Ambledown Financial Services announces new benefits

Johannesburg - At its annual benefit update this year, Ambledown Financial Services will reveal extensions to their product lines for their supporting insurers. 

One important new development is that our claims processes have been streamlined more effectively for providers and members.

“We have eliminated bottlenecks and refined payments to healthcare providers and members. Working with our updated CRM system and new machine learning algorithms, our team settles claims faster than ever without compromising the attention each claim deserves,” says Michael Emery, Marketing Executive at Ambledown. 

“We also have a new virtual assistant coming soon, AmChat, which is built on the Chat GPT engine, to give members and brokers instant answers to their service-related queries,” explains Emery.

“Other benefit updates include an increase for the casualty ward benefit and the co-payment for the use of a non-designated service provider.”

Cancer treatment extensions

A major announcement relating to cancer treatments spells new hope for the growing numbers of cancer patients. Ambledown has extended its cover to include five additional biological cancer medications and selected small molecule cancer drugs. These cutting-edge cancer treatments complement the existing cover for cancer, making Ambledown Gap Cover one of the most comprehensive and progressive coverage solutions in the South African market.

Some of these groundbreaking therapies are already in effect to the benefit of policyholders.

“The extensions covering the new cancer treatments are particularly important as projections show that African mortality rates from cancer are set to double by 2030.”

Cancer mortality rates have doubled over the last 30 years in Sub-Saharan Africa, according to a report from The Lancet Oncology Commission. More than 500 000 people died of this disease in 2020; unless we are able to halt this progression, the annual cancer death toll could hit 1 million by 2030, and the mortality rate could double again by 2040.

The overall incidence is 128.2 per 100 000, exceeding the average of 115.7 per 100 000 people and 108.5 per 100 000 for countries in the low and medium human development index regions globally. Egypt, Nigeria and South Africa (in that order) are the top three countries for cancer cases and deaths on the continent.

Researchers say that factors driving these figures include infection, aging populations, behavioural changes (such as diet, alcohol use and smoking), exposure to environmental triggers, and genetics. Public education programmes can be successful if tackled in the right way, but the sad truth is that Africa looks likely to follow in the footsteps of the developed world, where less healthy but more pampered lifestyles have led to high rates of cancer – 295.3 cases per 100 000 people in very high human development index countries, and 190.5 in countries that fall into the high category.

On the plus side, spending on oncology worldwide is on a strong upward curve. Statista figures indicate that spending on oncology, including supportive care, rose from $61 billion in 2013 to $193 billion in 2022, and is projected to rise to $253 billion in 2024. All of this spending is leading to increasingly effective medical interventions to prevent, ameliorate or cure the disease.

These treatments include:

Nuclear medicine scans (also known nuclear imaging, radionuclide imaging, and nuclear scans) are helping oncologists detect tumours and see the spread of cancer much more effectively and early. Better information is making treatment decisions much more precise. For example, nuclear medicine is helping create tailored treatment plans across multiple disciplines for patients suffering from prostate cancer.

Immunotherapy could be seen as the “good guy” to chemotherapy’s “bad guy”. Chemotherapy kills fast-growing cells everywhere in the body, cancerous and non-cancerous. It’s very much a reactive therapy. By comparison, immunotherapy seeks to boost the body’s own immune system so that it can identify cancer cells better – and then destroy them. Chemotherapy and immunotherapy can be used together, alone, or in combination with other treatments. Chemotherapy has an immediate effect, while immunotherapy can help the body continue attacking the cancer once treatment is concluded.

Hormone and targeted therapy is being used in cases of hormone-sensitive breast cancer. It can reduce the recurrence of these cancers, and greatly reduce their spread. Hormone therapy can be used in conjunction with targeted therapy, medicines that attack specific chemicals in cancer cells.

Photodynamic therapy combines light energy with a drug designed to destroy cancerous and precancerous cells. It is increasingly being used to halt the spread certain types of localised cancers, and improve sufferers’ quality of life.

Finally, stem-cell transplants replace blood-producing cells destroyed by treatments such as chemotherapy and radiation.

The importance of gap cover

Africa’s challenge of rising cancer mortality rates is potentially able to be addressed by the growing numbers of treatments. However, for the majority, they are unaffordable. Even for those who have medical cover, rising costs have created a substantial gap between what the medical aid pays and service providers charge for treatments.

“As its name suggests, gap cover was created to bridge this difference,” Emery points out. “Both medical aids and providers of gap cover are under a strong moral obligation to keep on top of advances in medical treatments and protocols and, after investigation, to add the ones that show promise to their cover. Gap cover is not a medical scheme and the cover is not the same as that of a medical scheme. Gap Cover is not a substitute for medical scheme membership.”

“We are delighted to be leading from the front in this regard.”