management companies, while the number of insurers has
reached seven million. The Council will continue to play its supervisory and regulatory
role, under which it has filed 330 complaints against insurance companies. But if we
compare the number of complaints to the number of insurers, we notice that people
are becoming more aware of the cooperative health insurance system.”
AXA Cooperative committed to Saudization
AXA Cooperative Insurance Company
(AXA Cooperative), one of the top five
insurance companies in the world,
announced that 37 percent of their staff
comprises of Saudi nationals, in line
with the company’s commitment to
increase its Saudi staff by five percent
annually to meet the Saudization target
of the company.
Henri de Castries, Chairman and
CEO of AXA Group, told newsmen at a press conference in
Riyadh: “The launch of AXA Cooperative in the Kingdom at
the beginning of the year is a pivotal step towards expanding
our footprint in the country. We are keen on providing the
necessary training to our Saudi staff both in and out of the
Kingdom in order to make them efficient resource personnel
in the insurance field.”
He added: “We will, therefore, continue leveraging our
international expertise and adapt these for the Saudi market.
We will also continue investing in our employees and use the
large pool of well-educated nationals as a prime source for
recruitments.”
Abdul-Aziz Al-Shahri, Director General for Human
Resources at AXA Insurance in the Kingdom said:
“The Company aims to recruit the best Saudi graduates not
only because of Saudization, but in order to take
advantage of the superior Saudi cadres.”
In a step aimed at reinforcing its market leadership
and competitive advantages in the insurance sector
across the region, AXA Insurance Gulf has launched
its new enhanced Home Insurance online, responding
to customers demanding more accessibility whilst
providing competitive benefits, a reasonable price
and good service.
Alexis de Beauregard, Chief Officer - Marketing
and Retail Products at AXA Insurance Gulf said: “Home
Insurance in the UAE has a very low penetration. However,
more and more people are looking to insure their homes and
we have enhanced our product to meet the varying needs,
providing flexible options along with the convenience of
buying the product online.”
He also went on to elaborate on the importance of Home
Insurance. “A home is the most important asset that a
person has and it needs to be protected from damage and
destruction. Not only will a good policy save your money
in an event that something untoward happens, but an
insurance company can also help with other matters such
as making your home more resistant to natural disasters or
providing you with an alternate accommodation if your
home is damaged.
Disasters cost insurance industry $36 billion
Natural catastrophes and man-made
disasters in 2010 cost the global
insurance industry $36 billion. However,
the economic loss for society was much
higher at $222 billion, scoring a 250
percent increase compared to a total of
$63 million in 2009.
Swiss Re, the second largest insurance
company in the world, said: “In 2009,
worldwide economic losses were only
$63 billion and insured losses were
34 percent less than that during 2010
($27 billion). Natural catastrophes
have cost the global insurance industry
approximately $31 billion during 2010
and man-made disasters have cost
around $5 billion.”
“Due to a comparably mild US
hurricane season this year, losses for
the worldwide insurance industry were
in line with the 20-year average in
2010,” Swiss Re said.
Severe
catastrophes
claimed
significantly more lives this year than
in 2009. Nearly 260,000 people died
in these events, compared to 15,000
6
Safar 1432 | January 2011
last year and the highest number since
1976. The deadliest event was the Haiti
earthquake in January, which claimed
more than 220,000 lives.
The United States of Diabetes
More than 50 percent of Americans
could have diabetes or pre-diabetes
by 2020 at a cost of $3.35 trillion
over the next decade if current trends
are anything to go by, according to an
analysis by the UnitedHealth Group.
New estimates show diabetes and prediabetes will account for an estimated
10 percent of total healthcare spending
by the end of the decade at an annual
cost of almost $500 billion – up from
an estimated $194 billion this year.
The report notes that the annual
health care costs in 2009 for a person
with diagnosed diabetes averaged
approximately $11,700 compared to
an average of $4,400 for the remainder
of the population.
COOPERATIVE HEALTH INSURANCE
7
News
Teachers may soon be covered by health insurance
Dr. Solomon Al-Kareda, DirectorGeneral of Teachers Affairs in the
Ministry of Education, said that the
Ministry has formed a committee
to study the application of medical
insurance for teachers. He told AlHayat newspaper that the Ministry
did not neglect this important
segment, and that all sectors in
the state, especially the Ministry of
Health, attach great significance to
the project.
“This comes in line with the future
goals of the Ministry. Many teachers are
still hoping for the day when they get
health insurance coverage. Therefore,
we formed a specialized committee to
study the issue from all its aspects and
the education ministry is constantly
working on it,” Al-Kareda said.
“When we say that a committee has
been formed, it means that we are ready
to implement this project, but we still
need time. Everyone is aware that the
Ministry did not neglect this segment
of society, which has been receiving
great attention from all sectors of the
state, especially the Ministry of Health.
We will spare no effort in providing
everything necessary for teachers and
creating a healthy environment for
them,” he added.
Asked if the teachers’ suggestions in
regards to the project were considered,
Al-Kareda said: “The history of the
Ministry attests in many areas the
involvement of teachers in the evaluation
of a number of projects and channels. We
do not say that all of them are involved
in the process of evaluating projects, but
teachers are always aware of the projects
implemented by the Ministry, and that
is done by different ways including
conducting questionnaires, field visits
and surveys.”
Tawuniya offers vehicle liability insurance
against rain, flood
The Company for Cooperative
Insurance (Tawuniya) issued a new
product aimed at covering insured
vehicles under the SANAD liability
program against rain and flood. This
coverage against natural risks is the
first of its kind in the Kingdom.
Deputy CEO Hesham Al-Sharif
said: “Tawuniya was considering this
coverage since the Jeddah floods of
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Safar 1432 | January 2011
2009. Most customers had not received
damages for their vehicles as they held
the compulsory vehicle liability policies
exclusive of natural risks.”
After rain and flood swept the city,
the company decided to launch the
SANAD policy, which will cover
vehicles against natural risks including
rain and flood. The coverage reaches
up to SR20,000. It is available to retail
customers for an additional installment
of SR50 per vehicle annually. Last year,
more than ten thousand vehicles were
seriously damaged by flood, according
to official reports.
Tawuniya has recently updated its
IT systems and has equipped all its
branches with publications explaining
the details
of
the
new
coverage, conditions and benefits.
COOPERATIVE HEALTH INSURANCE
9
News
EP Chamber of Commerce re-elects insurance
committee
The Insurance Committee in the Chamber
of Commerce and Industry in the Eastern
Province has re-elected its members.
Salah Mohamed Al- Jabr was appointed
as its Chairman for a term of four years,
and Hussein Al- Shabaan as the Deputy
Chairman. This was announced during
a committee meeting held recently,
where members discussed a number of
issues concerning the development of
the insurance sector in the local market.
Al-Jabr, who served as the Regional
Director for WEQAYA for insurance
and reinsurance in the Eastern Province,
presented to the 12 members of the
Insurance Committe a work plan designed
to enhance the work of the Committee,
achieve further gains service, and work
to overcome difficulties facing the sector
that were limiting its contribution to the
national economy.
He said: “There is no doubt that
the Insurance Committee depends on
the support and attention it receives
from the concerned authorities in the
insurance sector, especially the Saudi
Arabian Monetary Agency, the Council
of Chambers of Commerce and Industry,
and the Council of Cooperative Health
Insurance. Therefore, we will work in its
current session to strengthen this support,
and
develop
a
strong
relationship between all of these
parties.”
Al-Jabr expressed his thanks and
appreciation for the members of the
Insurance Committee, acknowledging
the confidence they entrusted him.
He
also
promised
to activate
the role of the Insurance Committee,
support its decision-making
process
through government
agencies related
to the insurance sector, and work to
increase the number of members of the
Committee to represent the
largest
number of service providers, brokers,
agents and providers of support services.
The Chairman of the Insurance
Committee noted that the Committee
made a number of recommendations
addressing the most important issues
facing the insurance sector, including:
• Providing training to Saudis
working in this sector
• Attaining the
Saudization percentage
required by insurance companies • Opening new channels for highclass training
• Providing the insurance
market with scientific and
field studies that serve the growth
and development of the sector and
its services.
Dr. Metab Al-Rougui, CEO of WEQAYA
for insurance and reinsurance in
the Eastern Province, expressed his
confidence in Al-Jabr’s election as the
Chairman, saying: “Al- Jabr is one
of our most qualified national
cadres and has an extensive practical
experience in the insurance field. He
is definitely eligible for this position
and his presence as the head of the
Committee will
have
a
positive
reflection on the sector as a whole.”
Gulf insurance incurs SR32 million losses
Gulf General Insurance Cooperative
Co suffered financial losses amounting
to SR32.078 million during the period
from March 1, 2010 until August
30, 2010. According to the financial
statements received from the external
auditors, the losses were distributed
between pre-operating expenses and
foundation expenses, as reported by
Al-Riyadh daily. The company began
operations in April this year.
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Safar 1432 | January 2011
SAICO recommends
capital increase
The Board of Directors of Saudi Arabian Cooperative
Insurance Company (SAICO) recommended increasing
the company’s capital from SR100 million to SR150
million in a step to expand its insurance activities and to
acquire the portfolio of Saudi Arabian Insurance Company.
The capital increase will take place via priority shares to
registered shareholders on the day of the Extraordinary
General Meeting- (EGM), which will be announced later.
The number of shares as well as the share price will be set
once the approval of the related authorities is secured.
The company confirmed that it will register with the
Capital Market Authority, the Monetary Agency, and
other relevant bodies in order to obtain final approval to
determine the requirements of the presentation and the
prices of the offered shares.
Malath electronically
links 500 medical service
providers
Malath Cooperative Insurance and Reinsurance has linked
more than 500 medical service providers in the Kingdom
and the Gulf region through an electronic system provided
by Waseel for the transfer of electronic information as per
the agreement between the two parties that allows Malath
to enjoy the service through its widespread network.
Ali Al-Aaed, CEO of Malath, in a statement to AlEqtisadiya newspaper said: “Malath is looking forward
to the implementation of the e-services project as it will
improve the quality of performance and will bring many
benefits to the beneficiaries of the insurance sector first,
in addition to operational benefits to the company and
medical service providers.”
He noted that the project underwent a trial period that
has been completed successfully with medical providers.
“The provided services will include the service of patient
eligibility for treatment, medical service approvals,
electronic claims service, as well as the service of
e-documents,” Al-Aaed added.
Riad Pajuda, CEO of Waseel, said that Malath would
benefit in many ways from joining the network for
electronic transactions, which include major local and
regional insurance companies. “This system will increase
the number of beneficiaries of electronic services.
Moreover, this step would be an incentive for medical
providers to engage in electronic transactions and benefit
from the great advantages.”
COOPERATIVE HEALTH INSURANCE
11
SAMA introduces new set of regulations
Saudi insurance regulator, Saudi Arabian Monetary Authority
(SAMA), has instituted two new sets of regulations governing
the insurance entities in the Kingdom, which will be added to
the five regulations currently in force.
Informed sources in the insurance sector said to Al-Jazeera
newspaper that out of the two, one of the regulations is related
to reinsurance and support; and the other is responsible for
investment. The second regulation will develop standards
that insurance companies must commit to when investing
their funds. SAMA will develop an outline and criteria for
investment, and insurance companies can choose through
them the investment they intend to enter into it.
These regulations are indicative of SAMA's refocusing
of its energies, supervisory activities, and a move to greater
regulatory scrutiny in the Kingdom. The volume of the
insurance sector now is estimated at SR10 billion, while many
experts are expecting the sector to grow to SR30 billion in the
next five years.
Through its supervision of the insurance sector, SAMA
has re-regulated the sector and transferred all the offices
that were operating in the market to the public joint stock
companies, according to specific and strict terms and
conditions. The number of insurance companies that have
been licensed and included in the Saudi market stands at 31,
while sources predict that about five other companies will
enter the market soon.
It is noteworthy that the regulations which are currently at
work include: the regulation of the behavior of the insurance
market, rules against money laundering, terrorist financing to
insurance companies, anti-fraud, risk management and the
costs of supervision and inspection.
Arabia Insurance
elects new Board
The ordinary General Assembly of
Arabia Insurance Cooperative Co.
(AICC) approved, during its meeting
held recently in the hall of Sheikh
Abdul Aziz Mukairin, Chamber of
Commerce and Industry in Riyadh,
the election of members of the Board
of Directors of the Company for
the second session extended over a
period of three years effective from
Jan.1, 2011.
The list of elected members include:
Dr. Saleh bin Abdulaziz Al-Omair,
Tariq Mutleq Al-Mutleq, Dr. Hisham
Sobhi Basat, Fadi George Shammas,
Khaldoun Abdul Rahman Abu Hassan,
Ghassan Ibrahim Aqil, Yusuf Talal AlZahid, Faisal Mohammed Al-Nowaser,
Abdulaziz Abdulhadi Al-Qahtani,
Mohammed Ahmed Arar and Khaled
Saud Al- Deghaither.
12
Safar 1432 | January 2011
Trade Union’s six new products
approved
The Trade Union Cooperative Company for Insurance recently announced that it
had obtained the approval of SAMA for six new products. The approved insurance
policies include: road transport (one trip), movable maritime cargo, maritime
goods (coverage is limited), maritime cargo (one trip), maritime units and marine
leisure units – bringing the number of final and temporary products that have
been approved to 34.
In the Spotlight
Islamic Arab Insurance Company, the first Shariah-compliant
insurance solutions (Takaful) provider in the world, was founded
in the United Arab Emirates, and began its operations in 1979.
In 2007, it was licensed to operate in Saudi Arabia under
the name of Saudi IAIC for Cooperative Insurance (SALAMA).
It went on to become one of the first companies to be
licensed under the law of the cooperative insurance.
SALAMA: World’s first provider of
Shariah-compliant insurance solutions
(Takaful)
Right from its incorporation as a pioneer
in the Takaful industry, to this day, as the
world’s largest Takaful and Re-Takaful
company, SALAMA has always stayed
true to its values and principles.
SALAMA subsidies in the Arab world
are: Islamic Arab Insurance Company,
UAE; Egypt Saudi Insurance Home
(ESIH), Egypt; SALAMA Assurances,
Algeria; SALAMA Assurances, Senegal;
BEST RE, Tunisia and TARIIC Holding
Company B.S.C, Bahrain.
Vision:
To be one of the top three companies
in the Saudi market in terms of market
share and/or return on equity.
Mission:
To be the leading provider of
innovative Shariah-compliant insurance
solutions (Takaful) at competitive
prices backed by strong operations,
excellent
human
resources
and
effective
distribution to
serve the
needs of customers, and maximize the
value for shareholders.
World’s Products and
Services:
SALAMA provides an extensive product
range to meet diverse insurance needs
of its customers. It provides all types of
cover through its Family, General and
Health Takaful divisions. A- Corporate Health Care Cover:
SALAMA provides cooperate health
14
Safar 1432 | January 2011
insurance policy that has distinguished
medical services with different categories
to meet the needs of all segments. All
health insurance classes correspond
with the requirements of the Council of
Cooperative Health Insurance (CCHI)
in terms of coverage and exceptions, as
follows:
1- Main Coverage (Annual limit
per person per policy year=SR
250,000):
• In-patient (hospitalization),
out-patient, diagnostic tests,
consultation, chronic and preexisting conditions
• Maternity (maximum up to
SR15,000)
• Acute psychological
treatment (maximum up to
SR15,000)
• Dialysis and hospital accommodation
(covered up to SR100,000 per person
per policy period)
• Congenital diseases in new born, if
life-threatening
• Dental (covered up to SR2,000)
• Optical (covered up to SR200)
• Hearing test and hearing aid
(covered up to policy max limit)
• Acute psychological
treatment (maximum up to SR15,000)
• Death repatriation (maximum up to
SR10,000)
• Consultation (GP - SR50, Consultant
- up to SR250)
• Physiotherapy (if medically
necessary and recommended)
All of SALAMA’s
health insurance
classes correspond
with the requirements
of the Council of
Cooperative Health
Insurance (CCHI) in
terms of coverage and
exceptions.
COOPERATIVE HEALTH INSURANCE
15
In the Spotlight
2- Covered all over the world for
medical emergencies:
• During business trips
• During annual leaves maximum up
to 60 days
• Coverage outside the Kingdom
should be as per the customary
charges of service providers
3- Non-emergency cases outside
the Kingdom are covered up to 80
percent subject to:
• Pre-approval from insurance
company
• As per the customary charges of
service providers
• Health insurance classes are divided
into five categories: VIP, A, B, C and
C Limited Network.
B- Motor Takaful is divided into
two types:
1- Motor Comprehensive: It covers
loss of or damage to the insured
vehicle, its accessories and spare parts
as a result of:
driver at the time of the accident and
the spouse, parents, children and the
employees of the insured if they are
injured during the working hours or
as a result of their work. • Damages for materials and property,
except those owned by the insured
or the driver at the time of the
accident or property held in trust or
in their custody or control.
C- Fire and Property:
Fire and Allied Perils: Fire insurance
policy covers immovable and movable
property including buildings, plant and
machinery, furniture, fixtures, fittings,
contents, stocks/ stocks in process,
raw material, goods held in trust or in
commission:
• Stocks at suppliers/customer’s
premises
• Machinery temporarily removed
from the premises for repairs due to
loss or damage by fire or due to any
of the following perils: fire, lightning,
aircraft, explosion, earthquake,
Premiums are based on the type of occupancy,
physical features and values at risk.
• Accidents or accidental collision
or overturning due to mechanical
breakdown or wear and tear
• Fire, external explosion, self-ignition,
lightning or thunderbolt
• Burglary or theft
• Malicious act of any third party
• Whilst being in transit (including the
process of loading and unloading
incidental to such transit) by road,
rail, inland waterway, lift or elevator.
2- Third Party Liability:
The company compensates the insured
in the event of an accident caused by or
arising out of the use of the motor vehicle,
subject to the limits specified in this
policy, which the insured shall become
legally liable to pay as compensation for,
including:
• Death or bodily injury to any person
including the passengers in the
vehicles except the insured or the
16
Safar 1432 | January 2011
strike, riot, civil commotion,
malicious damage, storm, tempest,
flood, bursting and overflowing of
water tanks, pipes etc. • In the case of a partial loss,
payments for repairs or replacement
are made. In case of a policy with
a reinstatement value clause, the
cost of reinstatement will be paid
on completion of reinstatement,
subject to an overall limit of the sum
insured. The insurance company, at
its discretion, may repair or replace
the affected property instead of
paying for the cost of restoration.
• Premiums are based on the type of
occupancy, physical features and
values at risk.
• Property All Risk: This Policy
indemnifies against the losses
mentioned above, in addition to
theft or attempted theft (by violent
and forcible entry to or exit from
the premises). The sum insured can
either be based on the actual value
or the new replacement value of the
property, but should be adequate
to cover the total exposure, and the
coverage is subject to the policy’s
exceptions and exclusions.
D- Miscellaneous:
1- Worker’s Compensation: It provides
no-fault benefits in the event of
death or injury to a ‘Worker’ due to
an accident at work. Employers can
protect themselves in case they are
required to pay under the terms of this
legislation for injury to an employee by
purchasing the Worker’s Compensation
policy.
2- Public Liability Insurance: It covers
any firm or any individual which/ who
in the normal course of business or
other activities may negligently cause
damage to the property of others or
injury to others. This may result in
that person becoming legally liable to
such persons whose property has been
damaged or who have been injured.
Apart from this liability, extensive
legal fees may have to be paid. Public
Liability Insurance policy will pay
all sums which a firm or individual
may become legally liable to pay as
compensation for bodily injury or
illness caused to third parties.
3- Fidelity Guarantee: Should a
company suffer a direct financial loss
because of an employee’s dishonest
activities the Fidelity Guarantee policy
will compensate the company for such
a loss.
4- Cash in Transit / Cash in Safe
Insurance: It covers robbery either
during normal business hours or after
normal business hours. Money may
be stolen whilst in transit between the
bank and the office or on any other
route. This policy will compensate
the business for such loss. It can be
extended to cover accidental injury to
employees of the business who may be
injured during a hold up.
E- Marine Insurance:
1- Shipping Insurance: covers loses
or damages to the goods whilst being
transported irrespective of their mode of
conveyance i.e. sea, air or land. Special
types of goods like bulk commodities,
perishable goods such as frozen items
are dealt with especially designed
covers according to the nature of these
consignments.
2- Marine vessels: This policy deals
with the insurance of the marine
vessels. The vessels could be of different
types i.e. from gigantic oil tankers, tug
vessels, normal goods carriers, gas
carriers, vessels built for carrying bulk
commodities, and passenger carrying
vessels to small pleasure yachts and
boats, etc. The policy covers physical
damage to the body and machinery of
the vessels and marine liabilities.
3- Carrier’s liability: It covers losses
or damages, the insurer is legally
accountable for in case of losses or
damages resulting directly during
the actual transfer of a vehicle – the
insurer is responsible for, within the
territorial limits set out in the policy,
subject to the terms and conditions
of the policy.
F- Engineering Insurance:
1- Erection All Risk Insurance: It offers
comprehensive protection during the
period and stages of erection of the
machinery, plant and steel structures of
any kind as well as third party claims
in respect of property damage or bodily
injury arising in connection with the
execution of an erection project. 2- Contractor All Risks Insurance: It
offers comprehensive protection against
loss or damage in respect to contract
works of civil engineering projects,
construction plant and equipment and
construction machinery as well as third
party claims in respect of property
damage or bodily injury arising in
connection with the execution of a
construction project. Contractor’s Plant and Machinery
Insurance: It offers comprehensive
insurance to contractor’s plant and
machinery on an annual basis. It offers
loss or damage occurring at work, at
rest or during maintenance or during the
transit of equipment and is not limited to
a specific construction site. Machinery Loss of Profit Insurance:
It covers the actual loss of gross profit
sustained because of a business
interruption caused by an accident
identifiable under machinery insurance.
The policy could cover the continuing
business expenses (standing charges),
the net profit, the salaries and wages
paid to employees, and the additional
expenditure incurred for avoiding or
diminishing a reduction in turnover.
This insurance is of special interest for
bottleneck equipment used in the field
of power generation like boilers, steam
turbines, generators, transformers and
process machinery, etc. Electronic Equipment Insurance: This
policy protects the insurer as lesser
or lessee, as operator, or as hirer, or as
maintainer. This policy covers almost
all the perils but only after successful
commissioning of the insured items. Machinery Breakdown Insurance: It
coversdamage–unseenorsuddenphysical
damage or manufacturing defects, errors
in design, installation errors, poor skill
of the
operator, neglect,
lack
of
water in boilers, blasts or wear caused
by centrifugation or circuit failure.
Motor Comprehensive
Insurance covers loss of
or damage to the insured
vehicle, its accessories
and spare parts.
COOPERATIVE HEALTH INSURANCE
17
Snippets
Insurance discounts for UAE’s safe drivers
Insurance firms in the UAE are planning to give claim discounts to drivers, who
manage to keep their traffic records clean. Saleh Al-Zahri, President of UAE Insurance
Association, told Al-Etihad newspaper that drivers can get discounts starting from 20
percent reduction in the premium for those who hold a one-year clean traffic record
to 100 percent reduction for those who hold a clean traffic record for five years.
Al-Zahri added that the Ministry of Interior signed an MOA with the Emirates
Insurance Association to ensure that safe driving translates into savings for motorists.
Under the new scheme, one year without traffic accidents and black points would
mean a 20 percent reduction in the premium for insurance policies against loss,
damage and civil liability. Drivers with a two-year clean traffic record would receive
25 percent discount, while the discount will be 30 percent for a three-year clean
record and 35 percent for four years.
He noted that this is the first time a reward scheme has been charted rather than
relying on traditional methods of penalizing drivers for traffic offences. “Be safe and
save” is the message authorities hope to communicate. “Giving incentives to drivers
who abide by traffic rules and regulations will help reduce accidents and road-related
deaths by promoting safety and safe driving,” Al-Zahri said.
Healthcare for all Egyptians
“The new Egyptian insurance law requires the state to treat
all Egyptians in various categories, including low-income
groups, which account to 20 percent of the total population,”
said Dr. Nasser Rasmi, head of the Health Insurance
Authority. “These groups will be totally exempted from
paying any charge for treatment or monthly subscription,”
he added.
He explained that the “socially poor” category, which falls
directly in the low-income category, accounting to 8 percent
of the total population, will get an exemption, but they will
contribute 30 percent of the treatment cost.
Dr. Rasmi, in an interview with “Good Morning Egypt”
TV program, said that the new law would be mandatory for
all members of the family, including school children and
staff, as well as workers in the private sector. In this case,
the employer is required to pay for a monthly subscription
18
Safar 1432 | January 2011
for each worker at a rate of three percent of his salary; the
worker himself will contribute by one percent.
“To improve health service delivery and performance, in
addition to reducing costs, the new law designates the Health
Insurance Authority to finance and collect contributions, while
hospitals will only be responsible for providing treatment,” he
explained. “The service will open the door for competition
between hospitals of all types, including hospitals of the army,
police and universities, each striving to offer the lowest cost
and best treatment for citizens.”
Dr.Rasmi said that well-off citizens have to pay their monthly
subscription even if they do not benefit from the health
insurance system, as many of them prefer to pay for their own
treatment in private hospitals. “There are medical conditions
that require complicated surgeries and expensive medicines,
and with the steady increase in the cost of healthcare services,
well-off people may not be capable of paying for treatment at
their own expense.”
He noted that the draft of the new law included
“committing instead of forcing” all segments of society to
pay for their health insurance subscriptions. “The overall
insurance network has been studied carefully and it
takes into account justice and balance. For example, the
monthly subscription would be reduced for the retirees, and
would be reduced further if it would be collected from his
widow after his death.”
Dr. Rasmi
said
the
new
system will
be implemented gradually, and it would be launched in five
provinces, fairly distributed between the Delta and Upper
Egypt, to cover all the provinces of the country.
Dar Al-Takaful launches
world’s first bloodstock
Takaful product
Dubai-based Dar AlTakaful (Islamic Insurance and Reinsurance)
announced the launch of its first Shariah-compliant bloodstock
Takaful product, offering protection to horse owners against
financial losses.
“I am delighted to announce that Dar Al-Takaful will offer this
exciting new coverage to horse owners in the Emirates. This Equine
product is another example of Dar Al-Takaful’s commitment to
innovation and originality in the dynamic Takaful environment
of the UAE,” Ayman Al-Ajami, Chief Executive Officer of Dar AlTakaful, told Al-Eqtisadiya newspaper.
“Dar Al-Takaful has established an equine underwriting unit in
Dubai, offering protection to horse owners against financial losses if
their animal dies, as well as the cost of veterinary fees, which might
be incurred when treating a sick animal, for all breeds of horse,
whatever it is used for,” he added.
The unit would be staffed by an equine underwriting team, which
would underwrite various classes of equine coverage, consisting
primarily of mortality, medical and surgical fees, loss of use, and
limited theft and unlawful removal, as well as bespoke solutions for
international competitors and large stables.
WHO: Lack of health
insurance leads to
poverty, ill health
Dr. Margaret
Chan,
Secretary of
the
World Health Organization (WHO), attributed the
spread of infectious diseases and poverty to the lack of
health insurance for the world’s poor. This came during
the presentation of the organization’s annual report in
the German capital of Berlin recently.
“The world’s poor, especially in Africa, some Asian
countries and some people of the Middle East
and Latin America, lack access to health insurance,
which is a critical factor for poor patients,” Dr. Chan
explained, pointing out that some families go bankrupt
in their quest for a treatment. “Poor families should
not be forced into bankruptcy to get healthcare,” she
said. Unfortunately, the road towards providing free
health insurance and healthcare treatment is next to
impossible in several countries.
COOPERATIVE HEALTH INSURANCE
19
Hot Topic
companies, even if they are prescribed in most cases - for medical reasons – and
not as a cosmetic or as supplements. “This also applies to children,
especially those aged between one
and six. For example, some types of
milk and vitamins, which are important
supplements, are refused coverage by
insurance companies. Also, diabetic
patients, especially those in their
forties, require certain vitamins and
Neuropharmacology medications. We
are surprised that the companies refuse
to cover these as well,” said the official.
He added: “Elderly patients who
suffer from sexual dysfunction and
need specific drugs are not covered
by insurance companies as well, and
similarly, hepatitis patients have to
pay an additional SR1000 for each
injection. Patients suffering from skin
diseases, especially those with allergies,
cannot have their creams covered by
insurance companies.”
The other issue, said the manager,
is the issue of price disparity of some
medicines. “There is a great disparity in
the prices of many medicines, depending
Medication Outside the Realm
of Insurance
Vitamins and Psychiatric drugs not covered
There is no doubt that insurance companies have solved many problems, eased the
sufferings of patients, considerably reduced the burden of government hospitals and
clinics, and contributed directly as well as indirectly to the growth of the national
economy through the provision of medical services that have led to better living standards
and higher productivity.
This beautiful picture of insurance
companies, however, has shortcomings,
one of which is the paradox of uncovered
prescribed drugs and medications. This
issue has prompted many to question the
logic behind this and to search for a way
out of the dilemma that is facing many
patients and medical institutions. In this
edition, we shed light on the subject of
uncovered drugs, an issue that still has
no feasible solution.
To find out the source of the problem,
we visited a few medical institutions in
order to explore the views of professional
doctors and insurance company officials
on this issue. We observed that the
majority of the people we spoke to did
not want to reveal their names saying
that they do not want to cause problems
with insurance companies, despite our
assurance that no particular company
would be blamed.
We explained to them that we are
discussing an issue that is causing
great imbalance in the field of medical
insurance and that a dialogue is necessary
so as to be able to find a solution to
20
Safar 1432 | January 2011
Corporate department manager: Not a single
month passes without getting non-approval replies
from insurance companies for medical prescriptions
we advice our patients. Thus, we bear the burden
and costs.
it. Respecting their views, we will not
disclose the names of individuals who
have asked to stay anonymous.
First, we met with a corporate
department manager working at a
medical hospital in Riyadh. When we
asked him about the main problems
facing patients in the area of medical
prescriptions, he said: “Not a single
month passes without getting nonapproval replies from insurance
companies for medical prescriptions we
advice our patients. Thus, we bear the
burden and costs.”
He sad he has observed that vitamins,
skin moisturizers and creams - in
general - are not covered by insurance
on the manufacturer, while the structure
and components of the drug are the
same. A medicine can cost SR100 in one
company, SR60 in a second company
and SR20 in the third. Both the doctor
and the patient are puzzled by this. So
when the doctor prescribes an expensive
drug, the insurance company refuses on
the grounds that the same medication
is available at a lower price, without
taking into account the effectiveness of
the medication and its side effects and
other considerations,” he said.
At the children’s clinic in the same
hospital, we met with a pediatrician, who
agreed with the corporate department
manger’s views. He said: “In addition to
COOPERATIVE HEALTH INSURANCE
21
Hot Topic
vitamins, creams and refreshments that
children need during their early years,
which are of course not covered by
insurance companies, the parents have
to pay for preventive medicines as well,
such as for allergies. Parents of children
with growth problems who need Vitamin
D, or X-ray to diagnose their condition
i.e. Osteomalacia, have no option but to
pay for all treatments and tests.”
The pediatrician explained: “There
is yet another problem when we give
the prescription. For example, when
a child has two diseases at the same
time, we cannot prescribe medications
for both the diseases because the
insurance company would refuse to
cover the expenses of one of them.
So we prescribe medication for one
disease, then the patient is required to
visit again so that he can get the other
prescription. This unnecessary trouble
needs to be avoided as many people
suffer from two diseases or more at a
time.”
We then visited another hospital,
which is located in the center of the
capital city of Riyadh, where we met
Dr. Essa Al-Essa, a pediatrician. In reply
to our query regarding this dilemma, he
said: “We have not received any lists
that categorize covered and uncovered
drugs, either from the Ministry of Health
or from the Council of Cooperative
Health Insurance. However, there is a
from his own account,” said Dr. Al-Essa.
Regarding the possibility of replacing
one drug with another that is covered
by insurance, Dr. Al-Essa said: “Some
drugs are not covered by insurance
companies and cannot be replaced, such
Hassan Abu Soud: There are special lists available
for all doctors at the department of the claims that
identify drugs as covered and not covered. “Overall,
the drugs are registered with the Ministry of Health
and the Council of Cooperative Health Insurance.
general practice in the insurance sector:
psychiatric medications and cosmetic
surgeries are not covered by insurance
companies.”
We asked the doctor if there is any
coordination between the doctors and
representatives of insurance companies.
“There is a coordination official, who tells
us which diseases and cases are covered
and which are not. Then, the doctor
explains to the patient that a particular
drug is not covered and that he must pay
as involuntary urination medications
for which there are no alternatives
and they are not covered by insurance
companies.”
At our next stop, the ophthalmology
clinic, the story repeats itself. The
ophthalmologist explained: “We live
in a very dry environment; therefore,
many people suffer from dry eye
syndromes, which is one of the most
common diseases in the Kingdom. The
patient requires refreshments, which
are very important for such a condition,
but the insurance companies refuse to
cover them.”
He noted that the same applies to
diabetics who need vitamins for the
treatment of the retina. In other cases,
they require double or more vials of
the drug itself, which is also refused by
insurance companies. “In this case, the
patient has to re-visit his doctor to get
a new prescription, but the insurance
company could reject it on the grounds
that the medication has already been
prescribed, without taking into account
the patient’s condition or his need to
take the medication for long periods of
time. Due to this, many Optometry tests
get rejected, placing additional burden
on the patients.”
Dr. Essa Al-Essa: We have not received any lists
that categorize covered and uncovered drugs, either
from the Ministry of Health or from the Council of
Cooperative Health Insurance. However, there is a
general practice in the insurance sector: psychiatric
medications and cosmetic surgeries are not covered
by insurance companies.
Incessant Suffering
Umm Mohammed holds the hand of
her three-year old child and enters a
hospital in Riyadh. She inquires at the
reception about the best pediatricians,
and proceeds to see one of them. She
tells the pediatrician that her son
suffers from involuntary urination.
The doctor’s response surprised her
when he told her that the prescribed
drug is not covered by the insurance
company, and that she must pay the
price of the drug. Astonished, she
approached this magazine and agreed
to share her story with us.
At another medical center, we met
21-year-old Nadia, who suffers from
severe pain in her joints. She told us that
she visited a major hospital in Riyadh
hoping to permanently say goodbye to
her severe pain. Her doctor prescribed
medication that was not covered by
the insurance company. She went to
22
Safar 1432 | January 2011
see the insurance representative in the
hospital who told her that the medicine
in question needed to be approved by
the insurance company. She contacted
her insurance company, who two days
later, told her that the drug cannot be
cashed in. Because of the high price of
the medicine and her inability to pay
for it, she had to stop the treatment.
She continues to live in pain day and
night.
The case of 30-year-old Ruwaida is
slightly better than that of Nadia. After
having undergone a dental surgery,
her doctor prescribed some medicines
that were not included in her insurance
coverage. She called the company,
only to find out that the medicine was
indeed not covered. Ruwaida ended
up paying for the medicine from her
own pocket.
Mohammed Al-Shahri, who works
as an accountant in one of the private
sector companies, said that some
insurance companies refuse to cover
expensive medicines, while others try
to evade the chronic and pregnancy
medicines in order to increase their
profits, even if that is at the expense of
patients who may not be able to afford
the costs of the treatment.
Also agreeing with Al-Shahri,
Ayman Abdo recalled his experience:
“I was shocked when my insurance
company contacted me to inform
that they will not cover my pregnant
wife and that they will not bear the
costs of her operation or medication
needed for our triplets. They claimed
that my wife had taken reproductive
drugs. I had to pay for everything.”
Insurance Companies: What do
they say?
To analyze the story from all the sides, we
met Hassan Abu Saud, Director of Medical
Policies in the Arabian Shield Insurance
Company. He explained to us that there
are special lists available for all doctors at
the Claims departments that identify the
uncovered drugs. They prepared those
lists as per their collective experience.
“Overall, the uncovered drugs are the
one that are not registered as a medicine
at the Ministry of Health in addition to
the medications that are not covered or
excluded from the unified policy issued
by the Council of Cooperative Health
Insurance such as cosmetic medicines,
herbal medicines, acne and obesity
medication, and so on,” said Abu Saud.
Asked if the price of the medication
is the reason behind the refusal to cover
some medications, he said: “The prices
have nothing to do with the refusal or the
acceptance to cover some medications.
It is all based on the medications
registered at the Health Ministry and the
excluded diseases specified at the unified
cooperative health policy. There is a
specific cap to the prices of medicines
and, if the dosage limit is exceeded, the
insurance company has to approve the
additional dosage or medications.”
The Director of Medical Policies in
the Arabian Shield Insurance Company
added: “In major hospitals there a
representatives of each insurance
company who has a good experience
to solve all the issues and problems that
could arise between the insurer and the
medical bodies, as when the doctors
tell the patients that they will pay for
the medications because the insurance
company refuses to cover the cost of it.
The main duty of these representatives is
an extension to the work of the approvals
and customer service departments in the
insurance companies.
Abu Saud urged all doctors in hospitals,
clinics and other medical institutions to
be aware of the regulations, articles and
documentations identified by the unified
policy of the Council of Cooperative
Health
Insurance
and
acquaint
themselves with what drugs are covered
and what are not.
COOPERATIVE HEALTH INSURANCE
23
Social Responsiblity
Bupa Arabia and the National Home Health Care
Foundation in Western Region:
Supporting community service
programs
The participation of companies and institutions in social responsibility programs
has become one of the main prerequisites of human development.
Economic philosopher Adam Smith of the eighteenth century once noted: “The
needs and wishes of the community will be best achieved through cooperation between
organizations, economic institutions and the community.”
24
Safar 1432 | January 2011
Princess Adela bint Abdullah: The Home Health Care
program comes in view of the growing need for this service in the
Kingdom, which requires high skills to enable nurses to take care of
patients in their homes far away from hospitals and health centers.
This program will also enable trainees to acquire the appropriate
communication skills in dealings with patients and their families, and
expertise to train the members of the family, if needed. In this context,
many
insurance
companies
have
started
to
support community service programssomething of great interest to the
magazine, which continues to monitor
the situation in the insurance sector, and
support the initiatives that strengthen
it. Hence, we are looking for initiatives
launched by insurance companies,
service providers and hospitals that
support this trend.
In previous issue, we highlighted the
experience of Dallah Hospital, and in
this issue, we explore the experience of
BUPA Arabia for Cooperative Insurance,
because of the nature and the size of their
initiatives, and because it came from an
insurance company. We were keen to
shed the light on insurance companies,
as they should be at the forefront when it
comes to social responsibility.
Bupa
Arabia is
the first Saudi
company specialized in
the field
of medical insurance. The company
has
immensely
contributed
and
supported community
service
programs
and
has played an
important
role
in launching social
responsibility initiatives. Among these
initiatives is the allocation of SR0.5
million for the National Home Health
Care
Foundation
and organizing
several health awareness seminars and
campaigns on topics such as swine flu,
diabetes, heat stroke and asthma. All
these fall under its program known
as “Total Wellness”, which stands in
line with the insurer’s efforts to give
back to the community it serves in.
This is in addition to strengthening its
partnership with the Human Resources
Development Fund for the recruitment
and training of 94 young Saudis.
Supporting Home Health Care
Given the importance of training
programs
for nursing
staff, Bupa
Arabia has allocated SR0.5 million
to support the efforts of National Home
Health Care Foundation Western Region
in providing training to 30 nurses in home
healthcare annually
for three years,
with the priority of registration being
given to Saudi nationals. The nurses
will be qualified to provide home
healthcare for the needy at the end of the
training period.
The agreement was signed between
Bupa Arabia and NHHCF in the
presence of HRH Princess Adela bint
Abdullah bin Abdulaziz, Chairperson of
National Home Health Care Foundation
Western Region.
In a press statement, Princess Adela bint
Abdullah said: “As the Kingdom’s
population is increasing steadily, so is
the number of elderly, mainly because
of availability of high quality medical
services, which is something that is
praiseworthy. Therefore, there is also an
increase in the number of people who
need healthcare in their homes and they
need qualified nurses to take care of
them.”
“The decision of Bupa Arabia to
generously contribute and support the
programs of National Home Health Care
Foundation Western Region that aim
at training nurses in home healthcare
demonstrates the foresight
of its
management. Thanks to them, hundreds
of patients will benefit from the services
provided
by the
Foundation in
the coming years.”
The Princess noted that the training
program will be held four times a
year for three days at King Abdulaziz
Bupa Arabia CEO
Tal Nazer: We are proud
that Saudis represent
almost half of all our
employees. Localizing our
manpower is at the core
of our strategic planning
for steady business
growth.
COOPERATIVE HEALTH INSURANCE
25
Social Responsiblity
A
recent
research
by
the
International
Agency for
Research
on Cancer (IARC) noted
that nonsmokers are
exposed to the
same
carcinogens inhaled
by smokers,
and there are increasing evidences
that passive
smoking causes damage
to the heart
in
the short-term and
long-term by lowering the natural rate
of oxygen in the blood.
University in Jeddah. She added that it has
been agreed between the Foundation and
Bupa Arabia to sponsor the program for
three years, thereby providing training
to 90 nurses.”
She stressed that the program comes in
view of the growing need for this service in
the Kingdom, which requires high skills
to enable nurses to take care of patients
in their homes far away from hospitals
and health centers. This program will
also enable trainees to acquire the
appropriate communication skills in
dealings with patients and their families,
and expertise to train the members of
the family, if needed. The Princess said
that NHHCF makes sure that the Saudi
Commission for Health Specialties
recognizes all of its training programs.
For his part, Tal Nazer, the CEO of
Bupa Arabia, stressed on the importance
of
providing
training
programs
for nurses, saying: “NHHCF has a leading
role in the field of home healthcare in the
Kingdom and it also has a long history of
successful programs. For years, it was able
to alleviate the sufferings of many patients,
improve the quality of life of those in
need of special care in their places of
residence, and provide them with medical
care and service, social support and health
education.”
“That’s why Bupa Arabia decided to
support National Home Health Care
Foundation Western Region and its
important project,” he added.
26
Safar 1432 | January 2011
Bupa Arabia has signed
a partnership with the
Human Resources
Development Fund
(HRDF) valued at more
than SR2.6m to recruit
and train 94 male and
female employees.
Anti-smoking campaign
As part of its social responsibility programs,
Bupa Arabia has organized a series
of seminars highlighting the dangers
of passive smoking on co-workers. In
collaboration with the National Bank,
the company organized a seminar on
ways to quit smoking for the staff of the
National Bank in Riyadh, Al-Khobar
and Jeddah. Through these
seminars,
Bupa Arabia aims to promote a culture
of “Prevention is better than cure” as
one of the most important goals that it
aspires to achieve, aiming to enlighten on
the range of ways to get rid of nicotine
addiction in general.
It is well-known that passive smoking
in the workplace causes many serious
health effects. Moreover, the inhalation
of cigarette smoke can cause many
serious diseases, both in the short-term
and long-term. Bupa Arabia’s H1N1 awareness
drive
In their effort to raise more awareness,
Bupa Arabia recently organized a twoday seminar on the risks of swine flu
at Dr. Soliman Fakeeh Hospital. The
seminar entitled ‘Preventing Swine Flu’
is the second of its kind in a series of
seminars aiming to inform corporate
employees on preventive measures to
tackle swine flu.
The seminars are part of Bupa Arabia’s
active approach to tackle the viral
disease by offering guidelines on how to
avoid infection and infecting others. It is
also a part of the company’s contribution
as a responsible corporate citizen. It
supports the efforts of the Ministry of
Health, which has launched a largescale campaign against swine flu.
Bupa to trains and recruit 94
Saudis
As part of its support to Saudization, Bupa
Arabia has signed a partnership with the
Human Resources Development Fund
(HRDF) valued at more than SR2.6 million
to recruit and train 94 male and female
employees for 15 months in various types
of work within the company.
The HRDF is an important link between
job seekers and the private sector,
playing a proactive role in recruiting
and training Saudi male and female
employees in order to integrate them
in the national workforce and enabling
them to be a part of the Kingdom’s social
and economic development.
The quality of training provided by
Bupa Arabia for new employees ensures
that the company’s high standards
are maintained at every level. On
completion of training, the employees
are fully qualified to take up positions in
a variety of departments at Bupa Arabia. To maximize recruitment opportunities
Bupa Arabia is a regular participant at a
number of job fairs. Most recently, Bupa
Arabia participated at the 5th Career Fair
at the CBA campus for girls, the CBA
Career Day for males, and the Second
Saudi Labor Market Exhibition held
at the Jeddah International Exhibition
Centre. “We are proud that Saudis represent
almost half of all our employees,” said
Tal Nazer, the CEO of Bupa Arabia.
“Localizing our manpower is at the
core of our strategic planning for
steady business growth and we are fully
committed to an ongoing partnership
with HRDF to train and recruit more
young male and female Saudis as we
continue to expand our operations.”
Bupa ranks 4th among the best
business environments
Because
of its
commitment to
provide the best services, the Kingdom’s
first specialized company in healthcare
insurance, Bupa Arabia, was awarded
the recognition of being the “Best
Medical Insurance Company” (2006-
2008) as well as the “Fastest Growing
Company” in 2009.
“This is the third year in a row that
the company has been placed in the
top ten. To be placed 4th in a list of
500 companies is an honor and I
congratulate everyone at Bupa Arabia
for their contribution in advancing our
position in the top ten,” said Tal Nazer,
the CEO of Bupa Arabia.
In order to achieve the highest
standards of Bupa International, all
new employees are required to pass
a three-month intensive training
period conducted by Bupa’s leading
experts. The program includes 40
courses run by a team of qualified
trainers. When needed, specialists from
outside the company help in drafting
and supervising the training.
Bupa Arabia is a pioneer in the
empowerment of women as it employed
its first female employee in 2001. Women
now make around one third of Bupa
Arabia’s workforce, which altogether
includes 42 percent Saudi nationals.
First aid seminars
In partnership with the Saudi Red
Crescent Authority, Bupa Arabia has
organized a series of first aid seminars for
its members in Riyadh, Jeddah and AlKhobar. The seminars aim to spread first
aid literacy throughout the Kingdom.
A wider knowledge of first aid could
save thousands of lives in Saudi Arabia
each year. This is why Bupa Arabia has
been organizing these seminars for its
members. One of Bupa Arabia’s prime
objectives is to establish a culture of
awareness in Saudi Arabia.
The members receive practical as well
as theoretical training on how to respond
to respiratory, cardiac and environmental
emergencies. The training also includes
cardiopulmonary resuscitation as well
as the treatment of burns, poisoning,
fractures and bleeding. All participants
are made to undergo an exam at the end
of the seminars.
COOPERATIVE HEALTH INSURANCE
27
Cover Story
ICD-10 Medical Coding
Towards Increased Efficiency and
Cooperation
Under the guidance of the Minister of Health Dr. Abdullah Al-Rabiah,
President of (CCHI), The Council of Health Services in Saudi Arabia has
implemented a medical coding system in order to benefit from modern
technology in managing health insurance. The system links the health
insurance companies, council of health services and the Council of
Cooperative Health Insurance (CCHI).
28
Safar 1432 | January 2011
This new strategy has resulted in many
benefits, which include, the improvement
of healthcare services provided to
patients in health centers and clinics,
an increased efficiency of services, and
improvement in the level of supervision
using sophisticated methods for the
exchange of health information, including
the use of International Classification of
Diseases (ICD), specifically the Australia
version (ICD-10-AM) for diseases
and therapeutic interventions (ARDRG) coding. As confirmed by Dr. Yacoub
Ben Youssef Al Mazrou’, the Secretary
General of Health Services Council who
stated that as per of Council’s vision to
strengthen coordination and integration
between the health authorities in the
Kingdom to ensure access to quality
healthy services, the Health Services
Council signed an agreement to use the
International Classification of Diseases
(the Tenth Australian version and related
health problems) known as (ICD-10AM-AR-DRGs) with the representative
of the health sector of the Australian
Commonwealth
Government.
He
added new version will be applied in
all health sectors in Saudi Arabia as this
classification considered one of the best
systems in place worldwide. The Council
has also formed a National Committee
to oversee the implementation of the
International Classification of Diseases
as per the decision of the Minister of
Health and Chairman of the Council. The
committee includes representatives from
all sectors providing health services in
the Kingdom including the public and
private sectors. We find out what the
medical coding system is all about, and
how it works in the current setup.
In view of the rapid developments
in
information
technology
and
communications, many countries are
competing with each other in providing
the best health services by improving
performance and enhancing medical
services. One of the most important
services in this regard is e-health,
which allows hospitals and doctors to
use the latest methods of information
and communication technology in
various areas, including collecting,
storing, retrieving and analysing health
information, standardizing electronic
health records, disseminating medical
information and conducting remote
surgical operations. E-health also helps
Dr. Al Mazroue: The
Health Services Council
signed an agreement
to use the International
Classification of Diseases
in using electronic smart health cards and
digital imaging, which aim to improve the
communication process with patients.
Successive developments in the
Kingdom’s health sector meant that there
is an urgent need to implement a system
of medical coding and linking it to the
electronic systems of other hospitals
and medical centers. Moreover, training
the medical personnel in the use of the
coding system has become one of the
most important priorities of hospitals and
medical centers in the Kingdom.
The International
Classification of Diseases (ICD)
The International Statistical Classification
of Diseases and Related Health
Problems 10th
Revision (ICD-10) is a coding of diseases
and signs, symptoms, abnormal findings,
complaints, social circumstances and
external causes of injury or diseases, as
classified by the World Health Organization
(WHO). The system is updated every ten
years and the current version is number
ten, and is known as ICD-10, which is
translated into 42 languages. There are
also customized ICD versions depending
on the needs of each country.
The code set allows more than 14,400
different codes and permits the tracking of
many new diagnoses, diseases and signs,
symptoms, abnormal findings, complaints,
social circumstances and external causes
of injury or diseases. Using optional sub
classifications, the codes can be expanded
to over 14,000 codes. Using codes that
are meant to be reported in a separate data
field, the level of detail that is reported
by ICD can be further increased, using a
simplified multiracial approach.
WHO provides detailed information
about ICD online, and makes available
a set of materials online, such as an
ICD-10 online browser, ICD10 Training,
ICD-10 online training and study guide
materials for download. The international
version of ICD should not be confused
with national Clinical Modifications of
ICD that include much more details,
and sometimes has separate sections for
procedures. For example, the new US
ICD-10 CM has some 155,000 codes.
Work on ICD-10 began in 1983 and was
completed in 1992.
Earlier Classifications
Sir George Knibbs, the eminent Australian
statistician, credited François Bossier
de Lacroix (1706-1777), better known
as Sauvages, with
COOPERATIVE HEALTH INSURANCE
29
Cover Story
the first attempt to classify diseases
systematically. Sauvages’ comprehensive
treatise was published under the title
‘Nosologia Methodica’. At the beginning
of the 19th century, the classification of
disease in most general use was one by
William Cullen (1710-1790), of Edinburgh,
which was published in 1785 under the
title ‘Synopsis Nosologiae Methodicae’.
For all practical purposes, however, the
statistical study of disease began a century
earlier with the work of John Graunt on
the London Bills of Mortality. The kind of
classification envisaged by this pioneer
is exemplified by his attempt to estimate
the proportion of live born children who
died before reaching the age of six years.
He took all deaths classed as thrush,
convulsions, rickets, teeth and worms,
abortives, chrysomes, infants, liver-grown
and overlaid, and added to them half the
deaths classed as smallpox, swinepox,
measles, and worms without convulsions.
Despite the crudity of this classification,
his estimate of a 36 percent mortality
before the age of six years appears from
later evidence to have been a good one.
The three centuries have contributed
something to the scientific accuracy of
disease classification, although many
had doubted the usefulness of attempts
to compile statistics of disease, or even
causes of death, because of the difficulties
of classification. Fortunately for the
progress of preventive medicine, the
General Register Office of England and
Wales, at its inception in 1837, found in
William Farr (1807-1883) its first medical
statistician to make the best possible use
of the imperfect classifications of disease
available at the time, but labored to secure
better classifications and international
uniformity in their use.
Farr found the classification of Cullen in
use in the public services of his day. It had
not been revised to embody the advances
of medical science, nor was it deemed
by him to be satisfactory for statistical
purposes. In the first Annual Report of
the Registrar General, he discussed the
principles that should govern a statistical
classification of disease and urged the
adoption of a uniform classification.
A uniform statistical nomenclature,
however is not perfect, as each disease
has, in many instances, been denoted by
three or four terms, and each term has
been applied to as many different diseases.
Vague and inconvenient names have been
employed, or complications have been
registered instead of primary diseases. The
nomenclature is of as much importance
in this department of inquiry as weights
and measures in the physical sciences,
and should be settled immediately. Both
nomenclature and statistical classification
received constant study and consideration
by Farr in his annual “Letters” to the
Registrar General published in the Annual
Reports of the Registrar General.
The utility of a uniform classification of
causes of death was strongly recognized at
the first International Statistical Congress,
held in Brussels in 1853. The Congress
requested William Farr and Marc d’Espine
to prepare an internationally applicable
classification of causes of death. At the
next Congress, in Paris in 1855, Farr
and d’Espine submitted two separate
lists, which were based on very different
principles. Farr’s classification was
arranged under five groups: epidemic
diseases, constitutional (general) diseases,
local diseases arranged according to
anatomical site, developmental diseases,
and diseases that are the direct result of
violence. D’Espine classified diseases
according to their nature (gouty, herpetic,
haematic, etc.). The Congress adopted
a compromise list of 139 rubrics that
represented the two scientists’ works.
In 1864, this classification was revised in
Paris on the basis of Farr’s model and was
subsequently further revised in 1874, 1880,
and 1886. Although this classification was
never universally accepted, the general
arrangement proposed by Farr, including
the principle of classifying diseases by
anatomical site, survived as the basis of
the International List of Causes of Death.
The Current ICD
ICD-10 was endorsed by the 43rd
World Health Assembly in May 1990
and came into use in WHO member
states from 1994. The classification is the
latest in a series, which has its origins in
the 1850s. The International Statistical
Institute adopted the first edition, known
as the International List of Causes of
Death, in 1893. The WHO took over the
responsibility for the ICD after its creation
in 1948. The World Health Assembly
adopted in 1967 the WHO Nomenclature
Regulations that stipulate use of ICD in
its most current revision for mortality and
morbidity statistics by all member states.
Significance of ICD
The ICD is the international standard
diagnostic classification for all general
epidemiological purposes, as well as
30
Safar 1432 | January 2011
many health management uses and
clinical use. These include the analysis of
the general health situation of population
groups and monitoring of the incidence
and prevalence of diseases and other
health problems in relation to other
variables such as the characteristics and
circumstances of the individuals affected,
reimbursement, resource allocation,
quality and guidelines.
It is also used to classify diseases and
other health problems recorded on many
types of health and vital records including
death certificates and health records.
These records also provide the basis for
the compilation of national mortality and
morbidity statistics by WHO member
states.
The classifications also enable the
storage and retrieval of diagnostic
information for clinical, epidemiological
and quality purposes. One simple example
is that the ICD-10 codes will let doctors
say whether a condition occurred on a
patient’s left or right side. ICD allows for
more detail on patients’ medical records,
thereby, keeping up with the many ways
medical care evolves each year.
Paper and Electronic Systems
Many countries around the world are
trying to replace traditional paper health
records with the more convenient
electronic systems. Electronic health
records are one of the most important and
sophisticated health systems that allow
doctors and medical centers to retrieve
information and patient data electronically
in the easiest and most effective way. It
also helps to identify patients’ needs, and
offers comprehensive medical reports
that include the medical history of the
patient, medicines, X-ray, labs and sick
leave, which will help in dispensing many
sections in the health sectors, such as
department of medical reports. E-health
records will save time and money in terms
of the number of employees, which will
ultimately result in huge revenues to the
health care sector, which remains under
constant pressure to provide high quality
health services for low costs.
Raising community awareness of the
importance of information technology
in the health sector, and its active role in
enhancing efficiency and improving the
quality of health services is one of the
most urgent issues requiring a good deal
of attention presently.
Table 1 demonstrates the different phases of the ICD classification
17th century
18th century
John Graunt
Classify death rates by cause of death
Sauvages
Nosologia Methodica
1853
William Farr
Form an international list of causes
of death
1893
Jacques Bertillon, President of the
statistical services in Paris
Bertillon classification
1920
Organization of the League of
Nations
Classification of causes of death
1948
World Health Organization
WHO became responsible for the
revision and ongoing publication of the
classification after the sixth issue, which
included causes of diseases
1975
World Health Organization
ICD-9
1994
World Health Organization
ICD-10
2007
World Health Organization
Latest version
ICD-10 is a coding of diseases and signs,
symptoms, abnormal findings, complaints,
social circumstances and external causes of
injury or diseases
COOPERATIVE HEALTH INSURANCE
31
Interview
In this issue of the Cooperative Health Insurance Magazine, we meet with Dr.
Rashid Bin Suleiman Bin Rashid Al-Rashid Alhomaid, Vice Chancellor of King Saud bin
Abdulaziz University for Health Sciences - Postgraduate Studies and the former Secretary
General of the Council of Cooperative Health Insurance (CCHI). Dr. Al-Rashid Alhomaid
emphasizes that healthcare services in the Kingdom are at par with those in the developed
countries, noting that when the CCHI was first established, it took some time and effort to
make the society accept its role as a regulator and supervisor of this sector.
Commenting on insurance policies, he
stressed that they meet the needs
of business owners, and that the goals
of the Council have not changed; only
the methods needed to reach them have.
At the academic level, Dr. Al-Rashid
Alhomaid, who is the first Saudi to have
a specialization in the digestive system
and liver from Canada, notes that the King
Saud University for Health Sciences is the
first specialized health university in the
region. He added that the establishment of
the King Abdullah International Medical
Research is an indication of the importance
of scientific research in the Kingdom.
Dr. Rashid Al-Rashid Alhomaid the former Secretary GENERAL of (CCHI):
Healthcare services in KSA
at par with those in developed countries:
32
Safar 1432 | January 2011
Q: Please enlighten us about the early
stages of the inception of the CCHI.
A: The CCHI was established under
the health insurance system upon the
decision of the Council of Ministers No.
71 dated 4/27/1420, corresponding to 8
Nov. 1999, in order to preserve the rights
of the workers in the Kingdom and to
shoulder the responsibility of regulating
and supervising the health insurance
sector.
Q: What were the main issues you had
to deal with at the time of its setting up
and how did you choose the staff?
A: Establishing a body like the CCHI was
not a familiar thing in the Kingdom then,
especially with the absence of qualified
staff, which was the most difficult
challenge we had to face. We were
first required to provide training to the
employees and implement appropriate
rules to organize the flow of work. Initially, we focused on how to make the
public and private institutions accept the
idea of having a health insurance regulator
and supervisor. This was not easy; it needed
a lot of time and effort. The employees
were basically selected on the basis of their
educational qualifications, experience in
the areas of public health insurance, their
willingness to learn and progress, and the
capacity for collective action.
Q: Did the Council’s goals change since
its establishment until now?
A: The goals are still the same, little has
changed, but because of the changing
circumstances and data, the working
methods have changed in order to
conform to the new realities.
Q: What do you think of the current
health insurance system, which covers
both the Saudi nationals as well as nonSaudi employees in the private sector?
Do you think more categories should be
included?
A: The current development of the health
insurance system to cover both Saudi and
non-Saudi employees is an important
milestone. I suggest that we should
now focus on improving healthcare
services for the target group until the
insurance process has fully matured. As
for the expansion and addition of other
categories, we will first conduct scientific
studies on them and then decide
accordingly.
I think this insurance policy
meets the needs of the
employers and gives the
workers the opportunity to
avail the best healthcare
services.
King Saud bin Abdulaziz
University for Health
Sciences is the first
specialized healthcare
university in the region.
Q: What do you think of the current
insurance policy?
A: I think this insurance policy meets
the needs of the employers and gives the
workers the opportunity to avail the best
healthcare services.
COOPERATIVE HEALTH INSURANCE
33
Interview
Q: The implementation of the mandatory
health insurance has placed an added
pressure on the private health sector.
What can be done about it?
A: The pressure on the private health
sector shows the success of the CCHI
in providing healthcare to workers in
the private sector. The private health
sector will grow and gradually it will
meet the public’s needs, build strong
expertise and achieve the aspirations
of the community.
Q: Given the experiences of developed
countries in the provision of health
services, what more does Saudi Arabia
need to do to reach their level?
A: Saudi Arabia has a free economy. There
is no doubt that many businessmen will
be able to meet the health needs based
on economic feasibility studies. I expect
to see a steady growth in the health
insurance sector and an expansion of
the private health sector facilities. I also
expect an increase in the number and
quality of advanced healthcare services.
34
Safar 1432 | January 2011
Q: As a doctor and an academic, how
do you rate the Saudi medical sector
and how can it emulate the medical
standards in developed countries?
A: The healthcare sector in the
Kingdom can be compared to that
in developed countries, and to some
extent, it has an edge over them. The
need to develop the health sector
continues in order to provide the best
healthcare services. The expectations
of the Saudi community from the
health sector are high and this proves
the success of the Kingdom’s health
sector.
Q: What makes King Saud University
for Health Sciences different from
other places offering similar academic
programs?
A: King Saud bin Abdulaziz University
for Health Sciences is the first
specialized healthcare university in the
region. We are interested in making
our students acquire the ability to learn
and excel, and therefore, we provide
modern and sophisticated curriculums
and rely on the latest technologies in
the field of learning, education and
health training.
the support of my wife, who has
always encouraged me and provided
psychological and social support that
helped me complete my studies and
training in Canada.
Q: When was the University
established and what are the faculties
and courses available?
A: The University was established in
2005, along with the launch of the
College of Nursing and Medicine.
We have 10,000 students in Riyadh,
4,000 in Jeddah and 3,000 in AlAhsa. Moreover, we have medical
schools in both Riyadh and Jeddah,
and nursing colleges in Riyadh, Jeddah
and Al-Ahsa. In addition to this, there
is a College of Dentistry, College of
Pharmacy and College of Applied
Health Sciences.
Q: Tell us more about your education
and professional experience.
A: I graduated from Cairo University
in 1977 and was appointed as a
lecturer in the Department of Internal
Medicine, Faculty of Medicine at
King Saud University. Then I went to
Canada to complete my studies and
training and returned home in 1986
with a degree in Internal Medicine,
with specialization in the digestive
system and liver. I was the first Saudi
to have specialization from Canada.
Q: What is the significance of
choosing the National Guard as the
University’s headquarters?
A: The Health Affairs in the National
Guard have a long experience in
training programs and in conducting
medical education because of the
presence of high-level hospitals and
experienced doctors in addition to
quality services. The establishment
of a health university needs such
features, which are only available at
the National Guard.
Q: Why is research a key element of
the health sector?
A: Development of scientific research
is the foundation of healthcare. The
University has encouraged all colleges
to introduce scientific research in their
curriculums and programs. There is
no doubt that the establishment of the
King Abdullah International Medical
Research emphasizes the importance
of scientific research for the University
and the country, at large.
Q: What prompted you to choose this
specialty?
A: Healthcare is a noble humanitarian
service. The ability to help people
and the society’s perception of the
importance of this speciality prompted
me to choose medicine. My father –
may God have mercy on him – was
my biggest supporter, and now I have
Q: Please tell us more about your
family.
A: I have – by God’s grace – five
children. My older son is a lecturer
at the Faculty of Medicine and he is
completing his studies in Canada in
Ophthalmology; my second daughter
has a master’s degree from the United
States and she has recently given
birth to our first grandchild; my third
daughter is a lecturer at the Faculty of
Administrative Sciences - Department
of Economics; I have a son studying
in the high school, and my youngest
daughter is studying in primary
school.
Q: What are your hobbies?
A: I love reading, travelling and meeting
people from different civilizations and
cultures.
Q: What is your favourite quote?
A: It is not a quote, it is a verse from the
Holy Qur’an, where Almighty Allah
says: “Woe unto the defrauders, those
who when they take the measure from
mankind demand it full, but if they
measure unto them or weigh for them,
they cause them loss.”
Q: Thank you sir. What are your final
comments?
A: I would like to thank and express
appreciation for all the brothers at the
CCHI for their tremendous efforts. I
pray to God to guide them always.
About Dr. Al-Rashid Alhomaid
Dr. Rashid Bin Suleiman Bin Rashid Al-Rashid Alhomaid is the
Vice Chancellor of King Saud bin Abdulaziz University for Health
Sciences - Postgraduate Studies. He holds an American Board
and Canadian Fellowship. Dr. Al-Rashid Alhomaid is Professor of
Internal Medicine and digestive system since 1998 and a consultant
since 1986. He is also the Chairman of the Scientific Council of
the University of King Saud bin Abdulaziz University for Health
Sciences, Chairman of a training committee to develop Health
Affairs’ staff at the National Guard and Chairman of the Training and
Fellowships for Health Affairs and the University of King Saud bin
Abdulaziz University for Health Sciences.
His contributions to King Saud University include: member of the
Scientific Council (2007), member of the Council of the Deanship of
Graduate Studies (2006-2007), founder of the Faculty of Medicine
for University Hospitals (1997-2000), Head of Internal Medicine
College (1993-1997), Chairman of the Internal Medicine Training
Committee (1993-1997), and in-charge of internal medicine training
programs (1987-1993).
In the Council of Cooperative Health Insurance, he served as the
founding Secretary-General of the Secretariat of the Council between
2000 and 2005, in addition to his member of the Board of The
General Organization for Social Insurance Council during the same
period. During 1994 to 2003, he was the founder and President of
the Scientific Board of Medicine - Internal Medicine and member of
the Executive Board of the Saudi Commission for Health Specialties.
Dr. Al-Rashid Alhomaid was also a member of the first session
of the Health Services Council and a member of the Board of
Directors of King Fahd Medical City during the period 2004-2009.
He is a member of the Arab Council for Medical Specialties/Internal
Medicine, and founder and board member of the Saudi Society
for the Digestive System (2004-2009). He co-examined in Internal
Medicine in Saudi medical schools and postgraduate studies,
faculties of medicine at the University of Jordan University of
Science and Technology in Yemen.
Among his many credentials, Dr. Al-Rashid Alhomaid holds
an Arab Specialty Certificate /Internal Medicine, Saudi Specialty
Certificate/Internal Medicine, Pakistani Fellowship/Internal Medicine,
Egyptian Fellowship/Internal Medicine, and Saudi Specialty
Certificate for the digestive system and liver.
At the level of scientific activity, he has published 73 research
papers in both local and international medical journals, lectured in
35 conferences locally and regionally, and attended 55 conferences
and workshops at local, regional and international levels. He also
worked as an external arbitrator to Saudi medical journals, and an
arbitrator for academic promotions in Saudi universities.
COOPERATIVE HEALTH INSURANCE
35
Finance & Investment Although insurance companies are
known for their risky elements as the
chances of facing losses are much
higher when compared to retail and
commercial activities, this is not exactly
the case in Saudi Arabia. Saudi insurance
companies do face losses, but these
losses are not directly related to the
typical risks in this sector and instead
are a result of something else.
It is important to find out the actual
reasons behind the huge losses in the
insurance sector and what can insurance
companies do to cover these losses and
budget deficits.
Controlling deficit and dealing with losses
Borrowing, merging
or innovating are the options
The insurance sector is considered as the main pillar in the global economy
and equity markets. However, it continues to witness difficulties in the Arab
market, specifically in Saudi Arabia, mainly because of the modest capitals and the
recent entry in the Saudi stock market. These reasons placed some of the insurance
companies in a critical position and weakened their impact in the stock market and
the economic sector in general.
36
Safar 1432 | January 2011
Many reasons for losses
According to insurance experts, there
are many reasons why Saudi insurers
incur losses. Perhaps, the most important
reason is the lack of knowledge and
experience in this field, as many
companies suffer from the shortage of
qualified personnel to run the business
efficiently and professionally.
The market abounds in companies
that do not know exactly what they are
doing. For example, some insurance
companies may insure some risks without
understanding the possible risks and
suffer massive losses they cannot bear,
especially that many companies do not
understand the benefits of re-insurance.
The second reason for losses incurred
by insurance companies lies in the
lack of qualified human resources and
efficient management, with a constant
consumption of the capital without any
material return to offset this shortfall.
Moreover, many companies fail
to promote their insurance products
in the market, or they are unable to
compete with other insurance products
due to a lack of human and material
resources, the inefficiency of technical
management or unsuccessful marketing
campaigns. Some insurance companies
cut down their activities after obtaining
the necessary license to practice the
insurance business because they are
unable to attract new customers.
Some experts suggest that one of the
reasons behind the losses may be the
rules and regulations in force that are
endorsed by the Saudi Arabian Monetary
Agency (SAMA) as many companies are
forced to spend large part of their capital
on the operating expenses to obtain
Al-Faris: Controlled
Tawarruq is a good Islamic
alternative that could help
in resolving budget deficit.
However, there are many
other options that should
be addressed as well.
Al Omran: The reasons
behind losses are related
to the incompletion of
insurance portfolios¹
transfer, weak operating
income and difficulties in
marketing.
SAMA’s approval and be able to market
their insurance products.
The domination of major insurance
companies in the Saudi insurance market
is also trimming down opportunities for
other small companies. The insurance
sector is a risk sector, where one year a
company could suffer a loss, but it could
also make profit the second year; which
means you can never expect an all-year
profit from the insurance sector.
Insurance specialists also point
out that the most influential reason
behind the losses is fraud (from
clients), as it causes substantial
damages to insurance companies
and affects their image in the market,
especially with a lack of knowledge
and expertise in dealing with
fraud issues.
related to the incompletion of insurance
portfolios’ transfer,weakoperatingincome,
difficulties in marketing – in light of the
fierce
competition between insurance
companies – and the unreasonably high
expenses and operating costs.
Dr. Khalid Al-Faris, Assistant General
Manager
of Falcon Insurance, says:
“Most insurance companies reevaluate all their policies and previous
plans to discover any shortcomings and
reasons behind lower profits or losses.”
He adds: “Most losses are related to the
expenses incurred by companies before
the incorporation, the competition and
the need to achieve large premium
volumes, and due to a lack of qualified
personnel and advanced IT systems to
provide information and daily reports.”
Al-Omran argues that the main
causes of the huge losses are related
to the exaggeration in the estimates
of feasibility studies at the time of the
establishment of these companies,
especially those studies that are related
to market size and expected growth
rates.
Marketing difficulties and fierce
competition
Some insurance companies, since their
inception, have budget deficits. The
reasons,
according
to economist
Mohammed bin Fahd Al-Omran, are
COOPERATIVE HEALTH INSURANCE
37
“Some founders of insurance companies
clearly exploit the rest of the founding
shareholders, this is a problem. Others
do not activate the compulsory health
insurance in the required and declared
form, taking advantage of the ill-informed
Saudi society,” he explained.
Al-Omran said that the most important
steps taken by insurance company to
reduce the losses should include reducing
the operating expenses, and concentrating
on specific sectors, products, or markets
until things settle down, and they have a
clearer short-term vision.
“Some insurance companies have
issued priority rights in order to strengthen
its capitalization. However, this option
will not be available to all companies that
incur losses; which means they should
consider the option of reducing expenses
as a strategic choice,” he added.
Proposed solutions
There are many solutions when it comes
to dealing with budget deficits. This
includes increasing the capital, either by
borrowing or subtracting new shares or
selling part of the assets. Some companies
prefer to re-evaluate their capital to avoid
losses, an option preferred by the Capital
Market Authority. Other options include
the integration with a company or other
companies to strengthen the position of
the new company.
Al-Faris added: “Controlled Tawarruq is a
good Islamic alternative that could help in
resolving budget deficit. However, there
are many other options that should be
addressed as well.”
Al-Omran does not think that integration
would be an appropriate solution because
of the different structure and infrastructure
of integrated companies, and the lack of
vertical or horizontal integration among
firms. Therefore, the available options are
either borrowing or issuing of liquidation
rights.
Commenting on the role of SAMA
and the Council of Cooperative Health
Insurance (CCHI), Al-Omran emphasizes
that both organizations have nothing to
do with the situation. “We must keep in
mind that insurance companies are, in
fact, public joint stock companies, with
shareholders and boards of directors who
are the decision-makers first and foremost
and have to solve the problems of their
companies.”
Disagreeing with Al-Omran, Al-Faris
said: “SAMA and the
CCHI must intervene to make sure all
companies are committed to the declared
standards and procedures. If a company
continues to repeat its mistakes, or its
management failed to have a clear policy
for development, growth and profitability,
then the relevant authorities should have
a say.”
“I believe that the regulations and instructions
issued by SAMA will have a positive impact, God
willing, on our profits in 2010,” Al- Faris.
Between borrowing, integration and
other practical solutions, Al-Faris prefers
integration. He says: “Integration is the
best option because borrowing will not
solve the problems or the causes that led
to losses, and may perhaps lead to more
losses and increase the burden on the
shareholders. As a result, the company
may leave the market because of its
inability to fulfil its financial obligations
resulting from the borrowing policy.”
He noted that there are other good
options as well, which include: Islamic
Tawarruq, buying goods with a delayed
payment and then selling it to other than
the seller (from whom one bought the
goods) in order to obtain cash money.
38
Safar 1432 1432
Muharram
| January
| December
2011 2010
Commenting on Falcon Insurance, AlFaris said that the company did not incur
losses, but experienced a decrease in the
level of profits in 2009 “because of the
pre-incorporation expenses, which were
very high. I believe that the regulations
and instructions issued by SAMA will
have a positive impact, God willing, on
our profits in 2010.”
In a related context, recent studies
revealed
that
medical
insurance
companies are incurring annual losses of
SR1.2 billion because of “fraud”, noting
that most fraud cases are reported from
remote hospitals. According to Al-Hayat
newspaper, insurance experts believe
the rates of fraud in medical insurance are
high because of the novelty of the insurance
sector, the lack of sophisticated IT systems
and the delay in application of the mostneeded regulations.
Luay Abdo,
an
insurance
expert,
said the
newly-established
companies must stabilize in the
third
year of operation
because “their
losses during the first two years are
natural and logical”. He emphasized in an interview with
CNBC Arabia TV channel that the
number
of insurance
companies in
Saudi Arabia (35) is too high compared
to the size of the insurance and financial
market in Saudi Arabia, which has
only 13 banks. Abdo expressed his
surprise at the fact that some insurance
companies expect to achieve an income of
one billion riyals after the first and second
years of operation, while the total size
of the insurance market is estimated at
SR15 billion.
SR535.9 million in profit
A recent study conducted by “Arqam”
Website on the financial results of
insurance companies in Saudi Arabia in
the first nine months of 2010 revealed that
the consolidated earnings of 23 insurance
companies listed in the Saudi market
amounted to SR 535.9 million, an increase
of 130 percent compared to SR232.5
million in the same period last year.
The study pointed to a rise in total
premiums of insurance companies that
started their operations, to reach SR9.88
billion by the end of September 2010,
achieving an increase of 34 percent
compared to SR7.38 billion in the same
period last year. During the first half of
this year, insurance companies incurred
claims of SR3.99 billion, an increase of 43
percent during the same period last year. The registered insurance companies
achieved a surplus from insurance
operations after discarding the returns
on investments amounting to SR577.8
million, up 100 percent from the surplus
during the same period of 2009.
Finally,
some
failed
insurance
companies may end their series of losses
by offering new and innovative insurance
products, which would add new quality to
this sector, and may pave the way for more
competition. This can help companies in
changing the course of their losses and
may lead them to profitability.
Combi
ning Pea
ry..
e
ce of Mind & Pro
v
i
l
e
D
e
c
i
v
r
fessional Se
Tech world
Interactive TV:
The World at Your Fingertips
Interactive TV, or ITV, a term we often hear these days, is a technology that allows the
viewer to interact with the television set in ways other than simply controlling the channel.
ITV allows the viewer to act as his own editor-in-chief by being able to select to view a film
or a soap opera, entertainment or educational program, sports, news, or play games, vote
or provide other immediate feedback, and shop from home.
Thanks to this new technology, viewers
will have to no more wait for their favorite
TV show as they can simply choose when
to watch the show, or even to re-broadcast
a snapshot or a scene they missed. The
interactive technology does not stop
here; it offers special programming, news,
home shopping, video-on-demand and
home banking. No wonder it has been
described by an international expert as
“the technology that brought the world to
the hands of the recipient.”
As a mass communication device,
television succeeded in winning over
radios, newspapers, magazines and
books. Combining “audio and visual”
aspects with the joy of movement and
multiple colors, no invention during the
twentieth century has so far been able to
match that of the television. The TV has
already secured a wide range of loyal
viewers who are yet to replace it with
anything else.
Like any other device, television too
has gone through many rapid changes
since the last century. If we compare
present day television with that of the
fifties, we find that it now features brighter
colors, higher resolutions, larger screen
size, better sound and lighter weight,
until it reached an even greater stage
of sophistication with the launch of the
Interactive TV.
TV sets are now going through
revolutionary changes since their inception
in terms of the commercial and technical
aspects. Many IT companies have
designed new computing applications
and advanced communications to remanufacture this device and make it a
totally new interactive tool that is able
to connect us with an abundance of new
services.
Interactive TV goes beyond just
watching your favorite programs
according to a pre-set schedule; it allows
you to choose what you want to see and
when you want to see it. Viewers can
even modify the schedule of the program
to suit their own schedules and personal
preferences. Main characteristic The main characteristic of ITV is that
it provides the viewer the opportunity
40
Safar 1432 | January 2011
to roam between 500 channels, by
choosing from a drop-down list that
displays all the available programs, as
is the case with the personal computer.
So instead of waiting for the date
specified by the channel to watch
a specific program, the viewer can
watch the program in a manner that is
similar to downloading it on his PC –
by connecting the TV with satellite or
cable service. Moreover, viewers will be able to
review different program categories,
such as children’s programs, science
fiction
movies,
documentaries,
sports and comedy shows. One other
characteristic of this technology is that
there are many TV channels that have
designed detailed lists of their programs
so that the viewer is able to register for
a certain show and display another, or
see two programs at the same time.
The History
The history of interactive TV reveals
that the concept remained a dream
for many years before it was actually
launched. The idea of ITV appeared
for the first time in the early sixties. It
continued to develop year after year
until the invention of computer, and
the emergence of the Internet, which
opened doors for the development of
ITV and helped turn the dream into a
reality.
At the end of the first half of the last
century, people were talking about
a future TV that can integrate a range
of services such as movies, radio and
television programs. However, what
actually materialized during that
period is the traditional television that
we know of today, where the viewer
can only receive information from the
broadcaster.
One of the major milestones in
the history of the development of
interactive television is the decision
of “Warner Amex Cube” Ohio, US,
in 1977 to develop a dual system
that allowed for the establishment of
a “dialogue” between the receiver
and the cable network by linking the
central computer with the head office,
called as interactive communication.
ITV offers special
programming, news,
home shopping, videoon-demand and home
banking. No wonder it
has been described by
an international expert
as “the technology
that brought the world
to the hands of the
recipient.”
Interactive TV may
substitute lecture
halls, and enable the
students to listen to the
professor and watch
him from the comfort of
their homes, or record
lectures and listen to
them later
COOPERATIVE HEALTH INSURANCE
41
Tech world
The company created a device that
connects the domestic television with
a set of buttons enabling viewers while
watching programs to vote or give
feedback (yes or no), in addition to
choosing programs, films and games.
Following this step, cable companies
started to provide viewers with
new interactive technology called
the remote control unit, or “remote
control”, which embodied the primary
forms of interaction with the TV and
helped in increasing the number of TV
channels.
Services
InteractiveTV provides many advantages
to its user, such as, participating in quiz
programs, communication between the
viewers in a way similar to chat services
on the Internet, video on demand and
other benefits that continue to dazzle
us day after day.
1 - Video on-demand:
This system allows users to select and
watch/listen to video or audio content
on demand at any time at home
without the need to go to video stores
and rent films and tapes using a cable
or satellite.
2 - Commercial TV:
The present embodiment of interactive
TV is led by corporations because the
initial target of all commercial television
networks is to urge the viewer to see
their ads. It is not in their economic
interests to divert the attention of
viewers to other interactive activities
unless they get additional revenue from
those activities.
As
a
result,
e-commerce
applications through the TV allow
viewers to buy goods, commodities
and products seen on television.
With interactive TV, e-commerce is
taking a new form, for example, you
can take a virtual tour of a clothing
store, and use your remote control as
a camera to move around and look
for something you like, then, you can
click on an image to see the details
(type of fabrics, sizes, colors, price,
etc.). If you decide to buy the item,
42
Safar 1432 | January 2011
you have many options to choose
from, including: electronic money,
credit cards, electronic bank checks
and electronic wallet.
3- Ads:
Ads on ITV aim at urging the consumer
to know more about those goods and
products. These ads appear while
the viewer is watching his favorite
programs without stopping the show
for a commercial break. If the viewer
wants to know more about the
product,
he/she
can choose the
product he/she
wants using a
remote control.
4 - Electronic
Program Guide:
This service
allows the
viewers to choose
from different
interactive TV
programs and roam
between different
channels, and pay
for the programs of
their choice. There
are many types of
developed electronic
applications that provide
a presentation of web
pages.
5 - Text messaging:
Text messages are
texts written on
the television and
broadcasted directly
from the sending
station; it appears
at the bottom of the
screen and displays
sports news, politics,
stock market, currency rates
and new TV programs. It is
also possible to use the texts as
titles at the bottom of the screen
to pop up during programs to
announce an important event or
provide a summary of the most
important news.
with common interests or goals on
television, using “yoyo” service offered
by Static Channel. The participants can
send their personal details to create
a profile and they can also record a
voice message for a period of thirty
seconds. Users can then communicate
with people they like through this
service or by an e-mail. Soon, viewers
will be able to touch the screen when
they want to see or change programs
or services.
The main obstacles
facing ITV is the
absence of legislation
and laws governing the
process of subscription
to this service or
censoring content.
Zoom in and out
Known as Interactive Sports, or
interactive point of view, among
other names, this service allows
viewers who are interested in sports
programs to choose the camera angle
he/she prefers to watch his favorite
game from. He/she can also split the
screen into several parts; each part
showing a snapshot from a different
angle. This feature allows the viewers
to zoom in and out, expand the
screen width, and review different
scenes. The idea of ITV appeared for the first time in the
early sixties. It continued to develop year after
year until the invention of computer, and the
emergence of the Internet, which opened doors for
the development of ITV and helped turn the dream
into a reality.
5 - Sports and multiple cameras:
The interactive system allows the
viewers to select between various
applications. During the Wimbledon
Tennis Championship in 2001, BBC
broadcasted footages from five different
games through its digital satellite. The
five matches appeared on one screen and
viewers were able to choose the game
they wanted to see in a full screen mode.
Viewers were also able to switch between
games using the remote control.
6- Computer games: Games are one of the most attractive
services in the field of interactive
television. In 2001, the British Sky
Sport Channel initiated a merger
between local sports and computer
games, thus, making the games
experience even more exciting.
Launched in October 2001, the new
game allowed the viewers to predict
the best and worst players during a
football game. 7 – Air chat: Interactive television has reached a
point where it has been able to merge
technologies of both the television and
the telephone. Users in Britain can
now interact and chat with people
Educational Television There is no doubt that interactive TV
will open up new vistas for distance
education. This technique may
substitute lecture halls, and enable the
students to listen to the professor and
watch him from the comfort of their
homes, or record lectures and listen to
them later.
Obstacles and Competition
The main obstacles facing ITV is
the absence of legislation and laws
governing the process of subscription
to this service or censoring content.
The service represents a revolution in
the technology world. However,
it
provides
many
investment
opportunities for companies which
are competing to attract more viewers.
Millions of people all over the world are
or will be benefiting from the services
of interactive television, announcing
their entry into a new era of modern
technology that will change the way
they look at television and electronic
devices.
COOPERATIVE HEALTH INSURANCE
43
Reports and Analysis
SR 535.9 million profit
recorded by 23 companies in
first nine months of 2010
The Saudi market recorded good financial results during the first nine
months of 2010. One hundred and two companies achieved a net profit of
SR61.32 billion, while 27 companies suffered a loss rate of SR2.63 billion.
The final outcome of the net profits of 129 companies listed in the Saudi
stock market amounted to SR58.69 billion.
Insurance companies enjoyed a fair
share of these good results as 23
insurance companies listed on the
market achieved a collective profit of
SR535.9 million, scoring an increase
of 130 percent over the same period
in 2009. The previous year’s profits of
insurance companies in the same period
amounted to SR232.5 million.
A study conducted by Argam Website
on the results of insurance companies
during this period revealed that the
increase came almost entirely from two
companies: Tawuniya, which recorded a
profit of SR395.1 million and MedGulf,
which recorded a profit of SR142.3
million. The remaining 13 companies
suffered losses during the same period,
including, SABB Takaful, Allianz, Saudi
Indian Company and ACIG. The study
did not include the newly-established
44
Safar 1432 | January 2011
companies, which had not yet started
their insurance business then. The study
did not also include companies that did
not disclose their financial statements
because they had not received the
approval of SAMA, as shown in table 1:
The total premiums for insurance
companies that started its operations
reached SR9.88 billion by the end of
last September, achieving an increase of
34 percent compared to SR7.38 billion
in the same period last year. Statistics
show that three companies (Tawuniya,
MedGulf and BUPA) seized control of
nearly 55 percent of the total premiums
until the end of last September, led by
Tawuniya with SR2841 million, followed
by MedGulf with SR2123 million and
BUPA with SR1441 million. All insurance companies recorded
an increase in underwritten premiums
during the first nine months of the year
2010, compared to the corresponding
period of the previous year, with the
exception of three companies whose
underwritten premiums declined during
the same period: Gulf Union (-22%),
IAIC (-40%) and Saudi Indian (-15%). As shown in table 2
Insurance Companies’ Profit
(Million riyal)
Insurance Companies’ Premiums
(Million riyal)
Average of Retention Rate
First nine months
First nine months
Insurance Subscribed Premiums
2009
2010
Change %
2009
2010
Change %
Tawuniya
Time
194.8
395.1
103
Tawuniya
Time
2729.3
2840.6
4
BUPA
Time
MedGulf
87.7
142.3
62
MedGulf
1495.6
2123.3
42
SAAB Takaful
BUPA
33.7
44.4
32
BUPA
1119.4
1440.5
29
AXA
Malath
5.4
15.3
183
Malath
275.6
488.1
77
MedGulf
Gulf Union Co
5.5
9.7
78
SAICO
10.9
429.3
Very high
Al-Saqr Insurance
Al-Saqr Insurance
5.6
9.4
66
Allianz
239.6
402.3
68
ACIG
SAICO
7.4
9.3
25.7
Gulf Union Co
368.5
288.5
-22
Arabian Shield
6.5
7.5
17
AXA
--
256.1
--
2009
2010
Change %
1438.2
100
226.8
204.8
90
256.1
224.5
88
1748.3
82
193.8
154.3
80
48.0
36.4
76
IAIC 115.0
86.2
75
Sanad
171.5
122.2
71
164.2
109.9
67
1835.6
65
IAIC 10.0
2.4
-75
SAAB Takaful
200.8
226.8
13
Wala’a
Saudi United
0.7
0.8
14.3
Al-Saqr Insurance
141.6
193.8
37
Tawuniya
ACE
Trade Union
Insurance
Wala’a
--
0.8
--
Arabian Shield
150.5
193.6
29
Malath
488.1
308.3
63
Al-Ahlia
38.7
191.9
396
Saudi Indian
54.8
34.6
63
Sanad
130.8
171.5
31
Al-Ahlia
191.9
118.2
62
Wala’a
93.0
164.2
77
Arabian Shield
193.6
120.3
62
Al-Ahli Takaful
80.0
154.7
93
SAICO
429.3
236.0
55
Allianz
0.7
2.0
185.7
11.7
5.2
-56
11.7
5.5
-53
Saudi Re
4.4
6.0
36.4
Al-Ahlia
20.2
6.1
-70
Al-Ahli Takaful
2.6
7.6
192.3
SAAB Takaful
13.4
8.7
35-
AICC
8.7
9.1
4.6
Saudi Indian
15.8
10.6
33-
AXA
--
12.5
--
ACIG
17.6
12.7
28-
Sanad
12.0
13.5
12.5
Total
232.5
535.9
130.5
IAIC 191.4
115.0
-40
Gulf Union Co
288.5
122.2
42
Saudi Re
46.9
93.1
98
Allianz
402.3
170.3
42
Saudi Re
93.1
34.4
37
Al Ahli Takaful
154.7
NA
NA
7104.7
73
Saudi Indian
64.8
54.8
-15
ACIG
0.6
48.0
Very high
Total
7378
9876.1
34
Table 2
Total
Table 3
Table 1
73 percent is average retention
rate
The average retention rates for insurance
companies in the Saudi market reached
73 percent, and the retention rates
for insurance companies under study
ranged between 30 to 100 percent. The
Saudi Arabian Monetary Agency
(SAMA) obliges licensed insurance
companies to a minimum retention
ratio of 30 percent, according to
Article 40 of the Implementing
COOPERATIVE HEALTH INSURANCE
45
Reports and Analysis
Regulations of the Cooperative Insurance
Companies Control. The same article
also requires companies to re-insure
30 percent of their total contributions
within the Kingdom when applying
for reinsurance. The retention rates of insurance
companies are usually affected by the
high retention rates in vehicle insurance
and health insurance, which constitute
the largest proportion of the total
insurance premiums. The Saudi Company for Reinsurance,
which focuses on providing reinsurance
services to insurance companies, was the
lowest company to retain its premium,
as the percentage reached 37 percent
only because of the concentration of
insurance premiums with the company in
other sectors (engineering and property)
in the absence of any premiums in the
health sector. BUPA, which operates in
the health field only, was in the forefront
and retained all its subscribed premiums,
as shown in table 3. SR4 billion worth claims
Insurance companies incurred during the
first half of this year claims amounting to
SR3.99 billion, an increase of 43 percent
in the same period last year. Claims are a
formal request to an insurance company
asking for a payment based on the
terms of the insurance policy. Insurance
claims are reviewed by the company
for their validity and then paid out to
the insured or requesting party (on
behalf of the insured) once approved. Claims are usually associated with the
size of premiums. The total of claims
incurred by the three largest companies
in terms of underwritten premiums during
this period amounted to 79 percent of
the total claims incurred in the sector as
a whole, as shown in table 4: Insurance companies registered a
surplus of insurance operations after
the deduction of returns on investments
amounted to SR 577.8 million, up
100 percent from the surplus during
the same period last year. Nine
companies incurred losses from their
insurance operations (deficit), including
SABB Takaful, Allianz, Wala’a, Saudi
Indian and ACIG, as shown in table 5:
Insurance Companies’ Profit
(Million riyal)
Insurance Companies’ Claims (Million
riyal)
First nine months
First nine months
Time
2009
2010
Change %
Time
Safar 1432 | January 2011
2010
Change %
1171.4
26
40
Tawuniya
2.8
32.0
1024
Saudi Re
20.4
15.0
-26
MedGulf
714.2
999.3
55
BUPA
701.3
951.5
36
Malath
43.2
134.1
210
Gulf Union Co
83.0
103.1
24
Sanad
29.4
97.9
233
MedGulf
8.5
13.2
Al-Saqr Insurance
4.0
3.4
-14
AICC
1.8
3.0
70
Sanad
1.7
2.2
28
Saudi United
1.0
1.6
61
SAAB Takaful
0.3
1.4
325
Malath
2.0
1.2
BUPA
Trade Union
Insurance
Wala’a
5.0
2.6
SAICO
0.2
87.9
Very high
Allianz
40.5
83.2
106
Al-Saqr Insurance
69.0
78.7
14
-42
Arabian Shield
31.2
72.9
134
1.1
-79
IAIC
92.2
58.8
-36
0.7
-73
Wala’a
17.8
46.5
162
--
42.5
--
Al-Ahlia
1.1
22.0
1841
Saudi Indian
18.0
18.5
3
Saudi Re
3.5
16.5
376
SAAB Takaful
7.9
7.8
-1
Al-Ahli Takaful
2.5
0.7
72-
AXA
--
0.6
--
IAIC
0.3
0.5
67
Gulf Union Co
1.4
0.5
62-
Arabian Shield
0.8
0.4
-55
--
0.3
--
Al-Ahlia
AXA
0.4
0.2
-52
ACIG
--
0.2
--
2784.6
3993
43
Allianz
0.4
0.3
-25
Total
ACIG
0.32
0.24
-26
Table 5
SAICO
0.17
0.24
28
Saudi Indian
0.4
0.2
-50
Surplus of insurance operations, after
the deduction of ROI (Million riyal)
--
0.16
--
First nine months
Al-Ahli Takaful
1.3
0.12
-91
Total
57.7
79.1
37
ACE
Time
2009
2010
Change %
Tawuniya
214.4
394.4
84
Table 4
MedGulf
90.8
145.7
60
Returns on investments
Insurance
companies
invest
cash received from underwritten
premiums in investment vehicles
under the supervision of the Saudi
Monetary Agency. Nine insurance
c o m p a n i e s a ch i e v e d r e t u r n s o n
investments (policyholders) amounting
to SR46.8 million in the first nine
months of the year 2010, compared
to SR13.3 million
in
the same
period last year.
The return on the investment of
shareholders’ funds amounted to
SR79.1 million during the current
period, compared to SR57.7
million
for the same period last year, as shown
in table 6.
BUPA
35.4
51.4
45
Malath
7.4
19.1
158
Gulf Union Co
11.1
15.4
38
Arabian Shield
11.5
13.6
18
SAICO
2.3
12.2
631
Al-Saqr Insurance
7.4
12.2
65
IAIC
11.1
2.7
76-
Al-Ahli Takaful
0.2
2.0
1100
SAAB Takaful
8.3
2.7
67
Wala’a
14.1
4.9
-65
Al-Ahlia
16.3
5.8
-65
Allianz
10.6
6.1
-42
Saudi Indian
14.5
9.7
-33
ACIG
5.1
12.6
147
AXA
--
13.5
--
Sanad
12.8
14.6
14
Saudi Re
16.0
21.0
31
Total
288.9
577.8
100
Table 5
46
2009
931.7
Tawuniya
Financial results for insurance companies
Tawuniya Insurance
Tawuniya Company for Cooperative Insurance, which is the largest and
oldest insurance company in Saudi Arabia, recorded a profit of SR395.1
million (SR7.90 per share) by the end of the first nine months of the year
2010, an increase of 103 percent compared to profits recorded in the same
period of 2009. The reason for this increase is the surplus of insurance
operations, the increase of underwritten premiums, the increase of net
profits on the investment, and the increase of reinsurance commissions
compared with the same period last year.
Malath Insurance
Malath Insurance recorded a profit of SR15.33 million (SR0.51 per share)
by the end of the first nine months of the year 2010, an increase of 183
percent compared to profit recorded in the same period of 2009. The
company attributed the cause of high profits to the escalation of operating
profits, the continued growth in the company’s customer base, the growth
of gross and net written premiums, the company’s ability to maintain
insurance contracts for key customers, and the expansion of insurance
channels and outlets in different regions in the Kingdom. MedGulf
The Mediterranean & Gulf Insurance and Reinsurance (MedGulf) recorded
a profit of SR142.3 million (SR1.78 per share) during the first nine months
of the year 2010, compared to profit of SR87.7 million achieved during the
same period last year.
Walaa Insurance
The Saudi United Cooperative
Insurance
Company (Walaa Insurance) reduced its losses to SR5.2 million (SR0.26 per
share) during the first nine months of 2010, compared to a loss of
SR11.7 million during the same period of the year 2009. The low losses
were a result of the high gross and net underwritten premiums compared
to the previous year, in addition to profits from policyholders’ investments.
The cause of profit during the third quarter is related to the same causes.
SALAMA
The profits of Saudi IAIC Cooperative Insurance Company (SALAMA)
declined to SR2.43 million (SR0.24 per share) during the first nine months
of 2010, down by 76 percent compared to net profit of the same period in
2009 . The company attributed the cause of the low third-quarter profit, as
well as low profits during the nine months, to the decline in the volume
of premiums in the same period the previous year.
Arabian Shield Cooperative Insurance Arabian Shield Cooperative Insurance increased its profit in the Saudi
market to SR7.5 million (SR0.38 per share) during the first nine months of
the year 2010, an increase of 17 percent compared to profit in the same
period of 2009. The company attributed the rise in third-quarter profit to
the high volume of underwritten premiums. Allianz Saudi Fransi Cooperative Insurance Company
Allianz Saudi Fransi Cooperative Insurance Company reduced its losses to
SR5.5 million riyals (SR0.29 per share) by the end of the first nine months
of the year 2010, compared to losses of SR11.7 million (SR1.17 per share)
during the same period in 2009, a decline of 53 percent. The company
attributed the decline in losses to the underwritten premiums, which
reported an increase of 68 percent, while the net of the underwritten
premiums increased by 70 percent. Sanad Insurance The losses of Sanad Insurance Company amounted to SR13.5 million
(SR0.68 per share) during the first nine months of 2010 compared to a loss
of SR12 million suffered during the same period in 2009. The company
attributed the cause of economic losses to the low value of the new
medical insurance and the high cost of medical compensation. Saudi Indian Insurance Saudi Indian Company for Cooperative Insurance, one of the newest
insurance companies in Saudi Arabia, decreased its losses to SR10.58
million (SR1.06 per share) by the end of the first nine months of the year
2010, compared to a loss of SR15.82 million for the same period in 2009,
down by 33 percent. The company attributed the cause of the low losses
in the third quarter compared to the same quarter of last year to the higher
reinsurance commissions, which have increased by 161.46 percent, and
the lower general and administrative expenses. Al-Ahlia Insurance Al Ahlia Insurance for Cooperative Insurance decreased its losses to SR6.1
million (SR0.61 per share) during the first nine months of the year 2010,
compared to a loss of SR21.2 million during the same period in 2009. The
company attributed the reduced losses to the high operating expenses. Bupa Arabia Bupa Arabia for Cooperative Insurance Co. achieved a profit of SR44.4
million (SR1.11 per share) during the first nine months of the year 2010,
compared to a profit of SR33.7 million during the same period in 2009.
The company attributed the gains to the low number of claims and an
increase in the insurance net, up by 35 percent. The reason for high results
of the third quarter of 2010 compared to the same quarter last year is
related to the increase in the insurance net by 41 percent. AXA Insurance AXA Insurance recorded a loss of SR12.47 million (SR0.62 per share)
during the first nine months of the year 2010. There are no comparative
figures because the company still new. The reason for the loss in the third
quarter of 2010 is related to the increased expenses of the establishment
as the company started its operations on Feb.18, 2010. ACE Insurance ACE Insurance Company suffered a loss of SR816,000 (SR0.08 per share)
during the first nine months of 2010. Here also there are no comparative
figures as the company is new. The company attributed the cause of losses
in the third quarter of this year to non-completion of the transfer of the
insurance company portfolio of the International Insurance Company and
ACE Arabia Insurance Company, in addition to the ill preparation of the
primary financial statements for insurance operations.
COOPERATIVE HEALTH INSURANCE
47
Around the World
Health Insurance in Australia:
Establishing Equality and Excellence
The health insurance system of Australia, which is known for its tolerant and diverse
society composed of many races, ethnicities and cultures, is characterized by its
unique concept.
The Australian state believes in society
and its role in promoting tolerance, which
includes both citizens and residents.
Therefore, its insurance system takes into
account this diversity and the elements of
freedom and equality.
The values of the Australian society are
based on respecting the law and other
cultures, freedom and dignity of every
individual, equality between men and
women, and justice and compassion for
the needy. Therefore, to understand the
working of the Australian health insurance
system, it is imperative to comprehend
these values.
48
Safar 1432 | January 2011
Australia is one of those countries
that have a comprehensive health
insurance system giving 100 percent
cover to all citizens. The commonwealth
government, the federal government and
provincial states, bear the responsibility
of developing a health database that
is required to manage all healthcare
services through a health department.
This department is an independent
governmental entity that helps and
supports the Australian government in the
implementation of all its health policies,
through specialized insurance programs,
relying on its vision of granting all the
Australian citizens the right to choose
between different healthcare systems,
enabling them to get the healthcare they
want.
There are two types of health insurance:
public and private. The public health
insurance system is called Medicare, in
which the state manages, supervises and
controls the health insurance. This type
of insurance reflects the philosophy of
the Australian government and its role
in providing healthcare services to all
its citizens without exception; and that
health insurance is a way to meet these
services.
The emergence of Medicare is relatively
recent; it appeared in the middle of the
eighth decade, and specifically in the
year 1973, after the ratification of the
Health Insurance Act. Since then, the
public health system has witnessed many
adjustments, based on the requirements
and needs of the communities.
What does Medicare cover?
This insurance is considered relatively
comprehensive; it covers all health
services provided in health centers and
government hospitals. Medicare (also
called National Health Services) is offered
free of charge in all public hospitals,
and it also assists in paying the costs of
healthcare outside public hospitals while
providing free medical treatment for
those who reside within the territory of
Australia – both citizens and residents.
With regard to the financing of the
government health insurance, it is done
through the programs of tax deduction
under the tax law of 1999.
It is clear that the Australian government
provides full assistance in the cost of
medical care and treatment. It also assists
in paying for most medicines under the
Pharmaceutical Benefits Scheme (PBS).
Anyone wanting to find out if he/ she is
eligible for the Medicare services, he/
she should visit the local (insurance)
office, with all the
official papers
including the passport, travel documents,
permanent residence or temporary visa,
and children’s vaccination documents.
If the individual holds a temporary visa,
he cannot register with Medicare, except
in some cases. In addition, Medicare
oversees
children’s
immunization
records and manages the Department of
Australian Organ Donor, where adults
can register to donate organs.
Information on Medicare is easily
available through out the country.
Medicare has a collection of audio CDs
translated into 16 languages, which
includes details on lists of services,
eligibility requirements, benefits and
payments. All this information can also
be found on its website, at its office as
well as the Migrant Resource Centre.
Selective Healthcare
There is another health insurance
option for the citizens of Australia, which
is the private insurance or optional
insurance, where citizens can get special
and distinct healthcare services. Health
insurance companies offer commercial
services for those individuals who choose
to pay for the additional funds, in addition
to the amount of money deducted as taxes
from them for the benefit of compulsory
insurance.
Medicare is a public health insurance system, in which the state manages,
supervises and controls the health insurance. This type of insurance reflects
the philosophy of the Australian government and its role in providing all
healthcare services to all its citizens.
COOPERATIVE HEALTH INSURANCE
49
Around the World
This form of insurance gives more
freedom to individuals to choose the
type of service they want. Essentially,
private insurance is a means of
accessing selective healthcare
services. The cost of the insurance
policy depends on the level and the
quality of the provided services in
private hospitals. Beneficiaries can
also benefit from healthcare services
provided in healthcare centers and
governmental hospitals.
This type of insurance presently
occupies a prominent place in the
insurance industry, as many people
choose to deal with insurance
companies that provide full health
coverage and treatment in addition
to covering services that are not
covered by Medicare, such as
dentistry and ophthalmology.
In order to encourage citizens to
Immigrants have a
special health system
that takes into account
their status and
conditions.
apply for private insurance, the Australian
government provides many incentives to
them, including the recovery of 30 percent
of the fees paid to private health insurance
companies. It also added an additional tax
of one percent on people with income of
more than five thousand Australian dollars
per year and who are not registered with
private health insurance companies.
Life Insurance
Health insurance for life is relatively new
and was introduced by the government
to encourage people to register with an
insurance company that covers medical
services in hospitals. This system states
that when an individual registers with
an insurance company after the first of
July following his thirty-first birthday, he
would pay a higher amount to meet the
same level of insurance compared to a
person who is registered with an insurance
company before the first of July following
his thirty-first birthday. In such a case, the
cost of the service will increase by two
percent for each year of delay of settling
with an insurance company.
50
Safar 1432 | January 2011
Immigrants have a special health policy
that takes into account their status and
conditions. New immigrants who arrive
in Australia after July 1, and are 31, will
not pay the additional fees if they sign
with an insurance company before the
passage of the first year on the day they
became eligible for the Medicare card.
Any delay in applying for an insurance
company after the first year results in
an increase in the cost, where the price
may include an additional fee for health
insurance for life.
Insurance for Students
In the recent years, the number of
students studying on scholarships in
Australia has increased and so have their
healthcare problems. There are now a
set of conditions for health insurance,
which students should abide by. First,
students must visit an insurance company
or its website and renew their medical
insurance up to their period of stay in the
country. They should also fill in a form of
compensation for medical bills.
After that, the form, along with a
health insurance card, confirmation of
membership and proof of payment must
be sent by regular mail. If the student is
coming to Australia with his family, he
should add the names of the escorts in
the insurance policy once he has arrived
in Australia or New Zealand. He or she
should inform the insurance company
of any newborn immediately after birth.
If the scholarship covers a husband and
his wife, who are studying at different
institutes, it has to be ensured
that they apply for the same
insurance for both the
spouses and the children.
As for the medical bills
that a student pays from
his account, the payment
can be cashed to him via
a special system. First, he
has to visit the insurance
company and ask for the
payment. He should have all
the invoices and the form of
compensation for medical
bills. He should paste all the
small bills on an A4 sheet
so as not to loose them and
reduce the waiting period
for compensation. The form
is then sent along with
copies of the invoices and
the compensation form.
Problems and Immediate
Solutions
Some students face problems when
applying for insurance because a few
companies and hospitals do not accept
their health cards. In such a case, the
cultural attaché in Australia advices the
student to review the website of the
insurance company in order to learn
about the hospitals and clinics approved
for treatment, and show their health card
when they visit any clinic or hospital.
Students must obtain all their medical
reports from the hospital or clinic they
visited and submit them to their insurance
company as a document proof showing
the projected costs for treatment. The
treatment can be divided into more than
one type for the same operation (cost of
anaesthesia, cost of hypnosis, costs of
surgery, etc.) so it is necessary that each
treatment is separated from the other
when it comes to financial matters.
With regard to medical insurance
for dental treatment, the student has to
submit a clear treatment plan that shows
all the stages of treatment, which should
be within the amount allowed for the
treatment of the student during the year.
After receiving reports from the insurance
company, the student should send these
reports by fax, email or regular mail
to the medical officer in the attaché,
enclosing the financial application form,
available on the Australian cultural
attaché’s website.
We list in every edition of the magazine a page of the commonly-used
terminologies in the cooperative medical insurance sector. This knowledge will
help to enrich the experience of those working in the medical insurance services
as well as those benefitting from them.
Reasonable and regular
medical expenses:
General exceptions:
The medical expenses that answer the fees of most
licensed doctors or hospitals in the KSA, on the condition
that these fees are for treating a similar situation, and
that the licensed doctors or hospitals are similar in
qualification and status to those who provided the care.
The medical treatment that is not fundamentally
different from what the licensed doctor considers as
acceptable considered as regular and normal for any
specific disease, is done by claiming the medical
expenses under this document.
Benefits and health services exempted of the coverage
and cited in a specific clause of the policy, and are
applicable on all the beneficiaries.
Emergency health services:
The identity card the company issues for every
beneficiary under the health insurance policy.
The health care services and equipment required to treat
any emergency.
Treatment category inside the hospital:
The category of the room and the hospital services
specified for the covered and deserved health services.
Approval to enter the hospital:
A document filled by the doctor treating the beneficiary,
and adopted by the company before entering the hospital.
Covered Category:
Model claim:
Categorizing the employees in the
employer’s category, so as to benefit from all services.
A document filled by the doctor on duty so the
beneficiary would get the coverage concerning the
benefits of using the clinics.
Insurance card:
Benefits Program:
Benefits of the resident patient:
A mixture of all the benefits the
beneficiaries are allowed to have based on their contract
with the company.
Health services:
The specified and excluded health care services and
equipment covered by the policy.
Approved Facility:
A hospital specified by the company as an approved
facility, and which made a contract with or on behalf of
the insurance company to provide the covered medical
services and the adequate health services to treat specific
diseases or cases.
A treatment inside the hospital or a
one-day treatment or under-surveillance, treatment in an
emergency room, which can’t be provided in external
clinics.
Resident patient:
A stay in the hospital requiring sleeping inside the
institution.
Prescription Drugs:
Medication the patient gets through a prescription written
by a licensed doctor.
COOPERATIVE HEALTH INSURANCE
51
Lifestyle
Mixing the sensations of the East and the West
Perfumes: A global industry
with an Arabic twist
Fragrances are tantalizing enough to delight one’s senses, take the breath away
and make you fall in love with them. They flow around like beautiful music,
capturing your senses and soul. Perfume comes from the Latin word “per”
meaning “through” and “smoke” as many ancient perfumes were made by
extracting natural oils from plants through pressing and steaming. The oil was
then burned to scent the air during celebrations and festivals.
52
Safar 1432 | January 2011
The history of perfume is
as old as man himself. More
than five thousand years ago,
the ancient Egyptians burned
scented materials, which were
composed of resin, a type of
gum, along with the extract of
different types of plants with
aromatic smell. This mixture was
burned everyday at sunrise.
Rich ancient Egyptians used
ointments and creams made
of lemon, anise, frankincense
and thyme, and used those
perfumes and fragrances for the
treatment of mental illnesses by
applying scented dough on the walls of
their homes, believing that the pleasant
aroma would help patients feel better and
optimistic.
The ancient Greek civilization went
even beyond this in using perfumes and
similar was the case with the Romanian
Empire. Legend has it that King Nero once
ordered that the roofs of his banquet halls
should “rain” fragrances on the heads of
the guests. The perfumes were still in the
form of an ointment or powder, and not
in the liquid form, as is available today.
The fragrances were available in small
bottles attached to the neck.
The perfume industry reached the
Arabs in the ninth and tenth centuries.
Arabs were not satisfied with the aromatic
extract of plants, and they developed
it with time, innovating many ways to
use them for their various festivals and
in daily life. They also used to bath in
incense and rose water and invented the
water distiller, which is used until now to
extract the abstracts of flowers and roses.
After entering Andalusia, the Arabs
spread the culture of fragrance to Europe
by exporting different types of roses and
scented plants, such as, amber. Arabs also
widely used incense, balsam, camphor,
and Damascus roses (known as Damask
rose).
The European interest in perfumes
increased after they arrived in Madagascar,
the Comoros and India, bringing in
many spices from India, flowers from
Madagascar and scented wood from the
Comoros.
During the reign of French King Louis
XIV, fragrance became indispensable in
order to get rid of the bad odour coming
from people or places, especially in Paris,
where the means of cleanliness were not
widespread, and the hygiene level was
less than acceptable.
Hence, need arose for a substance
that could cover up the stink and the
production of perfumes took root in
the 17th century. Later on, it became a
tradition of sorts for upper-class women to
spray their napkins with a light perfume.
In the 19th century, the perfume
industry developed to become like any
other luxurious industry. In the 20th
century, and because of the high demand
for its products, perfume houses resorted
to the use of certain chemicals in the
industry.
Several countries in the Maghreb are
now well-known for cultivating roses that
are exclusively used in manufacturing
perfumes, while in Europe, the French
village of Grass on the southern coastal
is home to hundreds of plants of lavender
and jasmine.
Global industry
The perfume industry is a major global
industry with revenues of $17.8 billion
annually. It has a strong presence in the
West and the Indian market, where the
industry is estimated at $0.25 billion. The perfume market is dominated by
five major players, namely, Givaudan,
International Flavors & Fragrances,
Firmenich,
Symrise
and
Quest
International. The eight most expensive
perfumes that are in huge demand
globally are:
1) Clive Christian's Imperial Majesty
($215000): This fragrance and its bottle
have entered the Guinness Book of
Records. The Prolific British Designer,
Clive Christian, designed the fragrance
and the bottle, which is encircled by
an 18-carat gold bracelet and 4-carat
diamond stones. Only five bottles
are produced each year.
2) Clive Christian No.1 ($2150):
This fragrance, made by the Prolific
British Designer Clive Christian,
is composed of Indian jasmine,
tangerine and sandalwood. The
bottle is handmade with crystal
and gold, and the stopper is
designed after the original pattern
granted by Queen Victoria.
3) Caron's Poivre ($2000): This
fragrance is made of lavender,
jasmine, rose, lotus wood,
sandalwood, and musk.
4) Chanel No.5 ($1850): This
fragrance is one of the most famous
perfumes in the world, and its composition
mainly consists of jasmine. Interestingly,
the House of Chanel had initially
requested the manufacturing of six
fragrances, but when the company liked
the fifth type it started distributing its
samples in stores for free.
5) Baccarats Les Larmes Sacrees de
Thebe ($1700): Baccarat, better known
for its pure and high-quality crystal,
decided to get in on the fragrance act in
the late 1990s, with three limited-edition
fragrances of its own. The price is largely
due to the pyramid-shaped bottle, made
of Baccarat crystal, and the fragrance,
which includes frankincense and myrrh,
is meant to evoke the ancient Egyptians.
6) Annick Goutal's Eau d'Hadrien
($1500): This fragrance consists of lemon,
grapefruit, cypress wood, and is designed
by pianist “Annick”.
7) Hermes' 24 Faubourg ($1500):
It is a French perfume for women from
Hormuz, which entered the market in the
fifties.
8) Jean Patou's Joy ($800): It is a popular
fragrance among Hollywood stars, and it
consists of roses and jasmine.
Oriental perfumes
Despite the popularity of French
perfumes, Paris opened its doors to
Arabic fragrances particularly because a
number of celebrities as well as members
of the elite class competed with each
other to own the newest Arabic fragrance
products, which include perfumes,
colognes, bed fresheners, incense, oud,
amber and natural flowers.
Some of the world’s most exotic
perfumes are difficult to extract from
nature, and are found only in the
COOPERATIVE HEALTH INSURANCE
53
Middle East. For example, amber is one
such rare fragrance, which is mainly
extracted from whales. Arabic perfumes
and products started attracting more
attention because of their diversity
and incredible aroma that comes from
natural roses, oud, musk, herbs, fruits,
oils, incense and mixtures in addition
to body care products and natural body
deodorants.
Fragrances have a special significance
for Arabs; and their usage dates back to a
long tradition of parents and grandparents
over the years. Fragrances are not only
used for the body, but are also used to
perfume the house with a variety of mindsoothing aromas.
The most popular type of perfume in
the Arab countries is the oriental type,
which is famous in the Persian Gulf, in
particular, and the most famous of the
oriental perfume is oud.
Aromatic oils developed in the Arab
region are distinct from those produced
in other parts of the world. In the Gulf
region, oud occupies the first position in
terms of importance, while jasmine and
rose are the key components of perfumes
found in the Levant, North Africa,
Egypt and Sudan. There are no specific
components of the oriental perfume as
they are imported from different regions
of the world and then processed in Arab
factories.
These perfumes are known as Arabic
perfumes despite their oriental origins
54
Safar 1432 | January 2011
mainly because they are very popular
among the Arabs.
Oud is characterized by the
concentration of essential oils; it stays for
a longer period on the body or clothing,
which is why it is widely used and liked
by the people of the Persian Gulf, who
have to cope with high temperatures and
the dry climate of the region.
Oriental perfumes are generally
expensive because of the high
concentration of fragrance in them
and the difficulty in obtaining its raw
materials. It is known that this type of
fragrance contains natural ingredients
without alcohol, in contrast to French
perfumes, for example, which have a
small percentage of fragrance and the rest
is alcohol.
Oud is made from the fragrant resin
found in Agarwood tree. Oud takes years
to form in the trunks of Agarwood trees
contaminated by a certain bacteria. Since
the Oud tree is not grown anywhere except
in some parts of Asia, the price of the wood
and its oil extracts has remained high.
Oud oil is used for perfuming the
body, while oud incense is suitable for
perfuming clothing and living areas. Oud
is also available in the form of creams,
skin products and cosmetics, while oud
oil, known as Mokhmaliya, is specially
used for perfuming the hair.
Oriental perfumes remain a cultural
icon associated with celebrations. They
are most in demand during seasons of
festivals and feasts. Many people prefer
to buy perfumes in the period between
January and May, when the Gulf countries
enjoy a moderate weather and a happy
wedding season.
Experts advise that people should
not apply perfume or fragrance on the
face as the facial skin is very sensitive,
especially that most perfumes contain a
high percentage of alcohol. It is advised
to apply perfume on the neck and chest,
and dab it on clean hair only, as the oils
that may exist in the hair can change the
nature of the fragrance.
The ideal way to spray perfume is to
do it from a distance ranging between
12 -14cm from the body. If you want the
fragrance to stay longer, it is advisable
to wear the perfume after taking a
morning bath.
Taif Rose
The dark, dense fragrance of Taif roses
makes one of the most precious and
expensive perfumes in the world. It is
generally extracted from the nectar of 12
or 32 flowers.
Taif Rose, a unique fragrance, is sold
in grams, and it is popular all across the
region. According to a recent statistic
issued by the Chamber of Commerce and
Industry in Taif, the rose farmers were
able to raise a revenue of around SR50
million this year.
The beautiful city of Taif, which sits on
top of the Sarawat Mountains, is home to
hundreds of roses farms scattered across
the region. Some of these lush valleys
include Al-Hada, Al-Shifa, Thaqeef, Bani
Saad and the Bani Malik.
Roses are reaped manually, starting
from the end of March and during the
months of April and May each year.
There is a specific time for the harvesting
process, which begins with the early
morning hours and extends until just
before the sunrise.
Newer villages are now entering into
the production of perfume roses, mainly
due to the support they are receiving and
the overwhelming demand for the roses
from distilleries and perfume producers
from around the world.
The price of a tola of Taif roses can
be as high as SR3000, and most of the
production is booked in advance. The
price of rose water varies with its variety:
Al-Aroos for SR50, Al-Thano for SR30
and Al-Sayer for SR10.
Travel & Tourism
Despite its relatively small area, Jordan
is a country that has many amazing
tourist destinations, which are worth a
visit. In this edition of the magazine,
we journey through a beautiful Arab
country that perfectly blends fun,
pleasure and the thrill of knowledge –
the land of Jordan.
In the past, many civilizations settled
in Jordan including the kingdoms of the
Ammonites, Edomites and Almwabeyen,
Nabatean Arabs, Hyksos, Egyptians,
Assyrians, Greek, the Persians and the
Romans, until the Islamic conquest in
the mid-seventh century AD. Jordan’s beautiful archaeological sites
stand testimony to these civilizations
until this day. The castles, forts and
towers, theatres, palaces and shrines
remind the world of these ancient
people. Jordan takes pride in its society,
which is a mix of cultures and races that
live peacefully together. The people of
Jordan are known for their kindness and
generosity.
Capital of Love
Amman, the capital of Jordan, also
known as “Philadelphia” linking it
to the Roman emperor Philadelphus,
means “City of Brotherly Love”. Amman
is known for its hills and mountains.
It is about 90 kilometers away from
Jerusalem. In the past twenty years,
the capital of Jordan has witnessed an
unprecedented construction boom,
expanding year after year to combine
the authenticity of the past with the
charm of the present creating a truly
fantastic city.
Jordan:
The Land of Civilization
Visiting a country that is rich in tourist sites – from ancient historic castles and forts to
magnificent wildlife reserves and other attractions – is always a splendid experience.
Choosing where to go or which place to visit becomes a difficult task, especially in a
country that abounds in geographical diversity and is considered to be a magnet for
tourists from all around the world, as is the case with Jordan.
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Safar 1432 | January 2011
Museums
If you are planning to visit Jordan,
you must start your trip by visiting
its many museums, most of which
are located in Amman. They include
the Jordan Archaeological Museum,
Jordan Museum of Popular Traditions,
Archaeological
Museum/University
of Jordan, Anthropological Museum/
University of Jordan, Jordan National
Gallery of Fine Arts, Museum of the
National Bank of Currencies, Royal
Automobile Museum and the Children’s
Museum.
These museums contain distinctive
collections such as rare artifacts from
Ain Ghazal, a Neolithic site located
in North-Western Jordan, dating back
to about six thousand years; a copper
manuscript of the Dead Sea written
in Aramaic letters, and many more.
Models of tools that were used in daily
life since the beginning of the nineteenth
century and early twentieth century are
found in the Jordan Museum of Popular
Traditions, in addition to over 2200
coins on display at the Museum of the
National Bank of Currencies.
Palaces and Castles
Given the many historical civilizations
that settled in Jordan, we, like any
basalt stone and it overlooks the walls
of the Azraq oasis.
In South Jordan, we visited the Shobak
Castle, which is a vivid example of the
engineering masterminds during the
Crusaders War. These places witnessed
military battles and wars in different
historic periods. The castle is located
at a height of 1330 km above sea level
and about an hour’s drive from the city
of Petra on the desert road. The castle
includes nine towers and is beautifully
decorated with inscriptions on the
exterior.
Amman, the capital of Jordan known as
“Philadelphia” linking it to the Roman emperor
Philadelphus, means “City of Brotherly Love”.
visitor to Jordan, came across many
outstanding castles and palaces, all of
which tell stories about their glorious
past. The landscape, the hills and
valleys are truly astounding. Qasr Amra
is a masterpiece of Islamic architecture
that is located in the heart of the desert.
It is famous for its elegant dome and
fine decorations that are designed in
a fresco style and represent scenes of
fishing trips and animals found in the
region in that era, in addition to images
of kings of that period. In the center of
the palace, there is a water well, which
employs an old barmaid to lift water.
The water used to flow in the corridors
under the floor of the palace to preserve
heat, almost similar to the working of a
central heating system of today.
To the east of Amman, we visited the
Qasr of Al-Harana, which is one of the
most important sites of the Umayyad
period. The place, which consists
of 61 rooms spread on two floors,
has undergone many maintenance
operations, and is characterized by its
unique architecture that is similar to a
castle.
Around 25 km from the city of Zarqa
is the Milkmaids Palace or Qasr AlHalabat. Archaeological evidence shows
that the site dates back to the Nabatean
period, although some archaeologists
believe its origins were in the Roman
era. In the eastern region, lies the Blue
Castle, also dating back to the Roman
period. The castle is built from black
Ajloun is home to a living example of
military Islamic architecture. The Castle
of Ajloun, known as Rabad Castle, was
built by Izz Al-Din Usama bin Monqez
(one of the leaders of Saladin) on the
summit of a mountain that oversees
a large part of the northern Jordan
Valley. The castle was used to monitor
all roads and commercial convoys that
linked southern Jordan with northern
Levant. It includes observation towers
and defences, living rooms, water wells,
twisted corridors and horse stables.
Jerash
At a distance of less than an hour from
the north of Amman is the city of Jerash.
Surrounded by many hills and forests,
Jerash is considered one of the most
important archaeological cities. This
Romanian city, which was fully covered
by sand, was discovered more than 70
years ago. The city appeared to have
paved and unpaved streets with high
peaks, suburbs, spas, waterfalls and
walls. In spite of being subjected to
Roman rule, Jerash reflects the spirit of
two cultures and civilizations: Greek
and Romanian.
Umm Qais
It was lunch time when we arrived in
the scenic city of Umm Qais. The city is
located on a high plateau in the northern
city of Irbid, overlooking the valley of
Yarmouk, the Sea of Galilee and the
Jordan Valley, opposite to the Golan
COOPERATIVE HEALTH INSURANCE
57
Travel & Tourism
Heights. Having a sumptuous
lunch in the company of nature’s
bounteous beauty was a moment
of pure bliss.
Umm Qais was earlier known
as “Jadara” and was one of the
Decapolis cities or the “Ten
Romanian
Cities”.
During
the Roman period, the city
witnessed a renaissance era of
literary, artistic and dramatic
development, and was the center
of culture, art and poetry. It was
home to a number of poets and
philosophers.
To the north of the city lie
the Hamma hot springs, which
are famous for their therapeutic
value since the Roman era. It has
great facilities, streets, theaters
and baths, all made of black
basalt stone. The spot is also
known for its luxurious markets,
gates and tunnels, which are
considered a masterpiece in
irrigation engineering.
There are other archaeological
sites that are worth a visit such
as: Fahel Tabaka, and Umm Al-Rasas,
which features in the UNESCO World
Heritage sites.
Dead Sea
A trip to Jordan would not be complete
without visiting the lowest spot on earth
– the Dead Sea. It is located about 55
km to the south-west of Amman. Not far
from the sea are Ma’in’s famous warm
springs. The Dead Sea mud, which is rich
in saturated sediment mineral elements,
is used in the treatment of arthritis, skin
diseases, and for revitalizing the skin.
There are many treatment centers near
the Dead Sea. Not only is the salty
water used in the treatment of many
diseases, its salts are also used in the
production of therapeutic bath products
and cosmetic products.
Madaba
Our next stop was the Mosaic city of
“Madaba”, located 30 kilometres south
of Amman. The city is famous for its
fabulous mosaics, which date back to
the Byzantine and Umayyad dynasties
of the sixth century. These comprise of
depictions of hills and valleys in bright
color stones. Many mosaic maps are
from the seventh century and are on
58
Safar 1432 | January 2011
is breath-taking. The city as
well as the castle has witnessed
many historically significant
events and cultural shifts in the
past. Nevertheless, the city has
maintained its originality.
A must-try in the city is the
most popular dish of Jordan –
the ‘Mansaf’ – which is mostly
served in weddings and parties.
Aqaba
Aqaba enjoys a special position
on Jordan’s tourism map. Its
economic
significance
lies
in the fact that it is the only
maritime to link Jordan with
the world through the Red Sea.
Aqaba is an important starting
point for tourists who wish to
explore historical monuments
and archaeological sites in the
southern areas of Jordan, such
as, Petra and Wadi Rum. The
journey from Aqaba to Petra and
Wadi Rum takes less than an
hour.
This is Jordan’s most heavily toured
city. Climbing, trekking, walking,
meditation, camping, and watching
the picturesque sunsets are some of
the activities that will feature on any
adventure enthusiast’s ‘to-do’ list.
The Pink City
The wonderful ‘pink city’ of the
Nabateans was hewn by hand from pink
solid rock. In 2007, it was chosen as
one of the Seven Wonders of the World.
Much of Petra’s fascination comes from
its setting on the edge of Wadi Araba.
The rugged sandstone hills form a
deep canyon easily protected from all
directions. The easiest access to Petra is
through the Siq, a winding cleft in the
rock that varies from between five to
200 meters wide. Petra’s excellent state
of preservation can be attributed to the
fact that almost all of its hundreds of
“buildings” have been hewn out of
solid rock: there are only a few freestanding buildings in the city. Until
1984, many of these caves were home
to the local Bedouins.
A number of caves, gates, arches and
other such archaeological delights – all
carved in pink stones and adorned with
inscriptions – continue to enthral their
visitors and explorers.
A trip to Jordan would not be complete
without visiting the lowest spot on earth –
the Dead Sea.
Shopping
The capital city of Amman is the main
shopping center of Jordan. The city
offers plenty of shopping options –
from commercial markets and modern
shopping complexes to traditional
souks, which are best for handicrafts and
souvenirs. Among the most important
and oldest industries of Jordan are the
carpet industry, embroidery, ceramic
dishes and pottery, silver jewelry,
baskets, and colorful sand bottles – all
of which reflect the rich civilization.
We bought some amazing souvenirs
to remind us of the wonderful time we
had in Jordan. We not only learnt a lot
from our trip, but also enjoyed every
moment spent here. As we prepared to
leave the country, we assured ourselves
that we will be back here once again
to explore a lot more of the remarkable
heritage and indulge in some more
retail therapy.
In South Jordan, we visited the Shobak Castle,
which is considered as a vivid example of the
engineering masterminds during the Crusaders
War.
display at the Madaba Archaeological
Museum. There are a number of
historically significant sites in Madaba,
such as Mount Nebo and Mkawer
Castle, among others.
Karak and Mansaf
In southern Jordan, on a triangular
hill, about 900 meters above the sea
level, lies the city of Karak, known for
the famous crusader castle Karak. The
castle is one of the three largest castles
in the region, the other two being in
Syria.
The Crusaders built this castle as a focal
point between the castle of Shobak and
Jerusalem. As we walked through the
castle, we came across secret passages
leading to underground rooms. The view
from the castle tower of the fascinating
natural scenery in the surrounding area
There are many interesting activities
that can be enjoyed in Aqaba, such
as, swimming, diving, cruising, etc.
Most of the boats have a transparent
glass floor to catch a glimpse of
the rare and diverse marine life.
Wadi Rum
If you are looking for adventure and
thrill, visit Wadi Rum, also known as
the “Valley of the Moon” because of
the similarity of its topography and the
topography of the moon. It is located
40 kilometers from the city of Aqaba.
Visitors can choose to ride horses and
discover the secrets of the valley, or
climb the magnificent mountains and
view the amazing rock inscriptions that
are as old as four thousands years. The
beautiful city of Aqaba offers plenty of
exotic sights. The city is also referred to
as the Gulf of Jordan or the Aqaba Gulf.
COOPERATIVE HEALTH INSURANCE
59
Survey
How informed are insurers
about their health insurance
policy?
It has been more than four years since the introduction of the health insurance
system in Saudi Arabia, yet there remains some uncertainty with regards to the
relationship between service providers, insurance companies and hospitals on the
one hand, and the beneficiaries of these services on the other. Many believe the
beneficiaries’ limited knowledge of the services provided by insurance companies
is the main reason behind this ambiguity.
60
Safar 1432 | January 2011
This has led to many complaints among
beneficiaries on issues such as: obtaining
approval of certain medical conditions,
disapproving
pre-emptive
medical
testing, delay in approvals of hypnosis
and in the approval of the disbursement
of medicines, particularly those related
to chronic diseases such as heart disease,
diabetes and blood pressure. Although
the executive list of the Council of
Cooperative Health Insurance has covered
these aspects, it seems that the lack of
awareness of all the involved parties is
the reason behind this uncertainty.
To find out what exactly are the
expectations of the beneficiaries from
their insurance companies, we surveyed
a group of health insurance beneficiaries
insured with well-known hospitals in
Riyadh, asking them if they had ever
carefully reviewed their and their
families’ insurance policies. Interestingly,
only one out of ten people answered in
the affirmative. Saud bin Sulaiman AlHelo Al-Sharif said he recently reviewed
his insurance policy. “All paragraphs and
provisions of my insurance policy are
clear and direct to the point. The only
problem is the delay that occurs in getting
approval for some medical treatments
even when they have all the required
documents,” he said.
Al-Sharif believes that certain diseases
should be included in insurance policies.
“Patients suffering from kidney failure, for
example, should have all the necessary
tests and treatments covered in their
insurance policy,” he said.
The Uniformed Majority
The rest of the group comprising of nine
members (90 percent) of the surveyed
people, stated that they had not reviewed
their insurance policy. Sobhi Awad,
Jordanian national, said: “I am not even
aware of the existence of an insurance
policy; I think my insurance company
covers all diseases and I have never had
a problem when it comes to requesting a
treatment for any disease.”
He added: “It should be noted that
most insured employees do not have
the documents that entitle them to take
advantage of insurance services, and
usually, they do not know the details of
their insurance policy.”
Amer Sufian Al-Saud explains his point
of view saying: “So far I didn’t face any
The lack of
awareness of
all the involved
parties is the
reason behind this
uncertainty
problem with my insurance policy, so I
didn’t need to review it. Moreover, the
approval process has been easy and took
no time.”
Abdul Majeed Sharaf Al-Din, a Sudanese
national said: “I agree that insurers should
be aware of their insurance policy and
the benefits included. The only glitch
for me is the delay that occurs when
requesting approvals for some tests and
treatments. Moreover, the percentage we
pay for insurance companies is huge and
the insurance company must pay for all
services without any trouble.”
Agreeing with Al-Din, Ali Al-Maliki
said: “Not being able to review or read our
insurance policy causes many problems.
For example, I had pain in my knee, and
when my doctor prescribed some tests, my
insurance company approved the X-ray
test and refused to pay for the other tests,
and so I ended up paying for those. It is
ironic that some hospitals take 20 percent,
while others do not, I wonder what is the
reason or logic behind this cut.”
Mohamed Jaber Al-Shaer, a Saudi
national who has a long-term experience
in the field of health insurance, says: “The
lack of knowledge of the insurance policy
hardly constitutes any problem for me or
my friends. Most of our problems are not
related to insurance policies, but come
from the delay in approving treatments,
which may take a lot of time in some cases
depending on the insurance company.”
“I would like to thank the Council of
Cooperative Health Insurance, which
has spared no effort to organize, control
Almost 90 percent
of the surveyed
people stated
that they had not
reviewed their
insurance policy.
and follow-up minute per minute the
happenings in the insurance market in
Saudi Arabia.”
Egyptian national Mohammed Hamid
seconds Al-Shaer’s views, stressing that there
is no urgent need to review the insurance
policy. “There are regulation authorities
that are responsible for preserving the rights
of all insurance parties. My only issue with
health insurance companies is the delay
and waiting for getting an approval. I do
not think all the diseases are covered by
my insurance policy.”
Another Egyptian national, Munir Ezzat,
who was accompanied with his wife,
said that his company does not show the
employees their insurance policy as is the
case with most insurance companies in
the Kingdom. “These details are discussed
between the insurance company and the
employer. Presently, my wife and I are still
waiting for the approval of our insurance
company to conduct some tests.”
Ahmed Sheikh El-Din Ahmad, a
Sudanese national, said: “All parties
should be aware of the insurance policy:
their rights, duties and conditions, this is
certainly very useful and helpful. More
importantly, insurance companies must
solve the problems of delays so that
the service becomes better and more
acceptable.”
Sharif Helmy, marketing and PR officer
at the Green Crescent Hospital in Riyadh,
comments on the difference between the
insured and the insurance companies.
“The health insurance system is still new,
and we need to educate the community
about it. Moreover, some of the terms of
the insurance policy are ambiguous to
some participants, so we need to make
things clearer to all,” he said.
The Conclusion
Based on the survey it can be safely
concluded that majority of the insurers do
not bother to learn about their insurance
policy. All they care about is getting their
insurance card, almost believing that
owning the card itself is enough to solve
all problems. Almost all the surveyed
people agreed that the main problem is
related to the delay in obtaining approvals
for medical tests/ treatments or operations.
The concerned authorities, including the
Council of Cooperative Health Insurance,
should continually keep an eye on the
work of the insurance companies.
COOPERATIVE HEALTH INSURANCE
61
Insurance Forum
Insurance Forum
Is it necessary that an employment contract specifies health
insurance for an employee or should the employer provide
health coverage to employees irrespective of that being
mentioned in the contract?
Hamad Al-Shahri – Jeddah
The employer is required to cover all his employees and
their dependents as per the contract of employment, whether
that contract specifies the right for health coverage or not.
Does the health insurance system cover injuries during
work?
Ahmed Basmir– Jeddah
Injuries during work are subject to workers and social
insurance systems.
Does the insured have the right to upgrade his/her
healthcare without preapproved transfer?
Saeed Al-Qahtani – Al Baha
Does the health insurance system apply to large companies
such as Aramco and SABIC
Sami Al-Hajri – Dammam
The system includes all employers in the Kingdom of Saudi
Arabia.
Which authority is responsible for the cancelation of
insurance policies, and how is it done?
Saad Al-Dosari – Riyadh
The employer, the insurance company and the service
provider can cancel any insurance policies, but they should
inform the other party in writing at least one month from the
date of cancellation. They should be able to provide a valid
insurance coverage the following day of the cancellation of
the policy.
Which authority grants licenses and rehabilitation to health
insurance companies?
The insured is entitled to upgrade to a higher level of
healthcare without transfer, but he will borne the cost
differential of the medical examination.
Is the cooperative health insurance policy comprehensive;
does it cover all health services without exception?
Maha Al-Ruwaili – Hail
The cooperative health insurance policy explains the benefits
and exclusions. The health benefits include the following:
A - All expenses of medical examination, diagnosis,
treatment and medicines, according to the policy.
B - All hospitalization expenses including surgery, treatment
per day and childbirth
C- Treatment of diseases of the teeth and gums
D - Preventive measures specified by the Ministry of Health
such as vaccinations, maternity care and childhood.
2- The expenses of repatriation of the insured person’s body
to his native country
Suad Hassan – Riyadh
The authority responsible for licensing is the Saudi Arabian
Monetary Agency, and the authority responsible for
rehabilitation is the Cooperative Health Insurance Council.
What is the role of the Cooperative Health Insurance
Council with regard to the settlement of disputes and
disagreements between the insurance parties?
Hassan Al-Shammari – Tabuk
Dear Reader,
As in previous issue, we are glad to dedicate this section, “Insurance Forum,” to you. In this
section, we welcome all opinions, constructive suggestions, concerns and questions about
the magazine, the cooperative health insurance sector and the topics we cover in each issue.
After receiving your comments, we will direct them to the officials and specialists in the
insurance sector to give you the correct and most appropriate answers.
62
Safar 1432 | January 2011
There is a committee or more formed by the President of the
Council of Cooperative Health Insurance that is responsible
for solving disagreements and identifying the violations of
the provisions of the insurance system rules. The President
of the Council shall sign the proposed appropriate penalty.
However, the affected parties can appeal against this
decision to the Board of Grievances.
Can an insurance company disclose the name of the insured
after applying for a claim?
Ali Anzi – Riyadh
The health insurance company is entitled to disclose the
insured after applying for claims at any authorized service
center within the insurance network. However, that is done
for only two times, within 60 days from the date of receipt of
the claim.
Does the health insurance system cover pilgrims and
Umrah performers?
Khaled Al-Akkad – Makkah
The cooperative health insurance system does not mention
insurance for Hajj or Umrah pilgrims.
Does the health insurance system cover certain groups such
as pensioners, elderly and students, free of charge?
Solomon Al-Assa’edi – Taif
The cooperative health insurance system aims to provide
basic health service for non-Saudis residents; it also covers
Saudi nationals who work in the private sector.
Does the health insurance system provide healthcare
services for the poor and unemployed, who cannot afford
to pay for an insurance policy, such as the system of
(Medicaid) in America and Canada?
Mutleq Al-Zafire – Riyadh
The cooperative health insurance system provides health
services to non-Saudi residents (and their family members),
who have come to work in the Kingdom. The system also
requires the employer to apply, for their benefit, for the
cooperative health insurance. The right of Saudi nationals to
healthcare and treatment is guaranteed by the state.
COOPERATIVE HEALTH INSURANCE
63
Break
Funny story:
Poem by Elia Abu Madi:
Stay optimistic even if your days are dire
Be a joyful soul even if others do not like
it
Life has given you all its treasures
So do not be mean to it
Be good even if you are faced with
difficult situations
Who cares about results or appreciation?
Look at the flowers; who will reward
them for their gorgeous scent?
Look at that bird, is he singing for
appreciation or to enjoy himself?
Count the number of good souls and
learn from them
The important things in life
Love and generosity
Love taught me valuable things
If the flower did not allow its scents to
reach us all
If the bird didn’t sing
Our life would be different and dreadful
So if you want to be happy
Make people happy
*****
Refresh the feeling of love in you if it is
asleep
If not for love, people would be puppets
With love, a small house can become a
palace But hate can make the whole world a
prison
Love the desert, and see how its sand
blooms
And how its sky rains
If you hate its sands and don’t understand
it
The desert will never tell you its secrets
Beauty is only for those who appreciate
beauty
While others cannot tell the difference
Do not you seek love from the ignorant
Love only comes with understanding
Deal with stupidity as if it is a sickness At the end, ignorance is worse than
blindness
Enjoy the beauty of the roses and forget
about thorns
And when the nature opens its heart for
you
Forget about the scorpions
Some thieves entered the house of Abu Said and took all his belongings. When they left,
Abu Said followed them carrying some of the things they left. They asked him, “what is
wrong with you, what do you want?” He said: “You did not keep anything in my house, so
I decided to come and live with you.” They laughed with him, and returned all the things
they stole.
Arabic proverb:
‘Came back with Hunain's shoes’ means ‘to returned empty-handed’
Story: During the Abbasid period in Baghdad, a Bedouin bargained with a Jewish
shoemaker named Hunain over a pair of shoes. After a long discussion, the Bedouin
did not buy them – something that infuriated Hunain – and he decided to take
revenge. He went to the road the Bedouin would pass by and threw a shoe on the
road, and threw another one at a distance of some meters. He hid, waiting for the
Bedouin to come.
The wonders of the Holy Qur'an:
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
It mentions the word “life” 115 times and the word “afterlife” 115 times.
It mentions the word “angels” 88 times and the word “demons” 88 times.
It mentions the word “people” 50 times and the word “prophets” 50 times.
It mentions the word “honesty” 50 times and the word “dishonesty” 50 times.
It mentions the word “Satan” 11 times and mentions how to seek refuge from Satan
11 times.
It mentions the word “Muslims” 41 times and the word “Jihad” 41 times.
It mentions the word “Zakat” 88 times and the word “Baraka” or “blessing” 88
times.
It mentions the word “Mohammed” 4 times and the word “Shariah” 4 times.
It mentions the word “woman” 24 times and the word “man” 24 times.
It mentions the word “life” 145 times and the word “death” 145 times.
It mentions the word “good” 167 times and the word “bad” 167 times.
It mentions the word “ease” 36 times and the word “difficulty” 12 times.
It mentions the word “moral” 6 times and the word “immoral” 3 times.
It mentions the word “loud” 16 times and the word “publicity” 16 times.
It mentions the word “love” 83 times and the word “obedience” 83 times.
It mentions the word “guidance” 79 times and the word “mercy” 79 times.
It mentions the word “peace” 50 times and the word “good things” 50 times.
It mentions the word “hardship” 102 times and the word “patience” 102 times.
It mentions the word “calamity” 75 times and the word “gratitude” 75 times.
It mentions the word “penalty” 117 times and the word “forgiveness” 234 times.
When the Bedouin passed by the road, he saw the shoe and said to himself, “This
looks like Hunain’s shoe, but the other one is missing, otherwise I would have taken
it.” He kept walking when spotted the second shoe. He regretted that he did not take
the first shoe. He tied his camel to a tree, and went back to look for it. At that point,
Hunain emerged from his hiding place, and ran away with the camel. The Bedouin
returned home without his camel, but with Hunain’s shoes.
Did you know?
•
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•
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•
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•
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•
•
•
•
•
The laser beam is four times
stronger than the sunlight.
The camel does not forget those
who treat him badly
The French expedition to Mexico
lasted for over five years.
The Saragaso Sea has no beaches as
it lies within the Atlantic Ocean.
The ancient Egyptian obelisk was
made from a stone column with
four sides and a small pyramid on
the top.
Alexander the Great died in
Babylon.
The dolphin is the smartest among
mammals.
Pigeons had a special department in
the Abbasid era.
The Chinese emperor who built the
Great Wall of China is Huang T.
Arabic poetry has 16 rhythms.
Gold Pendants are poems or poetry
from the pre-Islamic period written
on gold leafs.
The ancient Arabs named “gold” the
“buzzing yellow”.
Karun was famous in ancient history
for turning dirt into gold.
Gold is weighed in grams, and
diamond in carat.
Emerald has another name
“Aquamarine”.
The fly flutters its wings about 32
times per second.
Quote:
Success is not a gift; it can only be achieved by sacrifices and hard work.
64
Safar 1432 | January 2011
COOPERATIVE HEALTH INSURANCE
65
Opinion
REINSURANCE
We meet again
A recent talk show hosted by Alarabiya TV station discussed health insurance
in the Kingdom, inviting a group of insiders from the Saudi health sector who
spoke about the health coverage and the health system in the country. The
idea of the program was good especially because it sheds light on one of
the main concerns of the citizens and residents of our country – the health
insurance, the extent of medical coverage and quality of services.
At the end of the program, I tried to evaluate what I had heard and seen,
trying to be as neutral as possible, thinking from the point of view of an
ordinary viewer. I realized that the program did not offer anything new – the
questions by the presenter were poorly prepared, inaccurate and unclear. Not
only did the program not offer any solutions or fresh ideas, but the information
that was given by the guests, unfortunately, was inaccurate and sometimes
misleading.
In fact, the conversation that took place in the program was not in line
with the level of the subject at all. I do not think that anyone who watched
the program must have received any useful information or had a clearer
perception. Therefore, the program and its conductors failed miserably in
reaching their goal.
I am not trying to evaluate or criticize anyone. However, I have a question:
As long as it is an important subject, do we not have the right to listen and
see the concerns discussed transparently and clearly? Otherwise, what is the
benefit of such programs and discussions if they achieve nothing?
Unfortunately, when watching non-Arab TV channels or talk shows, we
appreciate the extensive knowledge of the presenter, who picks up his guests
accurately, asks clear questions and insists on clear responses, even if the
program is less than an hour or so. In this case, the program in question ran
for a full hour. In other programs, the viewer always understands what has
been discussed, and what has emerged from the discussion. We cannot help
but value presenters and the people behind the scene for their professionalism
and expertise – something our presenters obviously lack.
I am sure that the main problem was in not preparing for the program
before it started. I personally do not see a problem if the participants of the
program engaged in asking, discussing or debating with specialists, as far
as this will allow the viewer to understand the subject, as he/she is the one
targeted in these programs – actually in all programs.
The program was only about sharing general information, memories, and
other similar details that do not benefit the viewers, especially because most
of the information discussed has been changed or amended recently.
I repeat my point, the ill-informed presenter and the poorly-prepared guests
ruined the program and diminished its objective. I hope that in the future,
when deciding to participate in or presenting a program, all the involved
should be fully-prepared and must keep the viewer in mind before speaking
non-sense.
Indeed, such meetings and discussions are of great help, especially when
it comes to health insurance, in raising awareness and educating the public,
only if the matters are discussed correctly and thoughtfully.
66
Safar 1432 | January 2011
‫ﺍﻟـﻨـﺨـﺒــــــــــــــﺔ‬
‫ﻟﻮﺳـﺎﻃـــﺔ ﺍﻟﺘـﺄﻣﻴــﻦ‬
‫ﻭﺇﻋــــــﺎﺩﺓ ﺍﻟﺘـﺄﻣﻴــﻦ‬
Mohammed bin Salman Al-Hussain
Assistant Secretary General
Financial and Admin Affairs
Council of Cooperative Health Insurance
Our vision
Our main vision is to create an
organisation that will manage, lead
and help the regional insurance
industry in opening its door to the
international reinsurance market
arena and be widely recognized
as a great and exceptional source
and provider of credible and reliable
reinsurance services. We aim to
gain regional recognition as a centre
of excellence in reinsurance and
insurance brokerage services in the
Saudi Arabian market.
Our Customer ..
Our Partner
Kingdom of Saudi Arabia P. O. Box 305488, Riyadh Phone: 920007474
Customer service: 1130 - 1120 - 1110 - 5553 Fax: 920007474 Ex. 1222
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