In 2024, a.s.r. was the sixth largest provider of health insurance in the Netherlands, based on the number of customers, with a market share of 3.5%1 (2023: 4.3%). The four largest insurers had a joint market share of 85% (2023: 84%). a.s.r. offered health insurance under the brand a.s.r. and the label 'Ik kies zelf van a.s.r.'.
The combined ratio of Health remained approximately stable at 99.1% (2023: 98.9%).
(in %)
Markets
Two types of products are offered on the Dutch health insurance market: basic cover and supplementary cover. In the highly regulated healthcare market, all Dutch citizens are required to obtain basic health insurance based on an annual contract. The government determines the content of the basic cover, but the insurer can introduce certain variations to differentiate their products. Variation can be introduced in how claims are processed and the number of contracted medical providers whose treatment is eligible for cover.
Insurers are obliged to accept anyone who is legally required to obtain basic health cover as a policyholder. A state-managed risk equalisation system protects an insurer in case its customer base typically shows behaviour that is detrimental to its health situation, leading to higher costs for the insurer, and therefore balances risks across the industry. The compensation paid to insurers depends on the anticipated costs, based on the characteristics of their customer base. This risk equalisation system is constantly being adjusted.
In 2024, the number of policyholders that switched to another health insurer was the second highest since the introduction of the Health Insurance Act in 2006. The highest percentage was in 2023, when 8.5% switched; in 2024, 7.4% switched health insurer. Unlike basic health insurance, supplementary health cover is not compulsory. The number of insured people who choose supplementary insurance continues to decline. In 2024, 81.5% of policyholders on the Dutch market opted for supplementary health insurance (2023: 82.5%). Within a.s.r., the number of policyholders opting for supplementary health cover remained stable 96.2% in 2024 (2023: 96.3%).
Products
The types of health cover offered in 2024 under the a.s.r. brand and the label ’Ik kies zelf van a.s.r.’ were as follows:
Basic insurance with a broad coverage of medical costs, as prescribed annually by the government. a.s.r. offers three types of basic health cover:
Contracted care policy, in which the insurer remunerates costs directly to contracted care providers.
Non-contracted care policy, in which the customer is reimbursed for medical care payments, including for treatment from non-contracted care providers.
A combination of the two, applied through a combination of both policies.
Supplementary health insurance to cover specific risks not included under basic health insurance, such as the costs of dental treatment, physiotherapy, orthodontic treatment and medical support abroad.
The most popular basic health cover on the Dutch market is the contracted care policy1. At year-end 2024, 78% of total policyholders applied for contracted care policy.
Strategy and achievements
In 2024, the strategic direction of a.s.r. health was confirmed and the multi-year strategy was further completed in response to developments in the market and society, to provide future-proof healthcare, i.e. cover that is and will remain efficient, affordable and accessible. Furthermore, with the current strategic direction a.s.r. aims to maintain a stable customer base, and to refrain from further growth.
Regarding themes within CSRD related to healthcare purchasing, a.s.r. collaborates with other healthcare providers via the Dutch Association of Healthcare Insurers (Zorgverzekeraars Nederland). This way, a.s.r. limits the administrative burden on the healthcare field as much as possible, for this report but also for subsequent years.
a.s.r. health has developed various initiatives to promote future-proof health care, partly by encouraging policyholders to maintain a healthy lifestyle. During 2024, the ’Take care of yourself’ app (Zorg voor jezelf app) has been developed and was launched on January 1st, 2025. With the app, a.s.r. provides an online doctor, a dietician, a mental coach, and healthcare programmes that could contribute to a healthy lifestyle suitable for each individual.
The NPS-c measures customers satisfaction during contact moments, see the results in the graph.
(score: -100 to 100)
With an NPS-c of 42 in 2024 (2023: 35), customer satisfaction within Health improved. The improvement was a result of the change management with continuous focus on improving customer value, including digitalisation initiatives and the use of AI to enlarge customer convenience and satisfaction.
Customer-driven service remains a key element of a.s.r.'s strategy and is thus constantly being improved. a.s.r. Health has made great progress in digitalisation and the use of AI with the digitalisation strategy. a.s.r. Health was the first within a.s.r. to implement a Gen AI driven application called ‘Speech 2 Text’, which transfers phone conversations into written text. Furthermore, a.s.r. Health is also working on a language-help robot (Lingo), a quality measurement robot (Coach), and a Chat-in-app function.
Outlook for 2025
a.s.r. expects customers to remain price-sensitive in 2025 due to the high level of inflation, which persisted throughout 2024. As a result, premiums will again be decisive in the choices made by customers during the premium review season.
In 2025, a.s.r. will continue to take steps to keep health care future-proof in the form of continued accessibility, appropriateness and sustainability.
- 1Source: Vektis Zorgthermometer (2024)
- 2Source: Vektis Zorgthermometer (2024)