Briefing: MGA seeks capacity to bust taboos in ‘untapped market’

By editor Katie Scott

MGAs are often hailed as being at the forefront of niche markets and innovation, free of legacy complications and able to act with a pace that makes large insurers green with envy.

Matt Scott, co-founder of Insurance DataLab, explained: “MGAs tend to target niche market because it allows them to offer something different to the traditional insurer market.

“By focusing on a specific niche, they are able to curate specialist underwriting expertise that allows for excellent risk selection and a detailed understanding of their target market – something that a more generalist underwriter is simply not able to do.

“This is not only great for the loss ratio, but also for creating products that are tailor made to the needs of their customers – something that is particularly important under Consumer Duty.

“This specialist focus also allows MGAs to better service customers and brokers, offering fast responses and excellent levels of service because they are experts in that particular field.

“This appeals to insurers and capacity providers as it provides access to new markets that would be otherwise hard to reach, as well as diversification into a specialist area without the need for large investments in data and specialised staff.”

One niche area that has so far been an “untapped market” for insurers is reproductive health, which includes insuring areas such as family planning, polycystic ovary syndrome (PCOS), endometriosis, menopause, low testosterone levels, erectile dysfunction and gender dysphoria.

However, new MGA Juniper is looking to fill this void with a technology driven proposition that is distributed by brokers to organisations as an employee benefit, in a similar model to staff dental insurance policies, for example.

Ambra Zhang, the MGA’s co-founder and chief executive, told me: “It’s innovative. No one has ever underwritten [reproductive health] before. There’s a big tech play. We’re seeing a very interesting angle [as] to how we can disrupt the insurance market from a health insurance perspective.

“[Reproductive health is] a very tricky line to insure because it hasn’t been done before. It’s a taboo topic. People don’t want to speak about it. We really want to take care of it closely with [policyholders].

“That’s a massive missed opportunity for the insurance market.”

Sam Pratt, Juniper’s co-founder, added: “We want people to understand their body and [for] good reproductive health to be thought of in the same way as good nutrition.

“Eight years is the average time for women to get an endometritis diagnosis [in the UK]. And within that time, a lot of people leave their job, they quit entirely. So, people living in pain for ages.

“We want to understand what’s happening with people’s health. We don’t just want to be the insurer that sits on the side. We want to be very much involved in your journey – whatever your goals are, we want to help you get there.”

Claims and cost see-saw

Juniper is still in the early stages of its development. Background work on the MGA started in March 2023, with the company being officially founded in July 2023 after Zhang and Pratt teamed up the month prior in June.

Conversations with investors started in October 2023 and completed in January 2024 – venture capital firm Insurtech Gateway is the MGA’s lead investor, alongside smaller institutional and angel investors. The MGA’s pre-seed funding round raised £1.5m.

Juniper additionally gained its appointed representative status at the beginning of 2024.

Zhang was the driving force behind the business’ creation after being diagnosed with PCOS in 2015. According to the NHS, this condition affects around one in 10 women, with half having no symptoms. The main features of PCOS include irregular periods, an excess of testosterone and ovaries that are polycystic in appearance – this means they are covered in follicles that prevent an egg being released.

She subsequently realised that because PCOS is usually defined as “a chronic condition for health insurers, it’s not covered” in typical health insurance policies.

Equally, the NHS is more “reactive” in its approach to healthcare – according to Zhang – with patients often experiencing long waiting times for appointments.

“For a gynaecological checkup, the waiting time is four months now, which is pretty long. I cannot prepare four months in advance when I need to go see my doctor,” she noted.

Juniper, therefore, has a heavy focus on preventative healthcare, with the MGA actively encouraging claims so that individual policyholders can access specialists in the private health sector in a timely fashion.

She explained: “One thing that’s at the core for us is prevention. Health insurance, as well as all insurance, is not very much a fan of it because it requires capital upfront – it’s a guaranteed loss.

“What we are saying is we don’t mind a higher number of claims coming through. Come in early and get checked up so we can prevent anything or we can stop it when it’s very early on.”

To balance out the costs associated with greater claims volume, Zhang noted that Juniper will maintain “low [to] moderate costs” thanks to tapping into technology. Lower operational costs through the business’ platform, therefore, give the MGA more leeway to pay preventative claims.

“We’ve run the math to make it work,” Zhang said. “A lot of health insurance [does] not like [a] high probability of claims and low costs because it requires a lot of manpower.

“For us, a big piece of [this] is the tech stack and how can we streamline all the processes in the claims side of things.”

Alongside the importance of technology for Juniper is data. Although historic claims data for reproductive health is non-existent, Zhang noted, there are plenty of other sources the MGA has sought to collate in order to inform underwriting – this includes publicly available data, scientific data, medical and clinical records, as well as NHS and medical papers.

Zhang added: “We scrape all of that data and then we sit down with medical advisors. Our team for the pricing engine is pricing consultants as well as medical advisors together.”

It is this combination of data led underwriting paired with technology that Zhang described as Juniper’s unique selling point.

“It’s the insurance piece – data, pricing and underwriting, which hasn’t been done before. And the other piece is the platform and us being able to really be your friends in that journey,” she continued.

“Other insurers are so detached because they don’t want to have any interactions. They don’t want you to claim, they want you to forget about the policy.”

2024 goals

The main ambition for Juniper now is to secure capacity within the next four months so that it can roll out its 12-month proof of concept phase ahead of a full business launch next year. Zhang is exploring capacity options both inside and outside of the Lloyd’s market.

The MGA has big plans to write £14m of premium in the next three years, acting as an add-on to existing health insurance policies by working with a panel of insurers.

In addition, Zhang wants to continue growing her team – currently with six staff, she wants to reach 10 employees in total before the company’s next fundraise in 2025. When we spoke in May 2024, Zhang was in the final stages of recruiting a head of insurance too.

Securing broker partners and potential customers is also on the to-do list. Zhang has two signed letters of intent from possible clientele that are keen to see Juniper’s flexible product set launch.

“Now we’re continuing that sales effort and hoping to secure more so that we can show the carriers there’s [a] real market pool,” she said.

In terms of functionality, as of May 2024, Juniper was developing the third version of its pricing engine. By the end of the year, Pratt predicted that the MGA will have “partial delegation for claims handling” and be “set up from the support side as well”.

Let’s talk taboos

Some readers may be wondering why I have explored this health insurance-related topic that would typically be described as on the fringes on Insurance Times’ property and casualty wheelhouse.

Many of you know that I returned from maternity leave this year after having my son in May 2023.

Less of you know that, like Zhang, I have PCOS. My husband and I therefore had an incredibly fraught, stressful and heart-wrenching 18 months trying to conceive, while being batted from pillar to post by various NHS departments that consistently stereotyped me, referred me to wrong departments and cancelled vital diagnostic tests at the drop of a hat.

For example, I vividly remember my GP referring me to the hospital to discuss my options for family planning. I had a six-month wait for said appointment to then be told by the hospital consultant that I had been referred to the wrong department – but try this diabetes medication anyway, that might work. Fun fact – it didn’t. Instead, it gave me stomach cramps.

In another example, during a telephone GP appointment, the doctor encouraged me to review my diet and exercise regime without asking me a single question about my lifestyle.

I understand why she raised this, as many women with PCOS typically have a high body mass index or diabetes, however – as many of you know – I have a collection of half marathon medals and badminton trophies, as well as a personal training qualification, which indicates that I may not fall into the typical PCOS patient camp.

The saving grace in my personal situation was private healthcare, via a wonderful fertility consultant who performed all blood tests and scans in a matter of weeks, listened to me and provided tailored advice. This led to me taking a supplement, which in turn was pivotal in helping my husband and I to conceive.

At the time, neither of us had health insurance, so we had to pay for the tests that we underwent ourselves.

This may sound like a great deal of information about my personal life, but Zhang’s story showcases that situations like ours are much more common than many people realise – and yet reproductive challenges are still very much a taboo subject.

Even if those experiencing their own health challenges do not want to discuss it openly while they are in the midst of doctor’s appointments, hearing the stories of others and feeling less invisible or isolated along the way is so important.

A proposition such as Juniper’s could have been of great benefit to me and I can really see the value that the MGA could provide. I certainly applaud its efforts to address a taboo area and fill a current protection gap.

I wish Zhang and Pratt all the best in securing the capacity they require to make Juniper’s proof of concept pilot a success.

Who knows, the MGA could end up helping someone just like me – in turn, personal and relatable success stories could help bolster the industry’s reputation and boost engagement with both the general public and potential talent.