الهيئة العامة للرقابة المالية

Dr. Islam Azzam – FRA Chairman:

• Approving diverse products to stimulate the market, meet client needs, attract investment, and foster competition.
• Regulating and governing healthcare activities will directly enhance the quality of services.
• Sustaining ongoing dialogue with key players across the insurance sector and the broader non-banking financial industry.

Dr. Islam Azzam, FRA Chairman reaffirmed the Authority’s commitment to the strategic development of the medical insurance and healthcare sector. This mandate serves as a cornerstone of FRA’s agenda following the enactment of the Unified Insurance Law No. 155 of 2024.  For the first time, this legislation formally regulates and integrates Third-Party Administrators (TPAs) into Egypt’s broader non-banking financial services (NBFS) ecosystem.

These remarks were delivered during an expansive meeting convened by FRA Chairman with representatives from Third-Party Administrators (TPAs), attended by senior FRA leaders and specialized department Heads. This session is part of a sustained consultative series designed to foster direct engagement with regulated entities, enabling the Authority to gauge market sentiment and assess the real-world impact of recent regulatory implementations.

In accordance with the Unified Insurance Law, TPAs are required to register in a dedicated ledger, with their operations strictly limited to administrative services. The legislation empowers these firms to manage self-funded healthcare programs on behalf of institutional clients and employers, provided that the client retains full liability for the settlement of all medical service costs.

During the session, Dr. Azzam provided a platform for industry leaders to present strategic proposals, fostering an open dialogue on sector stability. He underscored the critical importance of this sector to millions of Egyptians, emphasizing that protecting policyholder rights and adhering to legal mandates are non-negotiable requirements for securing licenses and maintaining regulatory compliance.

The Chairman further noted that FRA is actively approving a diverse array of innovative insurance products designed to revitalize the market. By fostering a competitive environment and attracting foreign investment, the Authority aims to bolster global confidence in the Egyptian medical insurance market. This is being achieved through the rigorous application of governance standards and the integration of advanced financial technology (FinTech) to enhance the quality of care for all beneficiaries.

To date, FRA has granted provisional licenses to six companies, with several additional applications currently under review. In accordance with Board Resolution No. 229 of 2025, all active firms must regularize their status and meet specified regulatory standards by July 10, 2026. This deadline ensures a structured transition to the new legal framework, though FRA Board retains the authority to grant extensions if necessary.

Dr. Azzam emphasized that TPAs – acting as the vital link between insurers, healthcare providers, and beneficiaries – must maintain absolute neutrality and precision in claims processing. He mandated the implementation of robust internal controls and risk assessment frameworks, including rigorous auditing before claims are submitted to insurers. Furthermore, he highlighted the paramount importance of data privacy, strictly prohibiting the disclosure of client information without explicit consent or a formal judicial order.

The new framework places a great emphasis on corporate governance. TPAs are now required to hold an Annual General Assembly Meeting within three months of the fiscal year-end and prepare financial disclosures in accordance with Egyptian Accounting Standards. These reports must be submitted to FRA for review one month prior to the Meeting, supported by a report from an auditor listed under Category I or Category II (A) within FRA’s registries.

To eliminate potential conflicts of interest, the law outlines clear prohibitions for TPAs. Specifically, they are barred from selling, marketing, or brokering insurance policies, and they may not engage in direct underwriting. Additionally, firms are prohibited from retaining any portion of claims settlements – all excess funds must be returned to the insurer – and administrative fees cannot be calculated as a percentage of the claims value.

Companies are further required to establish a Conflict of Interest Policy for board members and employees. This mandate is designed to reinforce the principles of integrity and transparency, while institutionalizing accountability for any actions or practices that may lead to a conflict of interest.