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ESSENTIAL READING FOR TRAVEL INSURANCE INDUSTRY PROFESSIONALS november 2008 • ISSUE 94 Not so routine transport In the last issue of ITIJ, we reported on a patient who was denied boarding by a pilot at Ercan airport in North Cyprus, an independent republic of Turkey. Less than two weeks later, a repatriation was held up at Istanbul airport. ITIJ tells Air Ambulance Worldwide’s bizarre story

On 15 September this year, John Ray of Air Ambulance Worldwide was sent on a flight to escort a 26-year-old male, Reid Sanders, from the German Hospital in Istanbul, Turkey, to his home residence in Bend, Oregon. Sanders was an entertainer on a cruise ship, and had a history of diabetes. Having fallen unresponsive and unalert he had been transported via ground ambulance from the cruise ship port in Istanbul to the German Hospital. After a week in the hospital, Sanders’ doctors determined that he was fit to fly home, and could follow up with his personal care physician upon arrival. His mother and sister had come to Istanbul to accompany him home, and on the morning of 18 September, they all travelled with Ray to the airport. They arrived several hours early, in the small hours of the morning, and Sanders’ mother and sister went through to the departure gate whilst Ray and Sanders rearranged Sanders’ heavy luggage in order to avoid excessive weight charges. After the luggage was continued on page 6 Visa changes to US travel

Important information for air ambulance companies and medical escorts: under the terms and conditions of the US Visa Waiver Program, all international travellers who wish to enter to the US from 1 Travel insurer gets picky January next year will be subject to enhanced security requirements. From that date, entry requirements Australian travel insurer QBE is allegedly travellers the importance of taking out appropriate customers. Understandably, this approach is causing for the country will change and visa waiver forms dropping travel agent clients who are too insurance for both local and international travel. It considerable concern within the industry. must be completed at least 72 hours in advance much of a strain on their bottom line. Roger is somewhat disconcerting, therefore, to hear that Most travel agents have a wide range of customers, of required entry. If a person does not have entry Allnutt reports QBE, one of the two main Australia-based travel and it has been the case in the past that the risk approval prior to embarkation of the aircraft, they insurance companies, has been allegedly telling some profile of the individual applicant is the determining could be denied boarding. For further information, For many years, the message in Australia, as well travel agents that they will no longer be accepting factor of whether the travel insurer accepts the risk. interested parties have been instructed to visit the as other parts of the world, has been to stress to their business because of the claims history of their However, given continued on page 8 Department of Homeland Security’s website. 2

IN THIS ISSUE ITIJ CONTRIBUTORS

REGULARS Roger Allnutt is a freelance travel writer based in Can- berra, Australia and a member of the Australian Society of News continued 4 Travel Writers. He travels widely each year and his material Company brief 10 is published in Australia, New Zealand, US and the UK. Insurance matters 11 Other interests include classical music, food and wine and Editorial comment 12 tennis. Health matters 16 Air ambulance news 18 Stewart Farr is a freelance journalist with 30 years expe- Travel matters 20 rience in writing on insurance matters, especially in the areas Profile 38 of life, travel and business insurance, investment and pension Private Healthcare News 39 planning and in healthcare provision.For 25 years, he edited a Service directory 48 monthly journal for life insurance and pension practitioners. Grapevine 54 Diary dates 54 Petra Kendall-Raynor is a freelancer with experience On the move 55 writing for daily, weekly and monthly national publica- tions. She covers news, news analysis and features on many FEATURES subjects and has written extensively about the healthcare system, with work published in Care and Health, Nursing News analysis: banking woes 22 Standard, Health Insurance and Planned Savings magazines. Stewart Farr details the downs and downs of the financial markets around the world Milan Korcok is an award-winning freelance health poli- Feature: Acceptable cover? Part 1 24 cy and economics writer who covers travel insurance, public Alan berry asks what acceptable cover is, both for consumer and insurer health, and medical education issues in Canada and the US. He has been writing about health fi nancing and policy issues Feature: Who can you trust? 26 in these countries since the 1960s and is a frequent contribu- milan Korcok asks whether travel insurers are losing their clients’ trust, and if so, why tor to leading North American professional journals and consumer media. He lives in Fort Lauderdale, Florida. Assistance world markets: Turkey 32 Roger St Pierre charts the changing face of Turkish healthcare and assistance provision Roger St Pierre is an avid traveller who has visited 119 countries and rising. He writes and broadcasts extensively PHN feature: A place in the sun 46 on the tourism industry, motoring, cycling and music. He is Petra Kendall-Raynor looks at European expatriate movements and the factors also fascinated by how the global economy works. At 15, he influencing them already had fi ve regular newspaper columns covering sport but also happens to be a qualifi ed associate of the Chartered Insurance Institute and writes regularly on business and fi nancial matters for a number of prestigious publications.

ITIJ TEAm

Editor-in-chief: Ian Cameron ITIJ Published on behalf of Voyageur Publishing & Events Ltd, Editor: Sarah Watson Voyageur buildings, 43 Colston St, bristol bS1 5AX, UK Voyageur Buildings, 43 Colston Street, Bristol BS1 5AX, UK Assistant editor: mandy Aitchison Copy editor: James Wallis editorial: +44 (0)117 929 4636 The information contained in this publication has been published Designers: Eli butler advertising: +44 (0)117 925 5151 in good faith and every effort has been made to ensure its Steve Annette accuracy. Neither the publisher nor Voyageur Ltd can accept Julie Wiles fax editorial: +44 (0)117 925 2040 any responsibility for any error or misinterpretation. All liability for loss, disappointment, negligence or other damage caused by US correspondent: milan Korcok fax advertising: +44 (0)117 929 2023 reliance on the information contained in this publication, or in Conference manager: Denise Clements email: [email protected] the event of bankruptcy or liquidation or cessation of the trade of Production: Helen Watts any company, individual or fi rm mentioned is hereby excluded. Kirsty Diclaudio web: www.itij.co.uk Advertising sales: David Fitzpatrick design: V Creative Design Printed by Pensord Press, South Wales, United Kingdom James miller Finance: Louise Goddard Copyright © Voyageur Publishing 2008. Materials in this Illustrations: Chris Duggan WOULD YOU LIKE TO SUBSCRIBE? publication may not be reproduced in any form without permission VISIT www.itij.co.uk INTERNATIONAL TRAVEL INSURANCE JOURNAL ISSN 1743-1522

International Travel Insurance Journal ■ www.itij.co.uk International Travel Insurance Journal

4 NEWS

Whiteley ruling allows for return of premium claims Nanny insurance vital part of trip In June 2005, UK company Whiteley Insurance of premium. The resultant judgement was handed entitled to claim on their policy in respect of events Consultants was forced into liquidation when it was down at the end of July this year, and does allow for or losses that may have been incurred after that date, Taking a nanny on holiday with the family to help found that the company, together with its subsidiary such claims to be made. but they are entitled to a proportionate refund of out with childcare was formerly the preserve of the Kingfisher Insurance Services, had been selling travel However, only those people who purchased a policy their premium. In addition, policyholders may have very rich, but experts these days are seeing a change insurance policies that were not underwritten. between 1 November 2001 and 13 January 2005 further claims against Whiteley, such as damages in the type of family willing to pay for some help Subsequently, policyholders, insurers, travel agents are entitled to claim back the cost of their policy, and for breach of contract, in particular relating to the with the kids whilst abroad. However, it has been and suppliers were asked to submit any potential only if a claim has not been made or is pending on additional cost of replacement policies. highlighted that there are risks associated with taking claims against the company in order to help assess the policy. On 14 January 2005, Whiteley became Creditors have been warned that they should only a nanny on holiday, from visa problems and tension Whiteley’s solvency. It was later concluded that authorised as an insurance intermediary following a expect to receive a dividend in respect of their over accommodation and responsibilities, to what Whiteley had insufficient assets to pay creditors’ change in UK law, so anyone with an unauthorised claim and the Joint Liquidators are unable to say happens if the nanny were to become ill. claims in full, and the liquidators had to ask the courts policy purchased on or after this date cannot claim. at the moment what the final level of dividend will As Chris Harvey, CEO of US insurance comparison for direction on whether or not policies purchased Furthermore, holders of an unauthorised policy be. The amount will depend on the recoveries site Squaremouth, points out: “The vacation can from Whiteley that were not authorised – or that had not expired on 15 June 2005 (when the achieved, the total claims admitted and the get much more expensive in a hurry if something underwritten – were entitled to claim for a return company was given its winding-up order) are not expenses of the liquidation. happens to a nanny who isn’t insured.” It is vital, he continued, that everyone accompanying the family on vacation be properly insured. Harvey said that although it can be straightforward to add a nanny to – for example, a US family’s travel insurance policy – there can be exceptions, such as if the nanny is not from the US. If the nanny is meeting the family at the resort, it is mandatory to buy a separate travel insurance policy, and if the nanny is flying solo with the children, they should all be on the same policy. The crux of the matter, said Harvey, is that families must carefully check the details of their insurance policy, as some will not allow non-related travellers to be added.

Brits cut cover

American Express Insurance Services has found that one in four Britons (24 per cent) plan to go on holiday this year without travel insurance to protect them. It seems that as Britons find their personal finances more and more stretched, they are being forced to make cutbacks where they shouldn’t – namely with insurance. Chris Rolland, head of American Express Insurance Services, noted: “As the cost of living rises and there is less money left over at the end of each month, our research shows that one in four Brits are struggling to meet the cost of holiday insurance. If it is a case of people cutting back on travel insurance in order to afford their holidays then perhaps they should think twice before booking.” Based on the survey’s findings, it can be deduced that 14.5 million Britons are placing themselves and their families at risk of unexpected and potentially crippling bills. The results are part of a wider probe into current spending patterns by the insurer, which revealed that nearly half of those surveyed plan to cut corners on key financial safeguards this year.

International Travel Insurance Journal NEWS 5

www.itij.co.uk 6 NEWS

One third of claims due to winter sports Not so routine transport continued from page 1

eventually checked in, and the fee avoided, Sanders spoke English, so despite Ray’s repeated attempts and Ray proceeded through security and to passport to explain their situation and show Sanders’ medical control for the flight (business class with Lufthansa) back papers, he was effectively told to sit down and shut up. New research from snowboarders to injure their knees or thumbs, while to Oregon. Eventually, however, the immigration police brought personal injury insurer The snowboarders tend to sustain a wider range of injuries Upon showing his passport, however, Sanders was in a three-month detainee from French Guyana who Paul Rooney Partnership to the wrist, forearm and ankle. detained and taken away, despite Jones’ intense spoke English to interpret for the medical escort and has revealed that, in general, A spokesman for The Paul Rooney Partnership noted protestation, by several Turkish immigration police. Ray his patient. After pleading their case and again showing more than one third of all that skiing is growing in popularity, especially among tried to explain that he was a medical escort and needed travel insurance claims it young men with limited prior experience, making it to go with him, but the police did not speak English and receives are the result of winter even more crucial that people take comprehensive would not look at the paperwork, which contained … the Turkish police sports accidents. A distinct winter sports insurance with them when they hit the Sanders’ medical records and explained why he did not loaded Ray and difference in the number and slopes – especially if they hit them harder than they get his passport stamped when entering the country. type of casualties arising from expect to! The spokesman added: “Compared to a Sanders was taken to the airport police station, Sanders, together with snowboarding and skiing has beach holiday, the chances of injury are considerably whilst Ray went to the nearest information desk, also been noted by the higher, so it’s especially important that skiers and where an airport worker contacted a Lufthansa about 20 other detainees, insurer, with skiing injuries snowboarders take out a good insurance policy that will representative, who immediately came to try to help. into a police bus and accounting for the cover them in the event of an accident on the slopes.” The representative spoke with the immigration police highest proportion Recent research by online insurance comparison site and explained the reason that Sanders’ passport was transported them 20 of claims. Skiers MoneySupermarket found that 28 per cent of skiers not stamped was because he had entered Turkey are also more and snowboarders neglect to take out proper travel unconscious via ground ambulance. Nevertheless, kilometres downtown likely than insurance before going abroad. the police were adamant that since Sanders did to the immigration not have a Turkish stamp on his passport he was to remain in detention for illegally entering the detainee station country, and was going to be deported. Ray was, however, allowed to cancel the flight tickets, reclaim all of their medical records and papers, Sanders was the luggage and take a cab to the police station after placed in a cell with hundreds of long-term detainees Baggage claims reassuring Sanders’ family and encouraging them to and once more Ray was permitted to sit outside the take the flight home without them. cell and carry out his monitoring duties. reached 68 per day An immigration officer at the police station escorted By this time, Air Ambulance Worldwide’s client had Ray to Sanders’ cell, whereupon Ray found him been in touch with the American Consulate as well bewildered but physically okay. He explained the as Onur Dagoglu, an administrator for Regent Cruise Recent research has suggested that as many as situation to Sanders, and the police allowed him to sit Lines, who Sanders worked for. Ray was in constant 6,150 claims related to baggage were submitted next to the cell, letting the detainee out periodically contact with the involved parties, and when Sanders to UK travel insurers between April and June this for Ray to evaluate his blood sugar and determine was taken away yet again – at around 8:00 p.m, back year, an average of 68 per day. Of these, around when he should get his insulin. to the airport police station, this time without Ray 50.4 per cent were for damaged items, 26 per Again, Ray attempted to communicate with the being allowed to accompany him – Ray was told cent for lost or delayed luggage and 23.6 per airport police to explain the situation, but most of to wait outside the detention centre for Dagoglu. cent for missing items that had been taken from When Dagoglu arrived, they went back into people’s suitcases, according to estimates given the detention centre and met with the chief by Insure and Go. Perry Wilson, founder of the of immigration police, who told them that insurance company, said: “Between April and June Sanders had already been taken away, so, this year, we estimate that the travel insurance together with Dagoglu’s two assistants, they industry received around 68 claims a day for lost made their way to the airport. This journey or damaged baggage, but this is only the tip of the took them via the passport control office, iceberg because many victims of this problem will where Dagoglu attempted to resolve the issue not have had insurance. It is clear that the aviation of the missing stamp in Sanders’ passport, but industry needs to do more to reduce the number to no avail. of bags they lose.” Upon arriving at the police station, they found Sanders back in his cell, and were ‘reluctantly’ allowed to see him in order to check his blood sugar level and vital signs – all of which were thankfully fine. Ray took up his place outside of the officers reportedly seemed not to care, whilst Sanders’ cell, and monitored him through the night. Pregnancy ignorance causes concern the few that understood said there was nothing they At 4:00 a.m. Dagoglu came to pick up Ray, Sanders could do. All the while, however, he was in constant and an accompanying immigration officer to take Expectant mothers are inundated from all sides women are concerned about how their pregnancy contact with his head office, which in turn was in them to the airport. Upon arrival, the medical party with advice on what to eat, how to exercise and so will affect their travel insurance. “We get roughly 60 contact with their client, who had contacted lawyers checked in and proceeded once more to passport on, but when it comes to pre-natal travel advice, calls a day from women in their first trimester,” said to negotiate with the airport police and the port control with the immigration officer who had all information seems to be somewhat thin on the Bensusan, “worried that insurers classify pregnancy agent. As a result, one of the officers eventually stated of the necessary forms and paperwork to deport ground, according to UK-based Essential Travel. A as a pre-existing condition, and they’ll need special that if Ray could get himself and the patient new Sanders back to the US. At passport control, Ray recent survey found that four out of five pregnant travel insurance. They won’t. With a few exceptions, plane tickets, they could go. He immediately took a and Sanders were told to stand back whilst the women plan to take a so-called ‘babymoon’ overseas 99 per cent of pregnant women are perfectly fine taxi back to the airport and was able to get tickets for immigration officer and passport control discussed with their partners before giving birth, but Stuart and will be covered by a standard insurance policy.” the same flight at 5:50 a.m. the following day. the situation. Again, it looked like they were not gong Bensusan, sales director at Essential Travel, says many Bensusan did clarify the situation for mothers-to- Returning to the airport police station with the to let them through to catch the plane! Bizarrely, after be, however, by saying tickets, and assuming they were now free to go, about five minutes of intense arguing and shouting – that pregnancy is not Ray was subsequently informed by the supervisor almost fisticuffs – between the supervisor of passport classed as a medical that since Sanders was being deported, he would control and the immigration officer, the passport condition – unless the be transported to the airport – with an immigration control supervisor threw up his hand and said ‘go’. woman in question has officer – two hours before the flight in the morning. Needless to say, the pair rushed to the gate – still had problems during this Again, Ray was permitted to remain outside of with immigration officer in tow – where they were or a previous pregnancy. Sanders’s cell in order to periodically evaluate him. finally allowed to board for the long journey back to Most travel insurers will Not imagining things could get much worse, at around Bend, Oregon. Throughout the subsequent flights, cover emergency medical 2:00 p.m. the Turkish police loaded Ray and Sanders, Ray continued to periodically check Sanders’ blood expenses arising from a together with about 20 other detainees, into a police sugar and vital signs and made sure that he ate and pregnancy as long as the bus and transported them 20 kilometres downtown took his insulin as per normal. Thankfully, the rest of woman is not expected to the immigration detainee station, where people the journey was uneventful. Sanders made it home to give birth within eight are detained for sometimes months at a time before safely and was met by his sister at the airport. The weeks of the start of the being deported. They were the only ones not in patient took the extraordinary experience in his trip, during the trip or handcuffs. Upon their arrival, they were sent up stride, but was very glad to be home. He stated, within eight weeks of the four flights of stairs, with their entire luggage, to be however, that he didn’t think he would be visiting end of the trip. processed. Again, not one of the immigration police Turkey again anytime soon.

International Travel Insurance Journal

8 NEWS

Travel insurer gets picky continued from page 1 Canadian campaign

QBE’s new approach, it would seem that travel profile, the agent will have to partner with another A new campaign that aims to educate Canadian agents with ‘unusual’ customer profiles could be insurance provider, and that could mean a loss consumers about the need for emergency healthcare dropped by the insurer or avoided altogether. For of business for QBE if travellers are loyal to the cover when they travel has just been launched by example, there are agents that have a higher than travel agent. If the traveller is loyal instead to QBE, TIC, one of the country’s leading travel insurers. usual proportion of older customers – especially this could mean a potential loss of custom for the Gino Riola, director of marketing for the firm, noted: so these days when seniors are making up an previously ‘loyal’ travel agent. We shall have to “Many Canadians take their healthcare coverage for increasingly significant proportion of the travel wait and see where customer loyalty lies. granted. They forget that they’re not fully covered market. As older travellers generally make more ITIJ asked QBE to comment on this matter, but when they leave the country or even their province expensive claims, such travel agent clients may no they were unable to provide further information. of residence.” In order to rectify this situation, he longer be allowed to offer QBE insurance. A spokesperson stated: “Due to confidentiality continued, TIC has launched a series of information This move has implications for both the insurer agreements, QBE is unable to comment on posters, brochures and other materials that offer and agents. If the insurer refuses to insure specific agency arrangements or comment on consumers an overview of the essential need for customers from one agent based on customer individual matters due to privacy.” carrying travel insurance when leaving the country. Riola says the campaign was launched in response to feedback from both consumers and travel agents, who will use the material to explain to consumers in layman’s terms the importance of trip insurance.

Regulation threat felt in UK

In response to the government’s regulation of travel insurance sales by travel agents, which is coming into force next January, the first travel agent in the UK has announced it will stop its free insurance offer on domestic trips – having offered it for the past 25 years. The company said it had been forced into the move thanks to the impending regulation. Sales director Harold Burke said: “This has upset the travel industry and is not necessarily better for the consumer. [The regulation] is making the whole issue more difficult and more expensive to operate, which will ultimately have an effect on the consumer.”

NU findings prompt concern

Research carried out by leading British insurer Norwich Union has concluded - once again - that the credit crunch has led travellers to push travel insurance to the bottom of the pile. The study has shown that the number of people thinking about where they can cut their spending is steadily rising, and insurance is one of the first supposedly ‘non-essential’ items to be struck off the shopping list. Fifty-one per cent of British holidaymakers told researchers that they do not intend to buy travel insurance in the coming year in order to save a bit of extra cash. Unsurprisingly, upon publishing its findings, Norwich Union was quick to tell consumers of their folly, pointing out the false economy in not spending a few extra pounds that could protect them from medical bills of thousands. Suzie Fenn from Norwich Union told consumers: “Understandably, people are looking to make savings on their holidays this year, given the economic climate. However, with more than £60 million paid out in 2007 in insurance claims for everything from medical emergencies to damaged baggage, scrimping on this essential travel cost really isn’t worth the risk.”

International Travel Insurance Journal NEWS 9

Working Disabled travellers Defaqto releases terrorism cover analysis backpackers at risk warned on cover In its latest research on the topic, Defaqto has found related protection – not perfect perhaps, but a Concern has been voiced that some of the millions Disability advice charity Tourism for All has that terrorism cover is becoming an increasingly distinct improvement on last year. of students going travelling this year will invalidate provided disabled travellers with a check list crucial part of a travel insurance policy. The firm Mike Powell, consultant for general insurance their travel insurance policies by taking on voluntary of things they should do before embarking on added, however, that terrorism concerns were still at Defaqto, said: “Terrorism is not always a or casual labour whilst abroad. Philip Jordan, director a break. One suggestion is to make sure any not being considered by some travellers. consideration that you would even think about of marketing for UK insurer Essential Travel, is specialist equipment is covered under their Figures from the financial organisation showed when purchasing travel cover, but you should check worried about quite how many youngsters could be travel insurance policy. Brian Seaman, head of that while a majority of providers now offer with your insurer to confirm the cover provided, unaware of the danger they are putting themselves consultancy at the charity, has told passengers: “If medical cover for injuries sustained as a result of particularly if you are travelling to countries at risk in. “Working has become integral to the backpacking you use a wheelchair or have any other special a terrorist attack, far fewer would accept a claim of terrorism. Our research shows that there is a experience,” said Jordan, “Travellers like to volunteer equipment, you need to find out if it is insured or for lost bags and personal accidents under the significant proportion of people who are at risk from with overseas charities, or pick up casual jobs along not under your standard travel policy or whether same circumstances. Overall, the data analysed by purchasing inadequate cover.” Defaqto analysed the the way to eke out their budget.” The problem, he you need to take out an extension to the policy to Defaqto shows that 63 per cent of travel insurance travel insurance attached to 976 annual and single trip continued, is that backpackers insurance only covers cover those items.” policies offered some form of terrorist incident- policies in order to collate the data. people for non-manual labour: “When backpackers help local charities build a school or take paid work on a farm, they should know never to use power tools like electric drills or saws, or to drive heavy- duty vehicles. If they do and they’re injured, they will usually not be covered by their travel insurance.”

BA faces compensation claim British Airways has been hit with a compensation claim from 23 passengers who were affected by a flight cancellation in March this year. EUclaim, a law firm for airline consumer rights, has filed the claim for compensation under Regulation 261 in the Uxbridge County Court on behalf of passengers who were impacted by the cancellation of a flight from Heathrow to Lisbon. EUclaim states it already represents several hundred claimants who have suffered either cancellations or lengthy delays when travelling with the flagship carrier. CEO of the firm Hendrick Noorderhaven commented: “BA has produced numerous reasons for the cancellations and for the non-payment of their passengers’ claims – these range from insufficient cabin crew and staff sickness to technical problems. Quite frankly these are, in most cases, not extraordinary circumstances and the airline is simply hiding behind these excuses.” He believes that each year, UK air passengers are losing out on £130 million in unclaimed compensation.

Tourists die in Nepal crash Twelve German and two Swiss tourists were among 18 people killed when a passenger plane crashed in Nepal’s Everest region. In all, 14 foreigners are believed to have perished, according to local airport officials. Only one Nepalese passenger survived as the Yeti Airlines plane crash-landed at Tenzing-Hillary airport. Standing on a mountainside at an altitude of nearly 10,000 feet, the airport is often used by mountaineers and trekkers heading to expeditions on Everest. The runway, though, is a mere 20 metres wide and is set on a steep slope, with a 700-metre drop at one end.

www.itij.co.uk 10 COMPANYBRIEF

Astrum Assistance mPassport Claims technology Acumus offers travel established introduced breakthrough trade a way out

EuroCross International, Fidelia Assistance, Mobi24, HTH Worldwide, a health and safety services RightPath Insurance Solutions Ltd has developed its Acumus Insurance Solutions has offered the UK Roland Assistance, and SOS International have company, has launched mPassport, a mobile health Automated Travel Insurance Claims System (ATICS), travel trade another option with regards to the together established a joint venture for the provision information tool for global travellers. Subscribers which reportedly takes claims processing to the next regulation of travel insurance sold as part of a holiday of international assistance to the service have level. The programme extracts a series of answers package – the launch of an online training package services: Astrum Assistance access to the firm’s from the claimant and automatically generates a that will help travel agents clear the authorisation Alliance AG, with its head databases of global claims assessment – the company says that it is the hurdle so they may continue to sell insurance and office in Zurich. Each of health information first independent tool of its kind written specifically retain the ancillary revenues such sales produce. the partners holds an when they are on for travel insurance claims. The technology will Called the On-Line Appointed Representative Travel esteemed position in their the go through their allow claims experts to focus on managing only the System, or OLARTIS, it offers users the training domestic market, but it mobile phone or most complex of cases, while allowing those with necessary to become appointed representatives of is hoped that through laptop. The mPassport less expertise to process the bulk of straightforward insurance companies online. the set-up of Astrum the database lists over claims. John Bibby, managing director of Acumus, industry perception of 4,200 qualified, Andrew Commins, managing director of RightPath emphasised the revolutionary nature of the course: the companies involved English-speaking Insurance Solutions, said: “We believe the reason “We’re unaware of any travel trade insurance will be strengthened and physicians and dentists this software has not been produced before is the partner who is as far ahead as we are in meeting their international profiles in 180 countries, and level of intricacy that exists within a typical travel essential training needs of companies wishing to enhanced. selected emergency insurance product. When you look at all of the continue selling travel insurance under the new Astrum is already care facilities for over possible permutations of a travel insurance claim Financial Services Authority (FSA) rules. Companies represented in more than 1,100 destinations you begin to understand why it has failed to be that engage with the right regulated principal will 10 European countries, around the world. introduced previously.” Going on to describe the not only ensure compliance, but they will actually with its own representative Angelo Masciantonio, benefits of the programme, and the value it gives grow revenue by making products more accessible offices that are able to access an international CEO and co-founder of HTH Worldwide, said the insurer, Commins continued: “From a financial to customers through increasingly confident, well- network of over 100,000 service providers in more the new product is ‘about healthcare everywhere’, perspective, in an environment of 50,000 claims a trained staff.” than 190 countries serving more than 40 million end adding: “The doctors in the mPassport database are year, we would estimate net savings of well over £1 The modular training offers a range of sessions users. the highest quality specialists, emergency practitioners million, each and every year. These span many areas, covering not only the ‘how to’ of selling travel Lex Mentink, chairman of the newly established and family physicians. About half of Americans who including operational costs, fraud protection and insurance correctly, but also a background to the company and managing director of EuroCross go on vacation for two weeks or more get sick or claims leakage. However, it also boasts massive MI International, said: “Up to now our five assistance have some sort of medical problem; that’s why potential and allows for major advances in customer organisations have been able to assist domestic mPassport should be at the top of everyone’s packing experience, both of which can play significant roles.” clients on a global scale. With the establishment list.” of Astrum, we can furthermore offer clients with Apart from access to the database of doctors, international operations the entire range of services other helpful features of the new product include for their international end users.” More than 1,600 personalised health alerts delivered by SMS to a FirstAssist joins with staff members stand behind the new firm, and the traveller’s mobile, profiles of over 3,400 hospitals newly appointed managing director, Thorkild Lykke, and clinics around the world, medical translation help Sainsbury’s brings extensive experience to the role. and medication translation help. Following a competitive bidding process, FirstAssist Insurance Services has secured a partnership agreement with Sainsbury’s Finance to deliver a fully integrated travel insurance offering, including online medical screening. FirstAssist will provide annual, single trip, winter sports and long-stay travel insurance, all of which can be topped with a range of FSA changes. The system records how many times optional extras. the user has gone through the test and tracks their Commenting on the three-year agreement, Steve current status, and with the duration of tests being Scott, head of travel sales and strategy for FirstAssist, from 20 minutes to two hours, the training is very said: “We have worked closely with Sainsbury’s flexible. Added Bibby: “We’ve put together software Finance to develop a bespoke product offering that development and regulatory teams to provide accurately matches expectations.” Alistair Hardie, a seriously thought-through package, aiming to managing director of FirstAssist Speciality Insurance, ensure it meets criteria laid down by the FSA. This said he was delighted that the supermarket’s banking represents a strategic move to deliver cost-effective arm had chosen to work with his company, adding: and convenient training at the desktop.” OLARTIS, “We believe that in an increasingly competitive continued Bibby, can also be adapted for other types market and with impending further regulation this of insurance, meaning staff could tap into the lucrative agreement reflects the strength of [our] travel general insurance markets as a result of becoming an proposition in the travel insurance marketplace.” appointed representative. Peoplesure launched TFG brings Mexico by Chubb

cover closer UK-based Chubb Insurance has announced the Canadian company TFG Global Insurance launch of its new personal accident and business Solutions Ltd has launched a new website, travel insurance policy, Peoplesure. The new policy TravelInsuranceMexico.com, which will offer allows organisations to safeguard their employees travel insurance plans to people around the and minimise disruption to business in cases of world travelling to or from Mexico. The website sudden or long-term employee absence. The offers travel health and evacuation insurance, trip business travel insurance element of the policy cancellation and interruption insurance, group travel covers the death or injury of an employee while they insurance policies, international health insurance are travelling, including any medical expenses, as well for expatriates living in Mexico and global medical as loss of business equipment, fraudulent misuse of insurance for people living in Mexico who want cards and travel delay. worldwide coverage, including plans that cover Steve Ranzetta, accident and health manager at treatment in the US. Chubb Insurance, said at the launch of the policy: In addition, travellers using the website will also “While we may not be able to prevent accidents have access to useful articles on travel insurance and from happening, employers can protect their related issues such as policy wording and staying employees, and themselves, from the resulting healthy while travelling in Mexico. financial burdens. We can also guarantee speedy payments due to Chubb’s claims service.”

International Travel Insurance Journal INSURANCEMATTERS 11

Are you ready for Model miss: catastrophe modelling review NEWSWIRE Solvency II? Paul Miller, head of catastrophe modeling for Aon But even with the best data, the models do not Re Global in the UK and EMEA, thinks the insurance even address many of the key components needed industry is too reliant on uncertain risk models. to accurately predict a loss. Examples of types of Ping An Insurance Co. says it does not have Following hurricane Katrina in 2005, there was a loss and insured coverages that the models do not any risk exposure to Lehman Brothers or other public backlash from reinsurers and insurers on the address include: loss adjustment expense, contingent liquidity-hit US financial institutions, but its share accuracy of commercially available models. Despite business interruption, non-modelled perils (such as price plummeted on fears it might have to bear this reaction and the views from some parties that river flood in the US), ordinance or law coverage, more losses from its stake in Belgian-Dutch group there would be a significant reduction in the use environmental coverage, civil authority and regulatory Fortis. of models moving forward, the reliance on these or litigation ‘surge’. Insurers should evaluate their catastrophe models has grown tremendously loss potential to the list above and utilise adjustment The Chinese insurance regulator, CIRC, since the 2004 and 2005 US hurricane seasons. factors to their modelled results. Even a simple has asked the country’s insurers to report details of Further, this reliance is no longer solely restricted 10-per-cent factor utilised to account for loss their projects reinsured by US companies in a survey to insurance and reinsurance companies. Rating adjustment expenses would reduce the previously aimed at assessing the impact of the US sub-prime agencies, regulators, and investors now use output mentioned US hurricane model underestimation for mortgage crisis on the Chinese insurance sector. from these models in making critical decisions. In personal lines insurers by almost half. Reliance on studies revisiting the hurricanes that impacted the US the modelled output without adjustments for these Profits have fallen in the Irish insurance during 2004 and 2005, the current revised models missing elements can only lead to unwanted and sector, with net underwriting profit falling from €718 still underestimate the losses from these storms by unnecessary surprises. million in 2006 to €704 million in 2007, according an average of 25 per cent for personal lines insurers Without a doubt, catastrophe models are and to the latest figures from the Financial Regulator. and 50 per cent for complex commercial insurers. will continue to be key in the understanding The Solvency II process for UK insurers took a major With this kind of potential for ‘model miss’, how can of potential catastrophic risk. The users that The life insurance sector in India will largely step forward recently, following the publication of the the output from today’s catastrophe models be relied rely upon these models need to recognise that be driven by the propensity to save among Indians, Financial Services Authority’s (FSA) paper that sets upon? The answer does not lie solely within further reliance should not be made on the output of according to the latest research. This means that out what steps insurers need to take now to ensure updates to the models, but rather in an understanding these models without some adjustments. Factors life insurance products with a higher element of they are prepared for when the new regulations to of what a model can and cannot provide. for non-modelled perils, data quality issues, savings compared to protection will be more popular come into effect. The detailed, 62-page document The vendor models provide policy level loss model issues and even variations in damageability with customers. gives companies the clearest indication yet of the information, taking into account the financial structure should all be accounted for and quantified as best FSA’s thinking on the transition from the current of the policy, including deductibles, limits, and inuring they can. Adjustments should be made to event The total number of foreign insurers in ICAS regime. The FSA has stated that it expects reinsurance information. Underlying this financial frequencies in order to best reflect management’s China is expected to reach 70 by 2011, from fewer senior management and board members to read, as model analysis, loss estimations are generated on belief, not just the belief of a given modelling firm. than 50 at present, according to PwC. Their market an absolute minimum, the six-page ‘key messages’ each insured location. Data quality is absolutely Finally, every event will allow for new lessons to share should expand from six to 10 per cent in the summary, and that it should be tabled at a board critical. The ability to place an insured risk at the be learned, more claims data to be analysed, and same time frame. meeting. precise geographic location and collect and input adjustments to the underlying components of the Charl Cronje, general insurance partner at actuary accurate building attributes and values is all relegated models. The models are much better than they Insurance rates for most lines of business Lane Clark and Peacock LLP commented: “This to the insurer. Catastrophe modelling data quality were 15 years ago, let alone three years ago, and in the Middle East, Africa and Europe continued effectively marks the kick-off for Solvency II has improved dramatically over the last decade. they will only further improve in time. to soften in the first half of 2008, but could begin implementation in the UK, and is a must-read for firming soon, according to Marsh. anyone running a UK insurer. The FSA is making a strong statement that insurers must start their Solvency The general insurance sector in Australia II work now or risk not being ready for the coming Confirmation from BIBA is facing a tough year, with severe weather events, regime.” He continued that from March 2009, the FSA The British Insurance Brokers BIBA continues to represent all UK continuing volatility in the stock markets and will be chasing insurers to report on their progress, to Association (BIBA) has confirmed general insurance intermediaries competitive pressures, said international accounting check that they have appointed an internal Solvency that it continues to represent with key industry stakeholders firm KPMG. II champion, and to find out whether they intend to all UK general insurance and regulators both in the UK and use an internal model for calculating statutory capital intermediaries, including London Europe, including consensus building AM Best has upgraded the financial requirements, rather than the standard formula. The Market brokers, following the in Europe through its membership strength of Hiscox to ‘A’ from ‘A-‘, due to its FSA has also suggested that all insurers should carry proposal of a new association of the European Federation of ‘excellent consolidated risk-adjusted capitalisation’. out the QIS4 calculation, to assess to likely impact of for brokers operating in the Insurance Intermediaries. BIBA’s the regulation, even if they have not participated in the international wholesale and London Market Brokers’ Committee, AXA Insurance Gulf has signed an formal QIS4 process. reinsurance markets. It is meanwhile, will now focus on UK agreement with AXA Corporate Solutions to further However, Cronje had a word of warning to insurers: understood that this new wholesale and direct insurance. its aim of growing significantly in the marine and “The current crisis gives regulators a stick to beat association will want to take over Members who trade in this market large risks insurance and risk management sectors. the industry with. UK insurers, like their banking the administration of the London will continue to be represented by counterparts, should expect an intensification of Market reform work, which BIBA and will form the core of its Vietnam is implementing a new decree regulatory scrutiny in the coming months. This affects was previously managed by London Market Brokers’ Committee. to promote the benefits of compulsory motor not just the design of Solvency II, parts of which are still BIBA’s London Market Brokers’ Eric Galbraith, BIBA chief executive, insurance and to penalise owners of vehicles and being debated in Europe, but also the ICAS regime, Committee, on behalf of the confirmed: “It’s business as usual for motorbikes who fail to take up the insurance. which remains in force for the next few years.” Angerstein Fund Limited for now, Eric Galbraith BIBA and all of its members.”

www.itij.co.uk 12 INSURANCEMATTERS

NEWSWIRE Editorial comment

As the 100th issue of The Muang Thai Group has linked up with ITIJ nears, we’ve been the Islamic Bank of Thailand (ISBT) to offer Shariah- turning our thoughts to compliant insurance services to the country’s eight the developments seen million Muslims. The group will promote eight types within the travel insurance of takaful life policies through its sales agents in all industry – and its related 28 branches of ISBT. markets – over the last decade. Throughout the Fitch Ratings believes that balance sheets years, we’ve reported on how advancements pressures for insurance and reinsurance companies in technology and the use of the Internet have globally are becoming more severe as insurers transformed travel insurance marketing, sales, experience greater unrealised market value losses underwriting and claims processing; how the on their investment portfolios. The agency expects assistance industry has developed, matured a ramp up in such losses to be reported in the third and broadened its global reach; and how quarter. the global air ambulance industry continues to push the boundaries of aeromedical care. British American Insurance Co., a leading These and many more topics have, at the provider of life insurance in Mauritius, has same time, been debated at our annual travel introduced the country’s first Islamic insurance Lloyd’s warns of tough future insurance conferences; and this year’s ITIC policy, BAI Takaful. Muslims make up 18 per cent of Chief executive of Lloyd’s Richard Ward has warned the collapse of Lehman Brothers and of AIG’s federal event in Budapest is no different. the population of Mauritius. the industry that tough times are ahead, following loan – it is more than likely that shareholders in Rounding up the industry leaders and the announcement that the UK’s insurance market’s those firms would bring actions against directors and seasoned speakers from the worldwide travel A top US lawmaker has asked the chief interim profit almost halved – the first fall in profits officers of both companies, which could well lead to insurance marketplace, this year’s conference executive of AIG for details on how the company since 2005. The current market conditions, continued claims under policies that protected them. looks set to be the largest yet, with a broad has used its $123 billion of taxpayer rescue funding Ward, would severely test Lloyd’s ‘structure and Lloyd’s has seen an increase in both volume and range of subjects up for discussion, a series so far. Rep. Henry Waxman, chairman of the House resolve’, and would also affect full-year pre-tax profit cost of claims, with increasing commodity prices of focus groups, an expansive exhibition Oversight and Government Reform Committee, also for 2008, which he predicted would be significantly driving up the cost of replacement items. Despite the area and the usual array of social events. sought a list of events, retreats and conferences less than the record profits achieved in 2007. concerns, Ward made it clear that all was not a tale The conference culminates, of course, with paid for by the company since January, in the letter Speaking about the half-year results, Ward blamed of woe, as he confirmed that Lloyd’s has yet to see the ITIJ Awards ceremony, which recognises sent Friday to CEO Edward Liddy. the 47-per-cent fall in first-half profit on lower an increase in claims coming from the economic those companies that have achieved significant investment income, as well as tumbling prices for slowdown. Many insurers have already seen an developments over the last year. SALAMA Islamic Arab Insurance Co. has insurance and reinsurance policies, along with an increase in claims, including travel insurers, who If you’re reading this at ITIC, I hope you have partnered with DWS Investments, the global mutual increase in claims volume. The number of potential are enduring a higher level of fraudulent claims. a most enjoyable and productive conference. fund arm of Deutsche Bank Group, to provide Shariah- claims related to the subprime crisis in the UK now Meanwhile, the cost of hurricanes Ike and Gustav Best of luck to all the ITIJ Awards finalists! compliant unit linked insurance products to its clients. stands at around 200, up from the 100 that had been have yet to be calculated, although estimates are recorded in April. Another concern for Ward and that they could together cost the insurance and Lloyd’s is that they have yet to see the effects from reinsurance industries as much as $18 billion.

Sarah Watson Editor Munich Re pushes [email protected] price hikes

Munich Re has said the crisis on the financial markets will drive up earnings at reinsurance companies, as BNP Paribas uncertainty boosts demand for reinsurance policies. Torsten Jeworrek, Munich Re board member in acquires Fortis Bank charge of reinsurance, told an investor conference in London that the latest developments in the French bank BNP Paribas has agreed to take on the troubled financial markets are increasing demand assets in Belgium and Luxembourg of banking and for reinsurance, making the firm confident of insurance group Fortis for €14.5 billion, making it success in pushing through higher prices for the risk the Euro Zone’s biggest deposit bank. The move cover it offers to insurers. “For us, the next market followed a week of frantic talks with financial is the ‘hard market’ period. We could drive the regulators in Belgium and Luxembourg. Details of market into higher profitability,” said Jeworrek. He the deal show that BNP will buy control of Fortis’ went on to explain that the company is seeing an banking businesses in Belgium and Luxembourg increased demand for for €9 billion, funded through 132.6 quality reinsurance, million new shares, while it is buying catastrophe and long- Fortis Insurance Belgium for €5.5 tail business and was billion in cash. therefore pushing, The Fortis deal is the biggest cross- wherever it is deemed border rescue since the full force of possible, double-digit the credit crisis swept across European price increases in soil. Under a share swap arrangement its negotiations with announced by Belgian Prime Minister insurers for 2009 Yves Leterme and BNP Paribas’ chief coverage. executive Baudouin Prot, BNP will Jeworrek’s positive receive a 75-per-cent stake of Fortis prediction after several Bank Belgium and all the group’s years of declines has Belgian insurance operations. In caused concern to exchange, Belgium will receive an some in the industry, 11.6-per-cent stake in BNP through as rival reinsurers, the issue of new shares. In a statement including Hannover to the press, Leterme said: “The result Re, have said they of these measures will be that a leading Torsten Jeworrek still expect prices to European bank, BNP Paribas, will ensure fall overall, albeit at a slower pace than has been that Fortis Belgium fulfils the conditions necessary for endured in the recent past. sustainability and its development.”

International Travel Insurance Journal INSURANCEMATTERS 13

www.itij.co.uk 14 INSURANCEMATTERS

AIG to start sale of Japanese businesses

Despite assurances to the contrary, American insurance operations in Japan. Japanese business International Group (AIG) has now said it plans newspaper Nikkei speculated that due to the size to sell its three Japanese life insurance businesses, of the businesses, domestic life insurers could form in a sale that the Japanese media estimates could an alliance to make the purchase. Other possible reach or even exceed $9.5 billion. As part of its interested parties are Nippon Life Insurance, efforts to pay back the Federal Reserve’s $85-billion Tokio Marine Holdings, Britain’s Prudential plc and loan, AIG spokesman, Fumiyasu Sato, said the Germany’s Allianz, although this information was company intends to sell shares in American Life not confirmed by Sato. Aflac, one of the world’s Insurance Co. (ALICO), AIG Star Life Insurance largest sellers of supplemental health and disability Co. and AIG Edison Life Insurance Co. ALICO insurance, is also said to be a potential buyer – in operates as a life insurer in more than 55 nations an interview with Nikkei, Aflac chief executive and regions, including Japan, while AIG Star Life Daniel Amos said that he would assess the value and AIG Edison Life are life insurance units based of ALICO. AIG has said it wants to keep a majority and operating in Japan only. Sato added that AIG stake ‘if at all possible’ in its American International currently has no intention of selling its non-life Assurance life insurance unit, which operates in

countries including China, Singapore, Malaysia, Thailand, Korea and Vietnam, with annual earnings growth predicted to be more than 20 per cent. Meanwhile in Taiwan, AIG’s subsidiary Nan Shan Life Insurance has given assurances about its operations, following the announcement by its parent company that it is putting the business up for sale. Nan Shan has since agreed to place its assets under the government’s custody, with the exception of certain funds that are deemed necessary for daily operations, according to chairman Edmund Tse. He added that the firm would not be transferring its assets to its US parent without the approval of the Taiwanese regulator, the Financial Supervisory Commission (FSC). In India, J Hari Narayana, chairman of the Insurance Regulatory and Development Authority (IRDA) said in reference to the liquidity problems faced by AIG in the US that investors shouldn’t read too much into the situation. He added: “We should not forget that AIG is one of the largest insurance companies in the world. For instance, if we take Life Insurance Corp. of India, it has total assets to the order of US$200 to $300 billion and AIG is 10 times its size.” He confirmed that the solvency of Tata AIG is quite satisfactory, and added that the venture has adequate resources to meet all its liabilities and has much more than the minimum solvency required by law. New CEO of AIG Edward Liddy has said the company will not sell its US commercial lines property/casualty business or its foreign general insurance. Its personal lines business, however, will be put up for sale, except for its private client operations, which it intends to hold on to for the time being at least. In a statement to the press, Liddy said: “We are refocusing on our traditional strengths in property and casualty underwriting. We have a number of remarkable businesses with leading market positions and significant competitive advantages that could not be recreated today.” The firm’s worldwide property/casualty business generated approximately $40 billion in revenues in 2007. Liddy said that AIG is also pursuing a number of alternatives for its financial products business and its securities lending programme, although he added that the assets sales process must be flexible: “If we get more, we will sell less.” He also told reporters that he would prefer that the sales of assets be made sooner rather than later in large transactions with ‘brand name’ companies with strong ratings, which could happen soon: “We have already been contacted by numerous strong, stable parties, and we expect that buyers will recognise the value of these properties, be a good strategic fit and offer the greatest potential for growth, profitability, and continuing opportunities for employees. Our goal is to emerge from this process as a smaller but more nimble company that is solidly profitable and has good long-term growth prospects.” Liddy said he was confident that the company will be able to pay back the $85-billion loan from proceeds of the sales AIG undertakes.

International Travel Insurance Journal INSURANCEMATTERS 15

www.itij.co.uk 16 HEALTHMATTERS

Chinese milk victims increase Officials in Zimbabwe on alert The number of Chinese children who have fallen ill falling. In some areas, diagnoses rose alarmingly quickly from ingesting toxic milk formula may have nearly – for example, in the northwestern Gansu province, Health and immigration officials in Zimbabwe have doubled since the Health Ministry’s last count, the number of ill children climbed to 13,459 from been placed on high alert to detect the possible according to local media, who dispute the figures 1,695 in just eight days. So far, the worst hit province is existence of cases of a deadly virus that has claimed offered by the Ministry. The government (at the time Henan, where over 30,000 cases had been reported three lives in neighbouring South Africa (SA). David of writing) had not updated figures that were issued on by the end of September, while neighbouring Hebei Parirenyatwa, health minister, was quoted as saying 21 Septmeber, when it said that 12,892 infants were in has counted nearly 16,000 cases. Hebei is where that officials at the Beitbridge border post between hospital, 104 with serious illness, and close to 40,000 the Sanlu Dairy Group, the firm responsible for the government has revealed new dairy safety standards Zimbabwe and South Africa have been told to be further children were suffering some ill effects, but not contaminated formula, is based. that sets strict limits on the amount of melamine that more vigilant in the processing of people entering the serious enough for hospitalisation. However, reports Despite the huge number of cases, the government is can be added to powdered or liquid milk. The US country from SA. Beitbridge is the main gateway for from local media across the country that have been insisting it has the problem under control and recent Food and Drug Administration stated recently that travellers between the two countries, handling on compiled by Reuters suggest the number of affected checks have found no trace of melamine, the toxic no amount of melamine in baby formula is safe, but average more than 3,000 people a day. children has in fact risen to nearly 94,000, despite additive, in liquid milk. As part of an ongoing strategy to officials in China insist that it has set levels low enough So far, three deaths have been recorded from a claims from officials saying the number of new cases is restore confidence in the ‘Made in China’ brand, the to protect people’s health. mysterious illness that was first detected in mid- September when a woman from Zambia arrived in South Africa with a paramedic and nurse asking for treatment; the woman died two days after arriving, while the paramedic and nurse accompanying her died shortly afterwards suffering from similar symptoms. The symptoms include fever, nausea and external bleeding, indicating haemorrhagic fever, although a definite diagnosis has yet to be made. The UN World Health Organization has been brought in to help local health authorities.

Yellow fever strikes

The Ministry of Health in Guinea has reported two cases of yellow fever, both of which have now been confirmed in a laboratory by the Institut Pasteur in Dakar. Neither of the victims had had a yellow fever vaccination. An outbreak investigation team comprised of experts from the Ministry and the World Health Organization have visited 10 sub-prefectures and the Urbain Commune of N’zerekore, where the outbreak occurred, and two other sub-prefectures in the Prefecture of Lola. The outbreak investigation team found that according to the yellow fever case definition, 14 suspected cases were found retrospectively, one of these cases died having presented with symptoms of fever and jaundice; inhabitants of most of the prefectures were vaccinated in 2005, with a reported coverage of over 95 per cent of the population; the only areas where a lower coverage rate was reported were in the Bounama sub-prefecture, where the first victim originated from, the Urbain Commune and the Ivorian refugee camp of Kouankan. Based on its findings, the Guinean Ministry of Health decided to undertake a mass vaccination campaign in the vulnerable areas in October, targeting over 140,000 people. It has already submitted a request for yellow fever vaccines from the global emergency stockpile, which is managed by the International Co-ordinating Group on Vaccine Provision for Yellow Fever Control.

International Travel Insurance Journal HEALTHMATTERS 17

www.itij.co.uk 18 AIRAmbULANCENEWS

Judge reverses Air Trek revocation order Spotlight on the Learjet 36A On 17 October, law judge William A. Pope II of the suggesting the inspectors leave the facilities while National Transportation Safety Board issued an initial Mr Carr contacted his attorney (‘refusal to allow decision to reverse an Emergency Order issued by an inspection’), this did not warrant revocation the Federal Aviation Administration (FAA) in June that of the company’s certificate. By the fourth day revoked the Air Carrier Certifi cate held by Air Trek. of the hearing, the FAA had withdrawn six of the The Florida-based air ambulance operator was issued 10 counts in the revocation order and dismissed with an Emergency Order nine of the 14 regulatory to suspend their certifi cate violations. At the end in May pending compliance of the hearing, the with Federal Aviation remaining two findings Regulations (FARs), but this of violation related to was moved to a revocation pilot operations at the following a failed inspection company’s Winchester of the company’s Punta base, which had been Gorda base. closed since January Less than two weeks after 2007. These violations the emergency suspension were found not to have in June, FAA counsel been ‘directed, caused or ordered a surprise inspection of the Air Trek base in permitted’ by management. order to collect evidence to push the suspension to More importantly, the law judge held that the FAA a revocation. The company’s director of operations, had failed to present any evidence that aircraft Dana Carr, suggested the inspectors wait in a nearby were operated in an unairworthy condition. He diner while he contacted his attorney to ask him to did, however, order that Air Trek’s certifi cate be help coordinate the inspection. Before the attorney suspended until the company provides adequate could do this, however, the inspectors had been safeguards to ensure ongoing future compliance he Learjet 36 is a stretched, turbofan- Capacity: Flight crew 2 instructed by the Special Emphasis Inspection Team with FARs. powered version of the initial Learjet Stretchers 2leader to abort the inspection, and a few days later an Air Trek was represented by Gregory S. Winton Tmodels, the 23, 24 and 25. The availability max speed: 872 km/hour Emergency Order of Revocation was issued. of Aviation Law Experts, who commented: of the Garrett AiResearch TFE731 turbofan in the Service ceiling: 41,000 feet During the nine-day hearing that culminated on “This case is another example of inadequate late 1960s led to a development of the Learjet 25 Range: 4,673 km 17 October, the law judge ruled that although Air FAA investigation leading to protracted litigation that was initially known as the 25B-GF (Garrett max take-off weight: 8,300 kg Trek had made a technical violation of FAA rules by without substantial justification.” Fan). A testbed Learjet 25 with a TFE731 on its left Wing span: 12.04 metres side fl ew in May 1971. Improvements over the years led to the 36A model in 1976, with a higher Length: 14.83 metres standard maximum take-off weight. Turkey begins air Ontario to receive Specifi cations ambulance provision new HEMS fl eet

Turkish health minister Recep Akdag has For the fi rst time in decades, according to local announced that the country will soon see the press, Ontario is to receive a brand new fl eet of air beginnings of what will eventually become a fully- ambulances after the province’s service provider fl edged state air ambulance service. In comments announced the purchase of what it describes as to the national news agency, Anatolia, he said: the most advanced medical helicopters available. “Two air ambulance helicopters will begin to Ornge, the operator of air ambulance services in serve in Ankara and the province, has said Istanbul later in the it will replace its old year.” He added fl eet of Sikorsky S-76 that the Health helicopters with 10 Ministry has signed new AgustaWestland an agreement for AW139 aircraft. The new 17 helicopters in choppers, bought at a order to establish cost of around CA$130 the air ambulance million, is the country’s system. The aircraft most signifi cant purchase were purchased via a for transport medicine, service procurement according to an Ornge method and it is spokesperson. hoped they will Dr Chris Mazza, an be in action by the emergency trauma end of the year. Three air ambulance airplanes physician and president and CEO of Ornge, said will also be purchased by the Health Ministry to the new helicopters would bring several benefi ts for complement the helicopters. residents: “We can go further, we can go faster and ITIJ understands that the two state helicopters we can go through more weather. What this means currently being used in Turkey are HAL Dhruv is it increases access.” He continued: “With our aircraft, although details of the new helicopters current fl eet of helicopters, when the temperature have yet to be released. According to the minister, is over 25ºC we are often signifi cantly compromised the new air ambulance project includes the in what we can carry. As the temperature climbs installation of helipads on top of a number of up even higher, sometimes we can’t even carry our hospitals across the country, including in Istanbul, regular crew because it doesn’t have enough lift.” Antalya, Adana, Kayseri and Trabzon. Nationwide The new AgustaWestland helicopters have more coverage is planned, with the air ambulances powerful engines and larger interior cabins, which serving neighbouring cities and districts located up become mobile critical care units, while the cockpits to 200 km from their original bases. The decision are fully computerised with a built-in GPS system. to send an air ambulance to an incident will be They are also the fi rst mid-size helicopters in the taken on the basis they will be used to reach sites world with anti-icing technology, said Mazza. that would take a land ambulance more than 30 Ornge covers almost one million square minutes to reach under normal conditions. The kilometres of territory and performs about air ambulance helicopters and planes will also be 18,000 missions annually, as well as transporting used by the Health Ministry to undertake organ patients and organ recovery teams between transports. hospitals.

International Travel Insurance Journal AIRAMBULANCENEWS 19

Lifeguard Air Emergency ADAC breaks new ground Services marks 25 years Medical transport provider ADAC has completed flight simulators for helicopter models EC135 and a ground breaking ceremony for its new HEMS EC145, while for the training of physicians and their Greg Cilburn of Lifeguard Air Emergency clinical staff comprises 40 nurses and paramedics, academy, based in St Augustin near the Cologne- assistants, the academy will offer a medical simulator Services, which celebrates its quarter with an average of more than 17 years of Bonn International Airport. The training centre with extensive equipment. century this year, charts the changing face experience in emergency and critical care; all hold will include a simulation hall, as well as training The academy is due to open in June/July 2009. of air ambulance operations in New Mexico national certifications and teaching credentials. Its and briefing rooms that will be kitted dedicated dispatch centre is staffed by National out with the latest media technology The early 1980s was a fresh and exciting time Association of Air Medical Communications to give students the opportunity for for emergency medical services in New Mexico, Specialists certified communications specialists, all individual computer-based training and US. You get a hint of it in the state EMS Bureau’s of whom are also experienced paramedics, rare group lessons. newsletter for February in the industry. ADAC said it expects the new training 1983 – just the fourth It flies two centre will set new standards in issue of that publication: Beechcraft King education and training in helicopter MAST and verapamil were Air 90s, operated aviation, making the skies above getting a lot of attention. by SevenBar Europe a safer place to be for all Nine paramedic students Flying Service, involved. The HEMS Academy, as had passed their licensing out of its base at it is known, will also be the world’s exams. And Lifeguard, the the Albuquerque first integrated training centre for new air medical service International helicopter pilots, doctors and assistants based at the University of Sunport (ABQ). in the emergency air rescue industry. New Mexico Hospitals Lifeguard serves For pilots, there will be two full (UNMH) in Albuquerque, New Mexico and had completed three the surrounding missions. region, routinely flying to El Paso and Lubbock, The very first mission, on 29 December 1982, Texas; Phoenix, Arizona; and Denver, Colorado. It brought a seven-and-a-half-week-old female is renowned for outreach, taking ACLS, PALS, and Indian Ministry to boost HEMS with hydrocephalus and a malfunctioning shunt to other advanced training to healthcare personnel development UNMH from St Vincent Hospital, 60 miles to the across the region. north in Santa Fe. Caring for her aboard the Bell New Mexico – large, diverse, and sparsely The Indian Ministry of Civil Aviation (MCA) has said it continuing its strong growth rate, the Ministry 206L-2 were a registered nurse and an emergency populated – retains a touch of the Old West and will encourage the development of a HEMS industry believes that ‘many citizens and corporates would medical technician from UNMH’s emergency presents unique challenges to medical transport in the country, and has already voiced plans to take certainly avail [themselves] of such cover’. Once room. The cost: $250, plus $4.50 per mile. services. With an area of nearly 122,000 square up the issue with the Department of Health and there is a demand for air evacuation from the public, “It was do-it-yourself back then,” says chief flight miles and a population of less than two million, various hospital groups. the MCA suggests that private hospital groups would nurse Kevin Schitoskey, RN, BSN, CFRN, CMTE. it has a population density of just 16 people per A senior ministry official toldThe Economic Times, combine with helicopter companies to start providing “Budget was minimal. There were no industry square mile (compared to almost 80 nationally). an Indian national newspaper: “We would like to air ambulance cover. standards for guidance. The gear bags were in a Almost a quarter of the population is concentrated bring to the fore the concept of HEMS and how The MCA has called 2008 ‘The year of the closet, the helicopter was in the parking lot, and in Albuquerque, while some 42 per cent is in these services can be institutionalised for the benefit helicopter’ and is keen for the international working Lifeguard was an ER assignment that might recognised ‘frontier’ areas. One in six New of the public. The government will ask the state community to see the efforts it is making towards go to anybody.” Mexicans lives in poverty, one in five is uninsured, governments and private hospitals to develop developing the industry. The Ministry has recognised A quarter-century and 43,000 missions later ... and access to health services is a hurdle for many. helipads in and around metropolitan hubs as well as the importance of making sure infrastructure is obviously things have changed, and milestones “Serving New Mexico means long legs – our state and district headquarters for the service.” in place before it rushes into buying aircraft: “For have been passed. Fixed-wing operations were average trip one-way is 156 miles,” says Schitoskey. The Ministry also reportedly plans to formulate a effective use of helicopters in an EMS role during added in 1986, and the rotor-wing service was “Lifeguard has the advantage of being a department policy framework that would facilitate better and a mass casualty event, heliports and staging areas outsourced in 2005. In 1992, Lifeguard became of UNMH, which not only is partly publicly funded, increased use of helicopters in India. should be developed simultaneously. [The] Heliports the first service in the state and just the second but also is the state’s only Level I trauma centre The MCA’s statement also said that in order to Committee, convened by the MCA, has already in the nation to achieve accreditation by the and the seat of tertiary and quaternary care. We provide a swift response during a mass casualty identified two sites, one in Rohini and the other in Commission on Accreditation of Medical Transport can extend that level of service to the bedside of event, it recommends that some helicopters the Delhi area.” Services (CAMTS). Early on, in 1984, a fatal the remotest sending facility, and we don’t have to be pre-positioned in disaster-prone states such The funding of the medical helicopters will helicopter crash tragically forced a reorientation hesitate over transporting any appropriate patient.” as Uttaranchal, Orissa, Andhra Pradesh and come from various sources, according to an on safety, and ever since, says Schitoskey, “Safety Gujarat. State governments, continued the MCA spokesman, with either sole contributions is the core of everything we do.” In fact, the statement, should therefore consider integrating or combining cash from sources such as the Association of Air Medical Services gave its first Greg Cliburn, NREMT-P, is a flight available helicopter resources into their disaster government, hospitals, corporate donations, fees ever fixed-wing safety award to Lifeguard in 1995, paramedic with Lifeguard Air Emergency management response system. for services and membership programmes. He and this year’s CAMTS reaccreditation process Services in Albuquerque, New Mexico. He is It has also been proposed by the MCA that the also pointed out that HEMS provision provides brought accolades for Lifeguard’s active and also a captain in the Santa Fe (New Mexico) Insurance Regulatory and Development Authority wider economic benefits, as it brings with it innovative safety committee. Fire Department and adjunct faculty in the EMS encourage insurance companies to extend insurance less need for specialised hospitals, less need for Today, Lifeguard remains New Mexico’s oldest Institute at Santa Fe Community College. cover that will take care of aerial evacuation in high-level ground ambulance services and better hospital-based, all-ages air medical service. The medical insurance policies. With the Indian economy patient outcomes.

www.itij.co.uk 20 TRAVELMATTERS

Wheelchair woes Domestic holidays Oz tourism to benefit from rate cut

A holiday jet carrying 229 passengers narrowly on the up The Australian media has reported that the AU$24- it is hoped will also boost the number of people avoided disaster recently when a wheelchair stored billion tourism industry in the country will be one travelling to the country. Brown continued: “For most in the hold burst into flames shortly after landing in New research from caravan insurance specialists of the sectors that benefits most from the collapse of the world, Australia will always be an expensive the UK. Ground staff unloading the baggage from Towergate Bakers has in the value of destination. We can’t just drag tectonic plates closer the hold of the aircraft noticed blue sparks coming shown that the UK’s the Australian to one another, so when you overlay the high Aussie from the chair, swiftly removed it and placed it on traditional seaside towns dollar. As the dollar, it really makes it difficult to keep Australians at another vehicle, where it burst into flames and was are set to be some of the interest rate cut home and to attract the rest of the world to come destroyed. A spokeswoman for Manchester Airport, few net gainers from the of one per cent here, so we are unambiguously the low Aussie dollar where the incident occurred, praised the ground credit crunch and current further drives cheer squad.” handling staff for their quick reactions, and added economic turmoil. The the dollar down, One British couple interviewed by the newspaper that the battery on the wheelchair should have been latest survey from the firm the currently had been in the country around three weeks when disconnected in the Canary Islands, from where the has revealed that 65 per depressed tourism the rate cut came in, and it has made them consider flight originated. cent of British people will industry hopes for whether or not they want to extend the length of their The incident prompted the Civil Aviation Authority be switching to cheaper, a turnaround in stay: “We initially budgeted for spending around $420 (CAA) to issue a warning to passengers about the domestic holidays over the fortune, although a week, and we’ve been easily meeting that target,” dangers of ‘seemingly innocuous items’. Geoff Leach, coming year in order to optimism is explained Mark Nunn. “Australia is quite good value manager of contain their spending. The tempered due really, with a pleasant little bonus in the form of the the Dangerous research suggests that for to the global fall of the dollar.” On the other side of the fence, the Goods Office Britons at least, long-haul economic falling value of the dollar is also expected to discourage at the CAA, travel may be delayed until situation. Australians from travelling overseas, meaning more will said: “The cause the economy recovers. Chris Brown, managing director of the Tourism holiday locally, increasing income in tourist areas. of the fire is The research was undertaken to provide an insight and Transport Forum, said that the falling value of Meanwhile, a survey conducted by Insure4less, a currently under into UK driving holidays, asking more than 2,000 the dollar was definitely welcome news, especially travel insurer based in Australia, has found that the investigation, but people what sort of holidays they were planning for as it fell on the same day as the launch of a new majority of locals are proving resilient to the financial it does highlight the year ahead in order to avoid falling further into advertising campaign for Tourism Australia. Brown pressures and are refusing to give up their holiday the need for debt. Other key findings from the survey show that told The Australian newspaper: “It’s good timing – plans. Whilst some consumers are changing their passengers to caravan holidays are the top choice for couples or there’s a global economic malaise and we can’t sit plans, 70 per cent of respondents said foregoing be extremely parents in their 30s – 21 per cent of respondents around in the woolshed crying about it. We’ve all travel was not on their agendas. Aubrey Abbott, vigilant when dispelled the myth that caravanning is just for got a job to do, and the drop in the Aussie dollar managing director of the insurer, commented: “We taking items pensioners and showed that caravan breaks are combined with the launch of the movie makes the always knew that Aussies were born to travel and onboard aircraft. actually most popular with younger families. For the timing impeccable.” Brown was making reference they will forsake other luxuries in order to afford to Passengers need under-25 ‘festival generation’, camping is revealed to Baz Luhrmann’s new movie Australia, which travel. This survey supports that belief.” to be aware that some items, which are relatively as the top choice budget holiday, while the seaside innocuous in everyday use, are capable of posing a town revival is most prevalent among 20 and 30 serious risk to the occupants of an aircraft, no matter year-olds. where they are carried onboard, and therefore need Paul Havenhand, marketing director at Towergate Travellers pinpoint US trends to be carefully checked.” To underline the dangers Bakers Insurance, said business figures supported of everyday items, Leach reminded people of a fire the results from the survey: “As the UK’s leading Research by online travel community aboard another aircraft in February 2007, which was caravan insurer we have noticed a return to TripAdvisor has shown that an caused by a short-circuiting camera battery. That popularity of traditional UK holidays. Young parents increasing number of Americans plan fire began in an overhead locker inside the cabin of often have nostalgic memories of their own to be more environmentally conscious a plane that had just taken off from New York’s JFK childhood holidays and this, combined with the when making their holiday plans in Airport. Said Leach: “Passengers frequently travel economic downturn, will create a boom in UK 2009. The poll, which asked more than with electronic gadgets or other battery powered holidays in the year ahead.” He followed up with a 3,000 travellers their opinion, found items and, although the batteries in these rarely pose recommendation that first-time caravanners should an emerging trend in visits to national a safety problem, if they are loose or the equipment check their insurance arrangements to see what parks, hiking and adventure holidays. is inadvertently activated there is a danger of fire.” cover is available. Of those who took part in the survey, 32 per cent said they would consider the impact of their holiday on the environment this year, up from 26 per cent in 2007. Meanwhile, 34 per cent of respondents said they plan to visit an environmentally friendly hotel or resort in the next 12 months, up from 30 per cent last year. For many (61 per cent), the cost of fuel is now a vital consideration when choosing their next holiday destination. The poll also served to identify the top three emerging world hotspots for travel as Budoni in Sardinia, Agia Galini in Crete and Petra in Jordan. Making up the rest of the top ten international destinations were towns in Ireland, Italy, Cyprus, Spain, Sri Lanka and Germany. In the US, meanwhile, among the top destinations for 2009 were St George in Utah, Englewood, Florida; Keauhou, Hawaii; Haines, Alaska and Bainbridge Island, Washington. Attractions on the US’s own doorstep seem to be enjoying a revival at the moment, which will continue into 2009, according to the survey. It showed that 73 per cent of US respondents said they planned to visit a national park in 2009. Fifty-three per cent of those polled will go on a hiking holiday in the coming year, while 47 per cent said they would plan an adventure activity. As all the people planning a trip found out, however, air capacity sometimes isn’t what it used to be. Forty-nine per cent said they have had more trouble booking the flights they want in the past 12 months than they did last year, and 17 per cent said they had had a flight cancelled this year because their route or flight was permanently eliminated from their carrier’s schedule. In response to some slightly different questions, it was found that 50 per cent of Americans believe airlines will in the future charge for a window view, 71 per cent think families with young children should sit in their own section of an aircraft, while 13 per cent think airlines should prohibit parents from flying with infants, except in the event of an emergency. It seems children are the bane of some fliers’ lives, as a further 37 per cent of respondents said they would pay extra to sit in a quiet section of an aircraft, and of that group, 38 per cent would pay as much as a six to 10-per-cent premium.

International Travel Insurance Journal

22 NEWSANALYSIS Banking crisis: recession for travel insurers? Stewart Farr recaps on the latest financial market turmoil, and asks what effect it could have on travel and travel insurers around the world

n retrospect, mid-October 2008 could turn out that ‘challenges come from the US slowdown and to be the watershed forever enshrined in future the weak dollar, higher fuel costs and concerns about Imonetary treatises and economic textbooks; climate change’ but that continued strong expansion the time when governments around the world in emerging countries meant that the industry’s acted in tandem to shore up ailing banks and solve prospects remained bright into the medium term. lending crises as well as guaranteeing, at various The growth rate in the mature markets of the levels, investments and saving deposits. Global fiscal Americas (2.1 per cent) and Europe (2.3 per cent) meltdown seemed to be averted but recessions of was considered by TSA to be falling below the world varying severity were consequently predicted for average whilst the regions of Africa (5.9 per cent), many countries caught up in the credit crisis. Asia Pacific (5.7 per cent) and the Middle East (5.2 This may or may not be the case because, at the per cent) were exceeding it. “In particular, China, time of writing, world share prices are still yo-yoing India and other emerging markets are still growing (with a greater tendency to plunge rather than soar) rapidly, which will increase both business and leisure and financial headlines seesaw daily from optimism travel, while many countries in the Middle East are to abject gloom. Nobody, it seems, is certain that undertaking massive tourism-related investment the Great Bank Bailout programmes,” explained will actually work and John Walker, chairman of recession appears much Oxford Economics. more a probability If corporates are not Although the US continued than a possibility. to maintain its pole position We may be spared doing business, their as the largest travel and a repeat of 1933’s tourism economy (total Great Depression, but executives don’t travel demand accounting for the ramifications of a more than $1,747 billion recession are worrying per annum), TSA research enough. If corporates noted: “In 2008, the credit are not doing business, their executives don’t travel; crunch is leading to a marked slowdown in US if consumers lack spending power or become economic growth and is likely to restrict the business unemployed they don’t do holidays. In both cases, travel of those working in financial markets.” travel insurance becomes a casualty. Some six months later, that comment at best holds true, or at worst could be a massive understatement Uncertainty rules of what financial calamities might now face the travel Earlier this year, in March, research on travel and and insurance sectors. Since March, an awful lot has tourism from Tourism Satellite Accounting (TSA), rocked the world’s financial boat, which is now listing provided by the World Travel & Tourism Council very close to the waterline. There’s been the US (WTTC), anticipated a slowdown in the industry Treasury’s bailout of Freddie Mac and Fannie Mae, during 2008 but concluded that prospects were the non-bailout and subsequent collapse of Lehman bright for the next 10 years. This year tourism and Bros, the Federal loan – to avoid bankruptcy – to travel was expected to generate almost $8 trillion world-leading insurer AIG, the crashing of several with a level of $15 trillion expected by 2018. smaller US banks and the seizure of a much larger This, in essence, meant a slowdown in 2008’s annual one, Washington Mutual, by the regulators. growth rate to three per cent (compared to 3.9 In Europe, there’s been the UK’s financial debacle of per cent in 2007), reverting to mature but steady RBS, HBOS and Lloyds TSB; the country’s banking growth from 2009 and averaging out at 4.4 per cent system is reportedly being thrown a £500-billion per annum, supporting 297 million jobs and 10.5 lifeline (courtesy of the taxpayer), which compares per cent of global gross domestic product by 2018. favourably with the $700 billion earmarked by the WTTC President Jean-Claude Baumgarten noted US Treasury to rescue Wall Street. The Dutch-

International Travel Insurance Journal NEWSANALYSIS 23

still do not know what risks may await stock market tumbles, banks being bailed out by them overseas. To many of them ‘travel governments and tour operators/airlines going out insurance’ means trip cancellations and of business, the last several weeks have been very baggage protection, and they often neglect interesting indeed, muses McDonald. But the British to protect and prepare for medical or travelling public are apparently reluctant to give up security needs. “With Americans focused their summer holidays. Even when money is tight, on financial matters, the high-dollar risk she says, many families still seem to manage to involved in not having medical coverage save up their pennies and pounds and get away in and the affordability of most travel medical the summer. Reductions in capacity for 2009 mean programmes may actually convince that remaining tour operators in the market are travellers who previously did not purchase maintaining a healthy level of bookings. Air lines are a programme to do so. The opportunity also being helped by the recent drop in the price of to create smarter travellers, who are oil, the rise in which pushed some over the brink more prepared earlier in the year. before they go, We may see the “So, for travel is something that insurance, the prospects will benefit the importance of snowbirds for the next year may industry in the not be as bad as some long run,” said in the UK travel may think,” says McGee. insurance market rise McDonald. “We may “With our see some decline in the corporate to rival the Canadian sales of annual policies business, we do as people give up their not believe this and North American weekends away and Belgian Bank Fortis NV has also succumbed to chairman of the US Federal Reserve, stirred it up financial crisis will have a experience winter holidays, but this losses on credit derivatives, causing China’s Ping by telling Americans there would be no quick fix for long-term adverse affect may be compensated An insurance company to record a $2.3-billion their ailing economy. In the US, retail sales were on – nor does it eliminate the need for – business for to some extent by a rise in the sale of single-trip loss on its stake in the bank; this was a setback for reported to have suffered their worst fall since 1992, travel in a global economy,” added Mike Roban, policies.” And the market for older customers may one of the most ambitious foreign acquisitions to dropping at twice the rate analysts had expected. vice-president of sales for MEDEX. He commented continue to rise in importance. Those people who date by China’s state-owned banks and insurance An eight-per-cent share fall was recorded on Wall that mid-size companies may have to cut back on have been fortunate enough to retire on index-linked companies. Another Asian victim of the worldwide Street, and London and Paris both suffered seven- international travel, but believes that corporate pensions may be the only ones who can still afford to financial turmoil, Japan’s Yamato Life Insurance, went per-cent falls. The Dax in Frankfurt lost more than travel departments may be more concerned about travel regularly. This is particularly true in the winter, bust with debts of $2.7 billion. six per cent and Tokyo’s Nikkei was set to tumble gas prices than the financial crisis as it relates to when it may be cheaper for such pensioners to fly By the end of the first week in October, panic had by 11 per cent. Companies that underpin the global travel budgets. south, saving money on fuel bills (which have risen swept through the world’s financial markets, wiping economy – industrial groups, manufacturers, oil Fiona McDonald, head of underwriting for Europ dramatically this year) and making the prospect of a $2,500 billion from share values. The Dow Jones producers (the price of oil fell to below $75 a barrel) Assistance in the UK, also sees a couple of tiny long period in the sun financially attractive. “We may index dipped below and mining corporations – rays of sunshine for the travel and travel insurance see the importance of snowbirds in the UK travel the 10,000 mark for featured heavily among the industries between all the gloom. “There is an insurance market rise to rival the Canadian and the first time in four market casualties. Near- ancient Chinese curse that says ‘may you live in North American experience,” says McDonald, “If years, while the FTSE certain global recession, interesting times’. I think that pretty much sums up that’s the case, underwriters will need to get their 100’s fall of eight per there is a chance that an bringing the Far East into the times we are now living in,” she says. Between pricing right.” cent was the biggest economic downturn may its maw, was forecast by since Black Monday Rio Tinto’s warnings of a in October 1987. result in fewer leisure fall-off in demand for metal The Icelandic banking from China’s mills and system appeared to travellers and thus fewer factories. Fears of rising implode and banks travel insurance policies unemployment spread across Europe cast aside across Europe; in Britain it strategic planning as surged at its fastest rate for they sought to ward off 17 years. In the words of possible bankruptcy. The BRIC stockmarkets (Brazil, one market commentator, ‘the banking rescue act is Russia, India and China – representing many of the a year late’. emerging markets for travel and tourism) crumbled The following day saw the $60-billion bailout of as investors suffered their worst one day losses in UBS by the Swiss government, and a further slump history. in the FTSE 100 revealed British insurers amongst The International Monetary Fund stepped up to the hardest hit. Prudential shares fell by almost 20 announce that the world economy was in the grip of per cent and Aviva’s by almost 10 per cent. Ratings a severe downturn and may soon sink into recession agency Fitch reported that the sector may be the because of the credit crisis and increasing fiscal next casualty of the crisis with a ‘noteworthy ramp- chaos. The price of oil continued its downward trend up in losses to be reported by many insurers’. and metal prices – an indicator of manufacturing Days count: the world’s economic future, or at least resilience – also fell significantly. headline predictions of its fate, could have worsened by the time you read this. However, even if Governments step in confidence prevails, markets pull away from the brink Governments provided a swift response. President and unemployment is contained, the travel insurance Bush issued a direct plea to Americans to hold industry has to be realistic about future growth. Until their nerve as shares crashed further, while Prime the momentum intensified in September/October, Minister Brown called for concerted global action. insurance companies had managed, by and large, French President Sarkozy and German Chancellor to steer clear of the credit crisis carnage. Now the Merkel agreed a joint pledge with the 13 other spectre of mass unemployment could leave a big leaders of the eurozone to recapitalise banks and dent in the take up of holiday and travel plans (albeit guarantee lending between them. RBS was taken that a long-term fall in oil prices could work through under state control by the UK government at a cost to reduced airline costs and charges). of £20 billion and there seemed every likelihood of a Linda McGee, president of MEDEX, a US provider nationalised HBOS and Lloyds TSB. By 14 October, of insurance and assistance services, agrees there the sunshine had broken through; markets soared at is a chance that an economic downturn may the perceived world action to rescue banks. Global result in fewer leisure travellers and thus fewer shares made their biggest one-day advance for 19 travel insurance policies. “The potential decrease years; the Dow rose by 11 per cent and the FTSE in international travel is different than what we 100 closed up more than eight per cent. experienced post 9/11, when people didn’t travel Two days later, normal service, i.e. maximum due to fear for their safety – this time, people economic gloom, was resumed. Shares crashed might choose not to travel because they can’t again amid fears that a co-ordinated bank bailout afford to.” would fail to avert a global slump. Ben Bernanke, In general, the company feels that many Americans

www.itij.co.uk 24 FEATURE What is acceptable cover? Part I

Today’s traveller carries with them all manner of items that need to be insured. Alan Berry asks what constitutes acceptable travel insurance cover in our changing marketplace

he definition of ‘acceptable cover’ depends There are many driving factors that determine what is on what we are actually asking, and what and is not acceptable, but essentially insurance should Twe are looking to achieve. Irrespective of meet the needs, expectations and demands of its geographical boundaries and culture, the primary local market in terms of product, service and price. function of an insurance policy is to place a customer If it achieves these aims, it provides the very essence in the same financial position as they were prior of the reason why insurance evolved. Density of to the loss; it is not designed to benefit either the population can be a huge driving factor in how a customer or the insurer. If the insurance policy market evolves. In the Nordic countries, Denmark delivers the above, then surely it must be deemed has a population of around five million. Thus, any acceptable. negative publicity can cause immesurable damage to a company. Not so simple Furthermore, if as an organisation an insurer provides If the above is not the requirement, then what an exceptional product, but fails on service, the criteria are we defining as acceptable? Is it the level product becomes useless. Therefore it is essential of ‘sum insured’, ‘service’, ‘value for money’ or that acceptable travel cover be accompanied by ‘cover’? The topic actually raises more questions excellent service. than answers. If the above is true, then acceptable Travel insurance is essentially a temporary form of travel insurance cover in the UK differs from that financial protection intended for a short period of in Germany, France, the Nordic countries such as time. It is not meant as a replacement for private Denmark, and elsewhere. medical insurance or a home contents insurance

There will always be argument for a wider cover to be provided, but whilst market expectations are price driven, cover will be the casualty

policy. In an ideal world, a travel insurance policy Unique markets would cater for every individual and would cover Let us take the UK’s £760-million travel insurance every eventuality. Practically, however, this cannot market. What drives this vast marketplace? Is it happen: a travel insurance policy cannot cater for quality of service, quality of product, choice every eventuality that may befall a policyholder as the or price? For a start, various market forces cost to do so would be prohibitive. determine the framework of products on Acceptability, therefore, is purely a subjective offer. Competition in the UK in terms of matter. For example, if you surveyed 10 members distribution channels and suppliers is huge, of the public as to what would be acceptable as there is a high density of population, cover, you could receive 10 different responses. a constant quest for market share and This is due to the fact that we are all individuals elevated customer expectations. Thus, with fundamentality different sets of circumstances. product choice is vast. However, travel Is acceptable travel cover one that provides insurance is not compulsory in the UK, and financial protection against loss, theft, damage, it is generally perceived in a negative manner. It delay, missed departure, personal accident, liability, is often deemed non-important cover in a country cancellation, or curtailment for the majority, or where insurance consumers are predominantly should it mean the provision of financial protection driven by price. The most frequently asked question for everyone, irrespective of financial situation, is not ‘what does it cover?’, but ‘how much will it gender, health, disability, age or nationality? And is cost?’, and to this end travel insurance provided in it acceptable to ask a travel insurance provider to the UK is loaded with fixed-benefit cover, at a very provide this? low price. Ultimately, therefore, to the UK consumer,

International Travel Insurance Journal FEATURE 25

replacement for home Again, this model caters for the majority but not for contents cover, nor all. It is not uncommon these days for holidays to cost should it be considered in excess of £10,000 per person. a replacement for any If we take a look at the local market in Germany and specialist insurance the Netherlands, the system utilised is based around policy. the total trip cost, irrespective of the value of the In respect of holiday. It could be €50 or €50,000. This system, cancellation cover, the known as ‘tariff-based’, provides a solution that works UK model is based for these local markets, and provides a true risk value on a fixed benefit, to the cover being provided. Could it work in the ranging from £1,000 UK? Yes, it could. Would it succeed? Probably not. up to £10,000. There The market would likely not understand the concept are exceptions to this, nor deem it value for money. with very low cover of Overall, I believe the cover generally made available £300 up to unlimited, within the personal possessions section of a travel but the majority of policy is acceptable for the premiums produced, products provide provided the intention is that the consumer is placed cover within these in the same financial position that they were in prior parameters. to a loss, and provided the consumer understands Furthermore, the that the insurer, whilst they could cover every construction of cover eventuality that may befall a traveller, would not sell under UK wording is such a policy as the cost of the product to the acceptable. Standard consumer would be unacceptable. There will always cover is provided be argument for a wider cover to be provided, but against cancellation whilst market expectations are price driven, cover will due to death, disability, be the casualty. illness, redundancy, burglary, jury service and HM Forces leave cancellation, Alan Berry began working in personal which in turn is in line lines broking in 1987, with high street consumer expects 100 per cent of the claim to be with the socio-economic requirements of the UK broker Swinton. In 1995, he began if, as an organisation, covered and at purchase price. Maybe we should marketplace. UK policies do not cover cancellation writing travel insurance for a Lloyd’s an insurer provides an return to whether this is an education issue on the for any reason as do some markets; the reason being syndicate before joining provincial industry’s part? At the end of the day, the insurance that the UK is driven by fierce pricing. If the UK broker Henderson Insurance in 2002, exceptional product, but company’s responsibility is to provide cover for a adopted a cancellation product providing cancellation where he set up the travel insurance specific period of time for personal effects up to cover for any reason, it would cost more than the division. After a stint at JLT as business fails on service, the a designated sum insured with inner limits and an multi-risk packages currently available. development manager, Berry moved to product becomes overall maximum limit. However, as I stated earlier, we travel further and to ETI International Travel Protection in July more exotic locations and for longer periods, so is 2005 as the travel development manager. useless Higher expectations the current format of fixed-benefit cover ‘acceptable’? As we are constantly being reminded, the world is ‘acceptable’ cover is determined by price. a small place. In less than one day, you can literally A simple quotation request on a UK aggregator be on the other side of the world. Meanwhile, our comparison site can return some 450 different greater disposable income has meant that our travel products from over 40 suppliers. In reality, 80 per plans have diversified away from the typical one- cent of the quotations probably could be questioned week vacation in a beach resort, and we now travel THERE IS LIGHT ON THE HORIZON as to whether they are providing ‘acceptable’ much further, for longer and more often. We also travel insurance cover in the true sense. In the UK take many more gadgets with us on holiday than we marketplace, the actual product seems to play a used to, which begs the question: is it reasonable to small part in the equation due to the public emphasis expect the personal possessions section of a travel on cost rather than protection. This is why in the insurance policy to cover all the electronic gadgets, UK you see loaded ‘multi-risk package’ or ‘all-risk mobile phones, iPods, PDAs, MP3s, MP4s, portable insurance’, with providers striving to find another DVD players, portable LCD televisions, sat phones, ancillary cover to bolt into the product without adding Blackberries, laptops, camcorders, digital cameras and to the overall price. all the accessories that accompany these items? Add If we look at the terms and conditions under the on designer clothes, shoes and bags. The consumer personal possessions section of a standard policy, we would say: “Yes, this is exactly what the insurance see that cover is provided for specific events, such company should cover!” as theft, damage, loss and destruction to personal The problem is the consumer doesn’t differentiate baggage. Inner limits then apply against insurance company and travel insurance to valuables and single company; they just see ‘insurance company’. articles. Money cover However, travel insurance should not be the primary is also provided. This insurance for high-value electronic devices. If travel coverage is based insurers were to include these items then the cost on market needs of a policy would be prohibitive. Having said this, in > worldwide AIR AMBULANCE OPERATOR and expectations as the UK it is documented that one in 10 households > worldwide REPATRIATION & MEDEVAC well as commercial do not have household insurance, meaning the risk exposure, but disappointing reality is that the majority of consumers > worldwide AIRLINE STRETCHER SERVICE the customer’s are prepared to leave their belongings uninsured > worldwide MEDICAL AIRLINE ESCORTS understanding of what all year. It is not acceptable to expect insurance the personal possession companies to provide cover for specialist items for a > worldwide BED-2-BED TRANSPORTS section of a travel insurance short-period holiday if there is no cover in place for > PERSONAL MEDICAL CONSULTANCY policy is designed for is these items for the remainder of the calendar year. worlds apart from the I believe that the level of cover currently offered in insurer’s definition. The the UK market is acceptable. It is not meant as a 24 / 7 available for those in need! Tel: + 43 1 600 1212 to the UK consumer, ‘acceptable’ based in: VIENNA (LOWW/VIE), AUSTRIA cover is determined by price www. medicaljetservice.com

MJSlightonhoriz76.indd 1 24/4/07 16:01:04 www.itij.co.uk 26 FEATURE

Who can you trust?

Small print, denied claims and problems obtaining cover have all helped to give insurers a negative public image. Milan Korcok asks whether travel insurers are losing their clients’ trust, and if so, why

s never before, Caveat Emptor has one more drip of bad blood. become the rule for travellers placing trust Ain those promising to transport them, Not the whole story protect them, and deliver the goods and services In September, American Express reported that they have worked so hard to pay for. Holding on almost one in four Britons were planning to travel to trust, however, is not easy in the wake of the abroad without insurance – despite the recent news high-profile collapse of Zoom Airlines (connecting of the XL collapse. The reasons stated for those Canada and Britain), or the failure of UK-based choices were primarily economic – rising cost of XL Holiday Group, stranding 90,000 vacationers living, money shortages, cutting back on those items in some 50 destinations overseas. It is equally that seemed dispensable, like travel insurance: keep devastating for people caught in contracts they the holiday, maybe less lavish, but cut the frills. don’t understand, as in the case of a 19-year old In another poll released earlier in the summer, only British student who crashed a moped in Vietnam 49 per cent of Canadians said they always or usually

the relentless expansion of travel … has forced insurers to add more bells and whistles, but also to be far more rigorous in identifying risk factors before committing to contracts with customers.

but was denied medical or repatriation cover buy travel insurance when crossing into the United because he had the ‘wrong kind’ of motorcycle States, almost 43 per cent saying they never or driver’s license. rarely buy it – despite the admission by most that Despite all the signs of contrition and compassion they know their government health insurance will shown by the operatives at Zoom, or XL, or not cover them abroad. In the United States, a poll Boots Gap Year Travel Insurance, displaced clients done by the US travel insurance industry shows that are unable to understand why they fall between only slightly more than four per cent of travellers the cracks. They get angry and cynical and are specifically seek out dedicated supplemental health easily convinced that the decks are stacked against insurance when leaving the country. them by contracts they are not really meant to Thirty years ago, the purchase of travel insurance read, even though they are exhorted to do so. was a relatively simple business. You got your one- And so when the moped driver’s father has to page contract at a dispensing machine at the airport: pay £25,000 to repatriate his son from Vietnam no pre-existing conditions. Period. But today, more to London because of what he considers a well- and more travel insurers are in a catch-22 of their buried technicality, the trust binding insurer and own making: promising more, chasing bigger and client takes a terrible hit. If this were an isolated more diversified markets, forced into building better case it wouldn’t attract the attention it has, but firewalls to protect their risk, then catching hell from during this summer of financial slaughter, it’s just the public and the media for loading up their policies

International Travel Insurance Journal FEATURE 27

with too much fine print. Though the apparent reluctance to buy travel insurance may be partly economic, some is clearly borne of a deep suspicion and skepticism that insurers have it all one way; that all they want are the young and the healthy, and those 32-page policy contracts are there to fireproof the insurer more than they are to provide a safety net for the traveller. As publisher of a consumer-oriented website for travellers seeking information about travel insurance an independent ombudsman reviewer for clients appealing claim denials by Canadian travel insurers, I have intervened in hundreds of cases where poor communication was the main culprit underlying denials. Either individual clients (or their agents) did not understand or adhere to the terms of their contracts, or insurers failed to clearly explain the terms they were offering. Usually, they explained their benefits well: their exclusions and restrictions, far less well. Rarely did the clients deliberately try to distort information about themselves (though there was occasionally a tendency to forget inconvenient truths), and hardly ever did the insurer deliberately distort information to solidify a denial, although there was incidence of sloppiness, negligence, ambiguity and opacity that achieved the same result.

Trust loves simplicity It is not rare for me to receive queries or complaints revealing a deep distrust of conventional travel insurance: such as the correspondent who spends his winters in Mexico, but instead of getting travel insurance buys an air ambulance repatriation service which, he says, will ‘get him home fast’ in case of emergency. He prefers this option because air ambulance plans have ‘virtually no fine print’, only a few easy-to-read pages that explain what they do; while insurers ‘have a penchant for hiding things under the fine print’. He says that if he has a routine medical problem or a broken bone while in Mexico he pays as he goes locally and finds the medical services both cheap and of high quality. I respond that medical emergencies don’t always people couldn’t afford to leave their borders. allow the warning he may need to put that plan into Example: a query to my website from a Toronto man action, but he is willing to take the risk because of his with HIV. “I have been very stable for quite a few skepticism of what lies in the insurer’s fine print. He years with CD counts remaining about the same and concludes: “I agree that we should all thoroughly read a viral load that was undetectable. My understanding their convoluted policies before we sign up, but how of travel insurance is that insurance companies many people do we know who have ever done it?” could relate any type of illness that comes on while How many indeed? I am away to the HIV and thus I wouldn’t have any Once broken, trust is devilishly difficult to fix. And coverage.” such a fix is seriously impeded by a fundamental In attempting to help him find cover, I canvassed skepticism that people worldwide have about polices from some of Canada’s largest travel insurers.

When does the requirement for patient medical information go over the top? their dealings with insurers as an industry group. Some stated right off the top that an applicant with This past summer, the highly respected Edelman HIV was ineligible for cover, and, though frustrating, Trust Barometer, a scientifically credible survey that saved a lot of time. But researching others took done annually by the Edelman international public more work. I noted that some policies stated outright relations firm, showed that of all industry groups that HIV would be treated as would any other pre- (including technology, biotech/life sciences, banking, existing condition i.e. if the symptoms were stable automotive, healthcare, and consumer packaged for 90 days prior to application (virtually impossible goods), insurance and media companies were considering the tests and medication alterations the least trusted globally by 46 per cent and 45 necessary to control HIV levels). Others stated that per cent of respondents respectively. In North my correspondent would be covered for anything America, insurance companies had a 49 per cent unrelated to his HIV. But to find these variations in trust level, media companies 44 per cent and in cover and navigate their contradictions we had to go Europe insurance companies achieved only a 35 per far beyond the summary of benefits, the key points cent trust ranking while media were at 40 per cent. of the plan, past the definition of ‘stable’ and ‘pre- The survey was done in 2008 among over 4,000 existing condition’ to find the bottom line. In one, we opinion leaders in the 25 to 64 year age group in 18 went as far as page 19 of a 34 page contract to find countries. that though he might have been eligible for cover according to the wording of the summary and the You need me but do you love me? definitions, he would have been eliminated by the The age-old complaint about travel health insurers General Conditions – in the bowels of the contract is that they fail to cover those who need it most. A boiler plate. paradox, but true. Economic realities make it true. It is these fine print ‘gotchas’ that fertilize the Maybe that’s why insurers can’t expect to be loved negative perceptions of the travel insurance industry. – even though without their products, millions of In the case of James Pinnington, the Vietnam moped

www.itij.co.uk 28 FEATURE

victim, his insurer Boots said: “Our Gap Year Insurance policy wording clearly states that a claim will not be paid ‘arising from using a two wheeled Thirty years ago, the motor vehicle as a driver or passenger if you are purchase of travel not wearing a crash helmet and the driver is not a holder of a full UK class A motorcycle license’.” insurance was a Pinnington did not have a full UK class A motorcycle license, a law not officially applied in Vietnam. In relatively simple his defense, the Consumer Action Group argued business … today, more that insurers should be clear with customers when selling travel insurance and that in this case this and more travel insurers requirement should have been contained in the ‘Key facts’ booklet, whereas it was only stated on are in a catch-22 of their page 13 of a 64-page document. own making Furthermore, the Association of British Insurers, which denies that its insurers use ‘small print’ to avoid paying claims, noted that last year its members paid out £200 million for people who fell ill or had medical information go over the top? When is it just accidents overseas, and that more than 20 million too much for the medically-untutored customer people took out some form of travel insurance in to handle? For example: how reasonable is it to Britain, of which just over four per cent (850,000) ask an aging applicant the following question on a filed medical claims. self-administered questionnaire? ‘Have you (in the past five years) had an aneurysm greater than four Where will it end? centimetres in size – diameter, width or length, With the relentless expansion of travel, insurance which remains surgically untreated?’ Or ‘(Have) has become more complex because it is covering you had cardiac valve stenosis or cardiomyopathy more people, sicker people, clients who want with an ejection fraction of less than 40 per cent or cover for everything from white water rafting to a ventricular function grade of 3 or 4?’ – part of an golfing in the desert (with appropriate cover for application in one of Canada’s most popular travel their expensive clubs), as well as those travelling plans for seniors. to places that range from exotic to outright Many elderly patients are never told by their doctors dangerous. This has forced insurers to add more of a heart murmur, or a low grade heart block that bells and whistles, but also to be far more rigorous doesn’t require intervention, and are just advised to in identifying risk factors before committing to go ahead with their vacation in the sun and come contracts with customers. back when they return in the spring. At their age, Now, it is rare to find a policy that does not cover why worry them? And then they have an emergency, pre-existing conditions to some extent, but the and an investigation of their medical record shows language describing the exceptions to that and the inconsistencies with their application and they pages-long medical underwriting forms that must are dunned for a pre-existing condition or non- be completed can be traps for the innocent or disclosure. Whether it’s their fault or their doctor’s is unwary. When does the requirement for patient irrelevant. It’s a risk the insurer didn’t know about and

would not otherwise have undertaken. “My doctor never said that blackout I had five years This summer, I was interviewed ago was definitely a TIA and it never bothered me about travel insurance issues again so I didn’t think it was worth mentioning.” by a researcher from the CBC To the insurer, this is a case of non-disclosure – (Canadian Broadcasting grounds for voiding a policy. To the insured, it’s a Corporation) for a programme scam – a sleazy effort to dig around in the ruins scheduled this fall. I sensed a bit and come up with an excuse for not paying a of a set up when the interviewer claim. Especially egregious since the ‘possible’ TIA said: “Isn’t it true that insurers had nothing to do with the gall bladder excision routinely deny all claims then that precipitated the $21,000 emergency medical challenge their clients to fight for encounter in a foreign hospital. settlements, knowing that they will Non-disclosure of a symptom unrelated to a claim is give up in the end?” – or words a tough item to explain and one the media is likely to to that effect. After explaining the pounce on with fervour. It looks like a grenade held competitive and economic damage in the back pocket as a last defense, even though it is this would do to the insurer and to perfectly defensible in many cases. the insurance company’s investors, I am often asked by insurance customers if they I realized how quickly and easily need a lawyer to buy travel insurance. I take it as a millions of Canadians could, in joke and say no, not really, just read the fine print one instant, been turned to view and make sure you understand it – a statement that insurance as a corrosive force in tests my own credulity. And then I realize that it is their lives. On nothing more than lawyers creating these masses of indecipherable fine a futile grab for a sensational news print. Perhaps travel insurers need to turn the hook. After all, it was on television, mirror on themselves and honestly judge if in the so it must be true. Right? Sadly, process of making themselves fireproof, they are this happens all the time. not burning their customers.

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www.itij.co.uk Air Ambulance AirMed International is the leading Life Flight International inc. is based at Skyservice Air provider of the year air ambulance service in the United ‘Victoria International Airport’, Victoria, Ambulance operates States, offering unparalleled * AirMed International B.C. Canada. Founded in 1992, Life a fleet of five medical care and bedside-to- Flight provides air medical transport medically dedicated Learjet 35A air ambulances from bases * Life Flight bedside transportation on a World Wide. One call total transport set both in Montreal and Toronto, Canada with an additional * Skyservice worldwide basis. Chosen as up for bed to bed service is provided contracted aircraft in Vancouver, Canada. They are a exclusive air medical transport for two of the most acclaimed utilizing private aircraft, helicopter or commercial airline. university medical centre based program in association Sponsor - EURAMI hospitals in the world--the famed Mayo Clinic and renowned Life Flight owns and operates one Citation II with dual life with the McGill University Health Centre, Montreal Cleveland Clinic--as well as a preferred carrier for the U.S. ports, and has three contract aircraft (fixed wing and General and Children’s Hospitals. Skyservice Air Department of Defense, AirMed is CAMTS accredited with FAA rotor). Life Flight works closely with the Vancouver Ambulance was built from the ground up as a medical global authority. In 2008, AirMed expanded its fleet of medically Children’s Hospital and utilize the ITT teams for all service with an aviation component. Their accent is on the dedicated jet aircraft from 7 to 12. AirMed’s five strategic bases Neonatal transfers. Service is provided to private acute critical care transport of adult, neonatal and pediatric of operations in Alabama, Hawaii, Minnesota, Ohio, and individuals, hospitals, global assistance companies, and the patients on a worldwide basis. Skyservice Aviation is the internationally in Hong Kong provide advantageous geographic insurance industry. Life Flight proudly boasts our owner, operator and maintains the dedicated air ambulance coverage and rapid dispatch. AirMed has flown over 12,000 exceptional no incidents safety track record for the past fleet with worldwide operating authority granted by missions to more than 150 countries and routinely provides 16 years. From the smallest neonatal to bariatric or our Transport Canada. Skyservice Air Ambulance offers a one service to private individuals, the insurance industry, top mass movement of 36 patients in 1 move, you can count call medical transport solution to our clients worldwide air hospitals and global assistance companies. The company was the on Life Flight to complete the mission in a professional medical transport needs. We were honored to be the ITIJ recipient of ITIJ’s Air Ambulance Provider of the Year in 2007. safe manner. When Quality and Trust count, you can Air Ambulance of the Year 2006, Finalist 2007 and Finalist For more information, visit www.airmed.com count on Life Flight International inc. www.lifeflight.ca 2008. www.skyservice.com/airambulance

Assistance/Claims Europ Assistance UK & Ireland is part Fortis (Insurance, UK) is a SOS International a/s of the Europ Assistance Group, leading provider of - the leading claims and Handler of the year assistance organisation in * Europ Assistance which is represented worldwide in award-winning personal and over 208 countries and employs over the Nordics. Since 1961 SOS International have rendered * Assistance International (Fortis) commercial lines insurance solutions in the UK. Its successful 5,000 staff. Europ Assistance customer-centric strategy has been to align activities to how 24/7 service and assistance in more than 30 languages on * SOS International developed the concept of assistance in France back in the customers want to buy insurance, based on delivering behalf of the majority of the Nordic insurance companies. 1960s and in the UK we have been assisting travellers for high-quality products, manufactured at costs better than SOS achieve substantial savings for their customers through Sponsor - Air Ambulance Worldwide over 30 years. Over 300 million customers worldwide are market norms. Fortis’ unique multi-distribution capability cost and case management and offers electronic handling of covered by Europ Assistance, either directly or through enables the company to deliver its products face-to-face, by claims and invoices and fraud investigation. Customers are our partners and last year we handled over 63 million calls. phone (inbound and outbound), over the Internet and via able to access an advanced system for real-time case As one of the leading travel insurers in the UK & Ireland, SMS technology. Insuring in excess of 6.7 million customers monitoring and information sharing. SOS International are Europ Assistance is committed to providing the highest and working with a range of partners, Fortis is recognised for owned by the 22 leading Nordic insurance companies. With quality service at all times. Whilst an assistance-led delivering consistent and high-quality customer experiences. a superior global supplier network as well as representation philosophy is at the heart of the operation, the benefit of As the fourth largest travel insurer in the UK with in excess offices in more than 26 locations world-wide, SOS provide being able to offer the capacity of an insurance company of 4 million customers, Fortis is proud of its in-house medical and motor assistance for our customers’ customers. provides clients with a range of service options to the multilingual Assistance International team, with agents and Furthermore, SOS provide innovative solutions in the fields benefit of both clients and customers. www.europ- contacts from across the world to assist customers in medical of Health Care, Tracking and Crisis Management. SOS assistance.co.uk emergencies. www.fortisinsurance.co.uk International has subsidiaries in Sweden and Finland and is currently setting up operation in Norway. www.sos.eu

Cost Containment & ChargeCare International was created in Euro-Center has, Looking for a partner offering 1995 by Christiane Burniston who used since 1971, acted fully integrated travel provider of the year her wide expertise in medical assistance as the extended assistance services and claims * ChargeCare and travel claims to offer cost contain arm of travel administration in the * Euro-Center services to the British travel insurance insurers, healthcare insurers and alarm centres to Americas? Privately owned * Global Excel market. CCI remains to this day the only provide local assistance services to tourists, business and located in Quebec just UK independent company solely travelers and expatriates through its worldwide north of the US border, Global Excel Management is the Sponsor - AXA Assistance dedicated to cost containment. ChargeCare pan-European network of offices. The Euro-Center concept is as solution. Since 2000, Global Excel’s team has grown clients’ base consists of insurers, assistance companies and simple as it is efficient: By dealing with medical claims sevenfold to over 350 employees. Services are provided to other intermediaries. CCI has extensive networks of medical locally, i.e. where the accident happened or where the over 160 clients located in over 28 countries. Clients benefit providers in key European and Caribbean destinations. The expatriate is based, Euro-Center is in a unique position from one-stop service specializing in North, Central and company is managed from its UK Oxfordshire base with to ‘plug in’ its clients into local healthcare systems or South America and the Caribbean. Comprehensive services offices strategically located in Spain and Greece. During its 13 provide treatment through its large network of include a 24/7 Customer Contact Centre, assistance years, CCI has successfully maintained good relationships providers. This means that Euro-Center is able to services lead by two physicians, claims adjudication, legal with medical providers whilst reducing and containing the radically reduce medical claim costs and achieve recovery services and unrivaled cost containment costs of medical expenses for its clients. Its systems are state exceptional savings to its customers. In addition, the performance. Despite the rising costs of US healthcare and of the art, web based, for access by clients, medical providers claims are efficiently audited and processed locally at the recent downward savings trend, Global Excel continues and travellers. In this turbulent economic climate, low cost which further decreases the claim cost. At the to be ahead of the curve on savings results, providing clients ChargeCare with its strong place in the market, is the ideal same time Euro-Center provides an unrivaled customer with money back guarantees. To learn how we can put our partner to challenge costs in an energetic and successful service to its clients. It is no wonder local assistance expertise in case management and cost containment to manner. www.chargecare.co.uk worldwide is a winning concept. www.euro-center.com work for you, visit: www.globalexcel.com

Europ Assistance UK & Ireland is Europeiska Professional Travel Insurer/Underwriter part of the Europ Assistance Group, Reseförsäkringar is Insurance Company of the year which is represented worldwide in one of the key Limited (‘PTI’) is an over 208 countries and employs over players on the established name as specialists who implement and manage * Europ Assistance 5,000 staff. Europ Assistance Swedish market for leisure and corporate travel insurance programmes for niche groups and markets. Formed * Europeiska developed the concept of assistance in France back in the insurance. Formed in 1920, Europeiska has grown from in 1989, our first undertaking was to create a global travel and * PTI 1960s and in the UK we have been assisting travellers for being a small and domestic travel insurance company to personal accident programme for the International Airline over 30 years. Over 300 million customers worldwide are being the market leader in leisure and business travel Passengers Association (‘IAPA’) on behalf of its members. The Sponsor - Air Ambulance Connection covered by Europ Assistance, either directly or through insurance. Today we offer a flexible range of travel Collinson Group Limited acquired PTI in 1997 and provided our partners and last year we handled over 63 million calls. insurance tailored to individuals, medical insurance the resources to support the expansion of PTI into new As one of the leading travel insurers in the UK & Ireland, programmes for expatriates of international products and markets. The company was then able to expand Europ Assistance is committed to providing the highest organisations, exclusive insurance coverage for its reach, garnering a reputation with IAPA, Columbus Direct, quality service at all times. Whilst an assistance-led cardholders and insurance for watches and jewellery in Club Direct, Trinity, Mediquote and Insure For All, and a select philosophy is at the heart of the operation, the benefit of co-operation with retailers. We are proud of our client number of UK, Europe and international agents and brokers. being able to offer the capacity of an insurance company record, consisting of the major tour operators Through this network, we provide underwriting and servicing provides clients with a range of service options to the Fritidsresor and Ving. We also insure most of the largest facilities for tour operators, travel agents, an airport lounge benefit of both clients and customers. www.europ- Swedish companies, for example IKEA and Volvo. www. club – called Priority Pass, private health clubs, airlines and assistance.co.uk europeiska.com other travel sector service companies. www.ptic.gi

InsureandGo was Preferential was established in 1996 Intermediary Columbus Direct has founded in 2000 by and is based in Surrey in the UK. From of the year been a leading light for James Richardson and its inception, Preferential, unlike many * Columbus Direct travel insurance since Perry Wilson. They saw a others, has solely specialised in travel gap in the market and were driven to provide travel * InsureandGo 1988. We set out as the first independent provider to sell insurance; providing innovative, directly to the public. Now, we sell high quality cover in 50 insurance that was quick, easy and as cheap as possible. The tailored solutions to each customer’s requirements. The group is * Preferential countries world-wide — we are a truly global insurance company started as a small travel insurance-only business in uniquely structured and consists of three separate divisions.

intermediary. At home, we’ve been expanding our Braintree but quickly grew. As InsureandGo developed, Preferential Insurance Services is the business to business division Sponsor - Mondial Assistance UK marketing mix in 2008, including a new joint venture with home and motor insurance was added into the mix too. and is staffed by experienced travel insurance managers, providing The Daily Mail and The Mail on Sunday. We’ve also been Then in 2006 the company moved to bigger offices in solutions to the travel trade, financial services and affinity group developing new specialist products in the over 65 and Southend-on-Sea as the workforce had now reached over sectors. Optimum is the underwriting division. Now one of the impaired markets. Overall, Columbus concentrates on 200. Today, however much has changed, the aim is still UK’s leading travel underwriting agencies, Optimum manages delivering a first class experience to customers, from first clear. InsureandGo’s focused approach means that they each individual component of a travel insurance programme. It has contact, to claims and documentation; with premium continually review their extensive range of policies in order acted, since inception, under delegated authority from Groupama levels to match. For our affiliate and partner services too, to provide the customer with competitively priced, Insurance Company Limited and is a participating member of the we offer a variety of excellent white-label or dual-branding comprehensive cover that meets their individual needs. Travel Underwriters Group. Preferential Direct is the consumer solutions, so we can see our partners benefitting from Over the years the company’s reputation as experts in the division and markets a comprehensive portfolio of Preferential selling a strong product. We continue to grow our travel field of travel insurance has grown too, with Perry Wilson’s branded travel insurance products direct to specific consumer insurance business, by finding better ways to serve opinion regularly being sought after for press, TV, and radio groups. As a result, Preferential provided policies for millions of customers. www.columbusdirect.com programmes. www.insureandgo.com UK travellers in 2007, making them one of the leaders in the field. : : ITIJ AWARDS 2008 : : ITIJ AWARDS 2008 : : ITIJ AWARDS 2008 : : ITIJ AWARDS 2008 : : ITIJ AWARDS 2008 : : ITIJ AWARDS 2008 : : ITIJ AWARDS 2008 : : ITIJ AWARDS 2008 : : ITIJ AWARDS

International Travel Insurance Journal Awards Evening

The seventh annual ITIJ Awards will be held this year at the InterContinental hotel in Budapest. Taking place on 14th November, the glittering finale dinner and awards ceremony promises to be a night to remember, with the finalists spanning all areas of the travel insurance industry and all regions of the globe.

This outstanding event is the only one of its kind and celebrates excellence and achievement in the international travel insurance arena. Nominations for each of the Awards categories have been collated, and the votes cast and counted. Here, we provide a re-cap of the finalists in each category, who have all submitted a presentation to an independent judging panel. We look forward to learning of the judges’ decision on the night.

ITIJ wishes all the finalists the very best of luck! FINALISTS 2008 AWARDS Intermediary of the year Insurer/Underwriter of the year Europ Assistance MCI Spain AirMed International Fortis Assistance International Preferential Canadian Global Air ambulance provider of the year Cost containment company of the year ITIJ Marketing campaign of the year Assistance/Claims handler of the year

ITIJ marketing The foundation of The mission UnitedHealth ADAC-AmbulanceService of Raisbeck International campaign of the year in 1973 put ADAC’s air Engineering is focused on (judged independently) rescue system on an is to design, Skyservice Air Ambulance operates a providing  * ADAC international basis. develop and produce unique solutions fleet of five medically dedicated Learjet global health network access, insurance ADAC-AmbulanceService solutions and administrative services to * Raisbeck Engineering through advanced technology and 35A air ambulances from bases both in organises and carries out patient transport innovative engineering to enhance the Montreal and Toronto, Canada with an individuals and groups. CBS provides * Skyservice world-wide on ground and by air. The performance and operational efficiency of additional contracted aircraft in exclusive access to the UnitedHealth * UnitedHealth International services range from the transfer by ground aircraft. Raisbeck Performance Systems Vancouver, Canada. Skyservice Air Network of preferred providers, Sponsor - M Consulting ambulance to the repatriation of intensive improve aircraft performance, productivity, Ambulance was the proud recipient of delivering the most extensive and care patients in ADAC’s own ambulance jets. safety and comfort. Raisbeck provides the ITIJ Air Ambulance of the Year lowest-cost network in the US. CBS The ADAC fleet comprises Dornier-Fairchild performance packages and systems for Award in 2006. Skyservice Air facilitates products and services for 328-300 jets, Beechcraft Super King Air A350 Beechcraft King Air that offer great Ambulance was built from the ground up travellers, expatriates, indigenous and several Lear jets, equipped with operational flexibility, reduced operating as a medical service with an aviation populations, and medical tourists. These state-of-the-art intensive care facilities. costs, quieter cockpit and cabin, improved component. Skyservice Aviation is the services are supported by UnitedHealth ADAC-AmbulanceService attends to handling characteristics and higher resale owner, operator and maintains the Group companies and our strategic approximately 44,000 patients per year and value. Raisbeck also provides performance dedicated air ambulance fleet with partners worldwide. UnitedHealth Group carries out more than 15,000 transports - on systems for the 30 series Learjet that offer worldwide operating authority granted is a Fortune 100 company identified as ground and by air. Depending on the patient’s 25 percent less time to climb, 8-14 percent by Transport Canada. Skyservice Air the first or second most admired diagnosis, air-bound transport may also fuel savings, opens up many smaller Ambulance offers a one call medical company in the healthcare industry by involve additional transport options like airports, carry more payload/fuel, extended transport solution to our clients rankings, as published in Fortune stretcher, sleeper and PTC. range, and 30 percent annual return on worldwide air medical transport needs. magazine since 1995.

ITIJ INDUSTRY www.adac.de/ambulance investment (in fuel savings). www.skyservice.com/airambulance www.uhcglobal.com : : ITIJ AWARDS 2008 : : ITIJ AWARDS 2008 : : ITIJ AWARDS 2008 : : ITIJ AWARDS 2008 : : ITIJ AWARDS 2008 : : ITIJ AWARDS 2008 : : ITIJ AWARDS 2008 : : ITIJ AWARDS 2008 : : 32 ASSISTANCE&HEALTHCAREWORLDMARKETS A dual personality Turkey is a forward-looking country steeped in Eurasian history, with the potential to become a significant player in the world’s assistance and healthcare markets. Roger St Pierre and Sarah Watson take a closer look

urkey is a country of never-ending enigma. It In such rural areas, hospital provision is seriously Tstoutly maintains the strictly secular constitution lacking, and poor road infrastructure further hampers set in place in 1923, when, in the aftermath of the access to care. Where clinics do exist, doctors and First World War, the charismatic Mustafa Kemel physicians rarely speak any language other than Ataturk dragged it into the modern era; yet it has Turkish. a Muslim government – under the Justice and Although, overall, Turkey’s population profile Development Party. In 2003, this government continues to resemble a developing country introduced sweeping healthcare reforms aimed more closely than a developed state due to its at making healthcare available to a larger share of high rural population, the country’s advantageous the population through universal health insurance, geographical location, together with its recent and increasing the ratio of private to state health progress in membership negotiations with the EU, provision. The country’s healthcare market is still have increased Turkey’s attractiveness to companies dominated by a centralised state system, but the wishing to expand to new regions. In fact, General private health industry has grown rapidly since Electric Company, a subsidiary of GE Healthcare – the 1990s when the Ministry of Health began to worth €17 billion – moved its international managing restructure the health system. operations base in the eastern and African growth Turkey is an Asian country with a toehold in Europe: markets to the country in June. this populous land of 74.8 million has a modern, At the same time, Istanbul has 35 billionaires ­– free market economy and is poised for eventual placing it fourth behind Moscow, New York City entry into the European Union, but long-established and London – while the country’s GDP growth protectionist policies have been hard to kill off. rate between 2002 and 2007 averaged 7.4 per Thus, there is still a large measure of poverty in cent, making it one of the world’s fastest growing the country, especially in remote areas of Anatolia. economies, with the bonus of well contained

International Travel Insurance Journal ASSISTANCE&HEALTHCAREWORLDMARKETS 33

inflation. Only 7.6 per cent of GDP in 2005 was and since then successive governments have been actually spent on public healthcare, however, committed to a programme of rationalisation that will although this has increased steadily since 2000. ensure primary care in both urban and rural areas, A resultant growth in overall wealth has led to a and will create effective preventive and curative booming travel industry. The Asia Pacific region is services for all the population. As the bedrock of now a favoured destination for Turkish travellers, the state system, some 11,905 health posts provide along with the great cities of the US and Europe, with village-level healthcare, each of them serving the shopping a powerful draw for increasingly affluent needs of between 2,500 and 3,000 people. Some people. In fact, outbound tourism has increased from 5,366 health centres are spread across the country, 515,000 people, spending US$12 million in 1970, each serving between 5,000 and 10,000 people. to 8.02 million people and a US$2.87-billion spend Each of these has a full-time medical team, headed in 2005, the last year for which figures are currently by a physician but, unfortunately, most of these have available. Meanwhile, some 1.2 million Turks choose had no residency training in family medicine and little to live and work abroad. This has helped fuel an clinical training. Dr Hakan Yaman comments of the already flourishing insurance market, and has seen medical facility at the University of Akdeniz in Antalya: the continued development of the travel insurance “Turkey is now in the first world when it comes to and assistance industries in the country. medical care provision though work still remains to Turkey is also a huge draw for tourists, with thriving be done on the restructuring of primary healthcare.” international resorts and modern amenities. It does Some 1,180 hospitals, half of them run by the Turkish not have any reciprocal healthcare agreements, so comprehensive medical insurance cover is essential, as even emergency care in a state-run hospital must be paid for by foreign patients. Despite this, there were just over 27 million visitors to Turkey in 2007, contributing a massive US$18.5-billion to the national coffers and making it one of the world’s top 10 destinations, according to Professor Ferda Halicioglu of Tourism Economics journal. As with any country dealing with the number of tourists each year that Turkey does, healthcare standards in the country have developed to reflect a growing need for world-class medical care, especially in tourist destinations. A founder member of the OECD and the G20 industrial nations group, Turkey continues to work on its state healthcare policy, and at the same time has a flourishing private sector. Establishments in both of these sectors are used to working with international assistance departments, but these relationships can be tumultuous due to complex bureaucracy and problems with over- charging, as we shall see later in this feature.

Scratching the surface The standard and availability of healthcare in Turkey varies massively between regions and between towns, with most large towns and all major cities housing a mixture of state and private medical facilities. The healthcare and social medicine system has seen spectacular modernisation since the Ottoman era yet in rural areas hole-in-the-ground toilets and primitive hygiene standards are still abundant when you scratch the surface of modernity. At the other end of the spectrum, in the main cities some ‘five-star’ private hospitals pride themselves on the employment of top chefs for the creation of a range of a la carte meals for patients. A stay in such an establishment will set you back a bit, though: in The country’s healthcare provision is still dominated by a centralised state system, but the private health industry has grown rapidly since the 1990s

Istanbul, the Acibadem Hospital charges YTL 700 per day (€380; US$ 520), the American Hospital YTL 390 for a double room, and Memorial Hospital charges YTL 302. According to the Health Ministry, there are some 77,344 doctors working across the state and private health sectors of whom just over half (51 per cent) are employed by state institutions, 18 per cent by medical schools, 10 per cent in social insurance institutions and 15 per cent in private hospitals. However, many doctors work in both the state and private healthcare sectors. The socialised health service was introduced in 1961,

www.itij.co.uk 34 ASSISTANCE&HEALTHCAREWORLDMARKETS

Ministry of Health, provide in-patient care. The remainder of the country’s public hospitals are run by public universities and social security institutions. Overall standards in state hospitals are generally below those of western European countries, and overcrowding is a big problem. A lack of funding means that care can be basic and facilities limited. State facilities also lack the level of nursing care that visitors to Turkey may be used to in their home country. For example, the family of a patient is expected to take on many of the auxiliary tasks

many doctors work in both the state and private healthcare sectors such as changing bedding and providing emotional support. This said, some of the best hospitals in Turkey are the university hospitals, some of which are public and some private. These institutions are often a top choice when it comes to choosing a medical establishment for a specific procedure as usually the best surgeons are affiliated with one of the main university hospitals, such as Cerrahpasa Medical Faculty Hospital in Istanbul, Ege University Hospital in Izmir and Hacettepe University Hospital in Ankara. Some 43 per cent of the nation’s total health service resources are funded from the Turkish government’s general budget, 25 per cent from private insurance they’re ill. The private health insurance market is Paying for private Assistance niche payouts and 32 per cent from fee-paying patients relatively well developed in Turkey, with around The private medical sector in Turkey is fast expanding Turkey now has close on a dozen assistance within the state system. According to figures from 28 health insurers providing policies to around 1.4 and already boasts equipment and care levels on companies in all. Most of these are operating as the the Social Security Institution and the Association million people annually. According to US’s Library a par with international standards. In the country’s branch offices of large and well-established foreign of Turkish Insurance and Reinsurance companies, of Congress Federal Research Division, however, largest cities and resorts that have a high number assistance companies, including Europ Assistance, some 65 per cent of the population is covered by around 75 per cent of private health expenditures in of tourists and expatriates – such as Izmir, Istanbul, Mondial and Coris International, but include local state provided health insurance. Despite this, more Turkey in 2005 were out-of-pocket rather than being Marmora and Bodrum – hospitals are abundant. providers such as Marm Assistance and Aegean and more people are buying separate private health covered by insurance. Antalya alone boasts some 50 private medical Assistance. They all operate in a challenging market. insurance in order to get better quality of care if centres, employing between them more than 2,500 Overbearing bureaucracy and the poor infrastructure doctors and medical staff. In these areas, there are often found in rural areas of the country are just two The Asia Pacific region is now a favoured destination for Turkish travellers, along with the great cities of the US and Europe

also several private clinics where English, German of the problems faced. and other languages are spoken, and where it is Meanwhile, some medical facilities do all they can possible to arrange a consultation with a qualified, to avoid co-operating with assistance companies, multi-lingual foreign-trained physician. Foreign preferring to work directly with insurance residents with chronic ailments requiring medication companies so they can avoid cost containment are advised to keep a six-month supply on hand, scrutiny procedures that expose over-charging, however, as local pharmacies may not be able to fill certain prescriptions reliably. Today, Turkey has some 370 private hospitals and these provide around 15 per cent of the nation’s healthcare, including providing some treatments under contract for state system patients. Turkey’s leading private hospital organisations include Memorial Group, Acibadem Group, Anadolu Saglik Merkezi, Medical Park and the Universal Group. Many such hospitals in tourist and expatriate areas have direct agreements with BUPA and similar international health insurance companies. overtreatment, fraud and other problems. The cost of private care in the country is extremely Reportedly, insurers working directly with such competitive, if not inexpensive. As such, international hospitals often run into major problems with the insurers prefer to evacuate their patients from more customs authorities because they do not understand remote areas to Turkish cities as opposed to flying the often complex way in which routine procedures them into neighbouring countries such as Greece, work in Turkey, nor do they appreciate the need to Egypt and Israel. Depending on the nature of the involve expert input from the very beginning of a case patient’s condition or injury, however, they may history. sometimes be sent for treatment at a large state “We have around 800 contracted hospitals on or university hospital where a more specific or our database, including state hospitals, private sophisticated level of care can be found. hospitals, university hospitals and clinics,” says Marm Assistance’s Emre Dursum, “Our audit team

International Travel Insurance Journal ASSISTANCE&HEALTHCAREWORLDMARKETS 35

www.itij.co.uk 36 ASSISTANCE&HEALTHCAREWORLDMARKETS

periodically updates our database to ensure that the incurred by the foreign insurance company. hospitals we use are of a high standard. We have Aegean Assistance, which has its head office in Izmir ‘preferred service providers’ that are catagorised by and has worked on behalf of clients including Roland their specialty departments, number of physicians and Assistance, Assistance International, Inter Group beds, ICU capabilities, medical equipment standards, Assistance Services, med con team and Mayday hygiene standards, logistics and location.” Assistance, also urges international insurers and Stars Crescent Assistance (SCA) is another local assistance companies to make use of the knowledge player, owned by Marm’s umbrella company, which of local assistance providers to help overcome issues provides amongst other things medical assistance such as price inflation and over-treatment. Says programmes to the oil and gas industries: “Through the company’s Diray Oran: “If foreign assistance our multinational medical team we are now able to companies or insurers allow local assistance provide services throughout Turkey, the Caucasus region, the Balkans and beyond,” said a spokesperson. Among SCA’s diverse offering is a ‘medical counselling service’ that collates information from hospitals, patients’ doctors and other involved parties to present a comprehensive and customised case report to insurance companies. This service, says the company, helps avoid the communication problems that can occur between an attending physician and the insurance company’s medical staff due to language barriers and unfamiliarity with the Turkish health system. companies to act as a third eye on their behalf, The different medical approaches favoured by problems could be kept to a minimum.” With a local and foreign physicians is often the cause of preferred medical providers list spanning Turkey and dispute, but being intimately familiar with the local North Cyprus, Aegean has closely monitored many health system, local assistance company doctors international patients, right from their initial admission can determine whether or not there are any to hospital, and advises clients to transfer the patient discrepancies or indications of malpractice and if they are received into a medical establishment not whether unethical decisions have been made. on their list. The company does not sell assistance Furthermore, it is often difficult and time-consuming services to people residing in Turkey, but works solely for foreign insurers to reach an attending doctor on behalf of international clients. via an international telephone call, so again sca acts “Turkey is a country where assistance companies as an intermediary through its doctors being able have an important role to play,” a Europ Assistance to communicate with attending physicians on a Turkey spokesperson told ITIJ. “We need to continuous basis, substantially reducing the often be fully aware of the quality of medical facilities expensive international communications costs available and of the logistics linked to every claim.”

International Travel Insurance Journal ASSISTANCE&HEALTHCAREWORLDMARKETS 37

Turkish citizens prefer to continue their treatment in their homeland

This is especially important, he said, due to the increase in the number of travellers visiting Turkey. This increase has subsequently meant an increase in the number of serious medical cases treated in Turkish hospitals. Although most tourists present with ear infections or gastroenteritis, the number of hospitals and clinics treating either inpatient or outpatients has increased by a third since last summer. One concern, said Europ Assistance, is that the ratio of hospital admissions is much higher in Turkey than in other Mediterranean countries. Often, hotel guests seek treatment at an on- site outpatient clinic only to be redirected to a hospital, sometimes without even being examined. The company has also heard of instances where patients have been transported from a state to a private hospital once it has been realised that the patient has travel insurance. It is also familiar with the issue of over-charging and over-treatment, which it says must be challenged – and recorded – on the spot in order to help change the attitude still important to be informed and vigilant.” have been living and working or holidaymaking. providers are based all over Turkey. Due to the of medical providers in the country. This has Turkey’s insurance industry is well established and high volume of patients the company puts through successfully been achieved in other countries with Building blocks substantial in size. Every insurance company, native or hospitals in tourist areas, it is also able to negotiate an older tourism industry, and it is something Close on 300,000 travel insurance policies are foreign, that operates in the country is obliged by law good discounts with providers. Europ Assistance is working on with its cost currently in force in Turkey. However, as Dursun to become a member of the Association of Insurance With regards to air ambulance services in Turkey, containment partner ChargeCare International. points out: “There is a big gap in coverage levels and Reinsurance Companies of Turkey within three Redstar Aviation, a sister company of Marm “It is important to have an open and continuous between standard Turkish travel insurance policies months of being licensed by the Undersecretariat for Assistance, is the only air ambulance company in dialogue with hospitals and doctors in Turkey to – with a general ceiling of just €30,000 – and those the Treasury. The organisation currently has around Turkey to have been given accreditation by the negotiate fees and adjust payments according to obtainable in other European countries. This means 60 members and is headquartered in Istanbul. Turkish Ministry of Health. Redstar currently operates findings,” says the company. “Overall, our medical that assistance services are not generally included and Once inward looking, the Turks now set their sights one fixed-wing aircraft and four helicopters. expenses in Turkey are well controlled and we use a it is usual for separate cover to be taken out for such on international horizons. “Just a couple of decades Due to the poor quality of many Turkish roads, notification process to flag up significant costs, but it is needs. Otherwise, Turkish tourists abroad have to ago, there was virtually no such thing as travel especially in and around the smaller towns, road pay their medical insurance for Turkish residents,” observes Dursun. “In ambulance providers have to install specific medical treatment expenses the 22 years since our company began its operations, equipment, itemised and defined by the Turkish themselves and the Turkish assistance industry has developed rapidly Ministry of Health. The medical personnel aboard reclaim them on into an attractive sector to play in. Last year, we either a road or an air ambulance must include an IC their return while provided assistance for more than 10,000 individuals doctor, and an IC nurse or paramedic. repatriation is at and we reckon we have around 20 per cent of total their own cost.” market share.” Thus, evacuation Marm was very much a pioneer of assistance services ITIJ AHWM rating and repatriation are in Turkey and now has more than 75 staff working in Healthcare Cost HHH important issues. its dedicated call centre, including doctors, registered Especially so given nurses, social workers, customer representatives, Access to emergency care HHH the fact that, like mechanics, pilots, communication specialists and Overall quality of care HHH people in many support personnel who are able to communicate in EMS (air ambulances) H other nations, 14 different languages. Turkish citizens At the same time, Mondial Assistance Turkey, which Please note: prefer to continue has been in operation since 1997, is ranked in third These ratings are an overview of what ITIJ believes to be a fair reflection of the general standards in the country, and their treatment in place in the local market in terms of sales. It has do not represent any one hospital or service. ITIJ recognises their homeland, established good relationships with local medical that some individual facilities and services would receive rather than in the establishments and renews the contracts it has with different ratings than others, and to those shown in our country where they its network providers on an annual basis. These chart, should ratings of each be done separately.

www.itij.co.uk 38 PROFILE A global visionary

Jeff Baker, President of MedSave USA, speaks toITIJ about his career, the MedSave ethos, and what might lie in store for the travel insurance industry given the current economic climate

industry? What led you into Partners). Finally, from a visionary standpoint, ensure that it most effectively recovers costs your first role with MedSave? I have developed the medical record retrieval for its clients? As is typical, I had no intention product line, which has made MedSave one of the We have a very scientific approach to subrogation out of college to work in the domestic leaders nationwide in this market. identification, which is proprietary. In general, insurance industry. A friend worked when there is a catastrophic case, everyone knows for an insurance company and What are you most proud of? they should try to subrogate. It is on the smaller offered me a job that included Personally, I am most proud of my wife and kids. cases where the majority of claims are not identified a company car and I jumped at I have a beautiful wife who I love dearly, and my or pursued where we try to educate our clients on it. Up until coming to Medsave, children are the light of my life (Nicole 11, Brad the leakage. In addition, most carriers know they my entire career centred around P&C insurance claims. I was an adjuster out of college for Hanover I see the credit crunch as a global crisis and believe Insurance and worked my way to manager. I then went to AIG and it may cause a downturn in travel on a worldwide was a branch manager on Long basis...This will have an adverse effect, short term, Island. From there I became a regional vice president at GMAC on the sale of individual travel policies Insurance and had claims offices from Maine to Florida. I was looking to broaden my experience 10). Professionally, I am most proud of helping set a are on the hook for indemnity and set reserves for in the international market, which course of direction for the long-term business path same, and more often than not, the international is how I came to MedSave. What of MedSave, which incorporates both international community does not pursue. When they do, intrigued me specifically about and domestic products and services. legal action is rarely needed and lawyers not often the company was the global reach required. We have teamed with Aon Recovery of the Davidoff Group and the What are the advantages to travel insurers because their industry position, commitment to products and services (and clientele) of using MedSave’s record retrieval system service and technology are most aligned with ours. that I would be exposed to. as opposed to obtaining the records for It is a partnership with reciprocal exclusivity that has themselves? benefited both of us, as well as our clients. What have been your main MedSave is now one of the leading record retrieval Where were you born, where did you go to achievements at the company? service providers in the US. We collect thousands Why does MedSave use the term ‘cost school/college, and where do you live now? I think my main achievements have been in of records a month for our clients, who range from management’ as opposed to the industry I was born in Huntington New York, which is on several different areas. From an operational international travel clients to domestic P&C carriers standard of ‘cost containment’? Long Island, in 1966. This is where I grew up. I perspective, I have worked over the years to looking to obtain prior medical records on plaintiffs We call it cost management as opposed to cost went to Huntington High School and then went to set up best practices to make us as efficient as to mitigate damages. Our IT infrastructure allows containment because we believe there is much more Geneseo State University in Upstate NY and received possible (technology, customer service, workflow). our clients to review scanned records via the Web to this industry than simply repricing and trying to a Bachelors degree in Business. I currently live in From a relationship standpoint, I have secured and to download them. ‘contain’ the cost. We ‘manage’ the whole process Smithtown, New York, which is also on Long Island. relationships with the strongest HMO in the from the demographic selection of the best HMO United States (Aetna) and the largest subrogation More use is being made of subrogation by the and PPOs. We review for subrogation potential and How did you come to work in the insurance company (Aon Recovery – formerly Subrogation travel insurance industry. How does MedSave manage the process to recovery. We work with our clients to offer IT solutions for better turnaround and payment. It is a total process.

What are your hobbies? Do you get much chance to partake in them? My hobbies are working out, coaching football and lacrosse, and playing golf. I don’t get to play as much golf as I would like, but my son ensures that I have no choice but to coach all of his sports (and he is good at them). I also enjoy watching my daughter excel in gymnastics.

If you could have excelled in any other career, what would you ideally be? Political official

How do you think the credit crunch will impact on the cost containment industry? I see the credit crunch as a global crisis and believe it may cause a downturn in travel on a worldwide basis because people will be tighter on their travel plans in order to make ends meet. This will have an adverse effect, short term, on the sale of individual travel policies. Thus, you will see a ripple impact from a premium perspective from carriers generating less revenue and service providers seeing reduced volume of work. From a strictly selfish perspective, I believe this will mean much more competition, which allows clients to choose from best practice, which we feel we have an advantage in. New opportunities and different market penetration will make this an opportune growth environment. International Travel Insurance Journal privatehealthcareGLOBAL HEALTHCAREnews • IPMI • CORPORATE BENEFITS 39 GLOBAL HEALTHCARE • IPMI • CORPORATE BENEFITS

Singapore safety Singapore Medicine, a department of the Singapore Tourism Board, announced recently that medical care in Singapore had achieved a level of quality that put it on a par with, if not in front of, some Western countries. In both the private and public sectors, Singapore’s hospitals and medical centres have achieved outcomes in several tests that show the increasing quality of healthcare in the country. “There are several indicators used worldwide to continued on page 47

JCI starts primary care scheme Joint Commission International (JCI) has announced its newest accreditation programme, which addresses the front line of healthcare delivery – primary care. In what it says is recognition of the importance of primary care in promoting general health and wellbeing in patients, JCI is to make the standards for the programme available to the public. Primary healthcare is the main strategy of the World Health Organization (WHO) for achieving its goal of continued on page 41 Japanese rate hike $10 billion paid out to members The premium rate of the Japanese government-run health insurance scheme for employees of small Australia’s Private Health Insurance Funds to the impact that the Medicare legislation could … will continue to underpin Ramsay’s growth.” NIB and midsize companies may have to be put up paid more than AU$10 billion in benefits have should they pass it. To emphasise his point, he is feeling the effects, however, they are not as dire as by as much as 8.5 per cent, according to Yomiuri to members during the last financial year, continued: “The contribution of the private health some in the industry predicted. CEO Mark Fitzgibbon Shimbum, which cited the Health, Labour and setting records in all payment categories. sector has never been greater and it beggars belief has forecast a one-off loss of 25,000 policyholders, Welfare Ministry as its source. The premium rate Mandy Aitchison reports on the figures that a government would seek to encourage privately which represents six to eight per cent of its customer has been kept steady at 8.2 per cent since 2002; insured Australians to leave private cover only to add base. He told reporters that it was too early to tell however, increased medical benefits attached to The $10,060,034,811 injected into the healthcare extra pressure onto an already overstretched public how the reforms would ultimately affect the fund, the health insurance, along with rising healthcare system by private health funds in 2007–08 represents health system.” but he was sure it would increase pressure on both continued on page 41 a 10.4-per-cent increase in benefits paid during the During the financial year 2007–08, total hospital claims and premiums. NIB reported a 28-per-cent previous year. The percentage increase in benefits benefits paid on behalf of members increased by drop in normalised earnings to $26.7 million, which paid out on behalf of members is also more than 10.7 per cent to $7,438,138,279, while benefits paid it attributed to lower investment earnings, but during double the percentage by which private health for private hospital admissions increased by 9.6 per that time, the number of policyholders grew by over Jordan tops regional insurers were permitted by federal government to cent to $4,703,105,194 and by 12.6 per cent for 36,000. increase premiums. public hospitals to a total of $512,941,978. Meanwhile, the Canberra Times has reported medical tourism league CEO of the Australian Health Insurance Association, The change to the Medicare levy, despite all the that Australian consumers could be given more A study prepared by the Jordanian Private Hospital Dr Michael Armitage, commented: “This leaves no concerns that have been voiced by the private information to help them decide which is the Association (PHA) has shown that over 250,000 doubt that the private health insurance industry is sector, seems to have had little effect on two of the best private health insurance deal. Although the patients from around 84 Arab and other foreign an increasingly important player in the delivery of most vulnerable entities: Ramsay Healthcare and government already publishes information such countries were treated in Jordanian private hospitals, healthcare in Australia. It is also further evidence health insurer NIB. Last month, Ramsay reported as the average premium rate increase across the clinics and medical centres last year. PHA president that the Rudd government’s attack on the private an 11-per-cent rise in net profit to $123 million and industry, health minister Nicola Roxon has said she Fawzi Hammouri said that World Bank medical health insurance industry via its proposed Medicare chief executive Chris Rex dismissed the Medicare is considering whether consumers would benefit tourism experts have now ranked Jordan as number Levy Surcharge changes would cause dramatic change as a ‘bump in the road’, adding: “Healthcare from knowing the average rate increases of each one in the Arab region and the fifth in the world as effects on the provision of healthcare in Australia.” is an excellent industry in Australia, Indonesia and the fund. “This would enable consumers to assess their a medical tourism hub. In confirmation, Hammouri He then asked that senators give ‘serious thought’ UK. We expect the industry’s strong fundamentals continued on page 47 continued on page 40

www.itij.co.uk 40 privatehealthcarenews

Healthcare still attracts private equity Healthcare benefits Doctors feel

Alternative Provider of Medical Services initiative. key during crisis pressured by insurers The scheme to run 152 GP-led health centres and 100 GP practices is backed by £250 million of Research released by British healthplan provider The Medical Society of the State of New York (NYS) government money annually and is expected to run HSA has revealed that HR professionals are coming has released the results of a recent survey, which for at least five years.The Guardian reported that under increased pressure to justify the choice and indicate that health insurer rules can sometimes force likely interested parties include Merrill Lynch Private value of the healthcare benefits they have chosen. physicians in the state to alter the way in which they Equity, 3i and ECI Partners. One bidder that has been HSA’s Healthy Working Report asked 250 companies treat their patients. The rules, says the survey, seem confirmed is Alliance Boots, which is already owned about their healthcare benefits and the effects to have been developed to increase the profits of the by private equity firm KKR, and has a vested interest on benefits that were being felt as a result of the insurance companies while putting at risk best health in adding to its high-street pharmacy business. economic situation. The results were clear: 49 per practices. Mark Wilson, research director at Catalyst Corporate cent of those surveyed claim they will be looking for The survey questioned more than 1,200 doctors Finance, confirmed that early feedback showed corporate healthcare benefits that provide tangible working in NYS, and 90 per cent said they have that at least half the bidders are from the private results to the company as well as the individual. had to change the way they treat patients due to sector. He continued: “We see attractive private Richard Halley, head of B2B sales at HSA, explained: restrictions placed on them by an insurer, while 92 equity opportunities in primary care provision and “Our report has revealed that most companies are per cent said that insurance company incentives and we expect to see a substantial shift of funding in that not planning to spend less, and some actually plan to disincentives regarding treatment protocols ‘may direction. Healthcare consumerism is increasing; spend more. However, it is apparent that companies not be in the best interest of the patient’. The most India’s healthcare industry is likely to attract private people recognise that they can consume health in are under pressure to scrutinise the healthcare salient complaint from physicians was that insurers equity funding of up to $500 million in the next the same way as any other service.” Already this benefits they offer and to invest in those schemes had asked them to change prescription medicines, three years, according to industry estimates. The year, Merrill Lynch Private Equity has purchased that offer the best with 93 per cent investments in healthcare will focus on three key Integrated Dental Holdings for £300 million, and 3i value, combined with of respondents segments, according to the Press Trust of India, bought Ultralase for £175 million, showing that for visible results.” agreeing they had which are hospitals, pharmaceutical companies some, confidence is still strong. UnitedHealthcare, The survey also had this problem. and the emerging healthcare services market. for instance, said it was expanding and recruiting demonstrated that Furthermore, Such healthcare services include diagnostic chains, more staff in its UK operations, while Dr Mark Hunt, around 10 per cent 78 per cent said medical device manufacturers, disease management managing director of Care UK, said the company was of companies plan to that an insurance services and allied healthcare services, which are continuing to grow. increase the range company had increasingly attracting investments from a variety of For others though, the situation seems less of benefits offered restricted their venture capitalists. Although private equity investors auspicious. Ali Parsa, managing director of Circle over the next year, ability to refer have in the past been more prone to invest in retail Health, a private provider of NHS services, said it and 16 per cent are patients to the and financial services opportunities, with the global was not far fetched to assume that some private seeking to increase specialists they downturn fund managers are looking elsewhere for healthcare firms will struggle to survive in today’s the number of believed would healthy returns – hence the turn to healthcare, an climate. His reasoning was that creating more health covered employees. best treat the industry that remains robust. centres and moving services into the community Seventy per cent needs of the In the UK, meanwhile, private equity firms are was simply not possible when the firms’ share prices of organisations patient. A definite bidding for an estimated £1.25 billion worth of are so low: “Access to capital has been diminished with what is classed as ‘very competitive’ corporate majority of the doctors (87 per cent), meanwhile, National Health Service contracts to run primary and shareholders will be more restrictive about healthcare provisions enjoyed business growth in said they ‘sometimes’ feel they are pressured into healthcare centres. The contracts will be awarded what money is spent on. Policymakers need to think the last 12 months, compared to only 40 per cent of prescribing a certain course of treatment over before the end of the year through the government’s about this very carefully.” those businesses with uncompetitive benefits. another due to cost constraints. And tellingly, 62 per cent of those who took part in the survey said they were either ‘somewhat concerned’ or ‘very concerned’ that they could be cut out of an GPs choose PMI insurer’s network as a result of not following policies requested by the insurer. Health-On-Line, the online private medical insurance It was overwhelmingly agreed that decisions on (PMI) company, has reported a notable increase medications should be the reserve of doctors, in the number of general practitioners in the UK not insurers or health plans. And 91 per cent purchasing PMI. Mike Dalby, director of the firm, of doctors present said that there should be said: “A survey by the Hospital Doctor magazine enforceable legislation to regulate the restrictions earlier this year reported that nearly a quarter of GPs insurance companies can put on doctors with now have PMI, and since that survey was undertaken regards to the treatments they prescribe. we can report a steady rise in the number of GPs President of the Medical Society of the State of looking to purchase our product.” New York (MSSNY) Michael Rosenburg said: The survey was met by claims that individuals are “The survey was conducted as a result of the ‘deserting’ the National Health Service due to a lack medical society receiving numerous complaints of confidence in the system – a by-product of low from member physicians that insurance carriers morale among doctors. However, Dalby attributes were preventing them from giving their patients the rise in PMI sales to the ‘privacy and choice’ the most appropriate treatment for their particular offered by the private sector. healthcare needs.”

Jordan tops regional medical tourism league continued from page 39 added: “Jordan is the only country in the Middle US citizens were treated, 1,200 British people East that generates more income than it spends travelled to Jordan for medical reasons, while on health.” In fact, medical tourism revenues in around 400 Canadians chose Jordan over their 2007 exceeded $1 billion. He also noted that the own healthcare system. World Bank experts estimated that within the next At the moment, the private healthcare provision in five years, medical tourism expenditure around the Jordan includes 58 private hospitals, 44 of which world could reach $100 billion, rising from $45 are members of the PHA. There could soon be billion in 2007, indicating that for Jordan at least, more, though, as Hammouri said in an interview the only way is up. that a delegation representing the private medical According to the study, most of the patients sector, in addition to a representative from the came from Iraq, with the number of Iraqi patients Jordanian Investment Board, are to head to the treated in local private hospitals amounting to US to participate in an international conference 45,000 in 2007. Jordan is also very popular on medical tourism: “We hope that this event with Palestinians and Sudanese patients; around will open the scope of co-operation with the 25,000 citizens from each country visited Jordan US parties concerned with regards to medical for medical treatments last year. Around 1,800 insurance and medical tourism.”

International Travel Insurance Journal GLOBAL HEALTHCARE • IPMI • CORPORATE BENEFITS 41

Japanese rate hike continued from page 39 Private clinics flourish in Qatar costs for Japan’s elderly population has The private medical to work in the private left the ministry no option but to raise sector in Qatar is healthcare sector – 202 the rate by an unexpected 0.1 to 0.3 enjoying massive success, physicians were added to percentage point. despite free healthcare private rosters in 2007, Officials from the Health, Labour and services being offered bringing the number Welfare Ministry point to the fact that by the government, working in Qatar’s private payments and other spending to be made according to the Qatar sector to 1,421. under the insurance programmes in fiscal Statistics Authority’s In the public healthcare 2009 are expected to reach ¥7.59 trillion (QSA) latest healthcare sector, however, the (US$71.8 billion), a rise of 2.3 per cent report. The number of numbers of hospitals, from the previous fiscal year. Although the private clinics in operation has reached 219, with clinics and doctors have remained stagnant for some system is funded by the government with 38 launched in 2007 alone. The number of private years, despite the growing population in the country. subsidies of ¥970 billion, and a reserve pharmacies has also increased, from 165 in 2006 to In fact, according to the report by QSA, there has fund of ¥180 billion, it still needs ¥6.39 185 in 2007, while numerous private laboratories even been a significant decrease in the number of trillion taken from insurance premium have also sprung up. Furthermore, there was a beds available at publicly run hospitals. This has been payments to continue its operations. marked increase in the number of doctors opting attributed to the boom in private healthcare.

Medibank Private calls to end monopoly Australia’s largest health fund Medibank Private has called on the government to end the state health department monopolies over key health services and open them to the private sector. Katherine McGrath, Medibank Private’s group manager of corporate and medical affairs, spoke to The Australian about the topic and said the government had more chance of improving care in the community if it contracted out management of health services to the best company, whether it is public or private. The reasoning behind her request is that for the states and territories that receive federal funding for ward beds and emergency departments, there is no financial incentive to improve care for people outside the hospital. Professor McGrath continued: “It’s difficult to run hospitals and try to change the models of care, because you’re really caught by the infrastructure you’ve got.” In McGrath’s opinion, if health funds were to win tenders, patients would still be guaranteed the current base level of free healthcare, but they would also be offered more services in addition if they paid extra. The proposal would lead to major changes in the way the Australian healthcare system is financed, replacing the current system of split-level federal and state responsibilities by a single healthcare funder. “If you look internationally,” said McGrath, “particularly in the OECD countries where there’s a single funder, it is much easier to drive innovation in healthcare.” She added that the country’s biggest health insurers have already set up schemes that will ensure that ‘at risk’ members receive care before their health deteriorates too far – a model that combines counselling, support and treatment in a way that is very difficult to achieve in the current system.

JCI starts primary care scheme continued from page 39

‘health for all’, and the WHO definition of primary care has provided the JCI with the content and focus of its new standards. The standards were developed by an international panel of primary healthcare experts in countries around the world, and introduce the most important elements of patient safety along with ideas for allowing the provider to improve the quality of services it offers patients. Karen Timmons, president and CEO of JCI, commented: “In addition to impacting care in individual primary care organisations, the standards will be useful to Departments or Ministries of Health for building up the capacity of their primary care delivery system to deliver uniform, safe, quality care to patients.”

www.itij.co.uk 42 privatehealthcarenews

Company Brief Hospital wins Australian honour

Moratorium underwriting introduced KIMS Bahrain Medical Centre (KBMC) has become India. To Ms Pearson, it is clear that the issue of the first medical centre in the Gulf Cooperation accreditation for international hospitals is only William Russell has introduced moratorium underwriting their previous medical history, making the application Council (GCC) to receive international healthcare going to become more important: “International on all of its health insurance plans, ridding customers process simple, straightforward and above all, fast.” accreditation from Australia. The accreditation accreditation will soon be made compulsory for of the need to declare in detail their medical histories. The new international private medical insurance was granted by the Australian Council for Health all healthcare institutions in GCC countries as Many pre-existing medical conditions will become application can be completed online, and simply asks Care Standards International (ACHSI). Survey the UAE government has already announced [its eligible for cover after two years of continuous cover. the applicant to declare their height, weight and details co-ordinator Ros Pearson said that although there intention] to make international accreditation James Cooper, sales director for the UK company, of their current doctor. Moratorium underwriting is now are several hospitals that have won the council’s mandatory by 2010. Even insurance companies said: “Expatriates have told us that the biggest available on William Russell’s individual Global Health approval, KBMC was the first medical facility within are going to announce international healthcare hassle of taking out private medical insurance is Elite and Essential expatriate health plans and will carry the GCC to achieve the honour. accreditation mandatory for all their preferred the need to remember and record every single a four per cent premium loading to cover the increased KBMC opened in Umm Al Hassam in June medical providers.” The accreditation system is a health condition and medical consultation on the underwriting risk. Full medical underwriting will still be 2004 and is a multi-speciality hospital offering four-year membership programme, during which application form. We’ve dealt with this problem by available to clients who prefer to know from the outset outpatient and diagnostic services. It is a franchise time a survey or self-assessment will take place completely removing the need for expats to declare the exclusions that will apply to their cover. of the Kerala Institute of Medical Sciences in each year.

Marsh ties with XN Risk

Marsh Canada Limited and XN Risk Group, an operating division of XN Financial Services Inc, have together announced an insurance solution for Canadian corporations and their directors and officers (D&O) that combines comprehensive D&O protection with an insured private healthcare treatment plan, providing key directors and officers with priority access to healthcare treatment. The scheme is said to be the first executive risk insurance product of its kind to be offered to public Canadian corporations. Director Lifeline, as the new product is called, is available at Marsh, is underwritten by XN Risk and insured through certain underwriters at Lloyd’s of London. The insured private healthcare treatment includes diagnostic verification, transportation, accommodation and treatment at the top one per cent of hospitals in the US. Allan Garner, president and CEO of Marsh Canada, commented: “As part of their efforts to not only manage human capital risk, but to attract and retain the best talent available in their senior leadership, many public Canadian companies are taking steps to enhance the benefits and insurance protection that they provide for their directors and officers. To address these needs, we are pleased to collaborate with XN Risk on this new product, which reinforces our position as the leading experts on executive risk issues in the Canadian marketplace.”

Aetna expands programme Aetna has announced that it is to expand its Global Health Connections programme to provide international members with the additional resources to help manage their health while on assignment. The new offerings include enhancements to the International Maternity Management programme, as well as the introduction of various weight- management solutions through the Weight Watchers programme. Aetna Global Health Connections already features an International Disease Management programme, maternity education and a variety of healthy living programmes that teach members about eating healthily. Martha Temple, president of Aetna Global Benefits, noted: “Aetna Global Health Connections is a tremendous resource for our international members and we are excited to be able to bring them more programmes and services. The expansion of the programme further supports our commitment to member health and wellness across the continuum of care and stages of an international assignment.”

International Travel Insurance Journal GLOBAL HEALTHCARE • IPMI • CORPORATE BENEFITS 43

www.itij.co.uk 44 privatehealthcarenews

costcontainment privatehospitals On the move Spain

Harrington added to Aetna board Karen Ann Bagni Aetna has announced that Richard J. Harrington, strong knowledge of companies’ use of integrated Director of Ops. & Cust. Relations chairman of the Thomson Reuters Foundation, information solutions and strategic insights into 390 Rabro Drive, Hauppauge, has been appointed to Aetna’s board of directors, how best to serve customers.” NY11788 USA

with immediate effect, bringing the number of Prior to the acquisition of Reuters Group plc E-m a i l : [email protected] board members to 13. Ronald Williams, chairman by The Thomson Corporation in April 2008, We b : www.medsaveusa.com Medical Center Virginia Villanueva de Pedro and CEO, said: “Aetna is very fortunate to have Harrington served as president and CEO of The Te l : +1 631 780 5006 Medical Director Dick Harrington joining our board of directors. He Thomson Corporation, where he had worked in Fac s i m i l e : +1 516 622 1742 has a wide-ranging global business experience, a various positions since 1982. We b : www.caribeasistencia.com/cmcb www.centromedicocaribecancun.com E-m a i l : [email protected] Te l : +00 34 91 581 6707 Sp e c i a l i t y : Primary Care Attention

Melton chosen at Vanbreda Gigi Galen – President Vanbreda International, the Belgium- in the medical and 850 7th Avenue, Suite 803 headquartered provider of international medical disability market, the New York, 10019 USA Thailand and employee benefits insurance plans, has last nine specialising in E-m a i l : [email protected] appointed Kevin Melton as deputy director, international medical We b : www.starhealthcarenet.com responsible for market development. In his new insurance with a Te l : +1 212 581 8228 role, Kevin will also be responsible for developing global remit, Kevin Fac s i m i l e : +1 212 581 8272 sales and establishing relationships with brokers brings a wealth of and corporate clients in new and developing experience with him. Bangkok International Hospital. markets. Wouter Reggers, 2, Soi Soonvijai 7, New Petchburi Rd, Kevin came to Vanbreda after leaving Allianz director of international benefits at Vanbreda, said Bangkok 10320 THAILAND Worldwide Care, where he was head of Kevin ‘will play a vital role in the development of international sales. He has also held senior Vanbreda International’, while Kevin himself said: We b : www.bangkokhospital.com Private Bag X5, Benmore Gardens management positions at Standard Life Healthcare “I am very excited about the opportunities that my E-m a i l : [email protected] 2010, Johannesburg, South Africa Te l : +66 2 310 3000 and Royal & SunAlliance Healthcare and new role in Vanbreda International will provide Fac s i m i l e : +66 2 310 3105 Assistance. With over 20 years of experience the company and myself.” Te l : +27 11 245 5777 Sp e c i a l i t y : general medical Fac s i m i l e : +27 11 783 9277 We b : www.aims.org.za E-m a i l : [email protected] National Deposit boosts team United States National Deposit has that they will be very strengthened its intermediary successful in supporting the team to meet increased distribution of our private demand from brokers following medical insurance product the launch of its new group through intermediaries.” The healthcare Deposit account. newest recruits are tasked The friendly society has made with providing support to P O Box 3058, Bedfordview, two new appointments: Lisa intermediaries across the UK. 2008, South Africa Partington and Andy Jones are Lisa joins National Deposit 8940 North Kendall Drive, joining the team as intermediary from Southern Pacific We b : www.interhealth.net Suite 601-E, Miami, FL 33176 Em a i l : [email protected] sales consultants and will report directly to Mortgage Ltd, where she worked as business We b : www.baptisthealth.net/international Te l : +27 11 622 8010 Em a i l : [email protected] intermediary distribution manager Ian Talbot. development manager; she will cover the Fac s i m i l e : +27 11 622 8264 Te l : +1 786 596 2373 Alan Gledhill, sales and marketing director at southeast region of the UK in her new role. Fac s i m i l e : +1 786 596 5979 National Deposit, commented: “Both Lisa and Andy brings with him over eight years of financial Sp e c i a l i t y : General Health Andy have a great deal of experience in the services know-how, and will be responsible for financial services industry and I am confident the north of England. Dr. Colin Plotkin Consulting Neuville chosen as underwriting manager Dubai Insurance Company this important expatriate market.” 27-3088 Francis Road, Richmond, Jackson Memorial Hospital International has further its partnership with Elsewhere, WR has strengthened its distribution British Columbia, CANADA V7C 5V9 Jackson Medical Towers, East Tower, international insurer William in the Asia Pacific region with the appointment Suite 829, 1500 NW 12th Avenue, Russell (WR) in the Middle East of Philip Salter as regional sales manager for Te l : +1 604 241 9677 Miami, FL 33136 - 9998 USA Fac s i m i l e : +1 604 241 0733 by appointing Reni Neuville as Kuala Lumpur (KL). In his new role, Philip will We b : www.plotkinconsulting.com We b : www.jmhi.org underwriting manager for WR be responsible for broker support and sales of Em a i l : [email protected] E-m a i l : [email protected] plans. Reni joins the WR venture WR’s GlobalHealth international private medical 24h r Te l : +1 305 355 1212 from Dubai Insurance, where insurance range and expatriate protection payouts Te l : +1 305 355 5544 she was a key member of the in Indonesia, Vietnam, Cambodia, Singapore, Fac s i m i l e : +1 305 355 5545 team that established the firm’s Thailand, Malaysia, Laos and Brunei. Philip has healthcareinsurance Life and Medical department. been working in KL for the past five years, initially Previously, she worked for InterGlobal Middle as a project manager to establish a service centre East, where she was part of the launch of the for HSBC and latterly as a portfolio manager with Dubai office and was responsible for underwriting a local advisory firm. Nigel Harris, chief executive medical insurance policies. Before transferring of WR Asia Pacific, said: “We are continuing to see to the Middle East, Reni worked for InterGlobal strong growth in demand for our private medical Indonesia. and protection products across Asia Pacific and I Inez Cooper, managing director of WR, said the am delighted to welcome Philip to the company 1st Flr Suite, West Hs, 46 High St, 1099 N.W. 14th Street relationship between Dubai Insurance Company to further our relationships with financial advisors Orpington, Kent, BR6 0JQ, UK Miami, Florida 33136, USA and WR was ‘developing strongly’, adding: “Reni’s and brokers in the region. As the global downturn We b : www.travelandmedical.co.uk We b : www.uhealthinternational.com appointment will enable us to build on these bites, many expatriates are focusing their spending E-m a i l : [email protected] Te l : +1 305 243 9100 foundations and further increase our presence in power on essential protection products.” Te l : +44 845 058 8000 Fac s i m i l e : +1 305 243 9101 Fac s i m i l e : +44 845 053 3000

International Travel Insurance Journal GLOBAL HEALTHCARE • IPMI • CORPORATE BENEFITS 45

For the second time, this year’s IPHC conference will see a unique and innovative award category, voted for by the readers of PHN, Private Healthcare News. PHN is read across the globe by key decision makers and thought leaders in international private healthcare, from the insurers themselves, through to the brokers and intermediaries that sell the policies and the corporate buyers making use of these vital products. From Buenos Aires to Boston to Bangkok, this readership allows us to compile the most comprehensive vote to decide who in 2008 has provided the best policies and services to the IPMI markets.

Aetna Global Benefi ts & Goodhealth

Together, a powerful new force in the global market For more than 30 years, Aetna Global Benefi ts and Goodhealth Worldwide have been providing convenient benefi t options to international employers and their employees around the globe. Our history paints an elaborate picture of continuous growth, innovation and dedication, all of which have become the foundation for our day-to-day business. Our seamless integration, with the support of our US parent, brings over 150 years of experience in the benefi ts arena and further strengthens our ability to provide valuable coverage solutions to our members and clients. With more than 600 employees worldwide, we are proud to look after the health insurance needs of more than 325,000 members, through a unique and growing network of regional centres located in the key markets of Europe, Middle East, China, South East Asia and the US. Our products are tailored to meet the unique needs of a globally mobile population, helping multinational employers attract and retain qualifi ed employees for international assignments by recognising the different demands of the international expatriate by offering multiple solutions to meet the needs of a variety of companies and organisations.

InterGlobal

We are an award winning provider of international health insurance based in the UK. The company, founded in 1998 and known for its innovation, fl exibility and personal approach to customer service, has seen great success and growth in the highly competitive and growing international private medical insurance market. It has been an FSA regulated insurance company since March 2007 with an initial A.M. Best fi nancial strength rating of B++. This major development is evidence of our ongoing success and the faith of our investors, partners and customers in the InterGlobal brand. Innovation with a personal touch is at the heart of what we do, continually developing and improving our products and service to offer new and exciting benefi ts to our clients year on year. In addition to medical insurance InterGlobal have formed an exclusive powerful partnership with personal security specialists red24 to provide the benefi t of 24/7 security services, information and advice to our policy holders. InterGlobal policy holders who buy or renew their plans from this year now have access to red24’s security services as a standard part of their plan and at no extra cost.

Nordic Healthcare

Nordic Health Care is a division of Europæiske Rejseforsiking A/S, the leading Danish travel and expatriate insurance company with more than 80 years experience in the health insurance market, 170 employees and a turnover of USD 90 million in 2007. We have clients all around the world and enjoy the backing of one the world’s largest re-insurance companies with more than 33,000 employees and a turnover of USD 55 billion in 2006 and profi ts of USD 5.7 billion in 2007. Insurance is a matter of trust. Whether you live far away from your home country or you just want the best health insurance coverage possible, it is important to make the right choice when taking out international health insurance. Nordic Health Care is the right choice for you if you want peace of mind regardless of where you are. Our international coverage guarantees you access to the best hospitals, clinics and doctors in your home country and around the world. We offer global excellence, with a Nordic touch.

as voted by the readers of Private Healthcare News www.privatehealthcarenews.com Insurer of the year

www.itij.co.uk 46 phn feature

A place in the sun Expatriate movements may slow down as a result of current economic worries, but people will continue to re-locate overseas. Petra Kendall-Raynor looks at European expatriate movements and the factors influencing them

This decade, television shows about people to be the essentials. Those providers who offer we are seeing an increase in enquiries for these back to Spain in 2004. “I decided to go back because looking to start a new life abroad have dominated products that can be tailored in this way, will clearly territories.” But he admits that in terms of the I did not want to be part of the London rat race programming – from likeable former estate agents have the competitive edge.” economy, realistically, for UK nationals considering anymore. I wanted a different life and to reconnect hunting for a second home in the country to But research from Cater Allen Private Bank suggests a move abroad, the downturn in property prices with my family and friends who were still in Spain. well-turned-out presenters waxing lyrical about that more than three million people from Britain and the subsequent reduction in demand has meant For me, the quality of life is so much better, there is a the benefits of living abroad. But in the current alone will still buy a property overseas in the next that the dream of a move to a warmer climate is on very distinct pace to everything,” she said. A number economic climate, a number of questions have two years. Approximately 2.3 million Brits already hold: “With fears of a recession looming, potential of her customers who travel over to take advantage to be raised about whether people throughout own a property in a foreign country, with those over expatriates are arguably not in an ideal position to of tailor made golf packages, are also inevitably Europe are still as keen to live the dream by moving 45 most likely to buy at the moment. Even one out cash in on their equity to invest in their ideal lifestyle seduced by the lifestyle and decide to relocate. to another country. And for those who do decide of ten 18 to 34 year olds may also buy, according to abroad.” “This does not always work out because they do to take the plunge, will private medical insurance not research enough,” she explained. “I have seen still be a priority or just an added extra deemed an people lose a lot of money simply because they have unnecessary financial burden? Figures have emerged showing that 25,000 foreign nationals tried to set up a business in the wrong location.” Ms Falvey, who lives in Malaga, has been covered Recession planning move to Dubai on a monthly basis, taking advantage of the by Prevision Medica for two years and pays €58.50 A recent survey by health insurer Bupa International per month. She is covered for any operations and looked at almost 1,400 expatriates who had private lack of capital gains tax and low property prices for a small fee receives a series of tickets that can be medical insurance with the company. Around 72 exchanged for an appointment with a doctor, rather per cent said they were concerned about the credit the research. Obviously, not all of these buyers will He said the insurer was expecting at least a five-per- than paying around €50 per private visit. “I have crunch and over half said currency fluctuations were want to live full-time in the area where they have cent reduction in new business enrolments moving found the healthcare system in Spain to be quite a having an impact on their lives. Large numbers purchased a home, but equally high numbers still do. towards 2009 and like many international businesses, well oiled machine, but I have not had a need to use stated that they were cutting back on the amount Matthew Aston, international marketing manager is focused on recession planning more than ever. my private insurance for at least eight months this spent on going out, clothing and holidays. Tim Slee, at AXA PPP healthcare, explains that the company The property market in southern Spain has also year. It is an unnecessary expense at the moment,” global sales director at the company, says that in the has not seen a significant shift in British expatriate suffered, with prices falling by 30 per cent recently, she claims, “so I am likely to have a break for a year coming year the responsibility will be on providers behaviour in recent years: “The Spanish Costas, leaving both Spaniards and British expats with debt. and then look at getting insurance with Sanitas to and brokers to help customers who are watching Germany, Portugal, Greece and France are still “It is no wonder private healthcare might be one of cover my dental needs as well.” their Euros: “We need to ensure they remain proving popular destinations. However, with the the first things to go,” says Mr Ashton. well-covered internationally for healthcare at a price emergence of the new eastern European markets Rebecca Falvey, 33, director of Alba Golf Holidays, Expat movements that works for them,” he said, “even if this means and relatively cheap property in countries such as moved to Spain from England at the age of five, As a rule, explains Falvey, the Spanish tend to be adjusting their cover back to what they consider Turkey, Croatia and Hungary, it is no surprise that returned to England for a number of years then went quite ‘homely’ people, rarely moving abroad but

International Travel Insurance Journal phn feature 47

$10 billion paid out to members continued from page 39

own fund’s performance against alternatives, and could help drive more competition,” she said. She will also be changing the rules on health cover for families with adult children, as at the moment those aged between 20 and 30 years old have the lowest insurance penetration rate. Currently, private health insurance rules state that insurers may offer ‘extended dependent’ policies for families with young adults, at a higher premium rate than that for a standard family policy until the age of 25. Roxon told the press: “I will extend these arrangements for another year until legislative change can be put into place to maintain this policy into the future.” She also wants to persuade insurers to extend their cover to people with chronic conditions such as diabetes in order to relieve pressure on the public system and ‘increase choice for policyholders, creating a stronger insurance product’. As PHN went to press, the proposed changes to the Medicare surcharge levy were again being debated in the Australian Senate, weeks after they were from city to city within their own country. This is going to other EU countries as a result of their healthcare products available from other providers rejected by the upper house. Local newspapers are borne out by data that suggests only around two accession to the EU, such as Poles moving to the that are aimed specifically at the expatriate market in saying that this time round, the government’s hopes per cent of Europeans live in an EU country other UK,” he explains, citing Germany, Spain, France, Italy, China. of getting the changes passed have been given a than their own. But for those who do, European Benelux and the UK as top destinations for European boost as some senators who voted ‘no’ last time had expatriates like the Scandinavians, Germans and expats. However, even if expats from around Europe European reforms changed their minds. Senator Steve Fielding is one French, tend to go to Mediterranean countries like move only for work reasons in search of a better Aside from economic woes, healthcare reforms in such changeling, saying he would no longer stand in Spain and Portugal to retire or to spend most of the salary, statistics from the Federation of European some European countries are proving irksome for the way of the bill because of the need for economic year as a result of the better climate and healthier Employers out in October show that pay levels will expats and to some extent insurers also. Last year, stability due to the threat of the global financial crisis. lifestyle, according to Alvaro Muñoz, head of need to fall in 11 European countries if inflation is to it was announced that anyone who is not working European sales at Bupa International. be decreased to government targets. The countries and below retirement age would not be entitled to “There have also been movements of Europeans named are Belgium, Bulgaria, Estonia, Hungary, free healthcare in France. Expats from the UK can get Iceland, the Irish Republic, Latvia, Lithuania, the cover for the first two years with an E106 form, but Singapore safety Russian Federation, Spain and the Ukraine. will need to pay for their own care or coverage after continued from page 39 Outside Europe, Dubai is one of the top destinations it runs out. for Europeans. Figures have emerged showing In Germany, the state requires all expatriates as well benchmark the quality of hospital care, such as MRSA that 25,000 foreign nationals move to Dubai on a as local nationals to have cover from a local provider infection rate and the time lag for commencement monthly basis, taking advantage of the lack of capital licensed within Germany. Mark Ashton says that if of antibiotic therapy,” said Dr S. Thanasekaran, chief gains tax and low property prices. It is projected AXA PPP Healthcare is to compete in the market, medical officer of Parkway Health, a local healthcare that the country’s population will go up from one they need to advise customers that coverage from a provider. “For the first half of 2008,” he continued, million to three million by 2010. This is good news non-German provider is supplementary to what they “we have consistently achieved a lower-than-target for insurers, especially in light of the fact that from 1 are required to have by law. “This is relevant across MRSA rate of 0.33 per cent in our hospitals. This January next year the country will require mandatory many differing healthcare markets,” he says. “The compares very favourably to the US national average health insurance for all visitors and residents, after challenge for us as an international private healthcare of around 2.4 per cent.” an announcement from the Dubai Health Authority. insurer is to provide tailored healthcare propositions Another indicator often used to quantify a hospital’s Expats will receive a basic insurance policy from their for expatriates moving to these territories. It is no quality is response time for the administration employer but will have the opportunity to broaden good offering a product with benefit limits and of emergency medicine. The current standard coverage themselves. premium structure that far outweighs the nature of internationally is for antibiotic therapy to begin within “Asia, particularly China, is also a very popular the market.” four hours of admission to a hospital. Parkway Health destination for European expatriates,” says Mr He says for profitable growth, logical pricing is a is doing well on this measure, said Dr Thanasekaran: Munoz. “This could be as a result of increasing necessity. With governments intervening around the “We have successfully kept above the 90th percentile interest, particularly from professionals working for world to try to abate one of the harshest financial mark even as we aim for 100-per-cent compliance. international European companies and the potential crises in recent memory, interest rates are being Again, this compares well to the US national average for multinational companies to establish themselves slashed and banks are being bailed out in a bid to of around 80 per cent.” and operate in the Asian market.” Although many restore trust and confidence. But in these challenging Singapore’s steady climb up the healthcare rankings expats in this region make the choice to travel times, ultimately people still want to know they can is no mean feat. Currently, the country is ranked to Hong Kong for medical treatment, Bupa set be treated for health problems, even if it does come sixth best in the world and best in Asia by the World up offices in China two years ago and there are at a price. Health Organization.

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AIR AMBULANCE AIR AMBULANCE (CoNT.) AFRICA European Air Ambulance Patrick Schomaker – Director Sales & Mkt 175A, rue de Cessange [email protected] – President Air Ambulance Network Kirk Pacheco L-1321 www.air-ambulance.com 905 Martin Luther King Jr Drive [email protected] LUXEMBoURG Tel (24 hr): +49 711 7007 7007 Suite 330 www.airambulancenetwork.com Fax: +49 711 7007 7009 Tarpon Springs Tel(24hr): +1 727 934 3999 Florida 34689 Tel(toll free): +1 800 327 1966 USA Fax: +1 727 937 0276 Goodmans Rescue 24 Hrs Ground & Air Ambulances Dr Satish K Bhardwaj – Director Air Ambulance Worldwide Inc. Mark Jones – President M-2 Greater Kailash-Part 1 [email protected] New Delhi 110048 www.goodmansrescue.com 35246 US Hwy 19 North [email protected] INDIA Tel: +91 11 2923 1665 #210 www.airambulanceworldwide.com Mob: +91 98 1001 2126 Palm Harbor Tel: +1 727 781 1198 Fax: +91 11 2923 4665 Florida 34684 Fax: +1 727 786 0897 USA Hope Ambulance Service Dr Charles Johnson – Medical Director AMREF Flying Doctor Service Dr Bettina Vadera – Medical Director 56 Upavon Road [email protected] Singapore 507745 www.hopeambulance.com Wilson Airport [email protected] SINGAPoRE 24hr Tel: +65 6100 1911 LangataRoad www.amref.org Fax: +65 6400 5254 PO Box 18617 Tel: +254 20 600 090

Nairobi Fax: +254 20 344 170 KENYA JET ICU Bart Gray – President European Air Ambulance Patrick Schomaker – Director Sales & Mkt 17076 Helicopter Drive [email protected] 175A, rue de Cessange [email protected] Brooksville www.jeticu.com L-1321 www.air-ambulance.com FL 34604 Tel: +1 877 453 8428 LUXEMBoURG Tel (24 hr): +49 711 7007 7007 USA Tel: +1 727 524 9825 Fax: +49 711 7007 7009 Fax: +1 727 524 982 Medical Wings Dr Sommart Somsiri – Medical Director JET ICU Bart Gray – President 222 Room 3259 [email protected] 17076 Helicopter Drive [email protected] Donmuang Int Airport Moo 10 www.medicalwings.com Brooksville www.jeticu.com Viphavadee-Rangsit Rd, Sikan Tel: +662 247 3392 FL 34604 Tel: +1 877 453 8428 Don Muang, Bangkok 10210 Fax:+662 535 4355 USA Tel: +1 727 524 9825 THAILAND Fax: +1 727 524 982 Mediflight Chris Craft – Operations Manager Netcare 911 Aeromedical Wayne Thomson - Flight Operations Mgr Royal Adelaide Hospital [email protected] Netcare 911 House [email protected] North Terrace www.mediflight.com.au 49 New Road www.netcare911.co.za Adelaide Tel: +61 8 8378 6938 Halfway House Tel: +27 11 254 1392 SA 5000 Fax:+61 8 8423 3077 Midrand 1685 Fax: +27 11 254 1405 AUSTRALIA SoUTH AFRICA ozevac Anne Mordey – Operations Manager Skyservice Air Ambulance David Ewing – VP Int. Market Development PO Box 299 [email protected] YUL/Trudeau Int Airport [email protected] Hampton www.ozevac.com 9785 Avenue Ryan www.skyservice.com/airambulance Victoria 3188 Tel: +61 409 537 333 Montreal (Quebec) N AmericaToll Free: +800 463 3482 AUSTRALIA H9P 1A2 Tel: +1 514 497 7000 CANADA Fax: +1 514 636 0096 Pacific Flight Services Pte Ltd Katherine Yeo – Assistant Marketing Mgr ST Aerospace Engineering Bldg [email protected] AUSTRALASIA Seletar West Camp www.fly-pfs.com Air Ambulance Network Kirk Pacheco – President Seletar Airport Tel: +65 6481 3756 905 Martin Luther King Jr Drive [email protected] 797796 Fax: +65 6482 1727 Suite 330 www.airambulancenetwork.com SINGAPoRE Tarpon Springs Tel(24hr): +1 727 934 3999 Skyservice Air Ambulance David Ewing – VP Int. Market Development Florida 34689 Tel(toll free): +1 800 327 1966 USA Fax: +1 727 937 0276 YUL/Trudeau Int Airport [email protected] 9785 Avenue Ryan www.skyservice.com/airambulance Air Ambulance Worldwide Inc. Mark Jones – President Montreal (Quebec) N AmericaToll Free: +800 463 3482 35246 US Hwy 19 North [email protected] H9P 1A2 Tel: +1 514 497 7000 #210 www.airambulanceworldwide.com CANADA Fax: +1 514 636 0096 Palm Harbor Tel: +1 727 781 1198 – Managing Director Florida 34684 Fax: +1 727 786 0897 South Pacific Air Ambulance Scotty Watson USA [email protected] NEW ZEALAND www.spaa.co.nz Asia Assistance Partners Siriporn Wongurai – Int. Ops. Director AUSTRALIA Tel: +64 9256 9000 184/235 Forum Tower [email protected] SINGAPoRE Fax: +64 9256 9111 36 Flr Ratchadapisek Rd www.aapartners.net Huaykwang Tel: +662 645 3733-5 Bangkok 10320 Fax: +662 645 3732 THAILAND EURoPE Asia Medical Assistance Abhijeet Sachdev – Vice President ADAC-Ambulance Service Robert Glueck – Marketing & Sales Director DLF City-ll [email protected] Am Westpark 8 [email protected] M.G Road www.privathealthcaregroup.com 81373 Munich www.adac.de/ambulance New Delhi Tel: +91 9899 198 198 GERMANY Tel: +49 89 76 76 52 85 Gurgaon 122002 Fax: +91 1242 235 2527 24-h alarm centre: INDIA +49 89 76 76 50 05 CareFlight International Colin Robshaw – Co-ordinator Air Ambulance Network Kirk Pacheco – President Westmead Hospital Campus [email protected] 905 Martin Luther King Jr Drive [email protected] PO Box 159 www.careflight.org Suite 330 www.airambulancenetwork.com Westmead Tel: +61 1300 655 855 Tarpon Springs Tel(24hr): +1 727 934 3999 NSW 2145 Fax: +61 2 4751 2995 Florida 34689 Tel(toll free): +1 800 327 1966 AUSTRALIA USA Fax: +1 727 937 0276

CATEGORY KEY Claims Management Legal Services Air Ambulance Claims Subrogation Medical Escort on Commercial Airlines Air Ambulance Interior Commercial Repatriation Specialists Medical Provider Aircraft Performance Solutions Critical Care Patient Transport Medical Screening Assistance Companies Funeral Directors Re-insurance Catastrophic Claims Specialist Healthcare Clinics Travel Agents Cost Containment Hospitals Web & Design Services

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AIR AMBULANCE (CoNT.) AIR AMBULANCE (CoNT.) Air Ambulance Worldwide Inc. Mark Jones – President Medical Jet Services & Partner W Dichtl 35246 US Hwy 19 North [email protected] Radetzkystr 19 [email protected] #210 www.airambulanceworldwide.com Vienna www.medicaljetservice.com Palm Harbor Tel: +1 727 781 1198 1030 Tel: +43 1 600 1212 Florida 34684 Fax: +1 727 786 0897 AUSTRIA Fax: +43 1 713 2799-19 USA AirMed International LLC Jeffrey T Tolbert – President Red Star Aviation Mustafa Atac – CEO 1000 Urban Center Drive [email protected] Sabiha Gokcen Int Airport [email protected] Suite 470 www.airmed.com J Blok Kurtkoy www.redstar-aviation.com Birmingham Tel: +1 205 443 4840 34912 Tel: +90 216 588 0216 AL 35242 Fax: +1 205 443 4841 Istanbul Fax: +90 216 588 0225 USA Toll Free: +1 877 633 5387 TURKEY Air Medical Ltd Glenn Salt – Flight Operations Manager Skyservice Air Ambulance David Ewing – VP Int. Market Development Oxford Airport [email protected] YUL/Trudeau Int Airport [email protected] Kidlington www.airmed.co.uk 9785 Avenue Ryan www.skyservice.com/airambulance Oxfordshire Tel: +44 1865 842 887 Montreal (Quebec) N AmericaToll Free: +800 463 3482 OX5 1QX Tel: +44 1865 370 642 H9P 1A2 Tel: +1 514 497 7000 UK CANADA Fax: +1 514 636 0096 Augsburg Air Ambulance Roland Schoberth – Director Swiss Air Ambulance/REGA Walter Stunzi – PR/Marketing Mgr Roseggerstr 17 [email protected] D-86368 www.ambulanzflugdienst.de PO Box 1414 [email protected] Gersthofen Tel: +49 821 299 1020 Zurich Airport www.rega.ch GERMANY Tel: +49 821 299 2030 CH-8058 Tel: +41 333 333 333 SWITZERLAND Fax: +41 44 654 3590

Euro-flite Air Ambulance Juhani Missonen – Coordinator – Managing Director Helsinki International Airport [email protected] Tyrol Air Ambulance Jakob Ringler PO Box 187 Tel: +358 20510 1900 PO Box 81 [email protected] FIN-01531 Fax: +358 20510 1901 A-6026 www.taa.at Vantaa Innsbruck Airport Tel: +43 512 224 220 FINLAND AUSTRIA Fax: +43 512 288 888

European Air Ambulance Patrick Schomaker – Director Sales & Mkt 175A, rue de Cessange [email protected] NoRTH AMERICA L-1321 www.air-ambulance.com – President LUXEMBoURG Tel (24 hr): +49 711 7007 7007 Aerojet Stuart Hayman Fax: +49 711 7007 7009 4631 NW 31st Ave [email protected] #220 www.aero-jet.com

Ft Lauderdale Tel: +1 954 730 9300 FAI – rent-a-jet AG Volker Lemke – Director Sales & Marketing FL 33309 Fax: +1 954 485 6564 Flughafenstrasse 100 [email protected] USA D-90268 Nuremberg www.rent-a-jet.de Air Ambulance Network Kirk Pacheco – President GERMANY Tel: +49 911 36009 31 905 Martin Luther King Jr Drive [email protected] Fax: +49 911 36009 59 Suite 330 www.airambulancenetwork.com Tarpon Springs Tel(24hr): +1 727 934 3999 Florida 34689 Tel(toll free): +1 800 327 1966 German Red Cross Air Amb. Serv. Andreas Speich – Managing Director USA Fax: +1 727 937 0276 Aufm Hennekamp 71 [email protected] 40225 Düsseldorf www.grcairambulance.de GERMANY Tel: +49 211 917 49911 24 hr Alarm: +49 228 230 023 Fax: +49 211 917 49921 Global Medical Support otto Karud – Marketing Director Ullevaal University Hospital [email protected] 0407 Oslo www.globalmedicalsupport.com NoRWAY Tel: +47 22 96 50 50 Tel/Fax: +47 22 96 50 51

IFRA Dr Christian Steindl – Director Bahnhofplatz 13/5 [email protected] POB 160 www.ifra.at 3500 Krems Tel: +43 2732 825 610 AUSTRIA Fax: +43 2732 851 01

Jet Executive International Charter Günter Krahé – Marketing & Sales Mündelheimer Weg 50 [email protected] D-40472 www.jetexecutive.com Düsseldorf Tel: +49 211 602 7775 GERMANY Fax: +49 211 602 77766 “Homebase FRA & MUC” JET ICU Bart Gray – President 17076 Helicopter Drive [email protected] Brooksville www.jeticu.com FL 34604 Tel: +1 877 453 8428 USA Tel: +1 727 524 9825 Fax: +1 727 524 982 Mayoral Executive Jet Paulo Vassar – Commercial Director Dominguez Toledo S.A. [email protected] 118 La Orotava www.mayoralexecutivejet.com Malaga 29006 Tel: +34 952 048 609 SPAIN Fax: +34 924 048 612

Med Call GmbH Michael Diefenbach – CEO Black and Decker Str. 1-3 [email protected] 65510 www.medcallgmbh.com Idstein Tel: +49 61 2695 3708-0 GERMANY Fax: +49 61 2695 3708-11

Medic’Air International Dr Herve Raffin – General Manager 35 rue Jules Ferry [email protected] 93170 Bagnolet www.medicair.com Paris Tel: +33 141 72 1414 FRANCE Fax: +33 148 57 1010

www.itij.co.uk 50 SERVICEDIRECTORY To have your company listed in the Service Directory email: [email protected]

AIR AMBULANCE (CoNT.) ASSISTANCE CoMPANIES (CoNT.) Air Ambulance Professionals, Inc. Brian L. Weisz – President Netcare 911 International Assistance Brenda Durow - International Assistance Mgr Ft. Lauderdale Executive Airport [email protected] Netcare 911 House [email protected] 1535 South Perimeter Rd www.airambulanceprof.com 49 New Road www.netcare911.co.za Hangar 36B Ft. Lauderdale Tel: +1 954 491 0555 Halfway House Tel: +27 11 254 1387 Florida 33309 Fax: +1 954 491 6114 Midrand 1685 Fax: +27 11 254 1405 USA SoUTH AFRICA Air Ambulance Specialists, Inc. Donald Jones – President West African Rescue Association Florian Zagel - Managing Director 8001 S.Interport Blvd. [email protected] Klotey Cresent 6 [email protected] Suite 250 www.airaasi.com North Labone www.westafrican-rescue.com Englewood Toll Free: +1 800 424 7060 Accra Tel: +233 21 781 258 CO 80111 Tel: +1 720 875 9182 GHANA Tel: +233 244 312 496/7 USA Fax: +1 720 875 9183 Fax: +233 21 781 259 Air Ambulance Worldwide Inc. Mark Jones – President AUSTRALASIA 35246 US Hwy 19 North [email protected] #210 www.airambulanceworldwide.com Asia Assistance Partners Siriporn Wongurai – Int. Ops. Director Palm Harbor Tel: +1 727 781 1198 184/235 Forum Tower [email protected] Florida 34684 Fax: +1 727 786 0897 36 Flr Ratchadapisek Rd www.aapartners.net USA Huaykwang Tel: +662 645 3733-5 AirMed International LLC Jeffrey T Tolbert – President Bangkok 10320 Fax: +662 645 3732 THAILAND 1000 Urban Center Drive [email protected] Suite 470 www.airmed.com Asia Medical Assistance India Abhijeet Sachdev – Vice President Birmingham Tel: +1 205 443 4840 DLF City-ll [email protected] AL 35242 Fax: +1 205 443 4841 M.G Road www.privathealthcaregroup.com USA Toll Free: +1 877 633 5387 New Delhi Tel: +91 9899 198 198 American Care Air Ambulance Joel Reynolds – General Manager Gurgaon 122002 Fax:+91 2440 147 28 8775 Aero Drive [email protected] INDIA Suite 120 www.americancareairambulance.com Asia Medical Assistance Thailand Abhijeet Sachdev – Vice President San Diego Tel: +1 858 627 0515 50 Soi Sukhumvit [email protected] CA 92123 Fax: +1 858 627 0534 19 Sukhumvit Road www.privathealthcaregroup.com USA Klongtoey Nau, Wattana Tel: +66 225 833 55 European Air Ambulance Patrick Schomaker – Director Sales & Mkt Bangkok 10110 Tel: +91 9899 198 198 175A, rue de Cessange [email protected] THAILAND Fax:+66 225 822 77 L-1321 www.air-ambulance.com Assistance online Bertrand Guichoux – CEO LUXEMBoURG Tel (24 hr): +49 711 7007 7007 Fax: +49 711 7007 7009 Zendai Cube Edifice 6/F [email protected] 58, Changliu Road, www.assistanceonline-china.com Pudong Tel: +86 21 6104 9500 JET ICU Bart Gray – President 200135 Shanghai Fax: +86 21 6104 9484 17076 Helicopter Drive [email protected] CHINA Brooksville www.jeticu.com FL 34604 Tel: +1 877 453 8428 Customer Care Pty Ltd Janine Benson – Operations Manager USA Tel: +1 727 524 9825 Level 3 [email protected] Fax: +1 727 524 982 60 Miller Street www.customercare.com.au North Sydney 2060 Tel: +612 9202 8222 Life Flight International Inc. Chris Connor – Operations NSW Fax: +612 9202 8220 Victoria International Airport [email protected] AUSTRALIA Viscount Business Center www.lifeflight.ca 103-9800 McDonald Pk Rd Tel: +1 250 655 1630 First Assistance Mary-Jo McDonald – General Manager Sidney, British Columbia Fax: +1 250 656 9394 PO Box 17-310 [email protected] CANADA Greenlane www.firstassistance.co.nz Auckland Tel: +64 9 356 1650 National Air Ambulance George Martinez – Mgr Flight Co-ordination NEW ZEALAND Fax: +64 9 525 1278 3495 SW 9th Ave [email protected] Fort Lauderdale www.nationalairambulance.com FL 33315 Tel: +1 954 359 9900 Global Assistance & Healthcare Mario Babin – Chief Executive Officer USA Fax: +1 954 359 9500 Jalan Pattimura [email protected] 15 Kebayoran Baru www.global-assistance.net – VP Int. Market Development Jakaita Tel: +62 21 725 8115 Skyservice Air Ambulance David Ewing 12110 Fax: +62 21 725 7961 YUL/Trudeau Int Airport [email protected] INDoNESIA 9785 Avenue Ryan www.skyservice.com/airambulance Montreal (Quebec) N AmericaToll Free: +800 463 3482 South Pacific Air Ambulance Scotty Watson – Managing Director H9P 1A2 Tel: +1 514 497 7000 [email protected] CANADA Fax: +1 514 636 0096 NEW ZEALAND www.spaa.co.nz AUSTRALIA Tel: +64 9256 9000 SINGAPoRE Fax: +64 9256 9111 AIRCRAFT PERFoRMANCE SoLUTIoNS RAISBECK Engineering Nick Nicholson – Sales Manager EURoPE & THE MEDITERRANEAN 4411 South Ryan Way [email protected] ADAC-Ambulance Service Robert Glueck – Marketing & Sales Director Seattle WA98178 www.raisbeck.com Am Westpark 8 [email protected] USA Tel: +1 206 723 2000 81373 Munich www.adac.de/ambulance Fax: +1 206 723 2884 GERMANY Tel: +49 89 76 76 52 85 24-h alarm centre: +49 89 76 76 50 05 ASSISTANCE CoMPANIES AGI Assistance Dr Jacques Guedj – Medical Director 99 Bis, Avenue du [email protected] AFRICA Général Leclerc www.agi-assistance.com 75014 Paris Tel: +33 1 43 95 00 55 AIMS Bernadette Breton – Managing Director FRANCE Fax: +33 1 43 95 00 66 Private Bag X5 [email protected] Benmore Gardens 2010 www.aims.org.za Johannesburg Tel: +27 11 245 5777 ARC Transistance Hans Biekmann – Network Director SoUTH AFRICA Fax: +27 11 783 9277 Avenue des Olympiades 2 [email protected] 1140 Brussels www.arctransistance.com BELGIUM Tel: +32 2 706 6660 AMREF Flying Doctor Service Dr Bettina Vadera – Medical Director Fax: +32 2 706 6601 Wilson Airport [email protected] Langata Road www.amref.org PO Box 18617 Tel: +254 20 600 090 Assistance Plus Liana Absaliamova – General Manager Nairobi Fax: +254 20 344 170 6th Floor [email protected] KENYA 19 Zhukov Proezd www.assistplus.ru Moscow 115054 Tel: +7 495 748 8735 Interhealth Technologies Stephan Jacobs-International Assistance Mgr RUSSIA Fax: +7 495 748 8741 P O Box 3058 [email protected] Bedfordview www.interhealth.net NEW 2008 Tel: +27 11 622 8010 Atlantic Assist Adriano Gouveia – Operations Manager SoUTH AFRICA Fax: +27 11 622 8264 Rua da Alfandega 10-2.D [email protected] PO Box 750 www.atlanticassist.com 9000-056 Funchal Tel: +351 291 214 200 Madeira Fax: +351 291 214 202 PoRTUGAL International Travel Insurance Journal call +44 (0) 117 925 5151 To make an alteration to a listing email: [email protected] SERVICEDIRECTORY 51

ASSISTANCE CoMPANIES (CoNT.) ASSISTANCE CoMPANIES (CoNT.) Express Assist Vardan Azatian – General Director World Travel Protection Canada Inc. Dr Ron Mayer – President & Chf Med Officer 11-th Radialnaya, 2 [email protected] 400 University Avenue [email protected] 115404 www.expressassist.ru 15th Floor www.wtp.ca Moscow Tel: +7 495 775 2090 Toronto Tel: +1 416 977 3565 RUSSIA Fax: +7 495 775 2091 Ontario M5G IS7 Fax: +1 416 205 4676 CANADA Global Voyager Assistance Costas Danilenko – CEO SoUTH AMERICA PO Box II [email protected] 125124 www.gvassistance.com Cardinal Assistance Alberto C. Chapur – President Moscow Tel: +7 495 775 0999 Av. Cordoba 890 7° piso [email protected] RUSSIA Fax: +7 495 775 0998 (C 1054AAU) www. cardinalassistance.com Capital Federal Tel: +54 11 4129 7514 Buenos Aires Marm Assistance Jill Atac – CEO ARGENTINA Sabiha Gokcen Int Airport [email protected] J Blok Kurtkoy www.marmassistance.com 34912 Tel: +90 216 588 0588 CATASTRoPHIC CLAIMS SPECIALIST Istanbul Fax: +90 216 588 0602 TURKEY Dr Colin Plotkin Consulting Dr Colin Plotkin – Managing Director med con team GmbH Michael Weinlich – Managing Director 27-3088 Francis Road [email protected] Richmond Tel: +1 604 241 9677 Gerhard-Kindler-Str.8 [email protected] British Columbia Fax: +1 604 241 0733 72770 Reutlingen www.medconteam.com V7C 5V9 Tel: +49 7121 433 660 GERMANY Fax: +49 7121 433 619 CANADA

MK International Emergency Serv Minas Kaloumenos – General Manager CoST CoNTAINMENT 95, Ioanninon Street [email protected] 10444 Tel: +30 210 5154600 Athens Fax: +30 210 5131660 AFRICA GREECE AIMS Bernadette Breton – Managing Director

Private Bag X5 [email protected] Save Assistance France Franck Molinier – Director of Business Dev. Benmore Gardens www.aims.org.za 19 rue de Provence [email protected] 2010 Tel: +27 11 245 5777 78310 www.saveassistance.com Johannesburg Fax: +27 11 783 9277 Maurepas Tel: +33 13062 6752 SoUTH AFRICA 24hr Alarm Cntr: +33 13062 1122 FRANCE Interhealth Technologies Stephan Jacobs-International Assistance Mgr P O Box 3058 [email protected] SoS International Helle Drager – Comms & Marketing Manager Bedfordview www.interhealth.net NEW Nitivej 6 [email protected] 2008 Tel: +27 11 622 8010 DK-2000 www.sos.eu SoUTH AFRICA Fax: +27 11 622 8264 Frederiksberg Tel: +45 7010 5055 Copenhagen Fax: +45 7010 5056 DENMARK EURoPE NoRTH & CENTRAL AMERICA ChargeCare International Christiane Burniston – Managing Director Monument Business Park [email protected] ASISTUR Emilio Guevara – Managing Director 1D, Park Offices www.chargecare.co.uk Prado 208 [email protected] Warpsgrove Lane Tel: +44 1865 400 007 e/ Colon y Trocadero www.asistur.cu Chalgrove, Oxford Fax: +44 1865 400 707 Habana Vieja Tel: +537 8664499 UK Mobile: +44 777 44 35 649 Ciudad Habana 10100 Fax: +537 8668087 CUBA Marm Assistance Jill Atac – CEO Sabiha Gokcen Int Airport [email protected] Assured Assistance Inc. Martha Turnbull – Director of Operations J Blok Kurtkoy www.marmassistance.com 6880 Financial Drive [email protected] 34912 Tel: +90 216 588 0588 Mississauga Tel: +1 905 816 2495 Istanbul Fax: +90 216 588 0602 Ontario Fax: +1 905 813 4719 TURKEY L5N 7Y5 CANADA Medical Claims International Spain Fatima Guillen Grande – Managing Director C/Ciudad de Aguilas No.2 [email protected] Global Excel Management Brian Allatt – CEO Local 2A www.mcimanager.com 73 Queen Street, Sherbrooke [email protected] Madrid 28030 Tel: 00 34 913 016 145 QC J1M 0C9, CANADA www.globalexcel.ca SPAIN Fax: 00 34 913 016 160 17548 Deer Isle Circle Tel: +1 866 566 1130 Winter Garden, FL 34787 USA Fax: +1 819 566 8335 NoRTH AMERICA Medex Assistance Corporation Linda McGee – SVP of Sales Global Excel Management Brian Allatt – CEO 8501 LaSalle Road [email protected] 73 Queen Street, Sherbrooke [email protected] Suite 200 www.medexassist.com QC J1M 0C9, CANADA www.globalexcel.ca Baltimore Tel: +1 410 453 6300 17548 Deer Isle Circle Tel: +1 866 566 1130 MD 21286 Fax: +1 410 453 6301 Winter Garden, FL 34787 USA Fax: +1 819 566 8335 USA on Call International Michael J. Kelly – President & CEO Global Medical Management Raija Itzchaki – COO One Delaware Drive [email protected] 7901 SW 36th Street [email protected] Salem www.oncallinternational.com Suite 100 www.gmmusa.com NH Tel: + 888 289 0567 Davie Tel: +1 954 370 6404 03079 Fax: +1 603 328 1770 FL 33328 Fax: +1 954 370 8613 USA USA – Dir Assist & Cost Mngment oneWorld Assist Taka Katsube Health Systems International Peggy Novotny – VP / Gen Mngr Intl Bus. 10th Floor [email protected] 5975 Castle Creek Parkway [email protected] 6081 No.3 Road www.oneworldassist.com Suite 100 www.us-hsi.com Richmond, BC Tel: +1 604 303 2113 Indianapolis Tel: +1 317 806 2000 V6Y 2B2 Fax: +1 604 276 4593 IN 46250 Fax: +1 317 806 2033 CANADA USA SelectCare Worldwide Jacques LeTual – Director of Business Dev. Medsave USA Karen Ann Bagni–Dir. of Ops. & Cust. Rels. #1201 [email protected] 390 Rabro Drive [email protected] 438 University Avenue www.selectcareworldwide.com Hauppauge www.medsaveusa.com Toronto Tel: +1 416 340 7265 NY 11788 Tel: +1 631 780 5006 M5G 2K8 Fax: +1 800 533 2350 USA Fax: +1 516 622 1742 CANADA Toll Free: +1 866 261 6718 TMCA Margaret Whartom – Ops Manager 217 Broadway [email protected] oneWorld Assist Taka Katsube – Dir Assist & Cost Mngment Suite 600 www.tmcatravel.com 10th Floor [email protected] NYC Tel: +1 212 964 8580 6081 No.3 Road www.oneworldassist.com NY 10007 Fax: +1 212 406 1520 Richmond, BC Tel: +1 604 303 2113 USA V6Y 2B2 Fax: +1 604 276 4593 CANADA www.itij.co.uk 52 SERVICEDIRECTORY To have your company listed in the Service Directory email: [email protected]

CoST CoNTAINMENT (CoNT.) FUNERAL DIRECToRS SelectCare Worldwide Jacques LeTual – Director of Business Dev. Antea International Funeral Assistance Marica Hunyadi – Managing Director #1201 [email protected] Mihálkovics utca 12 [email protected] 438 University Avenue www.selectcareworldwide.com H-1091 www.antea.hu Toronto Tel: +1 416 340 7265 Budapest Tel: +36 30944 0944 M5G 2K8 Fax: +1 800 533 2350 HUNGARY Fax: +36 1216 6107 CANADA Toll Free: +1 866 261 6718 Star Healthcare Gigi Galen – President Funeral Home AURIGA Ltd. Helen Pradova – Chief of Intnl Dept 850 7th Avenue [email protected] B. Nmcové Street 1052/1 [email protected] Suit 803 www.starhealthcarenet.com 412 01 [email protected] Litomerice www.funeral-assistance.cz New York 10019 Tel: +1 212 581 8228 CZECH REPUBLIC Tel: +420 724 257 899 USA Fax: +1 212 581 8272 Fax: +420 416 735 800

Funeralcare International Roger Waddington TMCA Margaret Whartom – Ops Manager 221 Upper Richmond Road [email protected] 217 Broadway [email protected] Putney www.co-operativefuneralcare.co.uk Suite 600 www.tmcatravel.com London Tel: +44 20 8788 5303 NYC Tel: +1 212 964 8580 SW15 6SQ Fax: +44 20 8788 2525 NY 10007 Fax: +1 212 406 1520 UK USA Global Networks Funeral Assistance Cristina Almudi – Managing Director 23 Blindmans Lane [email protected] – Director of Business Development United Health International Philip Brun Cheshunt www.gnfa.info 15500 New Barn Road [email protected] Hertfordshire Tel: +44 1992 640 066 Suite 200 www.hygeia.net EN8 9DR Fax: +44 1992 785 030 Miami Lakes Tel: +1 305 594 9291 Ext.3312 UK FL 33014 Fax: +1 305 594 9201 John Allison Monkhouse Co., Ltd (Thailand) Apple Kaewprasert – General Manager USA President Park View Tower [email protected] 99/243 (30B) Pine Tower www. monkhouse.com.au Sukhumvit soi 24 Tel: +66 2382 5345-7 CLAIMS MANAGEMENT Klongton Klongtoey, Bangkok Fax: +66 81 584 5942 THAILAND Global Assistance & Healthcare Nathan Hannah – TPA Mgr Asia/Pac KCH Repatriation Specialists Robert Rowntree – Managing Director Jalan Pattimura [email protected] 83 Westbourne Grove [email protected] 15 Kebayoran Baru www.global-assistance.net Bayswater www. kchrepatriation.com Jakaita Tel: +62 21 725 8115 London W2 4UL Tel: +44 20 7313 6920 12110 Fax: +62 21 725 8951 UK Fax: +44 20 7313 6999

INDoNESIA MK Funeral & Transportation Services Minas Kaloumenos – General Manager – CEO Global Excel Management Brian Allatt 95, Ioanninon Street [email protected] 73 Queen Street, Sherbrooke [email protected] 10444 Tel: +30 210 5154600 QC J1M 0C9, CANADA www.globalexcel.ca Athens Fax: +30 210 5131660 17548 Deer isle Circle Tel: +1 866 566 1130 GREECE Winter Garden, FL 34787 USA Fax: +1 819 566 8335 Rowland Brothers International Melanie Walkling – Partner Interhealth Technologies Stephan Jacobs-International Assistance Mgr 299-305 Whitehorse Road [email protected] West Croydon www.rowlandbrothersinternational.co.uk P O Box 3058 [email protected] Surrey Tel: +44 20 8684 2324 Bedfordview www.interhealth.net NEW CR0 2HR Fax: +44 20 8684 8000 2008 Tel: +27 11 622 8010 UK SoUTH AFRICA Fax: +27 11 622 8264 Servilusa Vanda Castro – Manager Int Dept Agencias Funerarias SA [email protected] SelectCare Worldwide Jacques LeTual – Director of Business Dev. International Dept. www.servilusa.pt #1201 [email protected] Rua do Entreposto Industrial Tel: +35 121 470 6300 438 University Avenue www.selectcareworldwide.com 8-2 Esq, 2610-135 Amadora Fax: +35 121 470 6499 PoRTUGAL Toronto Tel: +1 416 340 7265 M5G 2K8 Fax: +1 800 533 2350 ZEGA Roberto Funeral Home Cristina Zega – General Manager CANADA Toll Free: +1 866 261 6718 Via Clelia, 26/28 [email protected] 00181 Rome www.zega.it Star Healthcare Gigi Galen – President ITALY Tel: +39 06 78 40 300 850 7th Avenue [email protected] Fax: +39 06 78 02 488 Suit 803 www.starhealthcarenet.com New York Tel: +1 212 581 8228 10019 Fax: +1 212 581 8272 HEALTHCARE CLINICS USA American Medical Center Natalia oleinik – Insurance & Assistance Companies 26 build 6 Prospekt Mira [email protected] 129090 www.amcenter.ru CLAIMS SUBRoGATIoN Moscow Tel: +7 495 933 7700 RUSSIA Fax: +7 495 933 7701 Medsave USA Karen Ann Bagni–Dir. of Ops. & Cust. Rels. 390 Rabro Drive [email protected] Hauppauge www.medsaveusa.com ASIA NY 11788 Tel: +1 631 780 5006 USA Fax: +1 516 622 1742 Privat Hospital Abhijeet Sachdev – Vice President DLF City-ll [email protected] M.G Road www.privathealthcaregroup.com CoMMERCIAL REPATRIATIoN SPECIALISTS New Delhi Tel: +91 9899 198 198 Gurgaon 122002 Fax: +91 124 235 3794 MedEscort International Craig Poliner – President INDIA 1730 Vultee Street [email protected] Allentown www.medescort.com EURoPE PA 18103 Toll Free: +1 800 255 7182 American Medical Center Natalia oleinik – Insurance & Assistance Companies Tel (US): 610 791 3111 26 build 6 Prospekt Mira [email protected] USA Fax: +1 610 791 9189 129090 www.amcenter.ru Moscow Tel: +7 495 933 7700 Voyageur Aeromedical Travel Marc Lucas – General Manager RUSSIA Fax: +7 495 933 7701 Voyageur Buildings [email protected] 43 Colston Street www.voyageur.co.uk Xanit Hospital de Benalmadena Dr. Juan Bosco Rodriguez Hurtado – Director Bristol Tel: +44 (0)117 927 3554 Camino de Gilabert s/n [email protected] BS1 5AX Fax: +44 (0)117 925 5940 Benalmadena www.xanit.net UK 29630 Tel: +34 952 367 190 Malaga Fax: +34 952 367 191 International Travel Insurance Journal SPAIN call +44 (0) 117 925 5151 To make an alteration to a listing email: [email protected] SERVICEDIRECTORY 53

HoSPITALS (CoNT.) MEDICAL ESCoRT oN CoMM. AIRLINES (CoNT.) NoRTH AMERICA NoRTH AMERICA Air Ambulance Network Kirk Pacheco – President Baptist Health Int. Center of Miami Yohandra Fuentes – Finance Manager 905 Martin Luther King Jr Drive [email protected] Suite 330 www.airambulancenetwork.com 8940 North Kendall Drive [email protected] Tarpon Springs Tel(24hr): +1 727 934 3999 Suite 601-E www.baptisthealth.net/international Florida 34689 Tel(toll free): +1 800 327 1966 Miami Tel: +1 786 596 2373 USA Fax: +1 727 937 0276 Fl 33176 Fax: +1 786 596 5979 Air Ambulance Worldwide Inc. Mark Jones – President USA 35246 US Hwy 19 North [email protected] Jackson Memorial Hospital Int. Abbe Bendell – Senior VP & COO #210 www.airambulanceworldwide.com Palm Harbor Tel: +1 727 781 1198 Jackson Medical Towers [email protected] Florida 34684 Fax: +1 727 786 0897 East Tower, Suite 829 www.jmhi.org USA 1500 NW 12th Avenue 24 hr: +1 305 355 1212 American Care Air Ambulance Joel Reynolds – General Manager Miami, FL 33136-9998 Tel: +1 305 355 5544 8775 Aero Drive [email protected] USA Fax: +1 305 355 5545 Suite 120 www.americancareairambulance.com San Diego Tel: +1 858 627 0515 M.D., M.B.A. – Dir Finance & Operations University of Miami Health System Jose Quesada CA 92123 Fax:+1 858 627 0534 1099 N.W. 14th Street [email protected] USA Miami www.uhealthinternational.com Life Flight International Inc. Chris Connor – Operations Florida 33136 Toll Free: +1 877 442 8676 Victoria International Airport [email protected] USA Tel: +1 305 243 9100 Viscount Business Center www.lifeflight.ca Fax: +1 305 243 9101 103-9800 McDonald Pk Rd Tel: +1 250 655 1630 Sidney, British Columbia Fax: +1 250 656 9394 CANADA LEGAL SERVICES National Air Ambulance George Martinez – Mgr Flight Co-ordination 3495 SW 9th Ave [email protected] Pannone LLP Andrew Morton – Head of Travel Litigation Fort Lauderdale www.nationalairambulance.com FL 33315 Tel: +1 954 359 9900 123 Deansgate [email protected] USA Fax: +1 954 359 9500 Manchester www.pannone.com M3 2BU Tel: +44 (0)161 909 3000 MedEscort International Craig Poliner – President UK Fax: +44 (0)161 909 4444 1730 Vultee Street [email protected] Allentown www.medescort.com PA 18103 Toll Free: +1 800 255 7182 Tel (US): 610 791 3111 MEDICAL ESCoRT oN CoMMERCIAL AIRLINES USA Fax: +1 610 791 9189 AFRICA MEDICAL PRoVIDER AMREF Flying Doctor Service Dr Bettina Vadera – Medical Director AMREF Flying Doctor Service Dr Bettina Vadera – Medical Director Wilson Airport [email protected] Wilson Airport [email protected] Langata Road www.amref.org Langata Road www.amref.org PO Box 18617 Tel: +254 20 600 090 PO Box 18617 Tel: +254 20 600 090 Nairobi Fax: +254 20 344 170 Nairobi Fax: +254 20 344 170 KENYA KENYA Atlantic Assist Adriano Gouveia – Operations Manager AUSTRALASIA Rua da Alfandega 10-2.D [email protected] PO Box 750 www.atlanticassist.com CareFlight International Sue Robshaw – Co-ordinator 9000-056 Funchal Tel: +351 291 214 200 Westmead Hospital Campus [email protected] Madeira Fax: +351 291 214 202 PO Box 159 www.careflight.org PoRTUGAL Westmead Tel: +61 1300 655 855 NSW 2145 Fax:+61 2 4751 2995 AUSTRALIA TRAVEL AGENTS

Medic’Air International 每递安国际 Dr Huaqun Gao – Medical Director Voyageur Aeromedical Travel Marc Lucas – General Manager 885 Renmin Road [email protected] Voyageur Buildings [email protected] Huaihai China Building www.medic-air.com 43 Colston Street www.voyageur.co.uk Room 808 Tel: +86 2163 558289 Bristol Tel: +44 (0)117 927 3554 BS1 5AX Fax: +44 (0)117 925 5940 200010 Shanghai Fax: +86 2163 558285 UK CHINA Medical Wings Dr Sommart Somsiri – Medical Director 222 Room 3259 [email protected] MEDICAL SCREENING Bangkok Int Airport www.medicalwings.com – Call Centre Manager Viphavadee-Rangsit Rd, Sikan Tel: +662 247 3392 Travel & Medical Insurance Services Lara Suttie 1st Flr Suite, West House [email protected] Don Muang, Bangkok 10210 Fax:+662 535 4355 46 High Street www.travelandmedical.co.uk THAILAND Orpington Tel: +44 845 058 8000 Kent BR6 0JQ Fax: +44 845 053 3000 – Operations Manager Mediflight Debra o’Brien UK Royal Adelaide Hospital [email protected] – General Manager North Terrace www.mediflight.com.au Travel Screen Sandra Howell The Seedbed Centre [email protected] Adelaide Tel: +61 8 8223 6618 Vanguard Way www.travelscreen.co.uk SA 5000 Fax: +61 8 8223 6340 Shoeburyness Tel: +44 1702 587 007 AUSTRALIA Essex SS3 9QY Fax: +44 1702 584 731 UK EURoPE Voyageur Aeromedical Travel Marc Lucas – General Manager WEB & MEDIA ADVERTISING Voyageur Buildings [email protected] 43 Colston Street www.voyageur.co.uk V Creative Design Steve Annette – New Media Director Bristol Tel: +44 (0)117 927 3554 Voyageur Buildings [email protected] BS1 5AX Fax: +44 (0)117 925 5940 43 Colston Street www.vcreativedesign.co.uk UK Bristol Tel: +44 (0)117 922 6600 BS1 5AX Fax: +44 (0)117 925 2040 UK www.itij.co.uk 54 SERVICEDIRECTORY To have your company listed in the Service Directory email: [email protected]

GRAPEVINE • GRAPEVINE • GRAPEVINE • GRAPEVINE • GRAPEVINVINE GRAPEVINE • GRAPEVINE • GRAPEVINE • GRAPEVINE • GRAPEVINE •G R •

A E P Diary Dates N E I V V I E N P Grapevine E A

3-5 December •

R th G 12 Annual Texas Workforce Conference G R

•

A Grand Hyatt, San Antonio E P

N Caution: E Texas, US I V

V www.riskvue.com/calendar I E N P heavy load V A I N R E

G 6-9 December

• G

An elderly Swedish woman

R NAIC National Winter Meeting E A

N misunderstood instructions while

I Gaylord Texan Resort and Convention Center P V checking in at the country’s main E Grapevine, TX, US E V P

I www.riskvue.com/calendar

airport, placing herself instead of N A E R

her luggage on the belt, and being G •

• G whisked away down the luggage R E 7-10 December A N

I chute. The 78-year-old was

P Society for Risk Analysis Annual Meeting V E

E preparing to fly to Germany when

V Boston, Massachusetts, US P I N A she lay down flat on an unmanned baggage belt in feet before sending her in the right direction to and other cabin crew were brought in as well for www.riskvue.com/calendar E R

G the genuine belief she was following instructions at departures. the flight.” Iron Maiden tours in its own Boeing •

• G

R E the check-in desk. 747, which is piloted by Dickinson. 15-17 December A N I th Fortunately, the lady’s ordeal did not last very long, P

V 6 GCC and Global Financial Markets E E V

P as she swiftly ended up in the baggage handling Summit

Maiden heaven I N A area, where staff members helped her to her Dubai, UAE E R Hotel sacks staff for

G • www.arabianbusiness.com

• Bruce Dickinson, lead singer G

R E of rock band Iron Maiden, was A N seducing women I P

V one of the many off-duty pilots E 4-11 January E V P

that helped to fly holidaymakers A hotel in Turkey has sacked every single male I Medicine with Altitude Conference N A E R stranded by tour operator member of staff because, said the manager, they Whistler, BC, Canada

G •

• www.medicinewithaltitude.com G

failures back to the UK. As well kept seducing older British women! Manager of the R E A N as his musical talents, the singer establishment Pelin Yucel took the pretty drastic I P V

qualified as a commercial pilot action when she caught her male waiters and E E 25-28 January 2009 V P I N A in the 1990s and went on to barmen bedhopping with guests seeking Shirley Windstorm Insurance Conference E R The Rosen Centre hotel, Orlando, work for Astraeus, a charter Valentine-style romances. The G •

• G company that no longer male staff members have Florida, US R E www.windnetwork.com A N

I operates scheduled now been replaced P V E E

services but leases with an all-female V P I N A its aircraft around team. 26-28 January E R

G the world. A Ms Yucel • Insurance Linked Securities Summit

• G New York City, R E spokesman commented: A N NY, US I

for Astraeus “It got beyond P V

E www.iqpc.com/us/ils E V

P said Dickinson a joke. The I N A

had been last straw was V R I G N

4-7 February

• employed as when I caught

E E

Windstorm Insurance Conference a full-time staff my bartender G N I R Jacksonville, V

member for coming out of A

E FL, US P P

the last seven a toilet with a E

A www.insurancejournal.com/events V R years, and regularly woman guest. She I N G

E •

piloted aircraft to was embarrassed but

• E

G 11-13 February

N Europe, Africa and the he was beaming all over his I R

V Global Healthcare Services Conference Middle East. A spokesman face.” She added that she could A E P

P Grand Hyatt, New York E

A for the firm said: “The roster never contact her night receptionist when she V NY, US R I meant that Bruce Dickinson needed to, as he was always ‘otherwise engaged’ N

G www.ibb.ubs.com/conferences

E •

was on holiday when this was with female guests. “The waiters would prey on • E

G N I going on. After XL went bump older English women staying at the hotel; they R V

A 26-28 February E

it just so happened that Bruce, would wait for them to come back from nights out P P

E Pan-Arab Insurance Conference A being on holiday, was available – often drunk – then seduce them.” V

R Bahrain

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G E N I V E P A R G • E N I V E P A R G • E N I V E P A R G • E N I V E P A R G • E N I V E P A R G • E N I V E P A R G • E N I V E P A R G • E N I V E P A R G • E N I V E P A R G • E N I V E P A R G • E •

The Claimers illustrated by Chris Duggan, story by Ian Cameron © Voyageur Publishing & Events Ltd

International Travel Insurance Journal ONTHEMOVE 55

GRAPEVINE • GRAPEVINE • GRAPEVINE • GRAPEVINE • GRAPEVINVINE GRAPEVINE • GRAPEVINE • GRAPEVINE • GRAPEVINE • GRAPEVINE •G R •

A E

P CEO chosen for New MD at RSA signs up EA selects vice N E I V V I E N

P Aviva France InsureandGo new UK CEO president E A

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R G G R

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A E

P Aviva has announced the Gary Lockett has The Europ Assistance Group has appointed Patrick N E I V

V appointment of Jean-Pierre been hired as the new Leroy as executive vice president with responsibility for I E N P

V Menanteau as CEO of Aviva managing director region three of the group’s business, which covers the A I N

R France, with immediate effect. of UK-based travel UK, Scandinavia, Ireland, North America and South E G

• G

Jean-Pierre has previously insurer InsureandGo, Africa. In addition, Patrick will also have responsibility R E

A for the performance of the group’s international health N held senior roles, including while Perry Wilson, I P V

E director of strategy and finance, the firm’s co-founder insurance activities, remote medical site services and E V P

I and MD since it Travel For Treatment services. As part of his new role, N at the Caisse de Dépôt et A E R Consignations Group, where launched in 2000, Patrick will also serve as general manager of Europ

G •

• G he worked from 1998 to 2004. is being retained as Assistance UK and Ireland. R E A N

I More recently, he held the a consultant. Gary Since 2003, Patrick has held the post of chief P V E

E position of chief financial officer brings with him 25 executive officer at the International Assistance V P I N A at SNCF, the French national rail years of experience in Group, a global alliance of 25 independent assistance E R

G • company, where he played a key the insurance industry, companies present in 46 countries.

• G

R E role in strengthening the firm’s including roles with A N

I Adrian Brown

P financial position. He has also Crawley Warren & V E E

V been a member of the board Company Ltd and P I N A and audit committee of Aviva Rattner Mackenzie RSA Insurance Group plc has announced that Bridget E R

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France since August 2007. Ltd. McIntyre is stepping down from her position as UK • G

R E Andrea Moneta, CEO of Aviva Speaking on his CEO, being replaced, subject to regulatory approval, by Smart moves A N I P

V Europe, commented: “I am appointment, Gary Adrian Brown, currently COO. Bridget has been with the E E

V at Mondial P delighted that Jean-Pierre is said: “Over the group for almost three years and has made a significant I Jean-Pierre Menanteau N A E R joining Aviva France. The French past eight years, contribution to the UK business; she is leaving to spend

G •

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subsidiary plays a key role within InsureandGo has more time with her family. Adrian Brown has been the R E A

N Aviva Europe and the group, making a valuable established itself as the UK’s leading direct travel UK’s chief operating officer since 2006; before this, he I P V

E contribution to results.” He continued: “Jean-Pierre insurance firm, with a strong brand identity, superb was responsible for establishing the UK’s direct business, E V P I

N has a proven track record in developing innovative value products and a reputation for excellent More Than, which he ran for two years before becoming A E R

growth strategies and an in-depth knowledge of customer service. We have exciting plans for the the UK director for personal lines in 2003. G •

• G the French financial community. His wide-ranging coming months and years, and I am looking forward Andy Haste, RSA Group CEO, said: “I would like to thank R E A N

I experience in financial services, combined with his to the challenge of delivering these and making the Bridget for the dedication she’s brought to advancing the P V E

E energy and leadership skills, make him the ideal company even more successful than it already is.” UK business. She’s developed a strong leadership team V P I N A candidate to develop further our business in France.” and I’m pleased to announce Adrian as her successor. He E R

G • Jean-Pierre succeeds Bruno Rostain as CEO of Aviva has an excellent track record with success in a number of

• G

R E France, who left at the end of Septmeber. key leadership roles.” A N I P V E E V P I N A V R I G N Ben Smart • AXA appoints

Buberl heads CEO picked for E E

G N I R

V finance director A to Zurich Aviva India Ben Smart has been promoted to the position of UK E P P

E Zurich Financial Services Group has appointed Aviva Life Insurance has approached the Insurance sales director for Mondial Assistance’s corporate and A V R I Jean Drouffe has been appointed to the role of Thomas Buberl to the position of chief executive Regualtory and Development Authority (IRDA) travel division, just one year after he joined the firm. N G

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finance director at AXA Insurance. In his role, he officer of Zurich Switzerland from 1 January in India regarding the appointment of TR Building on recent gains, Mondial has reorganised its

• E

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N is responsible for 2009. He joins Zurich in November to start a Ramachandran as CEO of its Indian operations. If sales team, with Ben at the helm, while Jody Baker I R V A two-month transition period and in January will E managing finance IRDA agrees to the appointment, Mr Ramachandran will become senior business development manager, P P E

A and risk across formally take over from Markus Hongler, who will succeed Bert Paterson, who has led Aviva India Aimee Charlwood senior account manager and V R I N the business is to become CEO of Zurich Insurance Ireland. since September 2006. Andrew Dagg account manager. Amanda Duffy has G

E •

• and providing a Annette Court, CEO Europe general insurance, For the past 19 years, Ramachandran has been with joined the corporate and travel team as well, in the E

G N I R strong governance said she was delighted to welcome Thomas to the Citibank, where he held different roles in credit role of key account manager, having transferred from V A E

P structure that group, adding: “His in-depth knowledge and broad cards, assets, commercial and retail banking. In his Mondial’s automotive division. Elsewhere, Matthew P E A V supports AXA experience equip him well to further build on the most recent role, he was head of retail banking, Harris has joined the firm as business development R

I

N

G E N I V E P A R G • E N I V E P A R G • E N I V E P A R G • E N I V E P A R G • E N I V E P A R G • E N I V E P A R G • E N I V E P A R G • E N I V E P A R G • E N I V E P A R G • E N I V E P A R G • E Insurance’s impressive results and leading position that Markus where he was responsible for the entire division, manager for telecommunications, Matthew Turner • business priorities. and his team have achieved in Zurich’s crucial including wealth management, branch banking, has joined as roadside assistance development His appointment home market of Switzerland.” investments and insurance, consumer assets and the manager and Catherine Anthony has been hired as a follows the re- Thomas joins Zurich from AXA NRI business. Bert Paterson key account manager. organisation of the Winterthur, where he was head of commented: “We have business by chief distribution and a member of the made enormous progress executive Philippe executive board. in Aviva India over the last Maso y Guell two and a half years. We Spiro elected Rivet. have grown strongly and, As part of his at the same time, laid the at Chubb new role, Jean foundations for even more has already put robust growth; hence, it is The board of directors of the Chubb Corporation Jean Drouffe in place a new the right time to hand over has elected investment banker Richard G. Spiro to structure by the reins to my successor.” the position of executive vice president and chief introducing finance business partners to provide Hook joins Elsewhere, Euleen Yiu Kiang financial officer. Richard joined Chubb on 1 October close support to each of the company’s four Healix Goh has been appointed as executive vice president and is to assume the strategic business units, helping them focus on as an independent non- mantle of CFO in early November, following the filing profitability and working closely with them in Healix has announced that Steve executive director of Aviva of Chubb’s Form 10-Q for the third quarter. Richard shaping new business solutions for the future. Hook has joined the company in the plc, with effect from 1 succeeds Michael O’Reilly, vice chairman and CFO, Commenting on his appointment, Jean said: “I very position of group sales and marketing January 2009. Most recently, whose retirement had already been announced. much believe the finance function should be at the director. Steve joins Healix from Steve Hook Euleen held the position of Richard joins Chubb from Citigroup Global Markets heart of any organisation and can add significant Mondial Assistance, and will, in his chief executive of Standard Inc., where he was a managing director in its financial value to the business-facing teams. In particular, new role, be responsible for developing revenues Chartered Bank in Singapore, the culmination of institutions investment banking group. He held a we should be involved in shaping the business from existing products and services, including medical 21 years with the company. She currently sits as a variety of positions there, including head of North decisions and finding the right solutions to ensure risk assessment, medical evacuation and repatriation, non-executive director on the boards of Singapore America, global head of insurance investment banking we manage risk, whilst improving our profitability medical help lines and third-party administration in Airlines Ltd, the Singapore Exchange Limited and and co-head of the insurance, asset management, and safeguarding our customers’ experience.” healthcare. MediaCorp Private Ltd, among others. exchanges and processors group.

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