The insurance and reinsurance sector in the Middle East is undergoing a transformative phase driven by several interconnected factors, most notably accelerated population growth, rapid urban expansion, large-scale infrastructure and energy projects, and regulatory reforms introduced by supervisory authorities across several Gulf Cooperation Council (GCC) countries.
In this context, Al Morakeb magazine conducted an in-depth interview with Ashraf Al Azzouni, Managing Director of RGA in the Middle East. The conversation addressed the current state of reinsurance in the region, the growing interest in establishing local reinsurance companies, the future of life and health insurance, and RGA’s evolving regional and global role amid economic and geopolitical change.
Looking at the broader picture over the past decade, we see insurance premiums in the region expanding significantly and rapidly (Figure 1). This growth has created a natural capacity gap and unlocked substantial opportunities for reinsurance companies. Population growth and urban development in countries like the UAE and Saudi Arabia have directly influenced all insurance lines – general, health, and life. Health insurance, in particular, has been the fastest-growing segment, driven by mandatory coverage regulations and rising population figures.
When we consider market size, we are talking about billions of dollars in reinsurance premiums that historically flowed abroad. It is only natural that investors today are exploring the establishment of local reinsurance companies to retain part of these premiums instead of exporting them entirely to global markets.
Without a doubt, Saudi Arabia is experiencing unprecedented momentum in infrastructure development, urban expansion, and renewable and sustainable energy projects. This economic transformation is accompanied by simultaneous population and urban growth, naturally resulting in strong demand for insurance and reinsurance.
Opportunities exist across the GCC, but Saudi Arabia – being the region’s largest economy – has clearly become a primary driver of growth.
Health insurance grows organically because it is directly linked to population growth and mandatory regulations. In the UAE, for example, the population now exceeds 11 million, all of whom must be covered under compulsory health insurance, an automatic source of growth.
A similar trend exists across the region. Qatar, Bahrain, and Oman are in advanced phases of deployment, and Saudi Arabia is gradually moving toward privatizing health coverage for citizens. We are talking about more than 20 million individuals who may enter the system in the coming years.
Life insurance, however, operates differently. Its growth depends more on financial awareness and distribution channels. Historically, distribution, especially through banks, focused more on investment-linked products rather than protection.
Yes, to a large extent. Bancassurance channels prefer investment products because they are easier to market; anyone with available liquidity seeks investment opportunities. By contrast, discussing death, protection, and securing the financial future of dependents is culturally sensitive and requires thoughtful framing within a broader financial planning context.
However, this is changing gradually. As family businesses, small and medium enterprises (SMEs), and wealth-transfer needs evolve, life insurance is becoming an essential tool rather than an optional add-on.
Most businesses in the region are owned by one, two, or three partners. The loss of a founder or key shareholder can threaten the continuity of the entire business, one of the major challenges facing family enterprises as well.
Life insurance plays a critical role in financial and succession planning. It is not merely an individual protection product; it is a strategic instrument that facilitates business continuity and smooth intergenerational transfer of wealth and ownership.
I am confident that this shift is only a matter of time, and significant growth in this field will become evident in the coming years.
2025 was a very positive year. We achieved excellent results in terms of profitability and premium growth, despite 2024 being an exceptional year with unusually strong expansion that made year-on-year comparison more challenging.
Nevertheless, we succeeded in growing beyond 2024 levels, aligned with our strategic plan, while maintaining a strong focus on profitability.
Our strategy has not fundamentally changed, but it has evolved. After strengthening our presence in life insurance in recent years, we moved more decisively into the health insurance space due to its rapid expansion.
We have also expanded our involvement in TPA-related services supported by strong technology infrastructure and continue to gradually evolve this capability. We believe technology is essential, but growing too quickly without a solid foundation entails significant risk.
The most notable development was the rollout of regulations and RFPs preceding mandatory health insurance in Qatar, Bahrain, and Oman – each progressing at its own pace, yet all moving in the same direction.
At the same time, geopolitical instability in the region remains a key factor necessitating caution in risk-management decisions. Geopolitics continues to introduce uncertainty, affecting investment behavior and risk appetite.
In 2025, RGA experienced strong global growth, highlighted by a landmark transaction in the U.S. with subsidiaries of Equitable Holdings, Inc. – the largest deal of its kind in the history of reinsurance. It was not only a major commercial agreement but also a strategic milestone that strengthened RGA’s position as one of the world's leading life and health reinsurers.
This momentum contributed to increasing the group’s assets under management to nearly USD $135 billion, signaling RGA’s transition to a new phase in terms of scale and capability to assume complex risks. This aligns with a clear strategy centered on biometric risk transfer coupled with robust asset management capabilities.
While the U.S. continues to be the largest contributor to RGA’s business – as one of the world’s largest life insurance markets – its relative share has shifted in favor of growing international markets. This diversification enables RGA to achieve sustainable expansion, reduce geographic concentration risk, and tap into emerging opportunities across regions, including the Middle East.
In this sense, 2025 was not just another year of growth for RGA; it was a pivotal milestone that reinforced the company’s position as a global leader in life and health reinsurance.
Contact us today to learn more about how RGA can help your business capitalize on the expanding opportunities in the Middle East.
