If you want to redesign health insurance, you can’t sit on the sidelines. You have to own the whole system. In this episode of Scouting for Growth, Sabine VanderLinden speaks with Roman Rittweger, Founder and CEO of Ottonova, one of Europe’s most ambitious digital health insurers—and a masterclass in what it really takes to build end-to-end innovation in a heavily regulated industry. Roman is unequivocal: health insurance is one of the most complex products you can build. That complexity is precisely why he chose not to remain a service provider to insurers—but to become the insurer himself. Control matters. To truly improve customer outcomes, you must be able to design the tariff, own the relationship from day one, manage the experience end-to-end, and optimise costs for all parties involved. That decision came after 10 years of preparation. Seven years into the journey, Ottonova has grown to 100+ employees, raised over $145M by Series E, and built a fully digital marketplace that allows individuals and self-employed customers to register, manage, and access health insurance seamlessly. In Germany’s traditionally conservative insurance market, that alone is a statement. But Roman goes further. Ottonova now operates across two ecosystems: As the most modern player in German health insurance As a software and platform provider within broader financial services and adjacent insurance verticals With a Net Promoter Score of 67—double that of the nearest competitor—Ottonova demonstrates what happens when customer needs, not technology hype, drive product decisions. One of the most revealing parts of the conversation? Roman’s insistence on listening before building. Customers didn’t want drones delivering medicine faster. They wanted bills paid within 24 hours. They valued reliable chat-based service more than flashy telemedicine tools. These nuances, Roman explains, are where real differentiation is created. The episode also offers a rare, honest look at funding realities in regulated markets. Roman shares how investors initially underestimated the cost, compliance burden, and operational weight of becoming a licensed health insurer. That reality forced Ottonova to explore alternative financing routes, including refinancing—and highlighted why corporate venturing and partnerships become inevitable growth stages for industry-led startups. Looking ahead, Roman sees health, wellness, and insurance converging fast. From fitness and wearables to cosmetics and dental partnerships, Ottonova is experimenting with embedded insurance models that reward healthy behaviour—enabled by digital agility incumbents simply can’t match. You’ll learn: Why full-stack ownership matters in complex industries How customer insight beats “sexy” tech every time What investors often underestimate about regulated innovation Why corporate partnerships are not optional—but structural This episode is essential listening for anyone building in health, insurance, or regulated ecosystems. 🎧 Tune in—and ask yourself: are you optimising part of the system… or designing the whole experience around the customer?