MetLife Accused of Misconduct: Running Health Business Under the Name of Insurance, Upgrading App Without Informing the Regulator

Kathmandu – MetLife Nepal has introduced a new update to its “One by MetLife” mobile app, allegedly acting against the principles of insurance. Without informing the regulatory body, the Nepal Insurance Authority, the company added a health risk assessment feature that measures blood sugar levels through the app, which operates in the health sector under the pretext of insurance.

The Authority has also acknowledged that the app was upgraded without prior information to the regulator.

According to an official from the Authority, the company has been ignoring directives issued to all insurance companies, claiming to operate only as a foreign branch office.

The app now includes a health risk assessment feature related to blood sugar levels. Only 5% of its services relate to insurance, while 95% are focused on health services. Despite this, the Insurance Authority has remained silent.

Even though MetLife is promoting health services under an insurance license, the regulatory body has not taken action. Insurance experts have openly criticized this issue.

Although irregularities were found during field supervision by the Authority, senior officials have remained silent. Some have described this as possible collusion between insurance officials and higher-level employees.

This allegedly illegal activity is being carried out through the “One by MetLife” mobile app. Insurance expert Rabindra Ghimire has stated that such actions are against the principles of insurance.

He emphasized that using the cover of insurance to operate health services through the “One by MetLife Nepal” app contradicts insurance principles and requires regulatory attention.

He further stated that the Authority must monitor companies to ensure they operate within the scope defined by the Insurance Act.

MetLife, which has been operating in Nepal since 2001 as a branch of the American life insurance company, formerly ALICO, has been indirectly conducting business through a health-related app that goes beyond what is defined in the Insurance Act 2022.

Through the “One by MetLife Nepal” app, the company is allegedly engaging in activities that violate insurance principles and laws. The app currently provides services such as medicine delivery, ambulance dispatch, and doctor availability, essentially acting as a health service provider while bypassing government oversight.

Although the company has been providing insurance services for 24 years, it has reportedly been offering health services under the guise of insurance for the past two years.

Initially, the app was approved by the Insurance Authority as a service for insured clients. It is alleged that the then-chairman Surya Prasad Silwal approved it through improper arrangements, despite legal provisions restricting such activities.

Currently, the “One” app, operated from MetLife’s central office in Pulchowk, shows little indication of insurance-related services and continues focusing on non-insurance features. The regulatory body has been ignoring and not monitoring the app.

The app appears to focus more on non-insurance services. Without being affiliated with a healthcare institution, the company is actively providing health services through insurance mechanisms.

The app’s “360 Health” feature integrates health services with digital insurance services.

Users of this feature can monitor heart rate, blood pressure, and other health data, along with AI-driven health risk assessments.

It also provides services such as appointment booking, home testing, ambulance services, virtual doctor consultations, and second opinions from international experts. The company is openly promoting these services even to non-customers.

With the launch of “One by MetLife” and “360 Health,” the company aims to revolutionize customer service and provide easy access to quality healthcare services across the country through a single app. However, insurance services appear to be given minimal priority.

So far, the app has been downloaded by 261,000 users, with 71,500 registered users. Among them, only 44,500 are insured clients.

This data clearly shows that the app is more focused on health services than insurance.

Out of 261,000 users, about 217,000 are non-insured individuals using the service.

An official from the Insurance Authority admitted that the app has recently been operating against insurance principles, as it provides services not only to policyholders but also to non-policyholders.