PhilCare, one of the country’s leading HMOs, is officially pivoting the local healthcare sector into the digital future. By integrating Verisk’s Health Risk Rating Solution, the HMO giant has successfully implemented a fully automated underwriting system for online health insurance. PhilCare is the only HMO that Verisk has partnered with for this groundbreaking initiative.
The partnership signals a major leap for the domestic insurtech industry. It builds on PhilCare’s long-standing commitment to digital innovation by making health coverage more seamless, responsive, and accessible for Filipinos. With faster application processing and more efficient risk assessment, the integration helps deliver a smoother customer experience while supporting PhilCare’s goal of expanding access to quality healthcare solutions in an increasingly digital landscape.
While the local insurance industry has traditionally relied on manual, time-consuming medical assessments, often resulting in long waiting times, delayed approvals, and limited access for individuals with pre-existing conditions, PhilCare’s new digital ecosystem allows for a real-time risk evaluation during the application process.
“At PhilCare, innovation is the cornerstone of our digital dominance and how we serve our members,” said PhilCare President and CEO Jaeger L. Tanco. “Our partnership with Verisk allows us to modernize the underwriting landscape, elevate the healthcare experience for individuals and families, and firmly establish PhilCare as the most advanced tech enabled leader in the Philippine HMO industry.”
More Accessible, Inclusive, and Sustainable
During a panel discussion on how technology is shaping the insurance industry at the recently held Philippine Insurance Summit 2026, PhilCare Vice President for Business Development and Training Services/Sales Abigail Garcia-Lising explained that PhilCare’s decision to implement Verisk’s Health Risk Rating Solution was driven by changing customer expectations and the company’s commitment to making quality healthcare more accessible and sustainable for Filipinos.
“Our members today expect the same level of speed, convenience, and digital experience that they receive from banking, e-commerce, and other industries. They no longer want to wait days or weeks for a health coverage decision,” she said.
“The partnership enables PhilCare to elevate its underwriting process through faster, more consistent, and data-driven risk assessments, allowing applications to be evaluated more efficiently while maintaining sound risk management principles and ensuring fair and objective decisions.”
PhilCare is now able to deliver faster approvals that respect the customer’s time, more accurate pricing tailored to individual health profiles, and expanded access to coverage for a broader range of Filipinos, including young families, freelancers, self-paying adults, senior dependents, and underserved digital buyers seeking more inclusive and accessible healthcare solutions.
Optimizing Operations and Digital Dominance
Beyond the consumer experience, this transition significantly optimizes PhilCare’s internal operations. The ability to deliver instant, clinically robust risk ratings enables the organization to scale its digital offerings rapidly to support individuals previously underserved by traditional systems while maintaining the profitability and stability of its health portfolios.
“Sustainable healthcare begins with responsible underwriting, striking the right balance among accessibility, affordability, and long-term viability for both members and providers,” Garcia-Lisingsaid.
She noted that automation benefits customers through faster processing, greater consistency, and more objective assessments based on individual circumstances rather than broad assumptions. It also gives applicants hope that even substandard medical cases can be considered through fair and appropriate pricing. At the same time, effective risk management enables HMOs to continue providing comprehensive benefits, invest in preventive healthcare programs, and keep coverage accessible to more people over the long term.
Global Partnership, Local Impact
According to Jeff Cook, Head of Life & Health at Verisk Life,Health and Travel, PhilCare’s adoption demonstrates how digital innovation can drive both commercial performance and significant social impact.
“By enabling instant underwriting, PhilCare is setting a benchmark for the region, showing how data-driven decisions can help more people live life with confidence. This particularly includes people navigating everyday healthcare decisions and seeking more proactive, preventive health journeys.”
As the Philippines continues its rapid digital transformation, PhilCare’s integration of automated underwriting ensures the local HMO industry remains competitive, transparent, and ready for the future, empowering more Filipinos to make confident health decisions with ease and accessibility.
