Strategic Advancement in Philippines Healthcare: The PhilCare and Verisk Automated Underwriting Partnership

PhilCare, a prominent Health Maintenance Organization (HMO) in the Philippines, has entered into a strategic partnership with Verisk Life, Health and Travel to implement automated health underwriting. By integrating Verisk’s Health Risk Rating Tool into its online application process, PhilCare becomes the first HMO in the Philippines to deploy this technology at scale.

"Healthcare decisions shouldn’t feel complicated or uncertain. Through our partnership with Verisk, we’re removing friction from the insurance journey — making health coverage faster, fairer, and more accessible." — Jaeger Tanco, President & CEO of PhilCare

"This technology allows us to grow responsibly. We can expand coverage while maintaining sustainable pricing, so customers can trust that PhilCare will be here for them not just today, but in the long run." — Abigail Garcia Lising, Head of Business Development at PhilCare

"PhilCare’s adoption demonstrates how innovation can drive both commercial performance and social impact. By enabling instant underwriting, insurers can reach more customers and help people live life with confidence." — Jeff Cook, Head of Life at Verisk Life, Health and Travel

The initiative aims to modernize the traditional, manual-heavy insurance landscape by providing instant, clinically robust risk assessments. This shift is designed to eliminate the friction of long waiting periods, provide transparent pricing, and significantly expand coverage for individuals with pre-existing conditions. Beyond customer convenience, the partnership is positioned as a means to ensure long-term business sustainability and reinforce PhilCare's status as a digital-first leader in the healthcare sector.

Overview of the Partnership

The collaboration bridges the local market expertise of PhilCare with the global medical risk rating capabilities of Verisk. This partnership is specifically focused on the digital transformation of the underwriting journey, moving away from historical reliance on manual reviews which have traditionally slowed application processes and restricted market access.

Key Entities Involved

Technological Implementation: Verisk Health Risk Rating Tool

The core of this initiative is the deployment of Verisk’s Health Risk Rating Tool. This technology allows for an immediate assessment of health risks based on lifestyle and medical data provided by applicants during the online insurance process.

• Global Scale and Reliability: The tool is utilized by insurers worldwide, performing over 40 million medical risk ratings every year.
• Clinical Foundation: The system is built upon more than 25 years of global medical underwriting expertise, ensuring that automated decisions remain clinically robust.
• Operational Efficiency: By automating the risk assessment process, PhilCare can deliver instant decisions, a significant departure from the "test of patience" associated with traditional manual underwriting.

Impact on Customer Experience and Inclusion

The transition to automated underwriting directly addresses major pain points for Filipino insurance seekers, particularly those who have historically struggled to secure coverage.

Key Benefits for Applicants

• Elimination of Wait Times: Customers no longer face long delays for underwriting results; decisions are rendered instantly.
• Pricing Transparency: The automated system removes "guesswork," providing customers with clearer and more predictable pricing structures.
• Greater Accessibility: The technology enables PhilCare to offer coverage to individuals with multiple pre-existing conditions—a demographic that previously found insurance difficult or impossible to obtain.
• Reduced Friction: The overall insurance journey is simplified, making healthcare decisions less complicated and uncertain.

Strategic and Commercial Objectives

For PhilCare, the adoption of Verisk’s technology serves both commercial performance and social impact goals.

• Responsible Growth: The technology allows the HMO to expand its coverage reach while maintaining sustainable pricing models.
• Digital Leadership: Implementing this tool at scale strengthens PhilCare’s position as a digital leader in the Philippine healthcare market.
• Long-Term Stability: By utilizing data-driven assessments, PhilCare aims to ensure it remains a stable provider for its customers in the long run.
• Market Innovation: As the first HMO in the country to adopt such a system at scale, PhilCare is setting a new standard for how technology can make insurance "simpler, faster, and more human."