Spanish startup Elma gets $3.2M for a digital-first health insurance play

Insurtech startup Elma has closed a €3 million (~$3.2M) Series A funding round led by Mangrove Capital partners to build out a digital-first health insurance business starting with Spain, its domestic market.

Also investing in the Series A are a number of unnamed local investors focused on the healthcare space, along with Barcelona-based investor and company builder Antai Venture Builder (AVB), Arroba Capital, and US VC Joyance Capital Partners. 

Elma’s co-founders — Miguel Ángel Antón (CEO), Albert Malagarriga (CPO), and Miguel Vicente and Gerard Olivé (also co-founders of its investor, AVB) — have a background in digital industries and startups, building “user centric experiences”, as Antón puts it.

Healthcare experience in the founding team comes via the COO who we’re told spent 12 years at a C-level position at one of the largest health insurers in Spain (now owned by Bupa). Elma also has a chief medical officer — who Antón touts as bringing a wealth of experience in “digital care”.

Since 2017 the team has been building a number of digital healthcare tools that can be accessed via an app. The idea is to entice subscribers to Elma’s healthcare cover with the promise of tech-enabled convenience and a shorter wait time vs Spain’s (free) public healthcare service for remote chats with doctors.

It’s also hoping to disrupt legacy health insurance giants by offering slicker digital tools and services.

“Few companies or entities have had the opportunity to think about patient journeys and build and articulate a product that optimizes healthcare outcomes while controlling costs,” argues Antón. “We believe insurers have a privileged position to do that, yet they seem to have little incentive to innovate and adopt digital tools to make it happen given their legacy. We want to build a digital health subscription to better healthier, that includes insurance and is (finally) user centric.”

Among the tools Elma will offer subscribers initially is a telehealth service that lets members talk to a doctor via video call and chat, providing remote primary care and digital prescription (it has a team of seven doctors to serve that from launch) — and a doctor search engine for finding a medical professional to deal with a specific condition (it has a pool of 23,000 doctors in Spain for in-person healthcare).

“We are currently working on a booking feature and integration with test providers to make getting blood tests, scans and so on much easier and interconnected,” adds Antón.

“We are one of the few insurers that provide a full online, comprehensive quoting system for people to understand our products and buy entirely online. These are just a few features that we are releasing with, but our vision is to pursue the digitalization of the industry to fulfil our mission. Prevention, promotion of good habits, digital therapies, are coming up next.” 

On the prevention front, this being an insurtech startup, Elma’s roadmap includes linking insurance premiums to healthier lifestyles — via some form of behavior tracking.

“Healthier people should benefit from their good habits and we are already testing tools that identify people’s habits,” Antón confirms, adding: “Other features in our roadmap for next year are integration with wearables, care plans, skin prevention plans, etc.”

The team will be launching its first health insurance product in Spain next month.

Its website already lists pricing for a range of plans “con copago” (which means there’s a monthly fee to pay for the insurance cover plus an additional fee when you access healthcare services).

“We will have a full “sin copago” product in two weeks but we are believers of insurance with copayment,” Antón tells TechCrunch. “Being healthy makes you reduce visits to the doctor so you can keep your premium low and pay per use which will be best for our customers. We really love copayments…. Best way to pay less.”

The Series A will be put towards scaling in Spain, which is the firm focus for Elma for the foreseeable future given a large addressable local market.

Some 10M+ people (~23% of the population) pay for healthcare, according to Antón, who says this is on account of long wait time for the free public service. A majority of those (60%) pay for health insurance via their employer — so Elma is focusing on selling in to corporates to provide cover for their staff.

“We have an agreement with [insurance broker] Willis Towers Watson who will allow us to quote the most relevant companies in Spain,” he says, adding that it’s already signed agreements with listed companies  (such as Masmovil, Red Electrica Española); startups (eCooltra); and state owned companies (Ferrocarrils de la Generalitat).

“Healthcare is very country specific, that’s why its really hard to scale this type of company [to other markets]. So far we want to concentrate in Spain. The market here is huge, growing 5%-7% a year and needs a lot of digitalization,” he adds.

“We want to became leader in our market. In the future we will look for markets where our product fits the best, and it may be countries with or without a strong public health system. What we believe is true is if we make it here, where we are competing with an excellent service which is for free (Spanish public healthcare system), we can probably make it anywhere.”

In terms of app-focused competition, on Elma’s home turf there’s MediQuo, another Barcelona-based startup that promises to put a doctor in your pocket — via an app where users can chat to a medical “amigo”. While it’s not a fully fledged health insurance play pricing is low enough that users could combine it with legacy health insurance elsewhere — augmenting their usual cover with an up-to-date app supplement.