ESSENTIAL READING FOR TRAVEL INSURANCE INDUSTRY PROFESSIONALS JUNE 2010 • ISSUE 113 Advice frustrates insurers

The curfew imposed in Bangkok on 19 April Channel Three news station was set on fi re, while allowed the government troops to begin a staff on English-language newspapers The Nation and steady march into the protest area of Bangkok, Bangkok Post were evacuated after threats were made surrounding the red-shirt camp and moving in against employees. Across regional Thailand, red-shirt to arrest the leaders of the group. Charlotte supporters staged their own rallies, prompting the UK Hodgman has the details Foreign and Commonwealth Offi ce (FCO) to issue warnings against travelling to Chiang Mai. According to reports, troops ‘made no attempt at According to the FCO website: “The Foreign Offi ce is secrecy, opening fi re almost as soon as they entered now advising against all travel to the city of Bangkok in the camp’. Troop carriers were driven at barricades view of the highly uncertain security situation and the of tyres and sharpened bamboo sticks, and despite currently unpredictable violence across the Thai capital. claims that the red-shirted protestors had no We judge that the risk to the safety of British nationals weapons with which to defend themselves, many has increased and have amended our travel advice were seen with hand guns and assault rifl es. accordingly.” It continued: “We have also decided to In the early afternoon of Wednesday 19 May, the advise against all but essential travel to Chiang Mai due leader of the red-shirts, Jatuporn Prompan, told his to the worsening security situation there.” fellow protestors to leave the area peacefully, saying: New Zealand’s Ministry of Foreign Affairs and Trade “Though the fi ght didn’t reach our goal, we tried travel advisory at the time of writing deemed Bangkok our best. Go home. We are sorry for not sending as an ‘extreme risk’, and the rest of Thailand has ‘high you home earlier.” After 68 days of protest, and risk’. Tourists from New Zealand have thus been one protestor killed for each day, the thousands of advised to leave, and further travel to Thailand is, for protestors that had followed him left the area. the time being, discouraged. Brent Thomas, retail As the leaders of the protest surrendered themselves director at House of Travel, a Kiwi tour operator, said to police to be charged with offences including that most customers were adopting a ‘wait and see’ terrorism, some of the other protestors showed approach for the moment, adding: “We’re not seeing their displeasure at the situation by looting shops, vast cancellations.” People who had decided to travel to setting buildings on fi re and attacking bystanders. The Thailand were said to be continued on p.8 Volcanic rumbling

As air travel around took the advice of the Dublin Airport Authority and the world continues stayed away from the airport during May’s closures to be disrupted by may well have invalidated their right to claim on the intermittent their travel insurance, according to one industry bursts of ash from spokesperson. Ciaran Mulligan, managing director of the Eyjafjallajökull travel insurance specialist Blue Insurances, said that volcano in Iceland, policies would typically compensate ‘anyone who travel insurers are checks in for a fl ight that is subsequently delayed being slated in the or cancelled’. She went on to say that passengers international press for a who checked in online at home, but then did not lack of consistency over journey to the airport could be covered, but only © Mick Shippen cover. Mandy Aitchison at their insurers’ discretion. Some travel insurers, they were supposed to fl y with. A spokeswoman insurance coverage. reports the latest news including Blue Insurance, have been paying claims as a for the Dublin Airport Authority said she was In the UK, Columbus Direct and Insure2Travel have gesture of goodwill, while others have directed their unaware that telling passengers not to travel to the both launched add-on products that customers can In Ireland, travellers who customers to seek compensation from the airline airport could have had an adverse affect on travel pay for in addition continued on p.10 IN THIS ISSUE ITIJ CONTRIBUTORS

REGULARS Robert Bailey is a business journalist and writer on the Middle East and Africa with more than 25 years reporting experience of both News continued 4 regions. He has carried out many in-depth assignments in these areas Editorial comment 8 for newspapers and magazines including the International Herald Tribune, Newsweek, Time Magazine, Wall Street Journal, Forbes and for Company brief 10 many other journals. He is also a specialist writer on aviation, tourism, News continued 11 telecommunications as well as security and defence matters. Insurance matters 12 Health matters 14 Travel matters 16 David Ing is a freelance journalist covering mainly travel and tourism Cross-border care 18 issues in Spain. He writes on air transport for a leading international news agency, as well as contributing special features to Newsweek and IPMI news 20 writing in-fl ight magazine articles and guidebooks. Air ambulance news 22 Profile 46 Service directory 47 Milan Korcok is an award-winning freelance health policy and Grapevine 54 economics writer who covers travel insurance, public health, and medical education issues in Canada and the US. He has been writing Diary dates 54 about health fi nancing and policy issues in these countries since the On the move 55 1960s, is a frequent contributor to leading North American professional journals and consumer media, and is publisher of the consumer website FEATURES www.travelinsurancefi le.com. He lives in Fort Lauderdale, Florida. News Analysis: Timing is everything 26 ITIJ takes a look at one of the most common pitfalls for Petra Kendall-Raynor is a freelance journalist based in London American consumers with pre-existing medical conditions with a decade of experience in the United Kingdom and abroad. Her work is regularly published in a wide range of national newspapers and Feature: A risk worth taking? 28 magazines. Clients include: Express newspapers, Guardian newspapers, In order to contain costs, some US insurers are offering medical London News Network, Mirror newspapers, Lunch, Chat, Pride, Care and tourism travel insurance – we take a look at what’s on the market Health, Nursing Standard, Inside Housing, Safety Management, Health Insurance, Planned Savings, Running Fitness. Feature: ITIC Review 30 All the information you need about the recent ITIC Domestic conference held in Brighton Dr Daniel de Klerk, MBChB, FRANZCP is a consultant forensic and aviation psychiatrist working in Auckland, New Zealand. He has Assistance & Healthcare World Markets: Kenyan care 40 experience in the assessment and planning of the international transport Road accidents cause the majority of fatalities in Kenya; of psychiatric patients. ITIJ evaluates the help on offer to tourists and locals

ITIJ TEAM

Editor-in-chief: Ian Cameron ITIJ Published on behalf of: Voyageur Publishing & Events Ltd, Acting editor: Mandy Aitchison Voyageur Buildings, 43 Colston St, Bristol BS1 5AX, UK Voyageur Buildings, 43 Colston Street, Bristol BS1 5AX, UK Sub-editor: Charlotte Hodgman The information contained in this publication has been published in good faith and Copy editor: James Paul Wallis Telephone: +44 (0)117 922 6600 every effort has been made to ensure its accuracy. Neither the publisher nor Voyageur Ltd can accept any responsibility for any error or misinterpretation. All liability for loss, Editor-in-absentia: Sarah Watson editorial dept: Ext. 3 disappointment, negligence or other damage caused by reliance on the information contained in this publication, or in the event of bankruptcy or liquidation or cessation Designers: Eli Butler advertising dept: Ext. 1 of the trade of any company, individual or fi rm mentioned is hereby excluded. Steve Annette James Elliott fax: +44 (0)117 929 2023 Printed by Pensord Press, South Wales, United Kingdom US correspondent: Milan Korcok email: [email protected] Copyright © Voyageur Publishing 2010. Materials in this publication may not be reproduced Conference manager: Denise Clements web: www.itij.co.uk in any form without permission Production: Helen Watts design: V Creative Design INTERNATIONAL TRAVEL INSURANCE JOURNAL ISSN 1743-1522 Kirsty Diclaudio Advertising sales: David Fitzpatrick Would you like to make a comment? James Miller WOULD YOU LIKE TO SUBSCRIBE? Finance: Elspeth Reid Please get in touch with Ian Cameron, VISIT www.itij.co.uk Editor-in-Chief of ITIJ, on +44 (0)117 922 6600 Louise Goddard

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

4 NEWS

Prime targets Greece is not the Slippery business A survey conducted by UK insurance provider Direct mistake. Holidaymakers should protect themselves Line has revealed that a fifth of holidaymakers become by ensuring that they have travel insurance in place to word The recent oil spill from an underwater oil pipe in victims of pickpockets and thieves whilst abroad, with cover against any losses should the worst happen.” the Gulf of Mexico has caused consternation among 41 per cent reporting having cash stolen, while 20 per According to the survey, mainland Spain is the top Figures from the latest GfK Ascent market statistics travellers heading to the Gulf Coast, while tourism cent have had their cameras pinched and a further holiday crime hotspot, representing a quarter of have suggested that some UK holidaymakers are officials hundreds of miles away on the Atlantic 16 per cent have lost their credit or debit cards to incidents, followed by France, the UK and the Spanish thinking twice before booking a sojourn in Greece Coast are cashing in on the concern, trying to lure thieves. The survey also disclosed that the majority Balearic islands. The company has urged travellers after rioting in the country’s capital Athens at the vacationers away from the trouble spot. of these thefts took place in the holidaymakers’ to keep valuables and important documents locked beginning of May – bookings for the summer 2010 Many holidaymakers are reportedly trying to alter accommodation, which accounted for 24 per cent of in a hotel safe and have additional funds set aside season were down against the rest of the Eurozone their holiday plans, but are facing steep penalties for the crimes, while pickpockets targeted 11 per cent of for emergencies, as well as ensuring they take out for the week ending 8 May, and Greek bookings backing out. According to Dan McGinnity, spokesman respondents to the survey and 10 per cent had items adequate travel insurance before travelling. across the Eurozone were down by 31 per cent on for insurance company Travel Guard North America, stolen from their car. the same period last year. According to the figures, travellers will not be covered by travel insurance Jennifer Thomas, bookings for summer 2011 have been relatively products as the spill is an ‘act of man’ as opposed to an spokesperson for Direct unaffected by the situation. ‘act of God’. He continued to state that most policies Line Travel Insurance, Sarah Smalley, GfK Ascent managing director, said only pay out if travellers can’t reach their destination commented on the findings of the findings: “We will be monitoring the situation or if accommodation closes, which he deemed as and the importance of closely as regards consumer booking behaviour unlikely, even if the oil starts rolling ashore. taking out travel insurance to see what develops over the coming weeks. Other sources state that the oil spill is hurting tourism before travelling: “Many Obviously with Greece being one of the most in Florida as well, costing the region millions of dollars people are looking for popular destinations for UK tourists, the industry will in empty rooms and beaches. Nicki Grossman, ways to save money on be keen to see what transpires.” president and chief executive of the Greater Fort the cost of a holiday in Lauderdale Convention and the current economic Visitors Bureau, commented: climate, but cutting back “In my opinion, this is a worse on travel insurance could dilemma than four hurricanes end up being an expensive in one season. We’re holding our breath.” Meanwhile, Stephen Leatherman, a Florida BA strikes go ahead International University professor, said: “They call it As ITIJ went to press, the cabin crews of British Brian Boyd, head of the Unite workers’ union the Emerald Coast because Airways (BA) were in the midst of their proposed that called the strike, said that there remained the water is green and the 15-day strike. The airline claimed that it was dealing ‘enthusiasm and determination’ among the sand [is] lily white. It’s arguably well with the strike, with seven in 10 passengers still strikers, and added that he expected flight the finest, whitest sand in catching their intended flights. It said there were still disruption to worsen as the strike went on. In a the world.” He continued: sufficient numbers of staff that had reported for work move likely to anger protestors, BA has painted “Obviously, if the oil hits any to allow it to run half of all short-haul flights and 60 the slogan ‘Keep the flag flying’ on a number of of these beaches, they’re not per cent of long-haul flights from Heathrow. its Heathrow-based planes. going to be on the list.”

International Travel Insurance Journal NEWS 5

Buoy, oh buoy Ready, set, cancelled

At least 60 people were injured onboard the cruise In line with a new rule that came into effect at the ship Carnival Ecstasy during a sharp manoeuvre to end of April 2010, passengers now have the right avoid a partially submerged buoy that was floating to get off a plane if it is stuck on the tarmac for three adrift near Mexico’s Yucatan Peninsula. Jennifer De hours, unless it is deemed a safety hazard. According La Cruz, spokeswoman for the ship’s operator, to airline officials, hundreds of flights are now likely Carnival Cruise Lines, confirmed that 60 guests and to be cancelled at the first hint of bad weather as a one crew member had suffered minor injuries during result of the new rule, as airline carriers try to avoid the incident and that some unsecured objects had potential fines for violating the three-hour rule. been damaged. However, no one required hospital David Castelveter, vice president of the Air Transport treatment. One passenger reported that she was Association of America, noted that many UK airlines thrown out of bed as ‘the whole boat just shifted’. were opposed to the new rule, which, in their The ship, which was carrying around 2,340 minds, will cause passengers more hardship with passengers and 900 crew members, docked safely even more flights cancelled. “Some will err on the at its homeport in Galveston, US, and the cruise ship side of caution and pre-emptively cancel flights, operator confirmed that the US Coast Guard had stranding passengers,” he said. been informed of the wayward buoy. Many experts agree, stating that as only 903 out of 6.4 million flights were delayed longer than three hours in 2009, the law is not needed. David Thomas Cook employees walk free Stempler, an aviation lawyer and president of the Air Travelers Two Thomas Cook employees have been cleared Chrysikopoulos, together with the head of the Association, agreed: “The misery of manslaughter over the deaths of two British hotel’s technical department Petros Stoyiannos, were index for airline passengers is children from carbon monoxide poisoning while on each sentenced to seven years in prison, while civil definitely going to go up.” holiday in Corfu in October 2006. Seven-year-old engineer Dimitrios Xidias was given two years on Others, however, say cancellations Christianne Shepherd and her brother, six-year-old probation. are unlikely, as carriers won’t want Robert, died after carbon monoxide fumes leaked The children’s father said: “If just one person had to risk losing revenue and passenger into the bungalow in which they were staying from done their job correctly. Christi and Bobby would loyalty during a period in which an outhouse next door, where a boiler had sprung be here today. Nobody deliberately set out to both are desperately needed and a leak. The children’s father, Neil Shepherd and his cause Christi and Bobby’s death but everyone who highly sought after. The fact remains, partner, Ruth Beatson, were left in a coma for days worked on or knew about the disgusting state of the though, that airlines have a powerful afterwards, but survived. boiler in our eyes were grossly negligent.” incentive to cancel flights early, as The three judges presiding over the hearing cleared Pete Constanti, chief executive for Thomas Cook UK the maximum penalty for violating the two Thomas Cook employees, Richard Carson & Ireland, commented: “We have always maintained the new rule is US$27,400 per (28) and Nicola Gibson (26), saying that the pair that this tragic accident was the result of a unique passenger per day – for a fully loaded had been ‘misinformed’ by the hotel manager that set of circumstances, none of which could be the medium-sized jetliner such as a there was no gas used in the bungalow, and were responsibility of the company or Richard Carson and Boeing 737, that equates to more therefore not responsible for ‘bringing about the Nicola Gibson. We believe that they should never than a $3.5-million fine. lethal outcome’. However, hotel manager Georgios have formed part of this court case.” Carnival Ecstasy cruise ship Carnival Cruise Lines

www.itij.co.uk 6 NEWS

New ombudsman makes her mark

Natalie Ceeney, the UK’s new chief financial time to resolve, but many could be done quicker.” ombudsman has said that one of her main tasks in One of the ways she hopes to achieve a shorter her new role is to ensure the Financial Ombudsman turnaround time for dispute resolution is through the Service (FOS) runs more efficiently. “If you go back greater use of technology: “We’d like to see systems 10 years, we were set up as a small in place so people could track where organisation dealing with 25,000 their claim is, and how long it is likely cases a year. This year we are to take. If the Royal Mail can do it expecting 200,000 cases. We need with parcels, we should be able to do to continue modernising, improve it with complaints.” our technology and reduce the The FOS might have to ready itself time it takes to handle some of the for a deluge of complaints relating cases.” to travel insurers following the One of the most common travel chaos that was caused by the complaints about the FOS is the volcanic ash, although Ceeney was length of time it can take before unsure how the situation would a decision is reached, with many develop. “We don’t know whether people waiting for several months. this will be an issue yet,” she told Ceeney responds that currently, The Telegraph. “Customers have to Take less, have more two-thirds of cases are settled register any complaint with their Travellers are being warned to check their insurance carefully, not only for the limits on individual items within six months, but that the product provider, and they have policies for the size of any ‘excess’ that may apply but also the combined value of luggage cover.” situation could still be improved eight weeks to resolve the problem. before they qualify for a payout, as well as any Stating that demand for increased cover is coming upon. She added: “By the time Natalie Ceeney Only after that can it be referred to payment limits on individual items. Online travel from the 18 to 29 age group, Jackson continued: people come to us, they have us.” She went on to say that the situation has been insurer Travel Insurance Direct has reported a “It’s now routine to travel with a whole suite of invariably been in one complaints loop or another made more complex thanks to a lack of clarity over surge in travellers seeking extra cover for electronic electronics, from iPhones and Blackberrys to … for quite some time. There are always going to be a which service provider is responsible for refunding devices, and last year there was a 36-per-cent iPods and tablet devices.” These gadgets, he claimed, handful of complex cases that are going to take a long customers caught up in the ash debacle. increase in the number of travellers taking additional can take a traveller’s total luggage value well beyond cover, according to general manager Ian Jackson. the limits of their insurance. However, even with travel insurance, many travellers According to the company, camera equipment was find themselves out of pocket after they discover that the biggest category of additional cover last year, at Mangalore tragedy Terrorism Tracker there may be caps on payments for individual items 41 per cent of specified items, followed by laptops such as jewellery, mobile phones and computer at 18 per cent, mobile phones at nine per cent and Nearly 160 people have died after an airliner released equipment. The Insurance Ombudsman reported jewellery at seven per cent. Travel insurance claims crashed while landing near the southern Indian city of one case in which a traveller lost US$160,000 worth in general accounted for 16 per cent of complaints Mangalore. Indian officials told the media that there Aon’s most recent Terrorism Tracker newsletter has of jewellery, amounting to around 10 separate items, to the ombudsman in the last financial year and were eight survivors among the 160 passengers and six given travel insurers some food for thought, as only to discover that their policy had a cap of $500 the most common source of disputes in insurance crewmembers onboard the Air India flight from Dubai. although not many of the incidents have made the an item. complaints overall was the ‘agreed understanding Reports from the scene state that the Boeing 737 international news, nonetheless insurers should be Jackson said: “Travellers need to check their policies about the extent of the cover.’ aircraft overshot the hilltop runway as it tried to land, aware of the dangers that terrorists pose to their bursting into flames in a valley beyond the airport. clients around the world. All passengers on the flight were Indian nationals, In the Americas, suspected Shining Path snipers with many returning from jobs in the gulf region to attacked a coca leaf eradication team in Peru, despite visit their families. Praful Patel, India’s civil aviation the fact that some 175 policemen were guarding the minister, said an investigation had been ordered into team at the time. Two civilians and an officer died in the crash, and that the flight data and voice recorders the attack. had been found. The US National Transportation In Europe, Swiss police arrested two Italians and Safety Board has also despatched a team of a Swiss national in Rüschlikon, Switzerland, on investigators to assist the Indian government. suspicion of planning to bomb an IBM corporation research facility. Media sources reported that the suspects belonged to the Italian eco-anarchist group Il Silvestre. In Athens, suspected anarchists bombed the entrance Just say no to a branch of HSBC. Although there were no casualties, the explosion caused some structural Following criticism of the travel insurance industry’s damage to the building. lack of cohesion on whether or not they would pay At the end of April, a suicide bomber attacked the out for claims relating to ash disruption, a recent convoy of the British Ambassador to Yemen as he editorial in a British newspaper claimed to show was going to work in Sana’a. The explosion injured ‘Insurers’ 10 favourite reasons not to pay’. The three people, but no-one from the Embassy was top reason given was ‘not checking in for a flight’, hurt. The Embassy was closed down for 12 days showing that the onslaught of damaging publicity after the attack. surrounding the industry is not going anywhere Elsewhere, Saudi Arabian security forces arrested a fast. The second most common reason was ‘not suspected female suicide bomber in Al Qasim. disclosing a pre-existing medical condition’, followed In South Asia, security services discovered three by ‘incorrect description of door locks’. The next unexploded bombs outside the Chinnaswamy cricket three reasons were all related to travel insurance, stadium in Bangalore, confirming that high-profile sporting being ‘leaving items unattended’, and ‘drinking while events are definitely on the terrorists’ radar – just a day on holiday’, followed by ‘forgetting to notify the earlier, two bombs exploded at the same stadium. police having been the victim of theft’. The rest of the most popular reasons for insurers to deny a claim were given as ‘failing to notify your insurer about car modifications’, ‘announcing that you are off on holiday on social networking sites’, removing ruined items from a flooded house before the loss adjuster has a chance to see them’, and ‘going to the Channel Islands uninsured’.

International Travel Insurance Journal

8 NEWS

Hikers perish in Experts recommend cover for US travellers

Pyrenees With summer holiday time fast approaching in the cover from a reputable source, such as a travel agent northern hemisphere, travel insurance industry that is a member of the American Society of Travel Two British hikers died recently after falling into a field experts are urging Americans to investigate the Agents, and that they should keep all the necessary of ice in the Spanish Pyreness. A third member of the ways in which they can protect themselves from documentation close to hand in case a claim needs group survived the accident, which occurred near the unforeseen costs while abroad. Travellers are being to be made. And so in the after math of the Eyjafjallajökull the Pico de Frondiellas in Sallent de Gállego in northeastern told that they should register in advance with the knives are already out for the travel insurers. Spain. The UK Foreign Office named the deceased US State Department, which could help a tourist Cue a headline from the centre pages of one of the men as John Peter Field and Richard Greenwood, to locate a nearby doctor when abroad and help British newspapers, the Daily Mail “What is the point adding: “We are providing consular assistance and we to arrange air ambulance repatriation, but that the of travel insurance?” (catchy eh?) are in the process of informing the next of kin.” added protection of travel insurance ‘can be critical’. Indeed … and we at ITIJ would have to concur. What It is believed the three men were hiking on a steep Dan McGinnity, vice president of Travel Guard North is the point of travel insurance if it only covers you for route that was treacherously covered with snow and America, said: “Americans have the concept that medical emergencies and accidents, lost baggage, trip ice when they slipped, despite being equipped with all when they travel, their health insurance travels with cancellation, injury, death etc.? the correct hiking gear. The Spanish Civil Guard has them,” which is a dangerous attitude to have. Not covering volcanic eruptions … Outrageous … reported that one climber was believed to have fallen Susan Pisano of America’s Health Insurance Plans I mean they happen all the time don’t they? I mean down a sheer drop, while the second is thought to encouraged potential holidymakers to read the think of how many times the whole of Northern have fallen after him when he tried to help. small print of their policies so that they have a clear European Airspace has been shut in the last 50 years understanding of what kind of expenses are covered, … should have seen it coming people! and the limits imposed upon those payments. The And while we’re on it, it’s about time we included in Watch where you go US Centers for Disease Control and Prevention has the policy trip cancellation because of alien invasion also got in on the act, recommending that travellers and medical injury from a Triffid sting. Bob Atkinson, travel insurance expert at UK price buy supplemental health insurance that includes Come on guys comparison website Moneysupermarket, has said medical evacuation. … from a PR ….and for those of you who that consumers need to be careful where they buy The US Travel Insurance Association said that point of view spend much of your time their travel insurance from, as some providers could more Americans than ever before are investing in insurers do surfing the web looking for be charging a great deal more than others. Research the protection that travel insurance offers, and the themselves no a new Russian girlfriend or by the website has shown that travel insurance publicity surrounding recent travel disruption has favours. Unless increasing your stocks of premiums can be an incredible 211-per-cent more prompted more inquiries about travel insurance insurers can Viagra, you’ll be pleased to expensive when bought as an add-on to airline from the general public. The group also commented speak with one hear, you can now further tickets or a holiday bought through a travel agent. that it has recently witnessed a strong increase in voice and explain diversify your search time by Atkinson said of the issue: “Airlines, tour operators and the number of policies sold that include cover for why the ash visiting ITIJ on Facebook and travel agents are known to try and lure customers into medical emergencies and evacuation. cloud was not Twitter which compliments taking out their preferred travel insurance policy. These The organisation has offered several tips to US covered, then our fab new website – follow policies can be wildly uncompetitive and might not suit travellers that should help them to choose the most there will always the links from our website to individual circumstances.” He continued: “By taking the appropriate cover for them. The tips state that a be a media ready see all the latest news from time to shop around for travel insurance [customers] tourist should know who is underwriting the travel to kick an industry the ITIJ team … and in the can jet away with the peace of mind that [they] know insurance policy, and then check out the company’s the public love meantime we’ll see if we can exactly what the policy covers while [they] are abroad.” financial rating and stability; travellers should buy their Advice frustrates to hate … but sort out some links to the wouldn’t want Viagra sites too … insurers continued from p.1 be without. Ian Cameron re-routing their flights so as to avoid Bangkok, according Editor-in-Chief to State Travel Insurance manager Michelle Boulger, [email protected] who said the company was ‘looking at alternatives like moving the flight destination [away from Bangkok] so customers can still have their holidays’. On 25 May as Thailand’s capital Bangkok slowly emerged from the violence, offices, schools and businesses began to reopen in the troubled city, Quality insurance which saw more than 80 people dead after nine weeks of protests. However, the military said that a ‘a must’ curfew is likely to remain in place in Bangkok and 23 Scott Gorman, travel insurance manager at UK provinces for another week. supermarket Sainsbury’s, has said that taking out Luzi Matzig, chief executive officer of Asian Trails, urged comprehensive cover should be a priority for anyone operators to encourage tourists back to the country: planning a holiday, and that good quality cover does not “Skytrain and the subway are back in operation and necessarily have to cost a great deal of money – but sightseeing tours are again being conducted according customers must learn what cover they need and can to established itineraries. The only thing missing now then search more efficiently. He added: “Whether you’re is tourists.” He continued: “May we ask for your kind heading thousands of miles away or holidaying in the UK support in spreading the word that Bangkok is safe to this summer, good quality travel insurance should be a visit, travel advisories are being normalised and Thailand must. The potential costs of not being covered should a is welcoming all foreign visitors with open arms.” catastrophe befall you, such as you or your partner falling It seems, however, that not everyone is convinced of the ill or your bags being stolen, are huge.” city’s safety – Australia’s latest government-sanctioned Current events such as the strike by British Airways Smartraveller advice still warns Australians not to travel to cabin crew and the eruption of the volcano in Iceland the city due to the ‘ongoing risk of sporadic violence’. have put the importance of comprehensive travel Most international travel insurers will not offer cover insurance in the spotlight – for more on these issues, to a destination that has been declared a ‘no-go please see the ITIC Review on page 30. area’ by the government of the country in which they are based, but there is no doubt that plenty of tourists will continue to travel to Thailand. The pleading from locals on the ground asking for the return of tourists will surely result in many travellers deciding to ignore their government’s warnings, but with the Thai government only offering to cover tourists for injuries that are sustained as a result of political violence, there are sure to be many tourists who are lacking insurance for other medical emergencies.

International Travel Insurance Journal NEWS 9

Poll Pamir Airways in safety row Scottish tourists prompts arrested The Afghan airline that operated the was concerned when the pilots allowed a female concern plane that crashed into mountains north passenger into the cockpit for much of the duration Police in the Brazilian city of Rio de Janeiro have of Kabul on 17 May has been accused of of the flight. She said: “I was really alarmed to see arrested four Scottish tourists after the men Steve Williams, head of ignoring a serious complaint about basic this woman who had been invited up to fly the plane were accused of taking their clothes off and travel insurance at price safety lapses just weeks before the crash knock on the cockpit door and stay there until after making ‘obscene gestures’ on the ever-popular comparison website occurred. The plane, which belonged to we landed. We had really bad turbulence and pilots Copacabana beach. According to news reports, an Confused.com, has said Pamir Airways, crashed while it was flying do not need that sort of added distraction.” intelligence official from the military police battalion that some consumers still from Kunduz, killing all 44 passengers Khalilullah Fruzi, the co-owner of Pamir Airways, has in Copacabana said the men were arrested after a overlook the importance onboard, including three British nationals. said that it is impossible to fit another person in the 52-year-old woman made a complaint to a police of having travel insurance The complaint came from a US cockpit of the Antonov-24 aircraft, adding that the patrol that happened to be passing by. As only one of while on holiday, after a photojournalist who had flown with witness may have mistaken a flight attendant taking the tourists could be formally identified, he was the survey by the company Steve Williams the airline a few weeks before and the pilots a cup of tea for a fellow passenger. only one to be charged with ‘inconvenient conduct’. found that seven per cent of respondents still intend to go on holiday without cover. He said that it was ‘a concern’ that some individuals still feel this way, despite all the delays that strikes and weather and natural disasters have caused in the first five months of the year. Williams said: “Travel insurance covers eventualities including delays and cancelled holidays and insurers are still offering cover for holidays affected by the ash cloud.” Further research by the company showed that 25 per cent of people who responded to the survey were less confident about booking a holiday due to the concern over whether they will actually be able to reach their destination, or be able to return home once the holiday is over.

Hurricanes hurt

US-based company Travel Insured has advised travellers organising trips this summer to plan ahead of the emerging storms that will hit, some of which have already been given names. The coming storms are listed in alphabetical order by the US National Weather Service’s Hurricane Center in advance of the 2010 Atlantic hurricane season, which runs from June to November. Starting on the date a tropical storm is identified and named, it then becomes a publicly known event and therefore no longer meets the ‘unforeseen’ definition that is required for travel insurance coverage. Travel Insured does not provide coverage for adverse weather claims due to a named tropical storm or its resulting weather patterns for insurance plans bought on or after the date when the storm is named. Although 2009 was a quiet hurricane season compared to yearly averages, there is no expectation that 2010 will be the same. Last year, the National Weather Service predicted seven to 11 named storms, with between three and six hurricanes. The actual result was nine storms and three hurricanes. In related news, Travel Insured has also urged travellers to protect the investment they have made in tickets to shows or sporting events. According to the company: “The price of sports championship tickets and hit show seats are higher than ever. It is advisable for savvy sports and entertainment travellers to buy event tickets with their trip arrangements from a tour operator authorised to sell and deliver valid tickets prior to departure. Missing a trip due to a last-minute need to cancel can mean a big loss for the grounded, uninsured traveller with unused event tickets.” The insurer has also issued a stark warning about special event tickets. The US Department of Transportation ruled in 2006 that event tickets sold in conjunction with an airline flight requires that, “An entity that offers special event tickets with an airline flight must be in physical possession of a sufficient number of tickets or have the written contract for the tickets; and that the entity’s contract for the tickets must be directly traceable to the actual sponsor of the event.” The American Society for Travel Agents has also advised customers to verify that sports and special event packages include valid tickets, urging them to book packages through a qualified travel agent with a consumer protection plan.

www.itij.co.uk 10 NEWS

Volcanic rumbling Ash cloud cover update continued from p.1 Virgin Money is not covering any claims to their normal travel insurance, which specifically at the Association of related to the volcanic ash. Virgin has classified cover travel delay/cancellation of a holiday as a British Insurers, tried the incident as a natural disaster and not result of the volcanic ash cloud returning. The his best to explain to weather related. upgrade from Columbus Direct, worth £4,000 per the public why travel Aviva is offering £25 per insured person for policy, is intended to cover customers for the cost insurance doesn’t, as every full 12-hour period of delay, up to £250, of alternative accommodation, or enable them to standard, include cover between the original scheduled departure and travel by alternative means to get home. Graham for volcanic ash: “Most the eventual departure time. Linney, director of Columbus, said: “Not all travel policies are designed Lloyds TSB, Halifax and the Bank of insurance is the same, and we are very proud to to stand alongside, Scotland have agreed to provide extra support be the first provider to offer such comprehensive not duplicate, the for policyholders stuck abroad by reimbursing cover that will help compensate people through very compensation that them for additional costs incurred because of the difficult circumstances such as the ash cloud, and people are entitled disruption. who knows what else in the future.” Low-cost airline to from their airline Post Office Travel Insurance will also Flybe claimed to be the first airline to offer cover or tour operator. compensate a customer if their flight is delayed for volcanic ash, with the policy being underwritten Any cover provided by travel insurance in these connected to the event under natural disaster or for more than eight hours as a result of the by Chartis. The cover kicks in when the UK’s Civil circumstances will vary as there is no such thing as a weather events coverage if the policy was purchased volcanic ash. Aviation Authority or any relevant overseas equivalent standard travel insurance policy. Customers should before the April eruption, according to Jim Grace, A spokesman for Sainsbury’s Finance closes airspace. therefore check their travel policy and speak to their president of the US Travel Insurance Association. He said the first port of call is through the airline; Over-50s insurer Saga is dealing with each volcanic travel insurer if they are still unsure.” He went on to said: “The ash is carried by the wind and hence is a however, they are taking a sympathetic eruption as a separate incident, meaning if a customer say that so far, “Travel insurers expect to pay around weather event.” In Australia, local insurer 1Cover has approach to reasonable claims from their takes out travel insurance when there are no flight £62 million following disruption caused by the recent said that it will honour claims brought by customers on policyholders. restrictions in place, and then the next day the closure of airspace. This represents 16 per cent of policies bought before 16 April. Age Concern Insurance stated that single volcano erupts again, the customer will be covered. the annual amount paid out by UK travel insurers.” Airlines have not escaped criticism for the way and multi-trip travel insurance policyholders are Nick Starling, director of general insurance and health Graeme Trudgill, technical and corporate affairs in which they handled the crisis, with a survey of covered for up to 60 days at no extra cost. These manager for the British Insurance carrier websites by the UK's Air Transport Users are cases where customers are delayed on their Brokers Association, also weighed Council finding that many airlines put information that return home for reasons outside their control. into the debate: “Insurance is for the could help passengers claim money back for flight Columbus Insurance offers its clients unexpected, and the Icelandic disruption disruption in unlikely places, making it more difficult coverage for travel delay if they were held is now a known event, so insurance for customers to locate the necessary information. for 12 hours and abandonment if they were policies bought since the first eruption A spokesman said: “We found that with many delayed for more than 24 hours. on 14 April will not cover the cost of airlines’ websites, instructions on how passengers Direct Line and Churchill insurers stated that travel disruption.” can go about claiming their expenses, and also on that their customers will be covered for travel Meanwhile, AA Travel Insurance is how to get a refund of a ticket if they did not travel, delay and missed departures as well. Direct reported to have reneged on a promise are either tucked away in a section of the site that Line will be extending cover for single trip travel to pay out on travel claims resulting from can be difficult to find or are not there at all.” The policies for customers who are stranded abroad. the volcanic ash cloud. The company organisation has called on carriers to provide links Customers who are unable to use their existing originally said it would pay out as a from the home pages of their websites to information policies will also be able to change the travel gesture of goodwill, but the underwriters on how money can be claimed back. dates on their policy to reflect their new travel have since re-considered their position According to CarTrawler, a car rental distribution arrangements at no additional cost as long as since airlines agreed to take the lion’s system company, the volcanic ash cost the car rental they have not submitted a claim. share of the compensation costs. Other industry €65 million. The company has estimated Direct Travel has stated that it will insurers who have shied away from that 22 per cent of global car rental bookings were compensate policyholders for delayed flights, offering cover for volcanic ash-related cancelled, with more than 95 per cent of passengers missed departure and abandonment if the policy cancellations or delays include Virgin not collecting their rental vehicle from European was purchased before 15 April. Money, Holiday Extras, Europ Assist, airports. CarTrawler chief executive Greg Turley said: In addition, HSBC, M&S Money and First Swinton and Endsleigh. Those insurers “Car rental companies received a large demand for Direct are willing to help UK travellers who are who are offering some form of cover international one-way rentals from travellers who stranded abroad by waiving withdrawal fees and include AllClear, Swiftcover, Tesco and were stuck abroad and needed to make their way looking favourably upon requests for increased Post Office Travel Insurance. home by road. However, the subsequent logistical credit and overdraft. Most US insurers who sold trip difficulties in returning the vehicles have resulted in Greenbee insurance, although sympathetic, says cancellation policies were issued before nearly 10 per cent of car rental fleets being located it will look at each claim on a case-by-case basis. the volcano erupted have paid claims outside their home country.” Smoke screen Rochelle Turner, head of research for Which? Holiday, disgruntled member recently who took our advice and This trickle has turned to a rush, however, with holders regarding the volcanic ash disruption and, questions whether the industry is doing enough for bought a Which? Best Buy insurance policy only to find those who are not covered for volcanic ash saying more worryingly, 17 of the 24 had no information customers caught up in the volcanic ash debacle out they weren’t covered for ash-related claims. This they feel let down that they have been caught out for potential new customers looking for reassurance just goes to show that people fully expect their travel by their travel insurance policy. A feeling that turns to about their future travel plans. This lack of clarity and The eruption of the Icelandic volcano under the insurance policy to cover them for all problems that anger when they see the piecemeal approach that information does not endear the travel insurance Eyjafjallajökull glacier and the subsequent closure of occur when they have left their home to go on holiday. has been taken by the insurance industry, particularly product to people, many of whom currently only buy UK and European airspace suddenly put the spotlight Complaints have always trickled into Which? about if they are covered by one of the companies a policy begrudgingly in the first place. Market analyst on an industry that until a few weeks ago had its policies that do not provide cover for things people neither including the ash in their standard cover nor Mintel estimates that while just under 10 per cent of criticism mainly concentrated among the over 65s or reasonably expect to be covered for. In April this providing cover on an ex-gratia basis. travellers do not bother with insurance, 30 per cent of people with pre-existing medical conditions. Which? people do not trust insurance companies to pay out in has been looking at travel insurance policies for more the event of a claim. The confusion over the volcanic than 15 years, recommending those that provide our This lack of clarity and information does not endear ash would have confirmed for many that a lack of trust minimum standards of coverage at the most affordable may mean that they don’t take out insurance in future. rates. All Which? recommended policies include the travel insurance product to people, many of whom Rightly or wrongly, travel insurance companies are at least £2 million in medical costs and £1,500 for only ever going to be judged on how well or poorly cancellation or curtailment of the holiday, and, until the currently only buy a policy begrudgingly in the first place they perform or whether they pay out on a claim. If events of the last few weeks, these were among some it is wrong for people to expect their travel insurance of the best priced policies for the main issues that year, Which? Holiday found that only 54 out of 80 Clear as ash policy to cover them for events that occur while they people needed – and wanted – travel insurance for. insurance company policies looked at would cover With the ash cloud still hovering, Which? members are on or about to go on holiday, such as volcanic ash, Among the policies Which? has recently recommended those who are caught up in a traffic jam while driving are rightly concerned about whether they will get terrorism, strikes or even their car breaking down are 15-day Europe single trip adult policies costing £21 in their own car to the airport and resultantly missed away for holidays booked over the peak summer on the way to the airport, then far more needs to be that would cover the volcanic ash disruption, while their flight. Forty-one per cent of those insurers period. At the beginning of May, Which? looked at the done to spell out these exclusions before the products other similar products, costing the same amount, surveyed told Which? Holiday that they would not websites of 24 of the top travel insurance companies. are purchased. Encouraging travellers to judge policies would not. “Why are you recommending policies cover scheduled airline failure, although 14 per cent Eleven of these websites had no clear information primarily on price is clearly not the best way to that are of no use?” was a challenge lobbied at us by a have it available as an extra premium. anywhere on the home page for current policy engender trust in a sector where it is clearly lacking.

International Travel Insurance Journal COMPANYBRIEF 11

STA Travel NEWSWIRE selects CSA Healix International has secured the contract to provide managed healthcare to STA Travel, a popular provider of student and gap employees of the UK’s Foreign and Commonwealth year travel packages, is to offer its customers travel Office (FCO). The three-year contract gives FCO insurance from CSA when they book their travel staff access to a full range of occupational health arrangements. The plans have been designed by services in the UK and overseas. CSA to cater to students, so the cost is relatively low, but the plan still includes coverage for trip delays Aon has launched WorldAware, an online and cancellation, medical care and accidents, loss travel information service designed to inform of baggage and other effects, as well as 24-hour business travellers about security situations in worldwide assistance. individual countries around the globe, to help them Kevin Jacobs, managing director of STA Travel, plan their travel more effectively and stay safe commented: “Travel insurance is a must-have for while abroad. students planning a trip, and a safety net for their parents.” Bob Chambers, director of operations AirBaltic has teamed with insurer ERV to for CSA, added: “While most students and young distribute travel insurance online for the Latvian travellers believe they are invincible, an accident airline. The insurance is offered as part of the flight or medical emergency, lost passport or luggage, or booking process, but can also be booked separately. delayed trip can ruin the most carefully planned trip.” Quick Quote ACE adds products Dogtag Travel Insurance has included launched in India for brokers financial failure protection of end suppliers to its policies. One of India’s leading insurance companies, Reliance ACE insurance company has launched a range of General Insurance, has launched a Quick Quote five new ‘Express’ accident and health products US-based International Services Inc. has system for the online calculation of the Premium to the company’s UK and Ireland e-commerce announced additions to the company’s Visitors Quote for its travel insurance policies through its platform – ACE Online. The products provide cover Insurance USA and Immigrant Health Insurance website. The system allows users to directly calculate for single or multi-trip business trips, with director portfolios. Plans can be purchased online, giving the premium for their entire holiday in one step, and employee injuries covered. The five products customers instant coverage. after the user provides some basic details about their are Business Travel Express, Businessclass Express, travel itinerary. Users can then buy insurance for Directors Express Injury, Businessclass Bespoke and Fiona Macrae has teamed up with specialist themselves, or for other members of their family. Workforce Injury. underwriter Travel Insurance Facilities to launch a Reliance General Insurance says the advantages of Jeff Dowling, accident and health product head, new web-based company, Insurancewith.com, to the Quick Quote system are that users receive an commented on the launch: “ACE Online minimises provide insurance to travellers with serious illnesses instant quote for a plan that fits their needs; there the number of clicks required to get a quote, such as cancer. are no lengthy logins or registration required; no ensuring that it is quick and easy to use. Our broker paperwork is required for calculating the premium, partners are now able to place vital accident and Travel Counsellors has gained a top rating and users can save the quote for seven days for health cover in minutes as well as renewing and for its travel insurance from Defaqto, following purchase at a later date. making adjustments to cover.” enhancements to the level of cover.

Over-50s insurer Staysure is aiming to double its turnover in the next 12 months, opening a new call centre that will employ up to 70 people.

Specialists team up

A group of specialist insurance brokers have teamed up to launched a new website, which Apollo Munich rolls has been designed solely to provide different out plan types of insurance to millions of people who can’t currently secure cover. The new website, called Cantgetinsurance.co.uk, offers travel insurance, India-based Apollo Munich Health Insurance has among others, to people who have previously been announced plans to launch a two-in-one health/travel declined by an insurer, including people with criminal insurance policy by the name of Optima Global, convictions, householders who have subsidence, or which will only be sold as an annual policy, giving those with certain medical conditions. peace of mind to regular travellers. The company has Chris Jordan, the main intermediary behind the filed the product with the Indian Insurance Regulatory scheme and managing director of Bureau Insurance, and Development Authority for approval, and is commented: “With the advance of the aggregators awaiting the result. Anthony Jacob, chief executive and the direct writers, more and more people are officer of the company, told a local newspaper: becoming marginalised with regards to insurance.” “[The] number of people travelling abroad on According to Jordan, one in five people are not taking holidays and work has gone up considerably. Why out the correct travel insurance: “The problem with go through the pain of buying travel insurance every travel insurance is that many people are getting cover time you apply for a visa change or go for a holiday? through their bank card, not realising that certain If you buy a policy like this, you only have to buy a conditions are excluded.” travel ticket or worry about a visa.”

Niger partners with Mapfre

Niger Insurance has re-packaged its travel insurance using its own underwriting firm to back its products. offering through a partnership with Mapfre Asistencia. In other news, Mapre Asistencia has inaugurated its new The insurance is valid for use in any of the Schengen headquarters in London. The inaugural act, which was countries, as well as other European nations. As attended by the Spanish Ambassador to the UK, was a composite insurance company, Niger Insurance also attended by senior managers from the company, transacts all classes of insurance business, as well as including its president and chief executive Rafael Senen.

www.itij.co.uk 12 INSURANCEMATTERS

The pain in Spain Insurance fraud to hit £2.5 billion NEWSWIRE The Spanish insurance sector saw its first fall in According to research from global information revenue in more than six years in the opening services company Experian, UK general insurance Aviation insurance rates look set to quarter of 2010, as the economic crisis began to fraud losses could reach £2.5 billion in 2010, after increase following May’s Air India Express crash bite. David Ing has the news from Spain the company’s recent Insight Report revealed that while the aircraft was landing at Mangalore insurance fraud rates nearly doubled in the final airport, according to the Indian media. Income from policies dropped to €15.79 billion, quarter of 2009 increasing from nine detected frauds 3.8-per-cent down on the same period a year per 10,000 applications in the third quarter of the A super financial regulator is to be set earlier, according to figures released in April by the year, to 16 in the fourth quarter. up in Indonesia by the end of the 2010 industry’s research body, Investigación Cooperativa James Heath from law firm Keoghs said: “With the according to Mr Fuad Rachmany, head of the entre Entidades Aseguradoras (ICEA). The last occasion Association of British Insurers highlighting that £1.9 committee – a board of seven commissioners a downturn was recorded was in the final quarter billion of insurance fraud probably went undetected will head the body. of 2003, which was blamed on a change in the in 2009, the industry needs to continue to develop way statistics are gathered on pensions. This time, its counter-fraud capabilities. Fraudsters are becoming Bahrain-based Trust Re has set up a new however, the Spanish insurance companies’ business increasingly sophisticated in avoiding detection.” company, Afro Asian Assistance, to offer association UNESPA says the fall is linked directly to assistance-related products and services under the country’s ailing economic performance in the reinsurance schemes and service agreements preceding year. supported by the company. Spain’s Gross Domestic Product sunk 3.6 per cent Catastrophe over 2009 as a whole, despite a slight recovery in The Bangkok Post has estimated the last three months to a 3.1-per-cent fall, and the payouts inhibited insurance losses of around 10 billion baht after most affected sectors had a marked negative impact more than 30 buildings, including shopping malls, on insurance, said UNESPA. ICEA’s figures show that The Insurance Commission of the Philippines has said were set on fire by anti-government protestors industrial policies were the worst hit, with the branch that only a fraction of the total claims made by clients during the city’s recent troubles. showing an 8.8-per-cent drop to €2.19 billion. But, affected by last year’s typhoons – Ondoy and Pepeng there was rather better news from driving policies, – have been paid by non-life insurance companies in The China Insurance Regulatory the worst performers in the last few years when both the country. Only PHP2 billion out of PHP13.5 billion Commission has indicated that the country may policy prices and car sales slumped. has been paid out by the industry so far. lift its existing ceiling of 20 per cent for a single Year-on-year, figures were down only €1.7 per cent The reason for the lack of payouts, according to the holder to have a stake in a local insurer. at €3.05 billion, an improvement attributed mainly Philippine Insurers and Reinsurers Association (PIRA), to the government’s plans to is low premium rates, with PIRA stating that Reuters has reported that insurers are stimulate the economy, which most non-life insurance companies dealing lining up launches of yuan-denominated policies included a ‘cash for clunker’ with natural disasters do not comply with in Hong Kong in order to tap into investor scrapping old to buy new cars the 0.15 per cent minimum catastrophe expectations of a rising yuan. The company also scheme. Home and business rate – the international standard rate is 0.3 stated that this poses the question whether policies managed a slight rise of per cent, but several insurers are charging insurance should be used as a vehicle for 1.2 per cent as did health and rates of 0.07 and 0.08 per cent for cover. speculation. multi risk, up 4.4 per cent and Michael Rellosa, chairman for PIRA, 1.1 per cent respectively to commented: “The only way for us to Insurance broker and risk advisor Marsh more than €1.7 billion in each safeguard the industry and insure the has reported that, despite the global financial case. While life policies saw a public’s interest is to close the gap between crisis, the commercial insurance market is poised rise in managed assets of five the potential cost of the damage and to remain stable throughout 2010. per cent, reflecting the move the actual rate being imposed.” PIRA is towards more people saving, pressing the government to penalise those The Lloyd’s of London insurance market the actual income from policies insurers who do not charge the minimum has received approval from the China Insurance fell 5.9 per cent to €€7.12 catastrophe rate. Regulatory Commission to conduct direct property billion. UNESPA said the drop insurance business in the country, according to its in the life branch was due to the type of products chairman, Peter Levene. contracted, but acknowledged that high interest bank deposit accounts could also be drawing investors away. Underinsurance caused by ‘misconceptions’ The Taiwan Economic News has reported that local life insurers in Taiwan have increasingly According to a study conducted by Australian ‘profound lack of awareness and understanding of been focusing more of the investments in foreign specialist life insurance broker Lifebroker, the major both the financial risks posed by illnesses, injury and assets over recent years due to continual Regulation causes of underinsurance in Australia are due to a premature death, and the insurance policies that declining interest rates in Taiwan. protect people from these risks’. tightening urged Chris Eade, chief executive officer for Lifebroker, The Controller and Auditor General, said that the research showed that 71 per cent which audits the Indian government’s accounts, The Insurance Regulatory and Development of Australians mistakenly believe the federal is seeking powers to audit the functions of over Authority (IRDA), India’s industry watchdog, has been government is required by law to provide financial 12 other government regulators that do not urged by general insurers in the country to tighten support to families if a family member dies have appellate tribunals or the decisions of regulations to help them to contain what have been prematurely; 82 per cent believe income protection which do not fall under the direct oversight of termed ‘runaway claims ratios’, according to reports insurance pays a replacement income if they were any other body. The news was reported by the by the Financial Chronicle. Mr KG Krishnamoorthy to lose, or resign from, their job, and 77 per cent Economic Times. Rao, managing director and chief executive officer of believed that everyone has life insurance through Future Generali India Insurance, said: “A request has their superannuation. The Philippine Land Transportation Office been made to IRDA to look into tightening the claims The study also revealed that only 21 per cent of those is to set up an enhanced verification system to filing process where a claim has to be filed only in the polled have income protection insurance and 49 per stamp out fake compulsory third party liability accident courts (tribunals) under whose jurisdiction cent had life insurance. However, 56 per cent had private insurance policies issued by unscrupulous insurers, the event (accident) has occurred or where the health insurance, 80 per cent had home insurance and and ensure the correct payment of taxes paid to policyholder resides.” Commenting on the fact that 86 per cent had car insurance of some type. national government on motor policies. some tribunals tend to be more liberal and biased in Commenting on the findings, Eade said: “If you look favour of consumers, a trend that consequently leads at Australians’ attitudes to insurance in general, you Independent research has disputed claims to higher claims, Rao continued: “Customers prefer see they are quite prepared to buy insurance when by UK-headquartered Prudential that its to file cases in such tribunals and hence insurance they realise a risk exists that is worth protecting. US$35.5-billion takeover of AIA will boost the companies stand to lose in such cases.” When asked, only eight per cent of Australians amount of business sold by the pan-Asian Mr SL Mohan, secretary general of the General strongly agreed with the proposition that they company’s agents. Insurance Council, added: “The companies have were knowingly prepared to take the risk of not been bleeding on account of the high claims ratio,” having insurance.” He went on to state that it is Emirates Insurance Company saw its net while a senior executive with a leading public sector the responsibility of the insurance industry to raise profits rise 58 per cent year-on-year to AED30 general insurance company said: “The insurer also awareness of underinsurance, the products that are million (US$8 million) in the first quarter of the asked for claims to be filed within 36 months of the available and to give prompt payment of claims when year. Gross income rose almost two per cent to occurrence of the event and not after that.” the need arises. AED217 million over the same period.

International Travel Insurance Journal INSURANCEMATTERS 13

Bright future for Potential for Vietnam bancassurance growth

The Vietnam News Service, citing a senior According to the Towers Watson India Bancassurance government official, has reported that the Vietnamese Benchmarking survey 2009-10, bancassurance is insurance industry is expected to grow by 15 per expected to generate 40 per cent of private insurers’ cent annually over the next 10 years. Speaking at an premium income in India by 2012 – significantly international conference, Trinh Thanh Hoan, head of higher than the present level of around 25 per cent. the Ministry of Finance’s Insurance Management and The survey also revealed that co-operative banks, Supervision Agency, said that the insurance sector had as a segment of the banking sector, top distribution grown 20 per cent in 2009, despite the economic tie-ups for insurance companies at 79 per cent, crisis, and had collected total premium income of while 71 per cent of insurers have teamed up with a VND25.2 trillion (US$1.32 billion). bank, 50 per cent of the insurance industry has tied Hoan stated that insurers need to focus on up with a non-banking financial institution, while 43 developing human resources to achieve growth per cent have collaborated with public sector banks targets, primarily at managerial level. Insurers should to increase their distribution networks. Just 29 per also co-operate with universities, insurance research cent of insurers have teamed up with regional rural agencies and foreign partners to organise training banks or foreign banks, demonstrating that the rural courses for staff, he said. communities in India remain underserved by the According to VietNamNet Bridge, the non-life industry. insurance sector in the country is set to grow at a The company also stated that more could be done rate of three-to-four times that of Vietnam’s gross to develop bancassurance in non-life insurance, domestic product over the next several years. The saying that the key inhibiting factor to a higher rate Vietnam Insurance Association added that the non- of growth of general insurance (GI) sales through Cambodian insurance growth expected life insurance industry grew by 26 per cent in the first bancassurance as being the lack of processes for quarter of this year, yet the Vietnamese economy selling GI products and the comparative low priority Survey results released by IndoChina Research have more disposable income and are looking to grew by just 5.8 per cent over the same period. given to this channel by general insurers – currently reported in the Phnom Penh Post have predicted a secure their car or house or motorbike.” Several non-life insurers have raised, or are expected 93 per cent of life insurance companies use the growth of 28 per cent for the Cambodia’s personal Meanwhile, Duong Vibol, managing director of to raise, their chartered capital, including Liberty bancassurance channel. insurance industry in the next year. Despite this, only Cambodian National Insurance Company (Caminco) Insurance (Vietnam), which received its licence from three per cent of those surveyed said that they had said that that the market is developing: “We have seen the Vietnamese government in 2006 to operate as insurance, while another 28 per cent indicated they year-on-year that more customers are buying insurance. a 100 per cent US-owned general insurer serving intended to purchase insurance in the next year. For Caminco, in the first quarter of this year we grew businesses and individuals – the company increased Insurers ready for David Carter, chief executive of Cambodian insurer 40 per cent compared to the same quarter last year.” its chartered capital to US$40 million in March. Other Infinity Insurance, agreed with the forecast, saying it The chairman of the General Insurance Association insurers in the country are also making efforts to kick-off was in line with his own predictions – the company of Cambodia Chay Rattanak also predicted that the increase their capital to the minimum level of VND300 saw growth of 23 per cent in 2009. He said: “People industry could expand by around 20 per cent in 2010. billion ($15.8 million), as is required by local laws. Insurers worldwide are gearing up for the start of the 2010 FIFA World Cup in South Africa, with insurance policies covering US$5 billion worth of risks linked to the games already sold. Some of the biggest parts of the risks and contingency will fall on two of the Terror China plans super insurance sector’s biggest players, Munich Re and Swiss Re, with Munich Re holding about $350 million cover in regulator of exposure, according to Sabine Bach, head of contingency risk at the reinsurer. “That’s not chicken Thailand News provider Reuters has reported that China feed. We have got the biggest share of insurers’ is reviving its plan to set up a ‘super regulator risks,” she said. Thailand’s Office to streamline the government’s oversight of the Commenting on South Africa’s handling of other of the Insurance financial sector and reduce infighting among existing international sporting events such as the rugby and Commission (OIC) watchdogs’. The new regulator would be placed cricket world cups, Bach continued: “Naturally the has urged business above those agencies currently in charge of China’s soccer World Cup is bigger, but South Africa has operators, retailers insurance, banking and securities industries and shown that they can do it. The cancellation risk is no and individuals to take could possibly be led by a vice premier who would higher than in many other countries.” She added: out insurance against co-ordinate financial supervision and monetary “For an additional premium, the risk of war or a riots and terrorism policymaking alongside the People’s Bank of China – terror attack can also be covered.” following the recent the country’s central bank. Swiss Re’s Hans Steffen said that his worst fear would troubles in the country’s The idea of a ‘super regulator’ was initially founded be “a terror attack at the opening ceremony in a Insurers count the capital, Bangkok and the Thai authorities’ subsequent in 2007 when China last convened its five-yearly stadium with several hundred dead,” while Bach’s declaration of the violence as an act of terrorism. national financial work conference, but the idea fears were a little more basic. “If the television cost of oil Chantra Purnariksha, secretary general of the OIC, said never progressed past the initial planning stages. screens were blank, that would be bad,” she said. that businesses could buy specific policies to protect According to the UK’s Financial Times newspaper, property against terrorism, including bombings. BP’s Gulf of Mexico oil spill is expected to cost Surachai Sirivallop, chief executive of Thai insurers up to US$1.5 billion, not including liabilities Reinsurance, however, commented that from environmental damage, and may hit the price businesses should consider buying cheaper of reinsurance as groups renew their cover. The spill protection for riots and civil unrest before follows losses related to the Chile earthquake and they opt for terrorism coverage, saying that the Xynthia windstorm in Europe, each thought to the Thai government’s labelling of the recent have cost the industry between $6 and $8 billion and violence as terrorism is ‘inconsistent with €1.5 to €2 billion respectively. international definitions of terrorism’, and that Stephen Vivian, managing director for industry premiums for cover against civil commotion consultancy firm Guy Carpenter said: “There will likely and riots are about 50-per-cent cheaper than be a marked effect on upcoming energy insurance rates for terrorism insurance. He then warned renewals. Drilling contractor businesses may witness that insurers might use the ‘terrorism’ label as rises of at least 30 per cent and liability programmes an excuse to deny compensation payments to could potentially attract rises of over 100 per cent.” the insured who have not bought additional Both insurers and reinsurers have already estimated coverage against terrorism, riot or civil the direct insurance losses from the oil spill to sit commotion. at around $1.5 billion, and companies such as “The overall premium rates in Thailand are Germany’s Hannover Re and Munich Re have relatively low compared with international estimated their individual exposures at $40 million rates. Our country is, in fact, not the target and $100 million respectively. area for terrorist attacks,” he concluded.

www.itij.co.uk 14 HEALTHMATTERS

Pandemic latest Cholera Breakbone fever in

As of 2nd May 2010, more than 214 countries and continues to actively concerns Florida overseas territories or communities worldwide have circulate in several Now available reported laboratory confirmed cases of pandemic countries of the region; It has been confirmed by the UK’s While cases of dengue or breakbone fever are influenza H1N1 2009, including over 18,001 deaths. however, respiratory Foreign and Commonwealth reported every year in Florida, with travellers ITIJ VIP The World Health Organization (WHO) is actively disease trends in the Office that cholera is continuing coming from endemic zones such as the Caribbean, membership monitoring the progress of the pandemic through region are variable. to spread in Papua New Guinea Central and South America and Asia, this year ---- UPDATEwww.itij.co.uk ---- frequent consultations with WHO Regional Offices In Malaysia, limited (PNG). So far, more than 2,000 the health authorities of Florida have reported a and Member States, and through the monitoring of data suggests that cases have been confirmed native case of dengue fever in Key West. The case multiple sources of information. pandemic influenza virus nationwide, with significant involves a 41-year-old man who lives in the region The most active areas of pandemic influenza virus transmission persists numbers in the Morabe Province, and has not travelled recently. www.itij.co.uk transmission are currently in parts of West Africa, with ongoing reports Madang and East Sepik Province. In 2009, a number of native cases of dengue had the Caribbean and Southeast Asia. In the temperate of new cases (including Outbreaks in the National Capital been reported in Key West – these were the first ESSENTIAL READING FOR TRAVEL INSURANCE INDUSTRY PROFESSIONALS zone of the northern and southern hemisphere, severe cases) and media District (Port Moresby) and the cases to be reported in Florida for nearly 40 years. MAY 2010 • ISSUE 112 overall pandemic influenza activity remains sporadic. reports of several school Central Province have also been As a result of the most recent confirmed case, Seasonal influenza virus type B continues to be outbreaks, particularly confirmed, and there are fears the local health authorities have reminded the detected sporadically across Asia, Africa, Europe, and during late April and that the disease is likely to spread public about preventive measures and introduced the Americas, however, low levels of late season virus early May 2010. In further. Tourists heading to PNG methods to control and combat the vector circulation have primarily been detected in East and Singapore, the national have been warned by the World mosquitoes. The two species of mosquito that Central Asia, southern Europe, and central Africa. level of respiratory Health Organization to eat and convey the illness, Aedes aegypti and albopictus, are In the tropical zone of the Americas, limited illnesses has been steadily increasing since early April drink safely while they are there. both found in Florida. Launch complete data suggests that the pandemic influenza virus 2010 and now exceeds the epidemic threshold; 37 Elsewhere, the Vietnamese health authorities have transmission remains active in several countries. per cent of sentinel respiratory specimens tested reported four confirmed cases of cholera in three In Central America, Guatemala reported three positive for influenza during the most recent tests. In different districts of Ho Chi Minh City, one case in The all-new and improved ITIJ website offers users unparalleled access consecutive weeks of an increasing trend of Thailand, the proportion of sentinel outpatients with Tang Lang in the north of the country and another in to the best resource in the international travel insurance industry respiratory diseases activity associated with a regional influenza-like illnesses and sentinel inpatients with Hanoi. In Thailand, 154 cases of cholera have been Norovirus hits flight spread of pandemic influenza virus and detection of pneumonia testing positive for pandemic influenza reported so far this year, while a cholera epidemic severe cases. In Cuba, detections of the pandemic virus infection has declined significantly since peaking has been declared in Cambodia, where 128 cases of ITIJ often reports about norovirus outbreaks virus and numbers of severe cases have increased during late March 2010. the disease have been confirmed by the authorities. causing misery on cruise ships, but until now since late March, however, overall pandemic In Europe, overall influenza activity remained low little has been heard about the illness striking air influenza activity may have recently peaked, with very low level co-circulation of pandemic passengers. However, following a case where according to the WHO. Although the overall intensity and seasonal influenza type B viruses. The overall a flight from Boston to Los Angeles had to be of respiratory diseases across the region remained proportion of sentinel respiratory samples testing diverted to Chicago shortly after take off due to low to moderate during April 2010, for short periods positive for influenza remained stable at about 5.3 Meningococcal the high number of people with vomiting and of time, circulation of pandemic influenza virus was per cent; and the total number of sentinel influenza B disease warning diarrhoea symptoms, it seems the virus is taking reported to widespread (in Cuba and Barbados) or virus detections continued to exceed that of influenza to the skies. All the ill passengers in the above regional (in Mexico, Honduras, Nicaragua, Columbia, A viruses, primarily due to low level seasonal case were members of a tour company’s bus Venezuela, Brazil, Ecuador and Bolivia). influenza type B virus circulation in the Russian Travellers to Chad have been warned that the tour, who were returning home to California. A In Southeast Asia, the pandemic influenza virus Federation and Kazakhstan. Ministry of Health has reported 1,531 suspected subsequent investigation by the US Centres for cases of meningococcal disease in the country, Disease Control and Prevention (CDC) found six including 151 deaths. So far, seven districts have confirmed and nine probable cases of norovirus crossed the epidemic threshold, while three others infection among the passengers who had been part have crossed the alert threshold. The International of the tour group, as well as one confirmed and six Co-ordinating Group on Vaccine Provision for probable cases of infection in non-tour group airline Epidemic Meningitis Control has provided 157,000 passengers. The investigators found that sitting in doses of trivalent ACW vaccine for a mass vaccination an aisle seat or near a tour group member were campaign in affected areas, as well as 282,000 doses strong risk factors for becoming ill, suggesting that of bivalent vaccine for mass vaccination. transmission occurred either directly or through contamination of armrests, tray tables or seat controls. Dr Aron Hall, a CDC epidemiologist involved in Long-term visas for the investigation, told Reuters: “This is the first time passenger-to-passenger transmission of norovirus he all-new ITIJ website has now HIV patients has been documented on an airplane.” Hall added back issues and supplements that ITIJ launched! The site incorporates has ever printed! For just £3, users can Need to fi nd that article from fi ve years that only three other norovirus outbreaks on planes the latest techniques in user- ago? Can’t fi nd the information on Registered users can comment on articles T download any back issue of ITIJ, and for and features, vote in online polls to Following a change in policy, HIV sufferers are now had ever been documented. friendly design, as well as offering hospitals in the Caribbean you need? readers access to all – yes, all – the £5, any supplement you want from the contribute to industry debates and obtain all selection available. All this information and more, is now permitted to obtain long-stay visas for the US. A It was noted by Dr John Holmes of the University available at the click of a button. the latest information on the International medical examination is compulsory for any foreigner of Otago in New Zealand, who wrote a paper on Travel Insurance Conferences worldwide. seeking a long-stay visa in the country, and anyone the topic, that aircraft bathrooms hinder good hand suffering from a contagious disease likely to pose a washing techniques and also make them difficult to threat to public health may be refused a visa. clean following an episode of illness.

V Creative Design is very proud to announce the launch of the ALL NEW ITIJ WEBSITE

International Travel Insurance Journal www.itij.co.uk

ITIJ-website update 113.indd 1 25/5/10 14:30:02 Now available ITIJ VIP membership UPDATE www.itij.co.uk ---- www.itij.co.uk ---- ESSENTIAL READING FOR TRAVEL INSURANCE INDUSTRY PROFESSIONALS

MAY 2010 • ISSUE 112 Launch complete The all-new and improved ITIJ website offers users unparalleled access to the best resource in the international travel insurance industry

he all-new ITIJ website has now back issues and supplements that ITIJ launched! The site incorporates has ever printed! For just £3, users can Need to fi nd that article from fi ve years the latest techniques in user- ago? Can’t fi nd the information on Registered users can comment on articles T download any back issue of ITIJ, and for and features, vote in online polls to friendly design, as well as offering hospitals in the Caribbean you need? readers access to all – yes, all – the £5, any supplement you want from the contribute to industry debates and obtain all selection available. All this information and more, is now available at the click of a button. the latest information on the International Travel Insurance Conferences worldwide.

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ITIJ-website update 113.indd 1 25/5/10 14:30:02 16 TRAVELMATTERS

Short-haul popularity rises

A report by Greenlight, a UK-based specialist search engine optimisation (SEO) and pay per click consulting firm, has Holiday spending shown that UK consumer online searches for flights to short-haul destinations in plummets March 2010 totalled 24.4 million, almost five times greater than the number seen in A study by Visa Europe has revealed that holiday December 2009. Based on data gathered spending by Brits travelling abroad fell by over £560 in March, the report, which covers million in 2009 compared to the previous year, with domestic, short and long-haul flights, spending in the US, Spain and France falling £178 found that searches for flights to Barcelona million, £117 million and £83 million respectively, and Alicante were the most queried. although all three countries still topped the list of Surprisingly, London was next on the list, destinations by spend. and Malaga fell just behind. The searches More than two-fifths of those questioned cited the for Alicante, London and Malaga combined strength of the pound as having an impact on their account for 20 per cent of the total 38 travel destination, but there was hope at the end of million flight-related searches performed the tunnel as 28 per cent of holidaymakers indicated online in March – a four-million drop on that they planned to spend more than they did in February’s total. 2009, while 21 per cent said they would spend Greenlight’s report also assessed and ranked the less. Analysis of transactions by 86 million UK Visa top 60 airlines, flight operators and aggregators that Online sales affected Social media leads cardholders revealed that the number of transactions were the most visible in both natural and paid search also fell from 134 million to 128 million. results. Some key findings reveal that consumer search The latest IMRG Capgemini e-Retail Sales Index the way The survey was not all bad news, though, as behaviour in March was a reversal of that seen in has revealed that sales of tickets and travel online Namibia, Lebanon and Kenya saw a 53-per-cent, December last year. Short-haul keywords accounted dropped by nine per cent in April as a direct result A new study by independent media agency Total 40-per-cent and of the disruption caused by the eruption of the Media has revealed that social media is becoming 28-per-cent upturn in Icelandic volcano, Eyjafjallajökull. Online retail sales, evermore influential for consumers when selecting spending respectively, however, increased by 13 per cent during the same holiday destinations, with less than 10 per cent saying but accommodation month. Tina Spooner, information director at IMRG, that they visit travel agencies. The Social Travel Report spending in general commented: "Growth in the travel sector slowed also revealed that many consumers are booking dropped 14 per cent to just five per cent in April, after recording yearly accommodation, flights and activities online based from £1.68 billion to growth in double figures during February and March. on the reviews of strangers, rather than based on £1.44 billion and car This may be an early indication of the impact of the recommendations from the industry. rental fell by a quarter volcanic ash cloud on the travel industry." The study found that nearly 70 per cent of from £65 million to Bruce Fair, managing director of online shopping and consumers use the Internet to book their holidays, £49 million. comparison site Kelkoo UK, added: "The recession compared to 23 per cent by phone and a paltry eight Tony Gibbons, cost the UK travel industry £3.7 billion in 2009 and it per cent in-store with a travel agent. Those aged head of debit at Visa looks like the sector will need to buckle its seat belt for between 35 and 44 were most likely to book online, Europe, admitted another bumpy ride in 2010. Just as forecasts were with price cited as the main reason for using the that the company indicating a modest financial recovery, with sales set Internet, together with information and convenience. had seen a ‘slight to increase by 2.4 per cent (£1 billion) this year, the However, 60 per cent of those who stated that they downturn’ in card Icelandic eruption threatens to throw cinders on the did still use travel agents said they did so because spend abroad over travel industry's recovery." He continued: "Our latest they ‘valued their expert advice’. the past 12 months as research revealed that flight prices are set to rise by Additionally, 25 per cent of British travellers said that a consequence of the five per cent over the next year as a direct result of online reviews written by strangers helped them economic downturn. the ash cloud, rising operational costs and escalating decide their travel plans, compared to 14 per cent He said: “The global oil prices. This means consumers will be forced to pay for online advertisements, 13 per cent for TV travel downturn hasn’t put us off travelling; instead we’ve for 64 per cent of flight-related searches in March, £1.8 billion more for travel in the next 12 months, programmes and 11 per cent for travel magazines scaled back our spending and are looking to extract compared to 19 per cent of searches in December, with the average cost of a flight to New York set to and newspaper supplements. What’s more, almost as much value from our trips as possible. For while generic keywords accounted for just six per creep up £62 per ticket." half of travellers aged over 45 admitted they used example, people are shifting spend from eating out cent of searches, compared to websites to submit reviews to recommend to eating in.” He concluded: “As people start to travel 63 per cent in December. It was or warn other travellers of their experiences. abroad again, we expect to see spend pick up over also noted that since December, Nick Oram, director of Total Media, the next few years.” search volume for long-haul commented on the results: “The travel flights increased from 2.9 million industry has embraced e-commerce as to 4.3 million; flights to New a way of making the booking process far York were the most searched-for more cost effective; it must now embrace Going the distance item in March. social media to ensure it’s communicating In the natural search, with consumers effectively, because when Brits are fed up with holidays in the UK and are CheapFlights increased its it comes to travel advice, British consumers seeking adventures and new experiences in countries visibility most, although Jet2 and would rather rely on each other than such as Egypt, Morocco and Tunisia, according to DealChecker also increased their recommendations from the industry.” He the UK’s Thomson Holidays. The operator claimed visibility. Monarch Airlines also continued: “Because the Internet makes it that the ‘staycationing craze’ is now on the wane and came out better than last year, far easier for consumers to pick and choose holidays abroad are back in vogue, as long as they moving up to position seven different elements of a holiday and book are not in the eurozone. from 23. In the paid search, their flights and accommodation direct, the Dermot Blastland, managing director for Thomson easyJet was the most visible opinions of amateur online travel critics can and First Choice, commented: “Our latest figures flight advertiser, attaining 55 per have a huge influence on the popularity show that Brits are determined to take a real break this cent visibility across the top 120 of destinations and performance of travel summer and its awaycations all the way – not just sea keywords – an increase of 50 brands.” and sand, but new cultures and locations. Consumers per cent on December’s figures. The report found that Expedia was the who hung back last year are more confident about Expedia featured the visible leading website for consumers planning spending this year and are benefiting from better individual ad. creative across trips of five nights or more, followed by deals outside of the eurozone.” He continued: “Our all flight keywords, achieving a Tripadvisor and lastminute.com. Google research shows that people are saying cobblers to the 14-per-cent share of the results. Earth and Google Maps were used by 14 staycation; we need a proper holiday this year.” The top three most visible flight per cent and 17 per cent respectively, but The company went on to state that long haul bookings websites in integrated searches below 10 per cent of consumers used sites are up four per cent, with the top five destinations were CheapFlights, SkyScanner such as Ebookers, Lonelyplant, the Foreign being India, Morocco, Egypt, Tunisia and Turkey. and TravelSupermarket. Office and Teletext.

International Travel Insurance Journal TRAVELMATTERS 17

Travel trends Increases all round Travellers see past Family cruises on revealed for the industry the ash the up

The World The results of a survey conducted A new study by online UK company Travelzoo The Passenger Shipping Association’s (PSA) annual cruise Travel & by the Association of has revealed that although nearly a quarter of review has revealed that record numbers of families Tourism Council Independent respondents had had travel plans affected by the are taking cruises and more than 75,000 under-18s (WTTC) has Tour Operators recent eruption of Iceland's Eyjafjallajökull volcano, are expected to take a cruise holiday during 2010 – a predicted moderate (AITO), in 84 per cent would still travel by aircraft in the future. sevenfold-rise over the past 10 years. The Association growth in the travel conjunction The study also found that 12 per cent of respondents also found that one in ten package holidays booked industry by 2011, with Wanderlust would be more interested in a UK-based holiday, is now a cruise, with passenger figures reaching 1.53 with spending in magazine, showed that with a further 64 per cent stating that they were million last year, a number set to rise to 1.65 million in real terms to grow 67 per cent of operators no more or less interested in changing their travel 2010. by one per cent are experiencing an preferences than before the eruption. Almost 25 per cent of those questioned said they and business travel increase in holiday However, 44 per cent believed the travel industry’s would choose a cruise based on value, with more than spending to decline bookings with a further 15 reaction to the disruption was very good or good, half believing that cruises offer better value for families by two per cent. per cent reporting similar a figure that increased to 51 per cent by those than hotel packages and overseas beach holidays. It has, however, levels to 2009. Although who were affected. Interestingly, 17 per cent of Additionally, nearly one in six people taking cruises said forecast that the travel destination is still proving those who were affected by the ash felt it should they travel with their children or other family members. industry will increase by to be the most influential be the government/taxpayer who should assume Bill Gibbons, director for the PSA, commented on the 4.4 per cent each year factor when purchasing responsibility for the disruption. In addition, 42 per results: “The survey shows that the amazing value and between 2010 and 2020. a holiday, the study did cent of respondents felt passengers should receive inclusive nature of a cruise holiday appeals strongly In terms of holiday trends, reveal that customer compensation for flights, accommodation and to families. The success of UK cruising, during one of WTTC believes that cruising service has jumped ahead of reasonable daily expenses. the toughest economic periods the world has seen, will remain popular – in fact, price in the importance stakes, Joel Brandon-Bravo, managing director for Travelzoo can be attributed to the value and high standards.” He according to a survey by German suggesting that cheap deals are not UK, said: “We were pleased to find that over half continued: “The all-inclusive nature of cruising and Travel Association DRV, one million viewed as importantly as they have been previously. of respondents believe the reaction of the British exceptional standards of quality and service are the key passengers opted for cruising in 2009, a 13.2-per- The study, which surveyed more than 60 operators, travel industry was good given the exceptional to our continued growth, along with the huge choice of cent increase on the previous year. found that 90 per cent are confident that bookings circumstances and 84 per cent won’t change worldwide destinations and the wide range in styles Euromonitor International has predicted that the will be up or at the same level as 2009, and 80 their plans to fly in the near future. The survey of cruising.” number of international tourist arrivals to South per cent reported a similar or increased level of also revealed that nearly Africa will rise by up to 15 per cent in 2010 as a passenger spending compared to last year. Derek two-thirds of people think result of this summer’s FIFA World Cup, bringing Moore, chairman of AITO, commented: “2009 was the travel provider is the total arrivals to 11.5 million and 32.9 million for the a challenging year for travel companies and while responsible party when it South African and sub-Saharan regions respectively. Britain’s exit from the recession is slow, we know that comes to compensation.” He Other African countries such as Namibia, people are less willing to forego holidays these days. concluded: “Fortunately the Mozambique, Kenya and Ethiopia are also expected It’s encouraging to see just how positive consumer ash cloud has not deterred to enjoy a greater influx of tourism through plans are for travel in 2010; tour operator bookings people from travelling in the promotion of new marketing initiatives, such as show that the desire to take holidays in 2010 is near future and this is great sustainable tourism and the World Cup. stronger than ever.” news for the travel industry.”

www.itij.co.uk 18 CROSS BORDER CARE

Climate survey results revealed Korea partners with Malaysian magic

The results of the Medical Tourism Climate Survey US firms In order to keep up with competition from 2010 are a reflection of the fragmented nature other Asian nations, the chief executive of of the industry and its recent growth, according The low cost of healthcare in Korea has prompted Malaysiahealthcare.com, Suresh Ponnudurai, has to Keith Pollard, managing director of Intuition three American subsidiaries of Korean companies – said that the country is taking measures to boost Communication. The survey was completed online Woori America Bank, Daewoo Electronics America its medical tourism industry through an advertising by 257 representatives of medical tourism businesses and Daewoo International America – to buy an campaign and the standardisation of treatment costs, from 55 countries, and examines key issues, current insurance scheme that allows the companies to send besides offering medical and tourism packages. activities, the state of the market and predicted their American employees for medical treatment in He added: “The medical authorities are upgrading business growth. Korea. Jung Ki-tek, a medical professor at Kyunhee services and facilities to meet the demands of the Key highlights of the survey include information on University, noted: “Even taking into account the global market, while ensuring the nation has a the top medical tourism destinations around the various travel expenses to get to Korea, it doesn’t sufficient pool of medical expertise.” world, as well as where the patients going to those cost half as much as medical expenses at US At the recently held Healthcare Tourism Congress destinations are coming from. The survey showed hospitals.” The insurance plan, offered by US-based 2010, Ponnudurai expounded the benefits of Malaysia that the leading medical tourism destinations are Patients Without Borders, is viewed positively in as a destination for health tourists, while the Health India, Thailand, the US, Hungary and Malaysia. The Korea, where it is hoped that the agreement will Ministry’s policy and international relations division US, UK and Russian Federation were identified as be a sign of others to come. It is the first time that undersecretary, Choy Lup Bong, said the average the leading sources of patients, both now and in the a Korean health insurer has offered a package that growth of the industry was around 30 per cent future. Countries rated as providing the best overall has been designed to bring foreigners to Korea’s year-on-year, and revenue per patient increased from service to patients are Thailand, India and Singapore. healthcare system, according to Lee Young-ho, head RM360 in 1998 to RM800 in 2008. The survey contains mixed views about the current of international marketing at Korea’s Health Industry state of the market, with over half of respondents Development Institute (KHIDI). believing that the market has declined or remained The insurance plan covers the medical costs static in the past 23 months. Around half of the associated with 14 illnesses, which range from organisations that took part in the survey have seen cancer and heart disease to spinal deficiencies. Upon no growth or a decline in their business over the past enrolling in the plan, employees are allowed to pick year, although 47 per cent state that their current between local treatment or travelling to Korea business situation is ‘good’ or ‘very good’. One third – those who choose to go to Asia would of respondents reported a growth in their medical pay between 30 and 40-per-cent less in tourism business of 10 per cent or more last year, monthly premiums than an employee who and the vast majority are confident about future chose to remain in the US for treatment. business prospects, with 76 per cent expecting the Jang Gyeong-won, KHIDI’s head of global overall market to grow in the next 12 months. That and a lack of professionalism in the industry itself. health business, noted that the recent revisions growth is expected by most to be centred on the Commenting on the results of the survey, Keith to the US healthcare system would provide more dental and cosmetic surgery markets. Pollard said: “The survey gives a realistic and current opportunities for Korean health insurers to take Major problems facing organisations involved in view of the industry. It is an invaluable insight into advantage of. If the bill that requires companies with medical tourism include competition, and marketing what is happening throughout the world of medical more than 50 employees to provide health insurance issues, as well as insufficient demand, insurance and travel today and is a useful tool for planning and for those workers is enforced, more companies will liability issues, lack of quality and international standards strategy for the industry and individual businesses.” be seeking affordable ways to comply with the law. CROSS BORDER CARE 19

Polish Dare to be different Indian market

potential Wouter Hoeberechts, chief executive of medical valued travel company WorldMed Assist, has said that According to an Insight the US healthcare reform offers opportunities for According to a recent FICCI-Evalueserve study, Market Research Solutions employers to ‘dare to be different’. He added: despite the economic downturn and safety concerns report entitled Poland “Forward-looking businesses see a strong competitive arising from the Mumbai attacks, India’s medical Medical Tourism Market advantage in a solution that retains employee loyalty tourism market is expected to reach Rs44 billion by 2013 – An Untapped through expanded healthcare options while at the 2012, with the nation set to enjoy a 25-per-cent Opportunity, the total same time shaving the cost out of the business.” share in the overall medical tourism marketplace. revenue generated by the However, not all companies will be looking for The survey states that India can expect one million medical tourism sector in innovative solutions medical tourists in 2012. Poland will double by 2013, to the healthcare There are several factors that have compared to the levels seen problem, according allowed the industry to continue its in 2009. A 20-per-cent to Hoeberechts: growth in spite of the challenges in the rise in average spending on “Sadly, a more past two years, including the vast range medical procedures such common approach of healthcare facilities now available, as dental crowns, implants is traditional cost the continuing low cost and the offer and surgeries such as breast cutting by reducing of more traditional therapies. The augmentation, will drive benefits or study goes on to say that the number the industry’s revenues in shifting an ever- of patient arrivals from the US, UK coming years, according to increasing portion and Europe has increased, however, US travel agents the research. “Besides this,” continues the report, of the burden the current market for Indian medical “the increasing healthcare costs in developed and responsibility tourism is predominantly limited to enter the game countries will force patients to look for other onto employees. patients from South and West Asian destinations, like Poland, for medical treatments.” Employees paid nations, although it noted there is a A new training programme has been started in the Poland’s low-cost treatment facilities, coupled with 17-per-cent more great potential to cater for African US, which allows travel agents to become involved a well-established tourism network, have already for insurance benefits patients as well. in the organisation of medical tourism. Atlanta-based led to favourable growth for the medical tourism in 2008 than in The FICCI-Evalueserve study also Global Surgery Providers (GSP) has launched the industry, with a large number of patients from 2007. This is a lose- points out that wellness tourism is a programme, which trains and licenses travel agents the UK, Germany and other destinations heading lose proposition: subset of medical tourism, and as a to be ready to deal with medical tourists, making it to Poland for affordable healthcare treatments. employees lose niche segment, it draws in high-end easier for agents to serve a market that is predicted However, challenging Poland for business are the precious benefits; inbound tourists. Ayurvedic medicine to grow at an impressive rate. well-established medical tourism destinations in businesses lose draws in more medical tourists from Founder and chief executive of the company Jack Asia, such as India and Thailand. Insight Market employee loyalty; western nations such as the US, Schafer commented: “We are providing retail travel Research Solutions, though, has said it anticipates and an ever- Canada, Germany, France, Sweden and agencies with a proven distribution channel. We will that Poland will be able to overcome this challenge increasing number the Netherland. Kerala is recognised as train their agents, qualify them, give them the best due to its proximity to European countries and the of Americans lose the most popular wellness destination medical tourism product in the industry, and license presence of well-trained medical experts similar to access to affordable in India, although other states are also them to sell it for full commissions.” western countries. healthcare.” emerging in this segment. 20 IPMI NEWS

AGB extends to Multi-lingual IMG breaks new ground

Europe podcasts offered IMG Europe, the European subsidiary of International disaster evacuation and accommodation benefi ts Medical Group (IMG), has enhanced its fl agship and access to and international medical information Aetna Global Benefi ts (AGB), the international CIGNA International Expatriate Benefi ts (CIEB) product, GlobalSelect International Healthcare service staffed by board-certifi ed physicians, business segment of US health insurer Aetna has is now providing health, wellness and benefi ts Cover. The international healthcare plan is designed pharmacists and psychologists. announced the launch of an online Wellness Centre podcasts in English, Chinese, French, German, for expatriates and local nationals, and is available Meanwhile, IMG in the US has announced the new for its expatriate members. Created to help combat Japanese, Spanish and Swiss-German for individuals to individuals or families of any nationality who are name for one of its specialty insurance products: some of the prominent health conditions in the on international assignments and business travellers, living, working or travelling worldwide. PatriotAdventureSM. The product, formerly known region, including cardiovascular disease and cancer, which are available from the company’s website. “Customer feedback told us that clients like their as Patriot Extreme, received a name alteration ‘to the tool aims to provide all AGB Europe health plan “We’ve seen the needs of multinational businesses loyalty rewarded, especially when they have not better refl ect the scope of its coverage, and to appeal members with information and resources to help and their globally mobile employees continually made a claim,” said Carl Carter, managing director of to a broader, more appropriate audience’. Joseph them achieve their optimal health. It is designed change and grow during CIGNA’s 30 years … IMG Europe. He continued: “So among the many Brougher, president of IMG, noted: “Extreme was to support members whether they are healthy, at in the expatriate benefi ts business,” said Ken enhancements we made, we introduced a 15 per cent a good name to market the product at the time it risk of disease or Vaughan, senior vice president of global sales, client no claims discount facility on all of the product’s sub- was introduced a few years ago. However, we’ve injury, managing a management and marketing at CIEB. He continued: plans. It gives a full discount after only one year, unlike since enhanced it by adding coverage for several new chronic condition “While some may say that the language of our other plans in the market that often require an insured activities, and we feel the word ‘adventure’ more or experiencing a business is English, we argue that the language of to go several years to build up a similar discount level.” accurately describes what those are.” Activities that major health event. healthcare is universal. As with all of our services, Some other notable additions to the product are are now covered under the terms of the plan include Debra Williams, AGB our multilingual podcasts are designed to help extended annual wellness benefi ts, as well as routine jungle zip lining, cave tubing, snowmobiling, surfi ng, Europe managing address our customers’ needs, regardless of their vaccinations; political and security evacuation and wildlife safaris, motorcycle/scooter riding, trekking director, said of the home country or where they do business.” repatriation benefi ts; identity theft benefi ts; natural and wakeboarding. new website: “We In related news, CIEB has announced that it is want to engage, seeking a head of global marketing to spearhead educate and motivate the initiative undertaken by the company to offer International importance members through individual private medical insurance to customers the AGB Wellness around the world. According to an article in the US-based publication domestic revenues. The editorial states that insurers Centre. We believe CIGNA Corporation, meanwhile, has reported its Health Plan Week, America’s largest health insurers including UnitedHealth Group, CIGNA and Aetna encouraging healthy results for the fi rst quarter of 2010 – adjusted income are placing ever greater importance on their are all seeking international growth opportunities. lifestyle choices will from operations for the fi rst quarter was US$281 international divisions, as they seek to augment their A recent report from Conning Consulting in help promote patient million, compared to $188 million Hartford, Connecticut, predicted: “Looking forward, compliance with for the same period last year. David both profi t pressures at home and higher growth care and medication Cordani, chief executive offi cer of rates overseas will drive increased international instruction, impact the corporation, commented on the expansion among US health insurers.” Conning’s health outcomes, decrease healthcare costs and results: “Our fi rst quarter 2010 results director of research, Stephan Christiansen, added: enhance employee productivity.” refl ect strong earnings contribution “In reviewing growth opportunities in health Meanwhile, Aetna has also announced a from our ongoing operations, and insurance beyond the US market, Asia and Europe commitment with Africa’s Executive Healthcare demonstrate the overall strength of represent near-term opportunities.” Regarding Solutions to jointly expand their operations on the our diversifi ed global health service Europe, Conning has identifi ed Italy, Portugal and continent – the latest commitment coincides with the businesses. These results represent Spain as having the greatest potential for growth; in companies’ 10-year anniversary of working together. meaningful progress towards achieving Asia the best countries, according to Conning, are In Africa, AGB and Executive Healthcare Solutions our 2010 goals as we effectively China, India and Indonesia. offer the Executive Healthcare Plan, a policy designed execute on our growth strategy.” for regionally mobile groups and individuals. InterGlobal extends IPMI PROVIDER Swiss Life targets expats reach International healthcare insurer Swiss Life has launched Dale Fleet, business and product development a new global group employee benefi ts product, which manager for Swiss Life, said: “There’s something International private medical insurer InterGlobal covers the health and protection sectors for expatriates. like 20 million international workers, and there may has partnered with Pakistani insurance company The plan, called Expat Select, consists of fi ve modules that often be benefi t provision for their families as well, so Alfalah Insurance Co. Ltd to make its award-winning cover retirement, death, disability, health and assistance we can increase that number. We also fi nd that a lot UltraCare range of plans available to individuals Interglobal benefi ts. Potential clients can choose any number of the of people are global nomads, spending lots of time and companies throughout Pakistan. Under the fi ve features, all of which are available at varying degrees away or facing additional risks often lacking a local HR new partnership terms, the range of plans will be CONTACT: Peter Rousseau - Group Business Devlpmt. Director of cover, while employers will only need to complete force, which this product can help support.” underwritten and distributed by Alfalah Insurance, Woolmead Hs East, The Woolmead, Farnham, one application per scheme, with a further one from each The policy has been designed with expats in mind, and reinsured and administered by InterGlobal. The Surrey, GU9 7TT UNITED KINGDOM employee, regardless of how many segments are chosen. although it also includes provisions for covering senior UltraCare range offers four plans, which provide tel: +44 (0)1252 745 900 Free cover limits are available and although they are not local employees working alongside the expatriate – cover ranging from in-patient medical treatment fax: +44 (0)1252 745 920 at a set level, Swiss Life has emphasised it will be taking a where the local facilities and benefi ts are deemed to only, right through to a full refund for most in and email: [email protected] web: www.interglobalpmi.com fl exible approach to requests. be insuffi cient. out-patient medical treatment.

International Travel Insurance Journal IPMI NEWS 21

www.itij.co.uk 22 AIRAMBULANCENEWS

Mental illness and the international Canadian dispute Tempus IC installed continues Etihad Airways of Abu Dhabi, United Arab Emirates, traveller - part 1 is installing new technology on its long and ultralong- Organisers of a campaign that has been started to haul aircraft that can monitor the condition of With budget halt the possible move of an air ambulance from passengers who display signs of sickness that might airlines northern Newfoundland have told the media that require immediate medical attention. putting they may end up turning to the courts for help with The Tempus IC system allows users to gather international their mission. The Newfoundland and Labrador information about a passenger’s health quickly and air travel government is planning on moving the current air efficiently. The data covers a wide range of the within the ambulance service from St Anthony to Happy Valley- passenger’s ‘vital signs’, including blood pressure reach of Goose Bay at the end of May, the reasons being, it and an electrocardiogram (ECG). It also allows the traditionally says, that it is more efficient to base the fixed-wing users to take photo imagery. On Etihad’s units, the economically aircraft in central Labrador. information is then transmitted to emergency care disadvantaged However, one of the organisers of the campaign to doctors at MedAire’s MedLink Global Response people, such as keep the air ambulance based in St Anthony, Norm Center. Following the advice from MedLink’s medical those with chronic Cull, thinks that the history of the air ambulance staff, the crew will take a decision about what to do mental illness, does, could provide grounds for an injunction against the next for the passenger and the flight. The device can there is an increasing unfortunately, move. He told CBC News: “The first air ambulance also be configured to send data to other providers or frequency of travellers not adequately that was put in this area was … owned by the private hospitals. becoming unwell with inform the airline International Greenfell Association. Since 1981, Although the device is primarily aimed at users serious psychotic illnesses in medical examiner of when the government took over – I don’t know if without medical training, such as cabin crew, the faraway destinations. Dr Daniel de Klerk parameters reflecting the severity or measure there are any stipulations in the agreement to say makers say it can also be of benefit to medically investigates the problem of risk as a result of behavioural dysregulation in that … it should stay in St Anthony.” trained staff, with the potential for use by a medical a person with acute or unstable mental illness. The Newfoundland government took the decision escort if their patient’s condition deteriorates The abuse of psychoactive substances whilst Furthermore, unless these forms are filled in by to move the air ambulance in March this year, unexpectedly, or if another passenger on the flight abroad may precipitate acute psychotic illness, psychiatrists skilled in the assessment of risk, the shortly after a consultant’s review found that most is in need of medical assistance. As a concrete even in people with no history of mental illness. information they contain may be incomplete. Labradorian residents would benefit from a quicker example, RDT cites the case of a male diabetic with Although literature describes unusual psychotic Travellers with mental health issues face challenges response from the high blood pressure, syndromes such as the ‘Jerusalem syndrome’ in accessing travel insurance, as insurers often service if it were to be cholesterol and history where travellers to Jerusalem experience acute exclude cover for mental illness itself, and will based in Happy Valley- of heart problems, en onset religious delusions, relapsing or de novo usually exclude a pre-existing illness. The nature Goose Bay. There have route from India to the psychotic illness is frequently seen by airline of mental illness is that it is often chronic and been protests from UK. The passenger medical personnel vetting fitness to fly. Active relapsing. When insurers exclude pre-existing many residents of the complained of a swollen, psychotic delusions, for example delusions of conditions it, therefore, effectively excludes Northern Peninsula blistered, right hand and persecution, or bizarre delusions such as the cover for long-term psychiatric illness. It then who believe that the an inability to bend his expectation of finding extraterrestrial objects in follows that if a person with a recurrent serious decision is politically fingers. The crew used a remote area of the world, may indeed be the mental illness such as bipolar affective disorder or motivated – last Tempus to take and reason for that person’s travel in the first place. schizophrenia suffers a relapse during their travels, autumn, the Opposition transmit his vital signs Another instance where irritable or agitated travel insurance may not cover their treatment or Liberals won the seat (including pulse, blood behaviour may be present is during the repatriation repatriation. from the Conservaties pressure and picture of of passengers who have just suffered a neurological Different jurisdictions deal differently with in a by-election. the hand) to the ground- A Tempus IC unit and accessories kit RDT insult, such as a stroke, or who may have had passengers with mental illness and access to based response centre. an acute deterioration of their dementing illness. travel insurance. The United Kingdom Disability Working with MedLink, In-flight airline personnel also report deliberate Discrimination Act 2005 guarantees that people a doctor who was onboard monitored the patient’s self harming behaviour in people with pre-existing with mental illness cannot be refused a travel American airlift vital signs at hourly intervals. A full 12-lead ECG was personality pathology, especially if further disinhibited insurance policy unless it is clear that there is taken when the patient began to vomit and complain by the consumption of alcohol onboard. an increased risk to the insurer. The chronicity from Botswana of stomach pains. This ruled out cardiac problems The repatriation of passengers with an active and relapsing nature of many chronic psychiatric and allowed the flight to continue and the patient to psychotic history or a recent history of illnesses can be seen as posing such an increased An American tourist who was holidaying in the Tuli be monitored for the rest of the flight. hospitalisation for mental illness is problematic in risk. Other aspects relating to air travel itself, such Block game reserves in Botswana recently was safely Ninety-nine per cent of all Tempus calls are that, even if insured, individual airline regulations as the increased stress of travelling, the crossing of repatriated back to Texas, US, by Global Rescue air transmitted into MedLink, where the medical and the International Air Transport Association many time zones resulting in circadian disruption, ambulance service after falling ill while hunting. The situation is managed by MedLink doctors. (IATA) guidelines complicate the arrangement of miscalculation of medication administration, man and his wife were hunting in the game reserve If a medical escort uses the Tempus IC to transmit data these transfers. International medical assistance sleep deprivation and the contribution of alcohol when he began coughing severely. He subsequently to a telemedical provider, who is now responsible for and repatriation organisations are often disinclined intoxication, may all contribute to the onset of visited a local clinic, where he was diagnosed with the patient’s care and what weight do the provider’s to become involved in the repatriation of these symptoms in a person with a mental illness. bronchitis; his coughing became worse and he recommendations carry? Rita Mody, MedAire training passengers, given the absence of insurance and the People suffering from a mental illness who act in an experienced shortness of breath. The professional manager, explained that when it comes to a decision possibility of unpredictable or dysregulated in-flight irritable and agitated way onboard an aircraft can hunter with whom he had been exploring the game of whether to divert a flight, any recommendations behaviour. lead to catastrophic outcomes. In August 2000, reserves called Global Rescue, whose medical staff offered by MedLink are directed to the captain of the In Resolution 700, IATA states the circumstances Jonathan Burton, a passenger onboard a Southwest obtained the man’s test results and recommended a aircraft as well as to the escorting medic. If the airline under which ‘incapacitated passengers’ may be Airlines flight, died from positional asphyxiation after medical evacuation from the game reserve’s camp. A accepts MedLink’s recommendation to divert, the transported by its members, saying that members being restrained by fellow passengers. The presence aircraft was despatched to transport the patient from captain still has the final decision. may refuse to carry mentally ill persons who of armed sky marshals in some parts of the world a remote landing strip to a hospital in Johannesburg. Paulo M. Alves, MedAire Inc. vice-president of are ‘incapable of assisting in their evacuation of adds an additional dangerous dimention to travelling There, he was diagnosed with congestive heart aviation and maritime health, said: “Tempus IC the aircraft’, unless an escort accompanies them with unstable mental illness – the fatal shooting of failure, and local physicians agreed with Global is invaluable when remotely managing a medical and takes responsibility for their needs. It goes Rigoberto Alpizar at Miami International Airport on Rescue medics that immediate bypass surgery was situation, because it gives MedAire’s MedLink doctors on to state that such patients would be subject 7 December 2005 as a result of sudden aggressive required. Following a lengthy and complex medical the clinical-quality data needed to make a better to prior clearance for air travel pending the behaviour is a salient example. It is, therefore, procedure, the man and his wife flew home to Texas diagnostic impression. The parameters available provision of medical information, usually on a imperative that the transport of psychiatric patients is on a commercial passenger flight. when taking a Tempus call are essentially the same as medical information sheet – the so-called MEDIF well planned. those one would have in most emergency rooms.” form. Individual airlines, however, often make In part two, I will look at the practical aspects of the Captain Richard Hill, Etihad Airways chief operations it very clear in annexes to the MEDIF form that repatriation of people with acute psychiatric illnesses officer, commented: “Passenger welfare and safety is passengers with ‘unstable mental illness without – such as those persons recently discharged from of the utmost importance to Etihad Airways, and the escort and suitable medication’ will not be carried. an acute psychiatric inpatient unit, including practical introduction of the Tempus IC system will ensure that The standard MEDIF form required by airlines measures for their repatriation. when medical emergencies do occur they are evaluated quickly. This helps ensure that the passenger can receive People suffering from a mental illness who act in an the appropriate treatment when the aircraft lands, whether this is as a diversion or at its final destination.” irritable and agitated way onboard an aircraft can lead Etihad is introducing the Tempus IC technology, designed and manufactured by UK-based RDT, on its to catastrophic outcomes A340 and Boeing 777 aircraft and then subsequently across the remaining long and ultralong-haul fleet.

International Travel Insurance Journal AIRAMBULANCENEWS 23

First Bell 429 Red Crescent on medical interior the up

Air Methods Corporation has delivered the first The Saudi Arabian Red Crescent Authority has medically equipped Bell 429 helicopter to Mercy announced that it is to receive six fully crewed air One of Des Moines, Iowa, US. Air Methods said its ambulances as part of a deal that has been struck products division is the first in the world to design, with Abu Dhabi Aviation (ADA). The helicopters engineer, manufacture, and certify a medical interior are expected to provide an invaluable resource for for the 429. emergency services in Makkah during the Haj and Tom Curtis, products division vice-president, Ramadan seasons. The SR81.6-million agreement commented: “We drew on our robust in-house was signed by Nader Ahmed Al-Hammadi, managing experience in designing, engineering, manufacturing, director of ADA, and Rasheed Al-Eid of the Saudi and certifying helicopter medical interior completions Red Crescent Authority. A SkyMaxx Seneca II Evac Americas to make this medical interior a reality. We are Four of the aircraft will be Bell 412 helicopters, while confident the design will enhance safety and the other two are AW139 models. They will be stationed in Jeddah and Riyadh in order to maintain New service for Panama coverage of the whole Kingdom. Evac Americas has launched as a new private- Schultz commented: “When a doctor requests Prince Faisal bin Abdullah bin Abdul Aziz, chairman membership-only air medical transport service, a medical flight, weather and other operational of the Authority, commented on the deal: according to the company. Using charter airplanes parameters are first checked. Pilots are never told “Undoubtedly, this agreement will prove that the and flight paramedics, the company says it now offers the patient’s condition nor are they pressured to Middle East aviation sector is capable of delivering low-cost memberships for flights previously only take a flight … A licensed medical doctor always world-class air ambulances for emergency medical available at higher private charter rates. makes the final decision regarding a patient’s service purposes across the region.” Hunter Schultz, Evac Americas company co-founder, suitability to fly.” commented: “Given the high charter cost for most Once the flight doctor and the pilot approve a flight, people, we used a membership business model an aircraft is assigned and prepared for the mission. Medilink launches enabling a far more affordable service.” The flight doctor also speaks with the receiving The company’s yearly membership plans begin medical facility in Panama City, the attending doctor, air ambulance at $26 for an individual and $45 for a couple. flight paramedics, and the pilot about any special Children are an additional $7.50 per child. Tourist patient concerns possibly affecting the flight. The A new international fixed-wing air ambulance memberships are $10 and valid for 90 days. flight is dispatched from Albrook Field in Panama City service has been launched from the island of Malta Saying that Panama now has over three million to the closest airport to the patient’s location. A flight in the Mediterranean Sea. Medilink International Air residents and tens of thousands of tourists heading to paramedic provides care during the return flight to Ambulance (MIAA) is a division of Medilink, which has the country’s outer provinces such as Chiriquí, Los Albrook Field, where a private ground ambulance been one of the top providers of healthcare in Africa for Santos, and Bocas del Toro, Schultz commented: transports the patient to a local private or public over a decade. Martin Farrugia, business development “Our need for air medical transport reached critical hospital depending on their condition and doctor’s manager of the new air ambulance division, said: “We mass some time ago.” preference. have now taken the next step to ensure a better service The company’s service starts when a medical doctor For its flight needs, the company uses local charter to our clients and set up MIAA. This dedicated air prescribes a flight based on medical need, and usually operator SkyMaxx Corporation, which has a fleet ambulance service is a natural extension of our mission because treatment is only available in the country’s of Piper Senecas and Britten-Norman Islanders.

Mercy One has received the first medically-configured Bell 429 for quality medical provision to our clients throughout capital, Panama City. The primary determining factors SkyMaxx has years of experience flying patients on a Air Methods Africa and the Mediterranean.” for a flight are weather and the patient’s condition. charter basis, said Schultz. functionality for crew members and patients.” The international service owns and operates a The Bell 429 medical interior can accommodate a Beechcraft Super King Air 200, and has access to other single, dual, or specialty transport and the roll-on, aircraft that are required for different medical transport fold-up litter system loads through the rear clamshell missions, such as a Learjet 60, also based in Malta. Jet Rescue opens Mexico City base doors. Combined with the large cabin, the medical interior design allows for full-body access, and two Jet Rescue Air Ambulance be deployed to even the most remote locations. patients can be carried with both medical attendants has announced the opening The aircraft’s internal layout includes provision for at the head of the patient. of a new business unit based the installation of medical equipment needed to The Air Methods Products Division worked with Bell in Mexico City. The Critical treat patients – for example, two standard rails Helicopters to develop and certify a glass cockpit Air business unit offers are positioned in the cabin rear bulkhead and on designed specifically for helicopter emergency emergency evacuation by upper side panels, which include outlets for oxygen, medical services operations, which the company said means of its A119 Koala emergency air and power. is intended to reduce pilot workload and enhance air ambulance helicopter. Jet Rescue Air Ambulance is intending to carry safety. Equipment includes night vision goggle lighting, The aircraft has been out missions including urgent response to major a helicopter terrain avoidance warning system, configured to transport up accidents, emergencies and neo-natal cases, rescue satellite weather monitoring, GPS navigation and to two stretcher patients of patients who find themselves in rugged terrain or satellite tracking equipment. An A119 Koala helicopter and medical crew, and will remote locations, and inter-hospital transfer services.

www.itij.co.uk

26 NEWSANALYSIS Timing is everything

the pre-existing conditions exclusion waiver as their policies are based primarily on covering medical emergencies up to multi-million dollar limits. That’s a big risk to waive. Matt Davies, client services manager for Ingle International, a Toronto-based brokerage that sells a broad range of travel products from various insurers, told ITIJ that many Canadian companies have become more flexible regarding trip cancellation policy purchase deadlines in recent years. “While at one point this type of deadline was common, only two of the trip cancellation plans we offer for Canadians must be purchased within a certain amount of time after the trip has been paid for. These policies also stipulate that such a deadline

Policies that allow for the waiver of pre-existing conditions usually tightly limit their loss exposure

is not applicable if cancellation penalties do not yet apply. In other words, an insured person would have to purchase the insurance at the time their trip is booked unless the amount they have paid is still refundable.” Davies noted further that: “The other trip cancellation policies we offer for Canadians do not have this type of strict rule regarding when the insurance must be purchased. However, one of them has an exclusion which states that … a CSA Freestyle and Freestyle Luxe will waive the claim resulting from a sickness (occurring) within Milan Korcok takes a look at the some of the pre-existing exclusion if the insurance is purchased 72 hours of purchasing the insurance will not be most common pitfalls for American travel within 24 hours of the final trip payment; Travel covered. Another cancellation policy states that if insurance consumers who have pre-existing Selling trip protection or Guard Cruise, Tour & Travel Platinum require a the insurance is purchased any time after the trip is conditions to contend with sign-up within 14 days after initial trip payment; booked, the insured person must be in good health travel medical insurance Travel Insured Gold, 30 days; Access America, and not know of any reason to cancel the trip in For American consumers with pre-existing 14 days of initial trip deposit; Travel Safe gives order to be eligible.” He went on to say: “While medical conditions, buying travel insurance to in tandem with, or as 15 days. Patriot Trip Insurance offers a pre- overall cancellation policies have become more protect their trip investment takes perseverance. existing conditions exclusion waiver if the policy accommodating for insured persons purchasing It’s not as easy as the website promotions suggest, close as possible to, the is purchased within 10 days of trip deposit. Some more than 48 or 72 hours after booking their given that insurers differ so markedly in what they grace periods go up to 21 days, even 30 days. trip, we still encourage our customers to purchase offer, what they exclude, and the demands they trip sale date, is common Selling trip protection or travel medical insurance cancellation coverage as soon as possible after make of their clients. in tandem with, or as close as possible to, the trip making their first non-refundable payment for a When Phyllis from Pittsburgh asks if she can practice sale date, is common practice in Canada too, even trip. As soon as a non-refundable payment has been get her money back for cancelling her trip to though Canadian insurers have not taken to offering made, a traveller risks losing that amount if their trip Patagonia because of a gall bladder attack, her travel insurer might say ‘yes’, ‘no’, or a ‘definite maybe’ – depending on what insurance according to one poll taken by the US Travel she bought, when she bought it and what shape Insurance Association (UStiA), such plans represent she was in when she bought it. As American only a four-per-cent share of the American travel consumers are finding out, they need to pay insurance market. attention to the details. Although all travel medical or trip cancellation plans are subject to pre-existing medical conditions Plans by design limitations, many now offer to waive such Most American travel insurance policies are designed exclusions and to cover pre-existing conditions. to protect the costs of a pre-paid trip against Sounds good in theory, but there are a few twists cancellation or interruption due to disruption of and turns to negotiate. travel arrangements, weather conditions, unexpected HTH Worldwide’s Trip Protector plan, for example, death in the traveller’s family, terrorism threat, will cover pre-existing conditions if the insurance is baggage loss, medical emergency or other unforeseen purchased within 24 hours of the final trip payment, contingencies. Although all trip protection plans and if the traveller is not disabled or prevented from have some coverage for medical emergencies and travelling by any medical condition at the time evacuation costs, the benefit levels for these are payment is made. The rationale for the 24-hour very low compared to most Canadian or European time limit is that the longer the client waits after travel insurance benefits – often just US$10,000 to purchasing the trip to buy cancellation cover, the $25,000. There are also higher cost travel medical greater the chance the client or a travel partner or and evacuation plans with emergency medical members of the family might develop a pre-existing benefits of $500,000 to $1 million dollars. But condition that would invalidate their coverage. International Travel Insurance Journal NEWSANALYSIS 27

pick up the bulk of costs (minus deductibles or copayments). Other plans label themselves secondary payers, specifying that if the applicants have primary domestic insurance, they will pick up the out-of- country charges their primary payers don’t (such as an air ambulance). Since primary payers are also responsible for pre-existing conditions, a pre- existing conditions exclusion by the travel insurer

About 85 per cent of Americans have private health insurance or Medicare to cover their medical needs at home

doesn’t seem like such a great risk. And there are some travel insurers that are primary payers, which means they will deal with foreign hospitals and doctors from the first dollar – going back to the domestic payer for is cancelled, so it is prudent for them to purchase which death ensues) of you, or your travelling use terms such as ‘out of area medical costs are their share – again, a pretty good hedge against cancellation insurance promptly.” companion, or your or your travelling companion’s covered’. pre-existing medical conditions. family member travelling with you which within Some trip protection or travel medical plans clearly All in all, for Americans who seem befuddled Loss limitation the 60 day period prior to the effective date of state that applicants must have primary health by their health insurance, travel insurers offer Policies that allow for the waiver of pre-existing your trip cancellation coverage under the policy: insurance (by a domestic insurer) in order to buy something of a safety net for travellers, even conditions usually tightly limit their loss exposure. (a) manifested itself, became acute or exhibited their out-of-country plan – this limits the travel those with pre-existing conditions. But finding Trip cancellation policies are limited by the total symptoms which would have caused one to seek insurer’s exposure as the primary insurer should out the rules of the game require some effort. n value of the trip, which rarely exceeds US$50,000. diagnosis, care or treatment; (b) required taking Travel medical policies that cover out-of-country prescribed drugs or medicine, unless the condition

Although all trip protection plans have some coverage for medical emergencies and evacuation costs, the benefit levels for these are very low compared to most Canadian or European travel insurance benefits

medical emergencies and evacuation or repatriation for which the prescribed drug or medicine is are limited by the costs of medical services taken remains controlled without any change in rendered and those can run to the hundreds of the required prescription; or (c) required medical thousands of dollars or more. treatment or treatment was recommended by a American trip protection policies stipulate that Legally Qualified Physician.” applicants for pre-existing conditions waivers be There are other definitions just as contorted, others medically able to travel and most are quite lenient less so; none of them written by language teachers about what that means. Generally, if a client has or journalists. a pre-existing medical condition that has not Because of the ragged nature of their domestic deteriorated, or is not imminently due for further health insurance, Americans buying trip treatment or diagnosis, or doesn’t physically cancellation or travel medical insurance must also prevent the client from travelling, it will be covered be aware of other arcane measures insurers use to so long as insurance is purchased within the given limit their exposure to medical costs. time period after the trip is purchased, and a About 85 per cent of Americans have private health deposit or trip payment has been made. insurance or Medicare to cover their medical needs Clearly, applicants with serious illnesses that at home and some of these will cover medical require constant medical intervention or are getting services abroad to a certain extent. But there are worse won’t make the waiver threshold. They are notable exceptions. Medicare, which covers some then subject to pre-existing conditions exclusions, 40 million elderly and disabled people, does not most of which rule out coverage for conditions cover out-of-country medical emergency services, that have manifested symptoms, required a change but most Medicare beneficiaries buy supplemental of medication, treatment or referral for further plans to top up their coverage and some of these investigation. The exclusion language can become do offer limited medical coverage while travelling. quite serpentine. Most, however, don’t provide direct payments One example found, from TravelSafe, states: to foreign hospitals or doctors and don’t provide “Pre-existing condition means any injury, sickness medical air repatriations; neither do many of or condition (including any condition from the private employer-based plans, although they www.itij.co.uk 28 FEATURE A risk worth taking?

Petra Kendall-Raynor examines how medical to continuous quality improvement. “As with JCI tourism has become an acceptable alternative to accreditation in the United States, facilities accredited elective care and what insurers and patients can by JCI must constantly strive for and demonstrate do to ensure they are properly prepared improvement in patient care performance and reduced risk,” she continued. Three years ago 750,000 Americans travelled While JCI’s patient-centred standards are the abroad for medical care; however, in a 2009 update same across all countries, the accreditation is will make sure the appropriate release forms are unless they are resident in Switzerland and, report, Deloitte revealed that outbound medical designed to accommodate specific legal, religious signed; they put every safeguard in place so that they therefore, covered by a Swiss health and accident tourism in the US could reach 1.6 million patients and cultural factors in a country. Accreditation is a cannot be sued.” Patients who are insured form a insurance plan. by 2012 with sustainable annual growth of 35 per voluntary process, but Timmons says it is important small, but rising category, he continued. The rule, however, does not apply to patients from cent, while the Deloitte 2008 Survey of Health Care that patients look for credibility of a healthcare Akins went onto explain that the few employers the UK, which, according to the spokesperson, is Consumers found that outbound medical tourism organisation before travelling there for care. would experience an ‘explosive growth’ over the In Dehli, Apollo Hospitals is India’s first JCI accredited next three to five years. People, it would appear, are hospital, boasting a Platinum Lounge that facilitates willing to travel for treatment for everything from the needs of international patients who can have dental and cosmetic operations to correcting serious their appointments scheduled, hotel accommodation medical care in countries such as India, Thailand cardiac problems, particularly as medical care in arranged, and queries relating to international medical countries such as India, Thailand and Singapore can insurance answered – a translator service is also offered. cost as little as 10 per cent of the price of the same Statistics from the Apollo Group appear impressive and Singapore can cost as little as 10 per cent of the treatment in the US. and the provider claims to have 90,000 heart surgeries What’s more, if prospective medical tourists want performed at a 99.6 per cent success rate. price of the same treatment in the US to check accreditation of the medical facility they Dick Atkins, a Philadelphia attorney and specialist are considering attending, they can go to the Joint in the travel insurance industry, believes medical Commission International (JCI), which was set up 13 tourism will continue to grow and that healthcare years ago and has a focus on improving the safety of costs in the US are likely to rise, despite President who have adopted medical tourism in order to due to legal concern. He went onto state that the patient care through the provision of accreditation Obama’s plans for reform. “The number of people save a substantial amount of money in medical care, hospital is obliged to accept patients, independent and certification services – it also provides an who are under insured or uninsured is only going to may offer employees the chance to travel abroad from their nationality or insurance status, in cases of advisory role. The commission accredits hospitals get greater; we also have millions of people losing with a partner and stay at a resort while receiving emergency, such as tourists who are affected by an along with various organisations, such as clinical their benefits,” he said. “If they are able to borrow treatment. “Mexico, or even a ticket to Thailand acute illness. laboratories, medical transport organisations and US$10,000 or $15,000 for an operation abroad for treatment, may end up being cheaper for primary care services. rather than $100,000 or $150,000 for the same employers,” he commented. “It was assumed that Be prepared Karen H Timmons, president and chief executive operation in the US, then they will do it.” Atkins people would jump at the opportunity, but they also There are a number of insurers who want to make officer of JCI, said: “A host of care issues confront added that people who travel abroad for operations have other things to take into consideration, such as sure they are ahead of the game for the minority patients who travel abroad to undergo treatment in this way very rarely think about the consequences their children.” of patients who want to err on the side of caution. and then return to their home countries. JCI applies and believe it will work out well. Some medical facilities have decided to remove the Since the end of 2008, US travel insurance company standards specifically developed for international threat of legal complications themselves. Seven Corners has been offering a medical insurance application using the input of experts around the Hope for the best University Hospital Zurich, known as one of the procedure product that offers medical complications globe to access and accredit healthcare organisations In fact, although it may seem surprising to some, largest teaching hospitals in Europe, offers state-of- coverage of up to $50,000 while the patient is in nearly 40 countries.” Timmons stated that the Atkins says that things almost always do work out the-art treatment from over 4,000 specialists for a abroad, and once they return home. There is also commission was created to meet the growing for the patient. He said: “There have been virtually range of illnesses. A hospital spokesperson said that $50,000 of medical coverage for acute illnesses and demand for a standardised method of evaluating no instances of patients suing. Many places are the medical facility is not accepting US and Canadian injuries, which may occur on the ‘medical tour’ of patient care and to demonstrate a commitment accredited and are really very good. Qualified staff citizens as elective inpatients and/or outpatients the policyholder and their companion.

International Travel Insurance Journal FEATURE 29

propensity to claim, means that some insurers in the he underwent a bone biopsy. Mr Haywood suffered market have had to look at innovation to stabilise complications and his family, unhappy with the their businesses,” he argued. treatment, urged him to travel to California in the US Aston echoes Pollard’s comments and says that for further medical investigation. people need know if things go wrong and should Mr Haywood said of the situation: “My family be aware of the limitations and aftercare available to sorted out the paperwork for treatment. I stopped them. Aston also states that although some insurers taking my tablets, had a detoxification process and are considering offering protection for post-operative lots of tests.” Following an operation, his condition complications, it is not considered an opportunity for improved considerably and he returned to the UK. AXA PPP healthcare at present. Some patients are also considering travelling between countries like the UK and the US for treatment. Alvan Haywood (84), from Fulham, London, has dual US and UK citizenship and was prescribed a significant amount of medication in the UK for an apparent ongoing medical condition for which “I informed my GP of the treatment, spoke to him on the phone and he said I sounded like different person,” continued Haywood. “The doctor then visited me to observe my improved condition for The number of people himself.” At the time of writing, Mr Haywood had returned who are under insured or to the US for follow-up treatment, but still believes he received better care away from the UK and uninsured is only going appreciates the fact he had a choice. “When you get to a certain age in England I feel the medical to get greater profession writes you off; in America that does not seem to be the case,” he concluded. n

Seven Corners’ co-founder, principal and executive He explains that until recently, there has been a gap officer, Jim Krampen, says the product targets those in the market for medical travellers who need travel who may not have a domestic insurance plan that insurance, but due to the fact that regular policies covers them. Not only does the product cover them do not cover those who wish to travel abroad for for the trip and any eventualities that may occur, he treatment, several policies have been developed continued, it uniquely protects them for up to 60 to fill the gap. Pollard mentions Seven Corners, but days following treatment should any complications also Angelis, Health Traveller and Free Spirit, saying: arise. Krampen stated: “People may travel abroad “In terms of health insurance, UK health insurers do for an operation, without realising that if they have not cover their subscribers if they opt for surgery a stroke or heart attack on the operating table, they overseas.” He then went on to state that there has will have to pay for any subsequent care for that also. been discussion within the industry as to whether What happens if you go to India for treatment then the introduction of the European Directive on Patient develop an infection upon returning home? You’re Mobility will change this. “If a National Health Service not going to go back to India to treat the infection.” (NHS) patient has the right to opt for surgery in He also said that the company has had a few claims Brussels rather than Birmingham, then a privately with the policy but admits they have not sold more insured patient has the same right,” he commented, than 70 policies in one year. Undeterred, Krampen “We may well see the introduction of health mentioned that there may be some changes to insurance products that are based around medical the product this year and he believes he has few tourism which will offer significant costs savings on competitors in the UK offering something similar. traditional private medical insurance.” UK citizens are also taking advantage of opportunities Pollard warns people who may be considering to receive medical treatment abroad for a fraction of treatment abroad that they should act like consumers the price and at a time that suits them. Keith Pollard, not patients, research ratings, reviews and check managing director at Intuition Communication Ltd, accreditations. Importantly, he highlights that all costs believes that there are two sides to medical tourism should be compared. insurance for insurers – travel and health insurance. Matthew Aston, international marketing manager at AXA PPP International/AXA PPP Healthcare, commented that the medical tourism industry is still an unknown quantity and presents an opportunity for some insurers some insurers, although not all. “There are a lot of considerations to take into account,” he said, “such are considering as level of risk involved in certain territories across the world. Some insurers’ lack of knowledge and offering protection understanding of international markets may put them off.” for post-operative Aston continued to state that the recession has hit UK PMI insurers hard, with more people now complications deciding to rely on the NHS for treatment, or self-fund if a situation arises. “This, combined with a population who still have PMI increasing their

www.itij.co.uk 30 ITIC REVIEW

The ITIC review includes synopses of all the speaker and panel sessions that took place in Brighton, along Brochure sponsored by with photos of the ITIJ-sponsored Welcome Function, the ITIJ Personality of the Year Award, gala dinner and comedy evening.

INTERNATIONAL TRAVEL INSURANCE CONFERENCE DOMESTIC

THE GRAND HOTEL | BRIGHTON | UNITED KINGDOM | 12-13 MAY 2010

International Travel Insurance Journal ITIC REVIEW 31

The ITIC organisers would like to thank all the sponsors of the event who made the two-day conference what it was. A huge ‘thank you’ goes out to Rowland Brothers for the conference folders, UnitedHealth International for The Cheeky Guide to Brighton, AirMed UK for the conference brochure, and StandbyMD and Olympus Managed Healthcare who sponsored the conference badges

Disasters – how prepared are we?

airport and little to no co-ordination of the rescue operation to deal with disasters within the insurance effort. Three days after the earthquake, the team industry, and found that the answer depended on landed in Haiti, and just an hour afterwards they were who she spoke to. The problem with co-ordinating given their section of the town to search. The team teams from different insurers to help insureds in rescued several survivors from the rubble during need is that some companies will always only want its time in Port-au-Prince, even though the medical to use their own team, either because of ease of infrastructure in Haiti made it very difficult for people communication or due to cost restraints. The travel to obtain care. One of the biggest concerns the team insurance industry does work together in certain had was for their safety, and due to machete-wielding situations, as is proved by the Travel Committee locals, the Rapid UK team was accompanied at all within the Association of British Insurers (ABI), said times by armed guards. Julie, although there remains a lack of consensus and no team to lead the industry into a disaster. One of the problems facing the development of Julie Remmington, Travel a crisis team is the fragmented nature of travel Insurance Suppliers Network insurance distribution in the UK, which then subsequently affects disaster provision. It was mooted Julie showed that 66 million trips abroad had that the industry needs a definite disaster plan so that been taken by British holidaymakers in 2008, but it can better respond to emergencies around the questioned whether the industry had kept up with world, with the possible involvement of the ABI. the number of travellers and their destinations to provide them with the appropriate level of cover. When Logistical readiness concerns equipment, and Rapid a disaster strikes abroad, she Clive Hodges, chief executive, UK has a principle of self sufficiency, with teams taking continued, there are several Rapid UK all the equipment they need with them, which is levels of help that a tourist can already packed and ready to go at a moment’s notice. and should seek before they ask Clive began by explaining that Rapid UK members The final type of readiness for Rapid UK is procedural for help from their insurer – local are all volunteers, who work for nothing at the – the charity has established principles, whereby they emergency medical suppliers, the registered charity. The organisation deploys search will only go if they are asked. tour operator, the embassy, family and rescue (SAR) teams after disasters, as well as The challenges to all the preparation needs are and friends, and finally the travel offering SAR training to countries that are particularly fundraising and maintaining the operational edge insurer. The British government prone to natural disasters, such as Pakistan. required for the work – such as keeping up to had little responsibility to take Speaking about how the charity prepares itself and its date with equipment upgrades and technical care of tourists caught up in volunteers to deploy in emergency situations, Clive developments. During an emergency, no matter overseas disaster before the Bali noted four different types of readiness: individual how well prepared the team is, challenges include bombings, but following criticism readiness of the volunteer, which incorporates the obtaining information from the scene, unique in- of the handling of the situation, volunteer ethos; a commitment from the person; country issues, giving support to the deployed team the Foreign and Commonwealth and an undertaking by that person’s employer that and, finally, training local teams to cope with the next Office said it would help more they are willing to spare that person should the need disaster on their own. in these situations, and the role arise. Training of each volunteer takes two years, with Clive then spoke on behalf of Dan Cook, also part of the government’s Rapid continuous training after that. of Rapid UK, who was unfortunately called away Deployment Team (RDT) In terms of organisational readiness, Rapid UK has and was therefore unable to attend the conference. during disasters was established gained INSARAG accreditation, which is recognised Dan’s presentation was concerned with the rescue further. The RDT is sent out to by the United Nations (UN) as the standard for mission in Haiti in January 2010, which he attended help deal with coach crashes, training and co-operation for rescue teams. The with the Rapid UK team. The first challenge was to tsunamis, avalanches and other accreditation means that Rapid UK undertakes to co- actually get the team from the Dominican Republic to humanitarian events. operate with the UN during SAR operations. Haiti, due to the complications at the Port-au-Prince Julie then centred on co-

www.itij.co.uk 32 ITIC REVIEW The economic climate

as commodities, and certain Turkish and Egyptian that could occur, as Ethan Ilzetzki, economist, clinics have spotted the chance to make money from well as researching London School of Economics billing for spurious medical treatments, or inflating medical facilities in the bill to ridiculous proportions – Thorir noted that country/region. one particular Overall, said Sarah, case where an the UK’s travel insurance company market has seen had been billed for a two-per-cent 54,000 bottles of decline coming up saline for just nine to this summer, patients. with a particularly Thorir said that marked drop in when the Turkish the popularity of Ministry of Health destinations that investigated 350 use the euro, which hospitals to check has translated for invoicing errors, into stronger it found, among growth outside other cases, that a the eurozone. hospital had billed Countries that an insurer for 10 use the euro have days worth of seen an eight- physiotherapy for per-cent drop in a deceased patient; tourist numbers compared to last year, while dollar many thought – the total number of outbound Ethan’s presentation centred on the economic hospital notes stated that one pregnant woman had countries have witnessed a 0.3-per-cent rise, and travellers has remained stable, and while the situation in which Europe finds itself at the moment managed to give birth at two separate hospitals; and countries that use neither currency have seen an total number of passengers plateaued, there was – for many the situation is unstable, but Ethan they checked up on 46 patients who were supposed increase in visitor numbers of 11 per cent. This significant growth seen in the cruise industry, which pointed out that it can be media reports that make to have undergone surgery, according to the hospital summer, said Sarah, Turkey, Egypt and Tunisia will is where many analysts say the growth will continue. the public focus on the wrong type of information bills – in fact, just 26 patients had a scar to prove they have a 22-per-cent share of the outbound UK tourist The outstanding growth in the cruise industry can be to properly assess a country’s economic situation. had undergone an operation. market. Given Thorir’s presentation, this statistic attributed to the opening of new ships, and different Instead of focusing attention on the complex For effective cost containment (CC), continued should hold some concern for British travel insurance ports, as well as different demographics – instead of government bond statistics, companies. cruise ships being dominated by silver-haired tourists, insurers should instead look Sarah predicted that following the volcanic ash crisis there are more families and young couples who at the country’s deficit, and (which is continuing), GfK Ascent will see a rise in are choosing to take a cruise holiday, taking in more the percentage of sovereign all-inclusive holiday bookings as the public seeks to countries and more sites on their holidays. debt a country has compared protect themselves against further disruptions to their With regards to outbound travel from the UK, to its gross domestic product holiday plans. Other booking patterns noted by the Luke’s figures showed that there were 69 (GDP). Ethan had several company include strong bookings between January million outbound passengers in 2008, and that slides that showed clearly and May this year, with a reduction in the importance independent travel is still growing in popularity, which countries in Europe had of late bookings. Tourists are booking their holidays although concerns over consumer protection has problems with sovereign debt to dollar destinations much earlier than those who prompted more customers to use tour operators in relation to their GDP and are heading to non-euro or dollar countries. as well. A further boost could be given to the UK’s their deficit. Sarah concluded that despite the economic climate in travel industry following the change in government, When deciding which the UK, consumers have not changed in that they still following the new coalition government’s decision countries are in economic want to go on holiday, and will do so, but they are to change the individual air passenger duty tax to a danger, continued Ethan, changing when they book their holiday, where they more straightforward aircraft tax. economists consider several go, and how long they stay for while there. There is Challenges facing the travel industry, though, remain, risk factors – primarily debt a trend developing that shows the popularity of an continued Luke. These include the changing holiday and deficit, but also the past eight to 13-night holiday, rather than the traditional purchase patterns mentioned by Sarah; the dual fiscal behaviour of a country, a 14-night holidays, as well as a decrease in short financial pressures for compensation for delays lack of monetary autonomy, a breaks being noted. combined with increasing costs; an increased political lack of labour market flexibility focus on the industry; possible intervention into and the contingent liabilities of regulation of the industry from the European Union a country’s banking sector. Concerning the issue of Thorir, the company must be in control of the Luke Pollard, head of public and an ongoing need for the travel industry to ‘speak past fiscal behaviour, it was noted that Greece and whole process of the claim. Before a claim is made, affairs, Association of British Travel with one common voice’. The issue of political Portugal were not as stable as some other European a cost container should perform site/clinic visits Agents (ABTA) intervention is one that isn’t going away, thanks to the nations, whereas the country with the least flexibility before any client is sent there. During an episode, confusion surrounding consumer protection and the in the labour market is Spain. Ethan highlighted Spain there must be seamless co-ordination between the Luke began by reassuring the conference delegates high level of publicity this topic has attracted following as being of particular concern, as the country has medical provider and the CC company, and after that the travel industry is actually faring better than strikes, adverse weather and volcano ash. had a labour problem for some years, therefore the the treatment is complete, the performance of the situation is much more complex to resolve. The UK, hospital/clinic should be evaluated. The CC company by comparison, has ‘got off quite lightly in terms of should then share its evaluation and process the labour markets’, according to Ethan. The lack of information with insurers and assistance companies. monetary authority in countries that use the euro is In conclusion, Thorir said that insurers should focus of concern to economists, as the individual countries on average claims costs, rather than the percentage have little power of the value of its currency, relying of savings; they should monitor and follow changes on other Euro-using countries to maintain stability in the market and alter the customer perception that and value. free choice of medical care is genuinely that – instead it should be evidence-based guidance. Thorir Aronsson, head of operations, Euro-Center Sarah Smalley, managing director, GfK Ascent Thorir spoke about the economic climate from a cost containment perspective, centring specifically GfK Ascent provides statistics for the UK’s leisure on two countries – Turkey and Egypt. The increasing market, providing market performance data and popularity of these two countries has led to the need analysis, which could help insurers to identify the for cost containment, as Thorir explained: “Where regions and countries that British holidaymakers are there are tourists, there is money, therefore private heading to. By knowing this information, insurers clinics start up.” In some countries, tourists are seen are better able to prepare for any influx of claims

International Travel Insurance Journal ITIC REVIEW 33

The ITIC Welcome Function, held in the Charlotte Room of the Grand Hotel, was proudly sponsored by ITIJ. The evening drinks fl owed nicely after a day spent in the conference room, as all the delegates caught up with the latest gossip from the industry. All the talk was of volcanic ash, the Haiti earthquake and the possible, then not, strike by British Airways cabin crew, demonstrating clearly how the travel insurance industry is involved, even if on the periphery, in global events.

New delegates mingled with old hands, and despite protests from some about how early the bar was closed, the evening was classed as a great success by all who attended!

www.itij.co.uk 34 ITIC REVIEW

Hazardous activities and winter sports

on the patient, and ‘T’ is ‘Then lose all Internationale de Ski (FIS) rules of practice, there was acquired is applied – as long as it was marketed interest in the patient other than sending are established protocols in place, which allow an there. Complicating the issue further, though, are an invoice for the treatment’. The doctor in English court to treat it with a status similar to the different countries’ approaches to testing and question has purchased a helicopter, which that of the Highway Code, whereby a breach of manufacturers guidance. Darren’s final piece of advice waits at strategic points in the Alps, and rules evidences negligence. The most helpful rule to travel insurers was to bring lawyers into a skiing he has also built a hospital close by so that is number 10, which states that every witness, injury claim early to establish negligence and the laws patients are picked up off the slope and whether a responsible party or not, must exchange that can be applied to a claim. treated immediately by his hospital. names and addresses following an accident. Moving on to what insurers and assistance Unfortunately, this only rarely occurs. companies can do to combat this niche Certain countries have established liability laws Julie Smith, claims director, industry, Thomas said that companies should already, said Darren, such as Article 1382 of the InsureandGo first question the need to operate immediately French Civil Code, which concerns excessive speed on the knee, as this need is dependent on the on the slopes, while Article 1384 makes the skier Julie began her presentation by saying that one exact nature of the injury, which should be responsible for damage caused by an object under of the most common claims the company sees is assessed through an MRI scan. Options for his control – for example, skis and poles. European for lift passes, whether they are unused (partly) or transport back to the client’s home country Commission regulation 864/2007 Article 3’s main damaged in some way. As lift passes can cost several should then be considered – a commercial rule is that the applicable law to a collision is that hundred euros, it can be a significant loss for both carrier, a ‘Plaster plane’, as run by Tyrol Air of where the accident has occurred. With regards consumer and insurer. Julie continued by showing Ambulance, an air ambulance, or, as is being to inadequate supervision, lawyers should examine delegates what the top 10 most hazardous activities used frequently by are for insurers – winter Dutch companies, a sports, skydiving, scuba long road ambulance diving and motorcycle/ journey. Assistance scooter riding, quad companies should biking, hand gliding, also ensure they have rock gliding, rugby, a medical expert on sea kayaking and shark call 24 hours a day, so diving. The cost of certain Thomas Buchsein, chief medical an informed judgement can types of claims was also officer, AXA Assistance Germany be made, no matter what the brought up, with statistics and UK time of day. Finally, Thomas showing that the cost of asked if there was a way in ACL injuries averages a Thomas focused his presentation on one of the which insurers could steer treatment cost of £1,900, most common skiing injuries – the anterior cruciate patients away from private while a fractured leg costs ligament (ACL) injury – and how this injury clinics that take advantage of around £3,800, while has become an Alpine business concept for some those injured on the slopes. to treat a client with a medical facilities in the region. Injury of the knees fractured back could cost constitutes one third of all winter sports injuries, an insurer over £5,000. according to Thomas, who also pointed out that Darren Lewis, On an annual basis, men were twice as likely to injure their knees as barrister, St John’s injuries such as the ones women. Two years ago, the most common injury Chambers above, together with a seen by Alpine medics were tibia fractures, but broken clavicle, neck, arm changes to ski bindings have contributed to the rise Darren’s presentation focused on the evidential FIS rules, where rules are given to instructors, to or a head injury, cost around £1 million. of injured knees. issues that insurers and their legal teams should see if there has been a breach. Concerning the use Moving on to those activities that insurers shy away According to Thomas’s figures, 46,000 people were consider when they are faced with a winter sports of ski/snowboard equipment, the main rule applies from, the top declined activities are working with hospitalised in 2008 in Austria after skiing accidents, claim – the most common of which at the moment that a court will apply the law of the country where animals, being in a rickshaw, sumo wrestling, polo and such a high number of potential patients has are claims for collisions on the slopes, followed by the claimant has his habitual residence – as long as and martial arts. New activities that insurers are prompted a doctor in Austria to adopt the ‘LTOT’ inadequate supervision and finally inappropriately the product was marketed in that country. If this is being asked to cover include swim hiking, night business model – ‘L’ is for Locate the patient; ‘T’ installed equipment. not the case, the situation becomes more complex, mountain biking, chariot skating, volcano boarding stands for Transport the patient; ‘O’ is for Operating According to Darren, thanks to the Federation and the law of the country in which the product and water zorbing.

International Travel Insurance Journal ITIC REVIEW 35 Digital marketing – what it can do for you

Internet – they are your customers of today and small company to make. The power of a successful tomorrow’. If no-one in the company is familiar viral marketing campaign, though, is undeniable – with social media, then the answer is simply to since its inception, 205 million people have played employ someone who will – even if it is only for one of TAMBA’s viral games. work experience. Moving on to why companies should involve themselves in social media, continued Sally, Mark Walmsley, strategy director, one only needs to look at how different firms Vivid Lime dealt with the ash crisis. By communicating clearly on multiple channels with the customers, Mark’s presentation centred on how companies can airline KLM increased the trust in their brand, use digital marketing, either through SEO or pay-per- and loyalty from their customers through click (PPC) advertising, to increase their revenues. their transparent approach to dealing with the The SEO can take place either on a page through the problem. Finally, Sally told delegates that online use of meta data; through a website using keyword presence in the marketplace is vital, as customers strategies, or offsite – ie inbound links to a company’s are changing their profile, and the industry website from Facebook. Mark then moved on to cannot afford not to keep pace. more advanced SEO, which includes the use of videos and images on websites, as well as sales channels, all of which can contribute to appearing higher up Jon Broomfield, account the Google rankings following a general search. director, TAMBA Internet Companies should be as open to Google as possible, continued Mark, putting plenty of information on Jon’s presentation focused on the underestimated their pages before a user is required to log in. A case power of viral marketing, first explaining that study was presented to delegates that showed that viral is anything that consumers will pass from after Columbus Direct used a more appropriate one to another. Viral marketing can come in the keyword strategy to what the company is offering, form of videos or games, but while videos are the company’s sales volume increased by 32 per cent. popular and get hundreds of thousands of views, PPC advertising has been shown to have a quicker viral games catch millions of consumers in their effect on a company’s sales volume through adverts net. Insurers should consider what viral marketing growth, while any return should be seen by the placed at the top of Google’s web pages after a search. can be used for, including raising mass brand company between three and six months after the Again, a case study was shown of the efficacy of Sally Broom, chief executive, awareness, data collection, voucher distribution, launch. Costs to the company can vary, continued such an approach, using Columbus Direct. Tripbod.com and audience acquisition. It is also important that Jon, who said that TAMBA Internet can offer Mark then moved on to brand bidding and brand companies consider the mix of marketing channels an entire viral package to a company for around hijacking – brand bidding ‘describes the use of Sally began the session by explaining that Tripod’s that can be used for viral purposes, including £10,000, so it is still a significant investment for a brands as keywords in PPC campaigns by affiliates, website offers travellers a global network of Facebook competitions, iPhone competitors, retailers, individual trip advisers (tripbods) who are based in applications, and Twitter. auction platforms the country that the traveller wishes to explore – the Viral games, continued Jon, are and price comparison online company hopes that by connecting trusted powerful tools thanks to a high sites’, while brand local experts and travellers, holidays will be safer and level of audience participation hijacking ‘describes the more enjoyable. and stealth marketing tactics; use of a brand owners The challenges in setting up the company were that they can give a company exact ad copy in PPC it was a new concept, in a new market, with a very permission to continue marketing campaigns’. Hijacking limited marketing budget, meaning the company to that audience and receive is a problem, as Google’s has to ensure that it is ‘shouting more loudly’ than recommendations from users. The policy on trademark many others. Therefore, it employed a mix of power of viral games was shown infringement can only different social media channels to pull in consumers, to the delegates through Virgin be investigated in the including blogs, which aid greatly with search engine Active’s most recent viral game, UK, the US, and a few optimisation (SEO), newsletters, press releases, which has been played by over other countries at the webinars, and, importantly, social networking and 23.7 million users since its launch moment, leaving many microblogging services Twitter and Facebook. For in February 2008. other counties free to all of these methods, the only cost to the company Moving on to the return on utilise such tactics. Mark was time, yet SEO was aided enormously, thereby investment that companies could offered delegates a few boosting sales. see after using viral marketing, tricks of the trade for For insurers that still hold concerns over social Jon assured delegates that it brand bidding, including media websites, Sally reassured them that they is money well spent, as games geo-targeting or spaces in are not ‘just a load of kids messing around on the present huge opportunities for brand names.

www.itij.co.uk 36 ITIC REVIEW Pre-existing conditions and mid-term adjustments

individual circumstances of a complaint. In doing medical expenses, while a consumer is often so, it seeks to distinguish between three issues – the more concerned with baggage cover or trip delay exclusion of a pre-existing medical condition, a insurance. While travel insurance is packaged to change in risk/mid-term adjustment, and non- look attractive and simple to consumers, it is also disclosure of a medical condition or medical history. packed with small print covering the more complex Regarding non-disclosure, the ombudsman asks if terms and conditions. a clear question was asked at the point of sale, and The point of sale process, said Paul, is therefore key. was it answered to the best of the clients’ knowledge? Failures in this process have led to a number of FOS For the exclusion of pre-existing medical conditions, decisions in favour of the individual rather than the Peter highlighted confusion between conditions and insurer, although stricter rules have led to fewer cases symptoms – the position of FOS in this situation is: being brought before the ombudsman. Restrictions What did the insured know about the condition, or on cover also cause confusion, through the words what should they have known? The legal position on ‘directly or indirectly related to…’ when referring mid-term adjustments is, as ever, murky. Following to pre-existing medical conditions, and while the the Unfair Terms in Consumer Contract Regulations intent is clear, often there is some disagreement on 1999, the unilateral right to vary cover is likely to whether a condition that developed on a person’s be seen as unfair and unenforceable. Insurance law, holiday is directly, indirectly or not related at all, meanwhile, states that there is a difference between a to a pre-existing condition. The issue here is that change in the nature of the risk versus a heightened ‘medicine isn’t black and white’, as Paul pointed out – risk, which the FOS relies on. indirect relationships can either be tenuous, or highly The FOS positions are: “A pre-existing medical significant, and two doctors could see the same claim Gary Murphy, European travel Peter Hinchcliffe, lead exclusion applies to excluded conditions that the differently. He then said: “There needs to be a system underwriter, ACE Group ombudsman for the insurance insured knew or should have known they had at of refereeing arguments, but the system needs to be sector, Financial Ombudsman the start of the policy term and conditions whose fair and consistent.” Disputes often end up with the Gary’s speech focused on what a pre-existing Service (FOS) symptoms were known to the consumer at the start FOS due to questions such as, whose medical opinion medical condition is; what a change of health is; of the policy term and which a reasonable consumer can be relied upon? Where does the burden of proof when there’s a duty to disclose; the key differences would have realised were likely to give rise to a lie? And should the FOS have its own medical expert between single trip and annual multi-trip policies; claim.” To justify a mid-term adjustment: “The on hand to settle these disputes? disclosure of health conditions and change of health; nature of the risk needs to be different – not the Paul also showed a letter from a client’s general and ACE’s position on mid-term underwriting and chances of a claim. Would a reasonable consumer practitioner (GP) who had been denied cover, why the company takes the position it does. One of believe that their general health was now different which prompted some discussion about the reasons the biggest problems, he stated, lies in the fact that than at the start of the policy?” why a GP that wasn’t involved in the treatment definitions of ‘pre-existing’ and ‘change of health’ of the individual would do so, and how much vary according to each underwriter. Equally, the credence the FOS should put in such letters from duties of disclosure can vary widely – it could be at Paul Beven, Healix Group interested parties. inception, renewal, or at the point of a claim. Moving on, Gary focused on the differences Paul began his presentation by making clear the Following the presentations, a lively and heated between annual and multi-trip policies – ACE different perceptions that the insurer and the debate ensued, with Peter being inundated with does not re-write single-trip policies, but will do customer have about travel insurance, which is approaches from insurers for more consistency so if the journey was booked before a change of partly where confusion over pre-existing conditions in judgements against travel insurers, to help the health occurred. In terms of treating customers stems from. The disparities include the fact that industry better understand its position in pre- fairly, “ACE,” continued Gary, “accepts that a an insurer believes travel cover is primarily for existing condition claims. customer’s health may change between buying cover and completing their journey, and do not look to re-underwrite trip policies mid-term, as the company does not believe that customers should be disadvantaged when buying an annual policy.” ACE’s view is that a mid-term adjustment should only be done if there is a ‘material change of risk’ – where there is an increased risk of a cancellation claim, a medical expenses claim, or a curtailment claim. Gary then showed delegates examples of two decisions made by the Financial Ombudsman Service (FOS) following cases of mid-term Peter said that the FOS has received around 2,000 adjustments being brought to its attention. The two complaints a year regarding travel insurers for cases were dealt with differently, emphasising the the past few years, showing that there is some problem that one underwriter could have a different significant disagreement between the sector and result to another, and Gary noted that the way in the ombudsman. He then gave an overview of the which ACE’s policies are underwritten are driven by ombudsman’s approach, which is to make individual FOS judgements. decisions based on what is fair and reasonable in

International Travel Insurance Journal ITIC REVIEW 37

Volcanic ash – problems and challenges

constituted weather – not the volcano itself, but Sean Tipton, spokesman, the wind factor that meant the dust spread over Association of British Travel European airspace. Consistency is, therefore, an Agents (ABTA) almost impossible task. Insurers are placed in a difficult position as there Sean spoke about the ash crisis from the is a constant battle between clarity and brevity in perspective of travel agents, who, despite travel insurance policies – an example of this was spending a large amount of money on discussed when Fiona asked if, going forward, the repatriating stranded passengers (Tui spent cover for ‘reasons beyond your control’ should an estimated £90 million, while Thomas be put back to ‘any reason’, as opposed to the Cook spent around £70 million), have situation at the moment, where those reasons come out of the crisis with a positive public are clearly stated in a policy’s small print. If the relations result. By looking after their clients, entire travel insurance industry were to cover the ABTA members have taken the opportunity volcanic ash delays and cancellations, the cost to create a positive spin on the package travel could potentially reach up to five per cent of the industry. The tour operators and travel agents entire industry’s income for the year, which, with had little choice but to perform well in the travel insurance margins so tight anyway, is a crisis due to the duty of care placed upon serious concern. members. Considering the industry’s response to Greg the ash crisis, Lawson, Fiona said that commercial the extensive director, media coverage Citybond led to a missed Suretravel against taking advantage of the situation by offering opportunity for selective cover that offers false hope to consumers the industry to Greg’s view is that the about their coverage. Ways in which this could Fiona McDonald, underwriting explain how travel travel insurance industry be achieved could be by adding volcano cover to director, Opera Underwriting insurance works, response should have policies, but with strict limits on payouts, and and what it is been quick, cohesive and offering the cover to consumers as an ‘added extra’, Fiona began by asking the questions that both the there to cover; consistent, but it failed which they would have to pay for. In this way, the public and the media have been asking since the and if there had in almost every respect. industry could also build up a cash reserve that Icelandic volcano Eyjafjallajökull began to erupt at been a specific Customer confusion, he would enable it to cope well with the level of claims the end of March – is it covered by travel insurers? travel insurance continued, is what leads should the same crisis occur again. Should it be? And how should the industry be industry to distress, and by not The industry must rebuild consumer trust in responding to this crisis? spokesperson coming out with a clear travel insurance, but the competitive nature of the There is no simple answer to the ‘is it covered’? to deal with the response, the industry UK’s travel insurance market remains a barrier to question, and as Fiona pointed out, although a good furore, it could is giving the public the comprehensive and consistent cover. approach would appear to be if all insurers had the have controlled impression that it doesn’t The situation remained unresolved at the end of same policy wording the situation would be clarified, at least some of know what it is doing. the session, but ITIJ will keep you up to date with but thanks to the Competition Commission, that the damaging Although he agrees that any further developments in the industry with would never happen! While some insurers will cover publicity that was the industry should come regards to volcanic ash cover, as the sector tries to volcano-related cancellation, travel delay or missed seen in the media. to an arrangement that meet the consumer demand that is so apparent. For departure claims, others won’t. There was also some would offer cover to more on the insurance industry versus the volcano, discussion among the group as to what exactly customers, he warned please see p10.

www.itij.co.uk 38 ITIC REVIEW For One Night Only… The ITIC Finale Dinner and Comedy Show

The ITIC Finale dinner was, as always, a massive success. With more fi rst-time delegates and guests attending than ever before, the food and wine fl owed freely throughout the evening. Although many people thought that the comedy night had started when ITIJ’s editor- in-chief Ian Cameron took to the stage, he was out-performed by the professionals! For One Night Only, the Grand Hotel was taken over by comedians, who went down a treat with the ITIC audience. There were plenty of laughs to be had, especially one particular moment, where poor old Iceland became the butt of a few jokes from the comic, who then chose his next victim from the audience for a bit of banter … choosing the only Icelandic person in the room, who received a huge cheer for being brave enough to admit it!

The ITIJ UK Personality of the Year award was won by Donna Sweetman of Optimum Underwriting Ltd. Donna was incredibly pleased to have been voted UK Personality of the Year, and the whole team at ITIJ would like to congratulate her on a thoroughly well-deserved win. Commiserations must go, though, to our fantastic nominees, without whom there would be no competition. It was a closely fought battle, and Chris Price, Fiona McDonald and Fiona Macrae (below) were all very worthy contenders.

International Travel Insurance Journal ITIC REVIEW 39

www.itij.co.uk 40 ASSISTANCE&HEALTHCAREWORLDMARKETS Kenyan care

the subsequent ‘Go-there-at-your-own- risk’ warnings, not one single tourist was the subject of an attack or was involved in any form of ethnic or post-election violent Kenya acts. The disaster and the destruction descended were confined to the Kenyan people themselves. from being an There was a gradual realisation that the areas that award winner were decreed as ‘no-go’ by the travel advisories of the ‘Best were villages, towns, districts and provinces that Adventure and were far off the tourist track. Slum townships, the Ecotourism scenes of the greatest violence, were never on the destination in itineraries of the casual visitor to Kenya. Africa’, which Using that fact, together with some extensive and subsequently prolonged lobbying, the local tourist agencies and had visitor rates associations brought Kenya back up again in 2009 rising from in the eyes of the travel market. Travel and tour 500,000 to just operators at all levels – from the sun-and-safari beach under a million, holidays in the coastal areas to the seriously up- In 2003 when the last article in this journal talked to a country subject to travel advisory warnings from market, thousands-of-dollars-a day, high-end visitors about Kenya, it was introduced with the slogan of the international governments – which consequently – have seen the gradual return of a vital foreign level slipped down to the beach, sun and safari Kenya Tourist Board: ‘Magical Kenya – Experience meant a 35-per-cent drop in its burgeoning tourist exchange earner. For the last three years, Kenya has holidays. But at least they started to return. a different safari every day’. At the time, Kenya was numbers. The UK’s Foreign and Commonwealth seen a steady growth in tourism; back now close In the words of the International Monetary Fund riding on the crest of a wave of optimism following Office (FCO), the US State Department and similar to the one million mark of 2007. (In the meantime, managing director Dominique Strauss-Kahn during a the election of 2002, which was hailed throughout agencies in other countries issued travel warnings local Kenyans queried the lack of travel advisories for visit to the region in March 2010: “As I’ve said many the world as a model of the democratic process in concerning ‘non-essential travel’ to specific areas of the UK, following a series of bombings in London.) times in the past, African countries were largely action. A lot has changed since then, but what have Kenya. The term acknowledges that a person may The recession of 2009 slapped Kenya once again. innocent victims of the crisis. Thankfully, the tide the effects been on the treatment of those needing need to travel for business, humanitarian or family Travellers at all levels held back from spending seems to have turned and all across the continent, medical attention whilst in the country? reasons. The ‘non-essential’ part of the phrase refers money. Once more, with extensive lobbying and we can see signs of a rebound – in trade, export to holidays and leisure activities. While the advice shrewd marketing, Kenya saw the growth start up earnings, bank credit, and commercial activity.” How quickly time passes was relaxed on 21 January, just 18 days after it was again. This time with more visitors in the middle But at whatever level the traveller makes his After the 2002 election, there was a smooth issued, the country’s tourism industry had suffered to lower ends of the scale – previously high-end temporary home, and this applies equally to the transition from the party that had held total power serious long-term damage. travellers went to the middle level and the middle business traveller, the questions come up in their for over 21 years to a loose coalition predominantly Most members of the UK’s Federation of Tour minds, ‘What if … I need to see a doctor/have an on an anti-corruption manifesto. Five years later, Operators heeded the advice and suspended holiday accident/need hospital treatment/need to travel back the December 2007 election was universally schedules to Mombasa. Some of these operators – to my home country for more intensive medical care?’ condemned both inside and out of the country, with including Thomas Cook, Thomson, My Travel and Slum townships, the Despite the image of being close to nature and the European Union describing the election process First Choice – decided to cancel all holidays to Kenya the photographs of tourists watching lions hunting as badly flawed and failing to meet international until May 2008. Malcolm Tarling, spokesman for the scenes of the greatest for their supper, attacks by wild animals continue standards. In the midst of a reaction against the Association of British Insurers, commented at the to be a rare event. By far the most serious and perceived rigging of votes, over 600 people died and time: “If you travel against Foreign Office advice and violence, were never common reason for medical evacuation is road traffic nearly 300,000 people throughout the country were are injured, insurers could argue that you are putting accidents. Despite the fact that the most common displaced in a little over a week of inter-tribal fighting. yourself at extra risk, and they expect you to take means of transport in Kenya is by road, Kenyan roads Homes, shops and businesses were burnt and reasonable care. Insurance policies are not designed on the itineraries of the are not well maintained and monitored. This lack of looted, and more violence continued to occur over to cover you in what might be seen as carelessness.” basic repair and maintenance, coupled with reckless the first few weeks and months of 2008. During the times of the post-election violence and casual visitor to Kenya driving by motorists and an almost futile attempt by

International Travel Insurance Journal ASSISTANCE&HEALTHCAREWORLDMARKETS 41

the government to legislate appropriately to minimise traffic accidents, combine to provide one of the leading causes of deaths in the country. Road carnage Despite the image of is alarmingly high, with the number of people who perish in accidents surpassing 300 a month. In 2009, being close to nature the road accident-related death toll reached 1,953 for the period January to June. and the photographs Public service vehicles are often driven hard and badly, with many drivers travelling enormous of tourists watching distances for long hours without adequate rest. The reduction in concentration and the desire to cover as lions hunting for their many miles as quickly as possible can cause reckless and ultimately dangerous driving techniques. supper, attacks by wild In turn, these are the very vehicles that can involve themselves with the innocent passing tourist mini-bus animals continue to be en route to a four-day safari somewhere in one of the game parks, with resulting carnage and a busload a rare event of injured tourists. So what medical care is available within the area for those helpless victims? insurance company has not guaranteed payments or if a patient is not insured. Its room rates per day Medical facilities range from $256 up to $480 for intensive care. Under the country’s power-sharing agreement, In common with other private hospitals these are there are two ministries of health – the Ministry just the ‘hotel’ elements in hospital charges, with of Public Health and Sanitation and the Ministry of doctors’ fees, procedures, medicines, diagnostic Medical Services. Health issues featured prominently costs and food all on top. in the manifestos of the two competing parties. While reasonable quality medical facilities exist in people being able to afford such an expensive However, critics claim the result has been a centres such as Nairobi and Mombassa, in other Care in the air service. Air ambulance services are provided locally, duplication of bureaucracy and expenditure without areas, the standard of medical facilities throughout One air ambulance company that does serve the regionally and internationally, evacuating patients to providing any discernable improvement in service Kenya varies considerably. The more remote an African continent is AMREF Flying Doctors, based in Nairobi, other destinations on the African continent delivery. area the less care is available and access to medical Nairobi, which probably plays the most important or intercontinentally to Europe, Asia and the Middle Health facilities in Kenya are either run by the evacuation services is vital. role in the pre-hospital EMS set-up of Kenya and East. The service also includes medical escorts on government, mission organisations or private The coastal areas, which have a vast influx of the neighboring countries, in particular because commercial airlines worldwide and the provision visitors from all over the world, have belatedly of its professional and high-standard of service, of ground ambulance services in Nairobi and other started to offer facilities that can deal with ‘normal’ which is available not only for its members but for destinations where AMREF Flying Doctors is able to tourist-related illnesses and injuries. Many of these anybody in need, including the poor. It is the largest subcontract a reliable service provider. will happily accept the patient’s own credit card as and one of the best-known flying doctor services Patients are brought back to Nairobi or repatriated a payment facility, but a large number of them are in the region and provides medical emergency to their home countries not just from within Kenya, very wary of accepting an overseas insurance or and trauma care to the sick and injured, and air Tanzania and Uganda, but indeed from all parts of assistance company’s guarantee of payment, leaving ambulance transfers between medical facilities. the world. The company’s 24-hour control centre the patient with the problem of a large outgoing AMREF Flying Doctors is the airborne medical is equipped with many means of communication to cost that will have to be subsequently reclaimed services arm of AMREF, the African Medical and help to make it possible for that first essential call to from the travel cover policy. Local knowledge and Research Foundation, an international non- get through: telephone, fax, mobile phone, satellite the ability to facilitate matters can relieve so many government health organisation founded in Kenya phone and fax, HF radio, email/Internet. HF radio, of the burdens that can affect a patient or client. in 1957. While AMREF’s priority intervention however, is still one of the most useful means of The private health sector caters mainly for the areas are focused on Malaria, HIV/AIDS, family communicating with remote areas in Africa. Most wealthy, the tourists and the expatriate community, health, water, sanitation and training and health police stations and missions have radios and once who either have health/travel insurance or can learning materials, the Flying Doctor service installed it is to all intents and purposes free to use, afford to pay US$100 per day for a ward bed, $320 is its airborne medical services arm. AMREF and is reliable. HF/email links are now also possible per day for a private room or $450 for an ICU bed Flying Doctors supports the Clinical Outreach and gradually becoming more widely available. per day, with an initial deposit of $3,000 to $5,000 Programme by regularly flying specialist doctors on admission. to over 150 remote hospitals in East Africa for Assistance services The possibility also exists for fraud, sometimes with patient consultations and specialised surgery. It Dr Bettina Vadera, the medical director of AMREF the collusion of the policyholder, but often started also provides charity evacuation flights to patients Flying Doctors, says: “We are the only air ambulance by just presenting the patient with a bill for ‘tests’ in need. Any surplus generated through the air service that owns and operates its own fleet of and ‘treatments’ that may or may not have even ambulance service goes towards the Clinical aircraft with blanket flight clearance into neighbouring been carried out, but have attracted a huge invoice. Outreach and the charity evacuation programmes. countries that has full-time medical staff, the radio The client pays up using their own means, and the The need for air ambulance services has been there network and most importantly the local knowledge institutions. European-type hospitals, a legacy from battle is then engaged between the clinic and the for as long as AMREF Flying Doctors has been in to work in the region.” The company is, thus, ‘acting the colonial healthcare system, are located in the insurance company to reduce or at least justify what East Africa, but demand is increasing with more more and more as a service provider for European larger towns. Nairobi boasts two of the best private can be an exorbitant invoice. hospitals north of Johannesburg and acts as a primary Elsewhere, medical facilities in remote areas are evacuation centre for the United Nations staff who few and far between and are generally poorly operate in other zones, including Somalia, Sudan the equipped. It is likely that some Good Samaritan, DRC and Chad. Between Sub-Saharan and Southern believing they are doing the best for the injured, Africa, the only specialised paediatric medical centre is will load the victims on to the back of a pick-up also based in Nairobi – Gertrude’s Children’s Hospital. truck and shuttle them to the nearest medical In 2003, Aga Khan Hospital in Nairobi became facility. The word ‘hospital’ or ‘clinic’ is often used the first hospital in East Africa to be awarded ISO to describe such a place, often giving European/ 9001:2000 certification for conforming fully to the US-based insurance companies a false impression International Quality Assurance standards for all clinical, of the facilities on offer to the injured. After that, the diagnostics and administration and support services requirement will come to move the patient/client to of the hospital. The certificate is dependent on somewhere with better facilities for treatment and/ comprehensive checks and regular surveillance visits. or recovery. A ward bed at the privately-run hospital in Nairobi Within Kenya, only a handful of organisations are costs $250 a day. A private room will cost $330 a involved in the provision of emergency medical day and an ICU bed around $356 a day. Executive services (EMS). Of these, the specialised insurance rooms are also available. providers cater only for their members, while Other private hospitals have similar rates and the public service providers such as St John’s payment procedures. The Diani Beach hospital in Ambulance are poorly funded and under-equipped. Mombassa accepts payments in Kenyan Shillings, On the African continent, professional air sterling or US dollars. It also accepts Visa and ambulance services are still scarce, with only a Mastercard and travellers cheques. Payment by handful of providers operating out of South, West these methods, though, is only required if an and East Africa.

www.itij.co.uk 42 ASSISTANCE&HEALTHCAREWORLDMARKETS

By far the most serious and common reason for medical evacuation is road traffic accidents

and American medical insurance and air ambulance companies’. “We can get their clients out of trouble quickly and safely and bring them straight to Nairobi’s modern health facilities and then, if need be, help send them home or transfer to a specialised centre elsewhere,” commented Dr Vadera. Assistance services are mainly provided to international insurance and assistance companies. Acting as their local agent, AMREF Flying Doctors liaises with hospitals and medical consultants on behalf of the insurance company; places payment guarantees where required; and is able to arrange

accommodation, air tickets, ground transport and Communication and infrastructure other services for insured clients, including funeral Ordinary fixed-line telephones are simply not available assistance and the repatriation of human remains. in most areas and to most people, and even in urban Where necessary, the company works through or semi-urban areas work poorly. People in Europe professional sub-contracted service providers may find it hard to imagine having to dial 10 or 15 like travel agencies or transport companies. Such times to make a call go through. Or maybe that a call assistance services are provided against a file fee. will never be made, if the lines have been stolen. From a local organisation specialising in bush airstrips It is still true, however, that the poor communications and evacuations from remote areas to Nairobi, the infrastructure often delays the start of evacuation EURAMI-accredited AMREF Flying Doctors service efforts. Recently, a light aircraft carrying three tourist now uses 10 aircraft – three Citation Bravo jets, passengers to Tanzania to a game lodge crashed in all fitted with twin LifePort stretcher systems; four high winds. The crash was seen by another aircraft, Beechcraft King Air B200 aircraft; and three Cessna whose pilot alerted the Tanzania air authorities; they Caravan 208B’s, allowing for safer evacuations over in turn contacted the Kenya Airports Authority, who both short and longer distances. then called AMREF Flying Doctors to assist. This chain of communication, though rather tortuous, did

International Travel Insurance Journal ASSISTANCE&HEALTHCAREWORLDMARKETS 43

work, but it was slow, and the air ambulance was lucky to be able to take off with just enough time to land near the crash site in the last of the daylight. Outside the main cities, airstrips are often minimally equipped, and often in very poor condition. AMREF Flying Doctors maintains its own database of information on many hundreds of bush airstrips, so that if called to one they know that, for example, the bush grows close to the strip and they may need the high-winged Caravan to be able to land; or that last time there were numerous potholes that the local community was asked to repair and that this must be checked before flying in again. Almost none of these airstrips have any radio communication or lighting; most even lack a windsock. The Tanzania air-crash rescue Nairobi boasts two of the best private mentioned above required landing on just such a bush airstrip. As hospitals north of Johannesburg and the evacuation flight had only set out in the afternoon, by the time acts as a primary evacuation centre the patients had been given first treatment and were ready for take- for the United Nations staff who off to Nairobi, night had fallen and the airstrip was completely dark. operate in other zones The pilot had, however, arranged for some vehicles to come to the airstrip, and was satisfied that he could take off safely in the light

from the headlights. All went well and the passengers were in their hospital beds in Nairobi before companies contract other agents to assist and follow midnight. up their clients locally. Some agents do not know of the high standards of care that are available within the country, or are not aware of the difficulties that Travel insurance are inherent in operating in Africa. They may not Another important market for evacuation services appreciate the time constraints that can exist when and subscription products is the tourist industry in the evacuation of a seriously ill client has to be East Africa. For the last four years, Kenya alone has considered. Some of the policies do not provide hosted over one million tourists every year. sufficient funds to cover the cost of evacuation, The majority of visitors will carry some form of hospitalisation or repatriation. It could be argued medical insurance or travel assistance cover, which that it is up to the customer to arrange sufficient is for the most part arranged through their travel coverage. But it could also be pointed out that it agent. (Although it is still surprising how many people is up to the agent to realise how expensive such launch themselves off in to the third world without facilities can be and to ensure the client is given the a care or thought for the ‘what if?’) Subsequently, best possible advice and support. business travellers and tourists to Kenya in need of air evacuation or repatriation to their home countries are A question of time usually covered as part of their travel insurance policy. In one incident, a family based in the Chyulu Hills The travel insurance industry in Kenya works – some six hours by dusty, poor quality road from through a network of appointed service providers Nairobi – called AMREF’s 24-hour Emergency and compensates on a fee-for-service basis. As Control Centre. Their child, aged three and a half, an extended service, insurance and assistance had been vomiting with diarrhoea for two days,

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and some locally obtained medication had in East Africa are situated in remote regions not produced any result. By the middle and provide limited medical facilities, AMREF of the third day the child was drowsy Flying Doctors were an ideal attribute to the and lethargic, and could take no fluids. existing safari tours in Kenya, Tanzania and The family realised that she must be Zanzibar. AMREF’s control centre administers taken to Nairobi immediately. The long communication and overall logistics. Its doctors and uncomfortable road journey would and nurses are on call around the clock.” be too slow, so they requested an air The Kenyan Government has also realised ambulance. the importance of working with the tourist While the flight was being prepared, the industry and officially implemented a Tourist family’s insurer in Europe was contacted Crisis Response Committee, which meets both and the usual procedures were set in regularly and on demand to co-ordinate and motion. By mid-afternoon in Kenya, control actions and reactions to any incident the child was now unresponsive, and that affects the travelling public. It includes unfortunately so were the insurers representatives from the Tourist Police Unit, the – they promised that the case ‘was travel and tourist industry, the Kenya Wildlife being reviewed’, but no decision was Service, the Kenya Tourist Board and the Kenyan forthcoming. The pilot finally stated that Tourist Federation – who unless the flight took off within 20 minutes also run a 24-hour tourist it would have to be delayed until the next emergency response system. morning. The sheer size of Kenya At this point, the family decided that can present problems. It is action was essential and offered their own a country still blessed with guarantee for the flight payment. The aircraft huge tracts of land where took off and collected the small patient and there are no towns, cities, her family. On arrival at the Nairobi hospital or facilities such as fuel it turned out that the parents’ instinct had supplies, and the planning of been right – their child had a serious gastro- The private each trip requires detailed intestinal infection and could easily have died local knowledge. It has to be in the night if they had not had her flown health sector always borne in mind that to Nairobi for treatment. There had been if things do not work out as more good news: about half way to Nairobi caters mainly expected, there are few or the pilot was able to tell the parents that no support facilities to help the insurer had called and that he was now for the wealthy, put things right. But it’s a authorised to take off. great place to live, work and have a holiday! n Pre-planning the tourists and Progressive thinking by the more astute With special thanks to Sean safari companies can help to maintain the the expatriate Culligan and Robert Bailey. support and feeling of comfort required by travellers. One example of pre-planning community Photos courtesy of AMREF.

and use of local resources comes from a recent scheme set up by Private Safaris, the business unit Although born in the UK, Sean Culligan of Kuoni Destination Management in Africa and one was brought up in New Zealand, moving back of the continent’s leading destination management to the UK to complete his education. He joined companies. A plan by Private Safaris to increase clients’ the Royal Air Force, leaving as a Squadron safety while on a safari resulted in the decision to go Leader after 15 very interesting years. He came into partnership with AMREF Flying Doctors. The to Kenya over 12 years ago, and has worked in goal was to facilitate medical emergency care and aviation both large and small since then. Sean evacuation services to all of its clients. has been with the Flying Doctors for over five Thomas Iten, executive director for Private years, handling international repatriations and Safaris East Africa commented, “The provision of the logistics this medical package met the high international of the longer emergency care standards set by Private Safaris for distance their clients. Given that many tourist destinations evacuation flights, as well Correction as marketing. Customer Care Pty is a member of International He finds it the Assistance Group, not Insurance Australia Group, most rewarding as was mistakenly printed in the last issue of ITIJ. and satisfying Ace Assistance is Customer Care and is no longer job he has ever the sister company of Covermore Insurance. had.

International Travel Insurance Journal

46 PROFILE Apps-olute commitment ndrew Apps, director at ALC Health, has venture German-Russian medical insurance company had a long and eventful career in the medical out of St Petersburg. What did I learn? Well, quite Ainsurance industry, and he still has a genuine simply, you need to get to know your market; don’t fervour for what he does. ITIJ recently spoke to him take everything you hear as being necessarily correct; about market development, making a difference in and the friends you make, stay with you. Russia and a new-found passion for running How did you come to your current role? Where were you born, where did you study, and I’ve been involved in the medical insurance industry where do you live now? now for some 28 years, the past 18 in the international A native of Middlesex in the UK, I went to an arena and I still enjoy almost every minute. It’s become independent school in North London, followed by a passion for me and one that never ceases to amaze Middlesex University where I studied for a degree on every level. The call to join Sarah Jewell and her in Graphic Design; hence the annoyance I cause colleagues at ALC Health came somewhat out-of-the- it re-occur. On the other side, short-term travellers to cancer care where there continues to be a great for those around me when it comes to styling new blue, and whilst I am still the ‘new boy’, I already feel sometimes over insure buy buying an IPMI product deal of misunderstanding as to what is and is not products and literature. For the past 20 years, I have very much a part of a great team. when a straight forward travel policy would suffice. covered between the various IPMI companies. been living in the beautiful West Sussex countryside We live in an electronic age and for many expatriates, having given up on the big-city rat race. Is the line between health insurer and travel insurer What are the top three qualities that travel insurers the Web is their window on the world and their main becoming increasingly blurred? look for in an assistance partner? route to keeping in touch with family and friends. With What was your first job and how did you come to Most IPMI providers already offer some degree of It is imperative that the assistance service takes time the Web increasingly seen as the principle source of work in the insurance industry? travel insurance cover either as an integral part of to understand what is going on in any given case. It information about what’s happening both locally and I started off working for a telesales marketing company their existing product range or as an optional add-on, may seem an obvious statement, but the policyholder internationally, so the importance of the Web to IPMI called Computacar (I can still hear their telephone but nonetheless travel cover tends to be treated very needs our help, is looking for efficient support and in providers is fast becoming a major development area. number ringing in my ears!), so appreciate the thankless much as an accommodation benefit rather than a many cases someone to talk to who really cares about Watch out for more innovation in the years to come task of cold-calling. How I managed to get into the product range in its own right. And with the current their situation. It’s not rocket science, but if you get it and expect much more online capabilities. medical insurance industry involved a bottle of wine and difficulties being faced by the travel insurance industry right at this point, the whole claims journey becomes the promise of a company car. It’s a long story . . . where the numbers are been squeezed on many that much easier and you’ll often end up with a happy, If you could do any other job in the world other different levels, this is unlikely to change. satisfied client who becomes one of your greatest fans. than the one you do now, what would it be? Can you tell us a little about your time in Russia? One of the issues facing both the travel and Now this is a difficult one. I guess it would have to be Working in Russia in the mid-90s was a time of great IPMI markets is the buying public sometimes How does your company ensure it offers access something artistic. Not with a brush, as I can’t paint to change and one that I will always remember. A little misunderstanding of when to buy travel insurance to the best possible medical provision no matter save my life, but perhaps something that involves wood. like the ‘Wild West’ must have been, where nothing and when to buy IPMI cover. Too often, long-term where in the world you client is? I have always been fascinated by the skills of a master stayed the same and what may have been true one day expatriates think that they can save on their premium The world is a big place and being able to know carpenter in being able to create something so intricate inevitably changed the next, so you could never take costs by buying a travel policy rather than an IPMI what’s going on everywhere simply isn’t possible, so out of a block of timber. The question would be, is anything for granted. I was initially involved in trailblazing product not realising that after making a claim, the it’s important to have strong partners on the ground. whether I have the patience or even the aptitude! reinsurance treaties for the region, and as the market medical event becomes a pre-existing condition and Using the extensive knowledge started to develop was involved in establishing a joint is often no longer eligible for future benefit should and experience of your assistance What motivates you? provider is paramount, but so is One of the issues Well, it has to be a job well done building your own expertise in your facing both the and to hear that simple phrase key markets. At ALC Health we ‘Thank you’ when things go right or spend a considerable amount of travel and IPMI a problem has been sorted out. It time travelling to where our clients markets is the buying really does make all the difference are based so that we can better and makes it all worthwhile. understand the issues that they face public’s sometimes every day and have recently (1 May) What are you most proud added a new online member service misunderstanding of of – both personally and in conjunction with HTH Worldwide, when to buy travel professionally? providing extensive information on Personally, it’s being married. My the very best medical services and insurance and when to wife still manages to put up with resources from across the globe. buy IPMI cover my travelling; and on a professional level, it would be the time I spent in ALC has an office in Spain, where Tbilisi (Georgia) helping to establish healthcare facilities have a reputation for paying IMEDI-L, the country’s first JV insurance company. An holiday representatives to steer patients their way. amazing time when I met some wonderful people, Why was this location chosen for a second office, experienced some interesting times and, in a small way, and how does ALC avoid the problem of ‘directional helped to make a difference. care’? We chose Spain as our Southern European centre What do you enjoy doing in your spare time? because of its proximity to three of our most At the moment, I’m in training to take part in a couple successful markets, namely Portugal, Gibraltar and, of half-marathons later this year. I ran both the Great of course, Spain itself. By being on the ‘ground’ we North and Great South last year vowing never to do have been able to not only establish and continue to anything quite so stupid again, but something went grow our business in the region, but to ensure that we wrong. When I’m not running (more like a jog), I’m avoid the pitfalls of ‘directional care’ so often seen by out shooting clays, usually with a group of industry travel insurers. colleagues, taking the odd picture (another new hobby !) or reading some spy novel (usually on an aeroplane) What other trends have you seen in the IPMI and listening to late-70s west coast American music market in recent times and where do you see these such as Steely Dan, Chicago and Supertramp (now I’m markets heading in the near future? really showing my age!). Unlike many domestic health insurance markets, IPMI has not been badly affected by the economic If you were having a ‘dream’ dinner party, who downturn of the past 18 months, and for many would be there – and what would you eat? insurers business has in fact grown as an increasing Where do I start? Any dinner party would need to number of governments have started to move have an eclectic group to make it fun but interesting, towards making medical insurance compulsory for and would include Lord Sugar (business), Jamie Oliver expatriate residents. IPMI product innovation is still (he can do the cooking) Tom Clancy (author), Alex in its infancy with most advances being limited to Guinness (actor), Jack Dee (comedian) and Alastair Sim ‘lifestyle’ cover such as health screening, vaccinations (50s actor). Whether this group would get on together and optical care, but there is without doubt a need to is anyone’s guess though. As for the food, something bring in some form of standardisation when it comes traditional like a good English Sunday roast.

International Travel Insurance Journal CATEGORY KEY CLAIMS MANAGEMENT INSURERS AIR AMBULANCE CLAIMS SUBROGATION MEDICAL ESCORT ON COMM. AIRLINE AIR AMBULANCE INTERIOR COMMERCIAL REPAT 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 48 SERVICEDIRECTORY To have your company listed in the Service Directory email: [email protected]

Air Ambulance International ) CareFlight International Mr Peter Veazey – CEO Paul Smith – National Manager P.O. Box 1044, Magnolia. Texas 77353, USA Westmead Hospital Campus, PO Box 159, Westmead, NSW 2145, AUSTRALIA

tel: +1 832 934 2390 email: [email protected] tel: (+61) 2 9893 7683 email: [email protected] (AFRICA) fax: +1 832 934 2395 website: www.airambulanceinternational.com fax: +61 2 9689 2744 website: www.careflight.org

Air Ambulance Network European Air Ambulance AUSTRALASIA

Kirk Pacheco – President ( Patrick Schomaker – Director Sales & Marketing AIR AMBULANCE AIR AMBULANCE 905 Martin Luther King Jr Drive, Suite 330, Tarpon Springs, Florida 34689 USA 175A, rue de Cessange, L-1321, LUXEMBOURG

24hr tel: + 1 727 934 3999 email: [email protected] 24hr tel: +49 711 7007 7007 email: [email protected] fax: + 1 727 937 0276 website: www.airambulancenetwork.com fax: +49 711 7007 7009 website: www.air-ambulance.com

AMREF Flying Doctor Service Flying Doctors Asia Dr Bettina Vadera – Medical Director Prithpal Singh – CEO , Director 313 Old Bird Cage Walk, #01-15/02-16, Seletar Airport, Wilson Airport, LangataRoad, PO Box 18617, Nairobi, KENYA SINGAPORE tel: +254 20 6000 090 email: [email protected] 24hr tel: +65 9297 7757 email: [email protected] fax: +254 20 344 170 website: www.amref.org fax: +65 6483 5407 website: www.flyingdoctorsasia.com

European Air Ambulance Hope Ambulance Service Patrick Schomaker – Director Sales & Marketing Dr Charles Johnson – Medical Director 175A, rue de Cessange, L-1321, LUXEMBOURG 56 Upavon Road, Singapore 507745, SINGAPORE

24hr tel: +49 711 7007 7007 email: [email protected] tel: +65 6100 1911 email: [email protected] fax: +49 711 7007 7009 website: www.air-ambulance.com fax: +65 6400 5254 website: www.hopeambulance.com

JET ICU JET ICU Mike Honeycutt – President Mike Honeycutt – President 2561 Rescue Way, Brooksville, FL 34604, USA 2561 Rescue Way, Brooksville, FL 34604, USA

tel: +1 352 796 2540 email: [email protected] tel: +1 352 796 2540 email: [email protected] fax: +1 352 796 2549 website: www.jeticu.com fax: +1 352 796 2549 website: www.jeticu.com

Netcare 911 Aeromedical Medical Wings Wayne Thomson – Flight Operations Manager Dr Sommart Somsiri – Medical Director 222 Room 3259, Donmuang Int Airport Moo 10, Viphavadee-Rangsit Rd, Sikan, Riverview Park, Janadel Avenue, Midrand, SOUTH AFRICA Don Muang, Bangkok 10210, THAILAND tel: +27 10 209 8387 email: [email protected] tel: +662 247 3392 email: [email protected] fax: +27 10 209 8405 website: www.netcare911.co.za fax: +662 535 4355 website: www.medicalwings.com

Skyservice Air Ambulance Ozevac David Ewing – VP International Market Development Anne Mordey – Operations Manager YUL/Trudeau Int Airport, 9785 Avenue Ryan, Montreal (Quebec), H9P 1A2, PO Box 299, Hampton, Victoria 3188, AUSTRALIA CANADA tel: +1 514 497 7000 email: [email protected] tel: +61 409 537 333 email: [email protected] fax: +1 514 636 0096 website: www.skyservicebas.com/airambulance fax: website: www.ozevac.com

) Air Ambulance International Skyservice Air Ambulance Mr Peter Veazey – CEO David Ewing – VP International Market Development YUL/Trudeau Int Airport, 9785 Avenue Ryan, Montreal (Quebec), H9P 1A2, P.O. Box 1044, Magnolia. Texas 77353, USA CANADA tel: +1 832 934 2390 email: [email protected] tel: +1 514 497 7000 email: [email protected] fax: +1 832 934 2395 website: www.airambulanceinternational.com fax: +1 514 636 0096 website: www.skyservicebas.com/airambulance

Air Ambulance Network South Pacific Air Ambulance AUSTRALASIA ( Kirk Pacheco – President Scotty Watson – Managing Director 905 Martin Luther King Jr Drive, Suite 330, Tarpon Springs, Florida 34689 USA NEW ZEALAND AUSTRALIA SINGAPORE

24hr tel: + 1 727 934 3999 email: [email protected] tel: +64 9256 9000 email: [email protected] fax: + 1 727 937 0276 website: www.airambulancenetwork.com fax: +64 9256 9111 website: www.spaa.co.nz

AirMed International LLC ADAC-Ambulance Service Jeffrey T Tolbert – President Robert Glueck – Marketing & Sales Director Airport World Trade Center, 1 Sky Plaza Road, Am Westpark 8, 81373 Munich, GERMANY Hong Kong International Airport, HONG KONG

tel: +852 3756 3680 email: [email protected] (EUROPE) tel: +49 89 76 76 52 85 email: [email protected] fax: +852 3756 3681 website: www.airmedasia.com 24h Alarm: +49 89 76 76 50 05 website: www.adac.de/ambulance

CareFlight Group Air Ambulance International Medical and Tasking Centre Mr Peter Veazey – CEO PO Box 5078, Robina Town Centre, Queensland, 4230 AUSTRALIA P.O. Box 1044, Magnolia. Texas 77353, USA

24hr tel: +61 7 5553 5955 email: [email protected] tel: +1 832 934 2390 email: [email protected] fax: +61 7 5553 5914 website: www.cmsairambulance.com fax: +1 832 934 2395 website: www.airambulanceinternational.com

CATEGORY KEY CLAIMS MANAGEMENT INSURERS Air Ambulance Network AIR AMBULANCE CLAIMS SUBROGATION MEDICAL ESCORT ON COMM. AIRLINE Kirk Pacheco – President AIR AMBULANCE INTERIOR COMMERCIAL REPAT SPECIALISTS MEDICAL PROVIDER AIRCRAFT PERFORMANCE SOLUTIONS CRITICAL CARE PATIENT TRANSPORT MEDICAL SCREENING 905 Martin Luther King Jr Drive, Suite 330, Tarpon Springs, Florida 34689 USA ASSISTANCE COMPANIES FUNERAL DIRECTORS RE-INSURANCE [email protected] CATASTROPHIC CLAIMS SPECIALIST HEALTHCARE CLINICS TRAVEL AGENTS 24hr tel: + 1 727 934 3999 email: fax: + 1 727 937 0276 website: www.airambulancenetwork.com COST CONTAINMENT HOSPITALS WEB & DESIGN SERVICES call +44 (0) 117 925 5151 To make an alteration to a listing email: [email protected] SERVICEDIRECTORY 49 ) Air Medical Ltd ) JET ICU Glenn Salt – Flight Operations Manager Mike Honeycutt – President Oxford Airport, Kidlington, Oxfordshire OX5 1QX, UK 2561 Rescue Way, Brooksville, FL 34604, USA

tel: +44 1865 842 887 email: [email protected] tel: +1 352 796 2540 email: [email protected] EUROPE EUROPE ( tel: +44 1865 370 642 website: www.airmed.co.uk ( fax: +1 352 796 2549 website: www.jeticu.com

AirMed International LLC Mayoral Executive Jet Jeffrey T Tolbert – President Paulo Vassar – Commercial Director AIR AMBULANCE AIR AMBULANCE 1000 Urban Center Drive, Suite 470, Birmingham, AL 35242, USA Dominguez Toledo S.A., 118 La Orotava, Malaga 29006, SPAIN

tel: +1 205 443 4840 email: [email protected] tel: +34 952 048 609 email: [email protected] fax: +1 205 443 4841 website: www.airmed.com fax: +34 924 048 612 website: www.mayoralexecutivejet.com

Augsburg Air Ambulance Medic’Air International Roland Schoberth – Director Dr Herve Raffin – General Manager Roseggerstr 17, D-86368, Gersthofen, GERMANY 35 rue Jules Ferry, 93170 Bagnolet, Paris, FRANCE

tel: +49 821 299 1020 email: [email protected] tel: +33 141 72 1414 email: [email protected] tel: +49 821 299 2030 website: www.ambulanzflugdienst.de fax: +33 148 57 1010 website: www.medic-air.com

Capital Air Charter Medilink International Air Ambulance Lisa Humphries – Sales Director Martin Farrugia – Business Development Manager NEW Exeter International Airport, EX5 2BD, UK 99 Mill Street, Qormi, QRM 3100, MALTA NEW

tel: +44 845 055 2828 email: [email protected] tel: +356 2278 5400 email: [email protected] fax: +44 1392 350 039 website: www.capitalaircharter.co.uk fax: +356 2278 5700 website: www.mi-aa.com

European Air Ambulance North Flying a/s Patrick Schomaker – Director Sales & Marketing Jesper Kragelund – Sales Manager 175A, rue de Cessange, L-1321, LUXEMBOURG North Flying Terminal, Aalborg Airport, DK-9400, Nørresundby, DENMARK

24hr tel: +49 711 7007 7007 email: [email protected] tel: +45 9632 2900 email: [email protected] fax: +49 711 7007 7009 website: www.air-ambulance.com fax: +45 9632 2909 website: www.northflying.com

Euro Link Air Ambulance Redstar Aviation Dr. Friedrich Renner – Medical Director Mustafa Atac – CEO Putzbrunner Str. 114, 81739, München, GERMANY Sabiha Gokcen International Airport, J Blok Kurtkoy, 34912 Istanbul, TURKEY

24hr tel: +49 89 613 72103 email: [email protected] tel: +90 216 588 0216 email: [email protected] fax: +49 89 613 72106 website: www.FlyEuroLink.de fax: +90 216 588 0225 website: www.redstar-aviation.com

FAI – rent-a-jet AG Skyservice Air Ambulance Volker Lemke – Director Sales & Marketing David Ewing – VP International Market Development YUL/Trudeau Int Airport, 9785 Avenue Ryan, Montreal (Quebec), H9P 1A2, Flughafenstrasse 100, D-90268 Nuremberg, GERMANY CANADA tel: +49 911 36009 31 email: [email protected] tel: +1 514 497 7000 email: [email protected] fax: +49 911 36009 59 website: www.rent-a-jet.de fax: +1 514 636 0096 website: www.skyservicebas.com/airambulance

DRK Assistance Swiss Air Ambulance / Rega Andreas Speich – Managing Director Peter Meierhans – Director of Sales Aufm Hennekamp 71, 40225 Düsseldorf, GERMANY PO Box 1414, Zurich Airport, CH-8058, SWITZERLAND

tel: +49 211 2711 2020 email: [email protected] tel: +41 333 333 333 email: [email protected] fax: +49 211 3018 0527 website: www.drkassistance.com fax: +41 44 654 3590 website: www.rega.ch

Greek Flying Doctors Tyrol Air Ambulance Dimitris Kanellis – Manager Jakob Ringler – Managing Director 3 Doukisis Plakentias Str, 152 34 Halandri, Athens, GREECE PO Box 81, A-6026, Innsbruck Airport, AUSTRIA

tel: +30 210 674 0600 email: [email protected] tel: +43 512 224 220 email: [email protected] fax: +30 210 674 0634 website: www.greekflyingdoctors.gr fax: +43 512 288 888 website: www.taa.at

IAS Medical Aerojet George Ditchburn – Operations Manager Stuart Hayman – President NEW 145-157 St John Street, London, EC1V 4PY, UK 4631 NW 31st Avenue, #220 Ft Lauderdale, FL 33309, USA

tel: +44 870 042 1465 email: [email protected] tel: +1 954 730 9300 email: [email protected] fax: +44 870 042 1480 website: www.iasmedical.com fax: +1 954 485 6564 website: www.aero-jet.com

IFRA Air Ambulance International Dr Christian Steindl – Director Mr Peter Veazey – CEO

Bahnhofplatz 13/5, POB 160, 3500 Krems, AUSTRIA (NORTH AMERICA) P.O. Box 1044, Magnolia. Texas 77353, USA

tel: +43 2732 825 610 email: [email protected] tel: +1 832 934 2390 email: [email protected] fax: +43 2732 851 01 website: www.ifra.at fax: +1 832 934 2395 website: www.airambulanceinternational.com

Jet Executive International Charter Air Ambulance Network Dennis Stoffel – Ground Operations Manager Kirk Pacheco – President Mündelheimer Weg 50, D-40472, Düsseldorf, GERMANY 905 Martin Luther King Jr Drive, Suite 330, Tarpon Springs, Florida 34689 USA “Homebase FRA & MUC” tel: +49 211 602 7775 email: [email protected] 24hr tel: + 1 727 934 3999 email: [email protected] fax: +49 211 602 77766 website: www.jetexecutive.com fax: + 1 727 937 0276 website: www.airambulancenetwork.com 50 SERVICEDIRECTORY To have your company listed in the Service Directory email: [email protected]

Air Ambulance Professionals, Inc. ASISTUR Brian L. Weisz – President Emilio Guevara – Managing Director Ft. Lauderdale Executive Airport, 1535 South Perimeter Rd, Prado 208, e/ Colon y Trocadero, Habana Vieja, Ciudad Habana 10100, CUBA Hangar 36B Ft. Lauderdale, Florida 33309, USA tel: +1 954 491 0555 email: [email protected] tel: +537 8664499 email: [email protected] fax: +1 954 491 6114 website: www.airambulanceprof.com fax: +537 8668087 website: www.asistur.cu (AMERICAS) AirMed International LLC Emergency Assistance North America Inc. Jeffrey T Tolbert – President Jaime Perez – Operations Manager AIR AMBULANCE

(NORTH AMERICA) 1000 Urban Center Drive, Suite 470, Birmingham, AL 35242, USA 580 St. Andrews Pl., West Vancouver, B.C., V7S 1V8 CANADA

tel: +1 205 443 4840 email: [email protected] tel: + 1 604 922-4443 email: [email protected] fax: +1 205 443 4841 website: www.airmed.com fax: +888 572-9956 website: www.eanorthamerica.com ASSISTANCE COMPANIES ASSISTANCE European Air Ambulance Global Excel Management Patrick Schomaker – Director Sales & Marketing Michael Drew – Vice-President Sales 73 Queen Street, Sherbrooke, QC J1M 0C9, CANADA 175A, rue de Cessange, L-1321, LUXEMBOURG 17548 Deer Isle Circle, Winter Garden, FL 34787 USA 24hr tel: +49 711 7007 7007 email: [email protected] tel: +1 866 566 1130 email: [email protected] fax: +49 711 7007 7009 website: www.air-ambulance.com fax: +1 819 566 8335 website: www.globalexcel.ca

Global Jetcare, Inc. On Call International Bart Gray – President Michael J. Kelly – President & CEO 16479 Runway Drive, Brooksville, FL 34604, USA One Delaware Drive, Salem, NH 03079, USA

tel: +1 352 799 7771 email: [email protected] tel: + 888 289 0567 email: [email protected] fax: +1 352 799 7776 website: www.globaljetcare.com fax: +1 603 328 1770 website: www.oncallinternational.com

JET ICU OneWorld Assist Mike Honeycutt – President Taka Katsube – Director Assistance & Cost Managment 2561 Rescue Way, Brooksville, FL 34604, USA 10th Floor, 6081 No.3 Road, Richmond, BC V6Y 2B2, CANADA

tel: +1 352 796 2540 email: [email protected] tel: +1 604 303 2113 email: [email protected] fax: +1 352 796 2549 website: www.jeticu.com fax: +1 604 276 4593 website: www.oneworldassist.com

Skyservice Air Ambulance SelectCare Worldwide David Ewing – VP International Market Development Magdi Riad – President YUL/Trudeau Int Airport, 9785 Avenue Ryan, Montreal (Quebec), #1201, 438 University Avenue, Toronto M5G 2K8, CANADA H9P 1A2, CANADA tel: +1 514 497 7000 email: [email protected] tel: +1 416 340 7265 email: [email protected] fax: +1 514 636 0096 website: www.skyservicebas.com/airambulance toll free: +1 866 261 6718 website: www.selectcareworldwide.com

AIMS TMCA - Travel Medical Casualty Assistance Bernadette Breton – Managing Director Margaret Wharton – VP Travel Division Private Bag X5, Benmore Gardens 2010, Johannesburg, SOUTH AFRICA 217 Broadway suite 600, New York NY 10007, USA

tel: +27 11 83 228 7804 email: [email protected] tel: +1 212 964 8580 email: [email protected] (AFRICA) fax: +27 11 82 323 7553 website: www.aims.org.za fax: +1 212 406 1520 website: www.tmcatravel.com

AMREF Flying Doctor Service Asia Assistance Partners Dr Bettina Vadera – Medical Director Siriporn Wongurai – International Operations Director 184/235 Forum Tower, 36 Flr Ratchadapisek Rd Huaykwang, Bangkok 10320, Wilson Airport, Langata Road, PO Box 18617, Nairobi, KENYA THAILAND tel: +254 20 6000 090 email: [email protected] tel: +662 645 3733-5 email: [email protected] fax: +254 20 344 170 website: www.amref.org fax: +662 645 3732 website: www.aapartners.net ASSISTANCE COMPANIES ASSISTANCE Interhealth Technologies Assistance Online (AUSTRALASIA) Kevin Thomas – Director - International Bertrand Guichoux – CEO P O Box 3058, Bedfordview 2008, SOUTH AFRICA Zendai Cube Edifice 6/F, 58, Changliu Road, Pudong, 200135 Shanghai, CHINA

tel: +27 11 622 8010 email: [email protected] tel: +86 21 6104 9500 email: [email protected] fax: +27 11 622 8264 website: www.interhealth.net fax: +86 21 6104 9484 website: www.assistanceonline-china.com

Netcare 911 International Assistance Customer Care Pty Ltd Brenda Durow – International Assistance Manager Janine Benson – Operations Manager Riverview Park, Janadel Avenue, Midrand, SOUTH AFRICA Level 3, 60 Miller Street, North Sydney 2060, NSW, AUSTRALIA

tel: +27 10 209 8387 email: [email protected] tel: +612 9202 8222 email: [email protected] fax: +27 10 209 8405 website: www.netcare911.co.za fax: +612 9202 8220 website: www.customercare.com.au

West African Rescue Association First Assistance Florian Zagel – Managing Director Mary-Jo McDonald – General Manager Klotey Cresent 6, North Labone, Accra, GHANA PO Box 17-310, Greenlane, Auckland, NEW ZEALAND

tel: +233 244 312 496/7 email: [email protected] tel: +64 9 356 1650 email: [email protected] fax: +233 21 781 259 website: www.westafrican-rescue.com fax: +64 9 525 1278 website: www.firstassistance.co.nz

CATEGORY KEY CLAIMS MANAGEMENT LEGAL SERVICES Global Assistance & Healthcare AIR AMBULANCE CLAIMS SUBROGATION MEDICAL ESCORT ON COMM. AIRLINE AIR AMBULANCE INTERIOR COMMERCIAL REPAT SPECIALISTS MEDICAL PROVIDER Mario Babin – Chief Executive Officer AIRCRAFT PERFORMANCE SOLUTIONS CRITICAL CARE PATIENT TRANSPORT MEDICAL SCREENING Jalan Pattimura, 15 Kebayoran Baru, Jakaita, 12110, INDONESIA ASSISTANCE COMPANIES FUNERAL DIRECTORS RE-INSURANCE CATASTROPHIC CLAIMS SPECIALIST HEALTHCARE CLINICS TRAVEL AGENTS tel: +62 21 725 8115 email: [email protected] COST CONTAINMENT HOSPITALS WEB & DESIGN SERVICES fax: +62 21 725 7961 website: www.global-assistance.net call +44 (0) 117 925 5151 To make an alteration to a listing email: [email protected] SERVICEDIRECTORY 51

South Pacific Air Ambulance Savitar Scotty Watson – Managing Director Lydia Semchenkova – Business Development Manager NEW ZEALAND AUSTRALIA SINGAPORE 25/1, 7th Floor, Trubnaya Str., Moscow, 127051, RUSSIA

tel: +64 9256 9000 email: [email protected] tel: +7 495 987 1775 email: [email protected]

fax: +64 9256 9111 website: www.spaa.co.nz (EUROPE) fax: +7 495 987 1776 website: www.savitar-gr.com (AUSTRALASIA) ADAC-Ambulance Service SOS International Robert Glueck – Marketing & Sales Director Helle Drager Sandahl – Communications & Marketing Manager Am Westpark 8, 81373 Munich, GERMANY Nitivej 6, DK-2000 Frederiksberg, Copenhagen, DENMARK

(EUROPE) tel: +49 89 76 76 52 85 email: [email protected] tel: +45 7010 5055 email: [email protected] 24h Alarm: +49 89 76 76 50 05 website: www.adac.de/ambulance fax: +45 7010 5056 website: www.sos.eu ASSISTANCE COMPANIES ASSISTANCE Altas Assistance COMPANIES ASSISTANCE TBS Team 24 d.o.o Arvydas Bebravi˘cius – Managing Director Edvard Hojnik – General Manger Lentvario Str. 7, Lt-02300 Vilnius, LITHUANIA Ljubljanska Ulica 42, 2000 Maribor, SLOVENIA

tel: +370 5 264 4020 email: [email protected] tel: +386 2618 2301 email: [email protected] fax: +370 5 264 4021 website: www.altas-assistance.lt fax: +386 2618 5800 website: www. tbs-team24.com

AP Companies CONNEX Assistance Middle East Natalya Butakova – Business Development Manager Lara Helmi – International Network Director str. 9, dom 5/7, ul. Nizhnyaya Syromyatnicheskaya, Moscow 105120, RUSSIA Office 703, Block B, Belrasheed Towers, Qusais, Dubai, UAE

tel: +7 495 989 1120 email: [email protected] tel: +97 14 257 82 84 email: [email protected] fax: +7 495 989 1130 website: www.ap-companies.ru fax: +97 14 257 82 85 website: www.connexassistance.com (MID. EAST) (MID.

ARC Europe SA Dr Colin Plotkin Consulting Hans Biekmann – Network Director Dr Colin Plotkin – Managing Director Avenue des Olympiades 2, 1140 Brussels, BELGIUM 27-3088 Francis Road, Richmond, British Columbia V7C 5V9, CANADA

tel: +32 2 706 6660 email: [email protected] tel: +1 604 241 9677 email: [email protected] fax: +32 2 706 6601 website: www.arceurope.com fax: +1 604 241 0733 website:

CNAS To have your company listed in our service directory Carole Luisy – Managing Director CATASTROPHIC 80 rue des alliés, 38100, Grenoble, FRANCE contact the sales department now:

tel: +33 438 49 83 49 email: [email protected] CLAIMS SPECIALISTS [email protected] or telephone: +44 (0)117 922 66 00 fax: +33 438 49 83 40 website: www.cnas-assistance.com

Global Assistance a.s. AIMS Petr Bold – General Manager Bernadette Breton – Managing Director Dopraváku˚ 749/3,184 00 Prague 8, CZECH REPUBLIC Private Bag X5, Benmore Gardens, 2010 Johannesburg, SOUTH AFRICA

tel: +420 266 799 770 email: [email protected] tel: +27 11 83 228 7804 email: [email protected] fax: +420 266 799 797 website: www.1220.cz (AFRICA) fax: +27 11 82 323 7553 website: www.aims.org.za

Global Voyager Assistance Interhealth Technologies Costas Danilenko – CEO Kevin Thomas – Director - International PO Box II, 125124 Moscow, RUSSIA P O Box 3058, Bedfordview 2008, SOUTH AFRICA COST CONTAINMENT tel: +7 495 775 0999 email: [email protected] tel: +27 11 622 8010 email: [email protected] fax: +7 495 775 0998 website: www.gvassistance.com fax: +27 11 622 8264 website: www.interhealth.net

Greek Flying Doctors ChargeCare International Dimitris Kanellis – Manager Christiane Burniston – Managing Director 3 Doukisis Plakentias Str, 152 34 Halandri, Athens, GREECE Monument Business Park, 1D Park Offices, Warpsgrove Lane, Chalgrove, Oxford, UK

tel: +30 210 674 0600 email: [email protected] tel: +44 1865 400 007 email: [email protected] fax: +30 210 674 0634 website: www.greekflyingdoctors.gr (EUROPE) fax: +44 845 003 9923 website: www.chargecareinternational.co.uk

Marm Assistance Marm Assistance Jill Atac – CEO Jill Atac – CEO Sabiha Gokcen International Airport, J Blok Kurtkoy, 34912 Istanbul, TURKEY Sabiha Gokcen International Airport, J Blok Kurtkoy, 34912 Istanbul, TURKEY

tel: +90 216 588 0588 email: [email protected] tel: +90 216 588 0588 email: [email protected] fax: +90 216 588 0602 website: www.marmassistance.com fax: +90 216 588 0602 website: www.marmassistance.com

med con team GmbH Medical Claims International Spain Michael Weinlich – Managing Director Fatima Guillen Grande – Managing Director Gerhard-Kindler-Str.8, 72770 Reutlingen, GERMANY C/Ciudad de Aguilas No.2, Local 2A, Madrid 28030, SPAIN

tel: +49 7121 433 660 email: [email protected] tel: 00 34 913 016 145 email: [email protected] fax: +49 7121 433 619 website: www.medconteam.com fax: 00 34 913 016 160 website: www.mcimanager.com

Save Assistance France CATEGORY KEY CLAIMS MANAGEMENT LEGAL SERVICES AIR AMBULANCE CLAIMS SUBROGATION MEDICAL ESCORT ON COMM. AIRLINE Franck Molinier – Director of Business Development AIR AMBULANCE INTERIOR COMMERCIAL REPAT SPECIALISTS MEDICAL PROVIDER 19 rue de Provence, 78310 Maurepas, FRANCE AIRCRAFT PERFORMANCE SOLUTIONS CRITICAL CARE PATIENT TRANSPORT MEDICAL SCREENING ASSISTANCE COMPANIES FUNERAL DIRECTORS RE-INSURANCE tel: +33 13062 6752 email: [email protected] CATASTROPHIC CLAIMS SPECIALIST HEALTHCARE CLINICS TRAVEL AGENTS 24 tel: +33 13062 1122 website: www.saveassistance.com COST CONTAINMENT HOSPITALS WEB & DESIGN SERVICES 52 SERVICEDIRECTORY To have your company listed in the Service Directory email: [email protected]

Global Excel Management Star Healthcare Michael Drew – Vice-President Sales Gigi Galen – President 73 Queen St, Sherbrooke, QC J1M 0C9, CANADA 850 7th Avenue, Suite 803, New York, 10019, USA 17548 Deer Isle Circle, Winter Gdn, FL 34787 USA tel: +1 866 566 1130 email: [email protected] tel: + 1 212 581 8228 email: [email protected] fax: +1 819 566 8335 website: www.globalexcel.ca fax: + 1 212 581 8272 website: www.starhealthcarenet.com

Global Medical Management To have your company listed in our service directory Raija Itzchaki – COO

(NORTH AMERICA) 7901 SW 36th Street, Suite 100, Davie, FL 33328, USA contact the sales department now:

tel: +1 954 370 6404 email: [email protected] COST CONTAINMENT [email protected] or telephone: +44 (0)117 922 66 00

fax: +1 954 370 8613 website: www.gmmusa.com CLAIMS MANAGEMENT

Olympus Managed Healthcare MedEscort International Steven Jacobson – CEO Craig Poliner – President 777 Brickell Avenue, Suite PH70, Miami, Florida 33131, USA 1730 Vultee Street, Allentown, PA 18103, USA

tel: +1 305 530 8600 email: [email protected] US tel: +1 610 791 3111 email: [email protected] fax: +1 305 530 0766 website: www.omhc.com fax: +1 610 791 9189 website: www.medescort.com SPECIALISTS OneWorld Assist Voyageur Aeromedical Travel Taka Katsube – Director Assistance & Cost Managment Marc Lucas – General Manager 10th Floor, 6081 No.3 Road, Richmond, BC V6Y 2B2, CANADA Voyageur Buildings, 43 Colston Street, Bristol BS1 5AX, UK

tel: +1 604 303 2113 email: [email protected] tel: +44 (0)117 927 3554 email: [email protected]

fax: +1 604 276 4593 website: www.oneworldassist.com COMM. REPATRIATION fax: +44 (0)117 925 5940 website: www.voyageur24.com

SelectCare Worldwide ADAC Jacques LeTual – Director of Business Development Christoph Ullrich – Director of Purchase / International Network #1201, 438 University Avenue, Toronto M5G 2K8, CANADA Am West Park 8, 81373 Munich, GERMANY

tel: +1 416 340 7265 email: [email protected] tel: +49 89 7676 2912 email: [email protected] toll free: +1 866 261 6718 website: www.selectcareworldwide.com 24hr Alm: +49 89 7676 5005 website: www.adac.de/ambulance TRANSPORT Star Healthcare Lufthansa Medical Services Gigi Galen – President Doris Ehring – Manager Sales & Marketing Lufthansa German Airlines, Lufthansa Base, FRA SX/M, D-60546, 850 7th Avenue, Suite 803, New York, 10019, USA Frankfurt/Main, GERMANY tel: + 1 212 581 8228 email: [email protected] tel: +49 (0)69690-20904 email: [email protected] fax: + 1 212 581 8272 website: www.starhealthcarenet.com fax: +49 (0)69690-58147 website: www.dlh.de CRITICAL CARE PATIENT PATIENT CARE CRITICAL

UnitedHealth International Albin Repatriation Ltd Philip Brun – Vice President of Sales & Service Emerson De Luca – General Manager 3100 SW 145 Avenue, Miramar, FL 33027, USA 83 Westbourne Grove, Bayswater, London W2 4UL, UK

tel: +1 954 378 0694 email: [email protected] tel: +44 20 7313 6920 email: [email protected] fax: +1 954 378 0771 website: www.uhgi.com fax: +44 20 7313 6999 website: www.kenyonrepatriation.com

Global Assistance & Healthcare ANUBIS International Repatriation Mario Babin – Chief Executive Officer Fabrice Kana – Development & Quality Manager Jalan Pattimura, 15 Kebayoran Baru, Jakaita, 12110, INDONESIA Tour Pleyel, 93200 Paris, Saint Denise, FRANCE

tel: +62 21 725 8115 email: [email protected] FUNERAL DIRECTORS tel: +33 149 195 960 email: [email protected] fax: +62 21 725 8951 website: www.global-assistance.net fax: +33 149 471 901 website: www.anubisgroup.org

Global Excel Management Funeral Home AURIGA Ltd. Michael Drew – Vice President of Sales Helen Pradova – Chief of International Department 73 Queen St, Sherbrooke, QC J1M 0C9, CANADA B. Nmcové Street 1052/1, 412 01 Litomerice, CZECH REPUBLIC 17548 Deer Isle Circle, Winter Gdn, FL 34787 USA tel: +1 866 566 1130 email: [email protected] tel: +420 724 257 899 email: [email protected] fax: +1 819 566 8335 website: www.globalexcel.ca fax: +420 416 735 800 website: www.funeral-assistance.cz CLAIMS MANAGEMENT

Interhealth Technologies Funeralcare International Kevin Thomas – Director - International Louisa Killen – Repatriation Specialist P O Box 3058, Bedfordview 2008, SOUTH AFRICA Murray House, 50 Whitta Road, Manor Park, London, Essex E12 5DA, UK

tel: +27 11 622 8010 email: [email protected] tel: +44 20 8788 5303 email: [email protected] fax: +27 11 622 8264 website: www.interhealth.net fax: +44 20 8788 2525 website: www.co-operativefuneralcare.co.uk

SelectCare Worldwide Global Networks Funeral Assistance Jacques LeTual – Director of Business Development Cristina Almudi – Managing Director #1201, 438 University Avenue, Toronto M5G 2K8, CANADA 23 Blindmans Lane, Cheshunt, Hertfordshire EN8 9DR, UK

tel: +1 416 340 7265 email: [email protected] tel: +44 1992 640 066 email: [email protected] toll free: +1 866 261 6718 website: www.selectcareworldwide.com fax: +44 1992 785 030 website: www.gnfa.info

CATEGORY KEY CLAIMS MANAGEMENT LEGAL SERVICES John Allison Monkhouse Co., Ltd (Thailand) AIR AMBULANCE CLAIMS SUBROGATION MEDICAL ESCORT ON COMM. AIRLINE Apple Kaewprasert – General Manager AIR AMBULANCE INTERIOR COMMERCIAL REPAT SPECIALISTS MEDICAL PROVIDER President Park View Tower, 99/243 (30B) Pine Tower, Sukhumvit soi 24, Klongton AIRCRAFT PERFORMANCE SOLUTIONS CRITICAL CARE PATIENT TRANSPORT MEDICAL SCREENING Klongtoey, Bangkok, THAILAND ASSISTANCE COMPANIES FUNERAL DIRECTORS RE-INSURANCE tel: +66 2382 5345-7 email: [email protected] CATASTROPHIC CLAIMS SPECIALIST HEALTHCARE CLINICS TRAVEL AGENTS fax: +66 81 584 5942 website: www.monkhouse.com.au COST CONTAINMENT HOSPITALS WEB & DESIGN SERVICES call +44 (0) 117 925 5151 To make an alteration to a listing email: [email protected] SERVICEDIRECTORY 53

Lutece International Medical Wings Zouhaier Hertelli – Repatriation Specialist Dr Sommart Somsiri – Medical Director 222 Room 3259, Bangkok Int Airport, Viphavadee-Rangsit Rd, Sikan, Don Muang,

56 rue Olivier de Serres, 75015 Paris, FRANCE (ASIA) Bangkok 10210, THAILAND tel: +33 1 56 08 00 23 email: [email protected] tel: +662 247 3392 email: [email protected] fax: +33 1 56 08 00 43 website: www.pflutece.com fax: +662 535 4355 website: www.medicalwings.com

Rowland Brothers International Medic’Air International 每递安国际 Melanie Walkling – Partner Dr Huaqun Gao – Medical Director 299-305 Whitehorse Road, West Croydon, Surrey CR0 2HR, UK 885 Renmin Road, Huaihai China Building, Room 808, 200010 Shanghai, CHINA

tel: +44 20 8684 2324 email: [email protected] tel: +86 2163 558289 email: [email protected] FUNERAL DIRECTORS fax: +44 20 8684 8000 website: www.rowlandbrothersinternational.co.uk fax: +86 2163 558285 website: www.medic-air.com

Servilusa AMREF Flying Doctor Service Vanda Castro – Manager International Department Dr Bettina Vadera – Medical Director Agencias Funerarias SA, International Dept. Rua do Entreposto Industrial, 8-2 Esq, Wilson Airport, Langata Road, PO Box 18617, Nairobi, KENYA 2610-135 Amadora, PORTUGAL tel: +35 121 470 6300 email: [email protected] (AFRICA) tel: +254 20 6000 090 email: [email protected] fax: +35 121 470 6499 website: www.servilusa.pt fax: +254 20 344 170 website: www.amref.org

BUPA Cromwell Hospital Greek Flying Doctors Shams Maladwala – Commercial Director Dimitris Kanellis – Manager

Cromwell Road, London SW5 0TU, UK AIRLINES COMMERCIAL ON ESCORT MEDICAL 3 Doukisis Plakentias Str, 152 34 Halandri, Athens, GREECE

tel: +20 7460 2000 email: [email protected] (EUROPE) tel: +30 210 674 0600 email: [email protected]

(EUROPE) fax: +20 7835 2444 website: www.cromwellhospital.com fax: +30 210 674 0634 website: www.greekflyingdoctors.gr HOSPITALS HOSPITALS Xanit Hospital de Benalmadena Redstar Aviation Dr. Juan Bosco Rodriguez Hurtado – Director Mustafa Atac – CEO Avda. Los Argonautas, Benalmadena, 29630 Malaga, SPAIN Sabiha Gokcen International Airport, J Blok Kurtkoy, 34912 Istanbul, TURKEY

tel: +34 952 367 190 email: [email protected] tel: +90 216 588 0216 email: [email protected] fax: +34 952 367 191 website: www.xanit.net fax: +90 216 588 0225 website: www.redstar-aviation.com

Baptist Health Int. Center of Miami Voyageur Aeromedical Travel Yohandra Fuentes – Finance Manager Marc Lucas – General Manager 8940 North Kendall Drive, Suite 601-E, Miami, Fl 33176, USA Voyageur Buildings, 43 Colston Street, 43 Colston Street, Bristol BS1 5AX, UK

tel: +1 786 596 2373 email: [email protected] tel: +44 (0)117 927 3554 email: [email protected]

(AMERICA) fax: +1 786 596 5979 website: www.baptisthealth.net/international fax: +44 (0)117 925 5940 website: www.voyageur24.com

Integrated Healthcare Services Air Ambulance Network Brenda Escobar - International Services Manager Kirk Pacheco – President 450 E. Las Olas Blvd., Ft. Lauderdale, Fl 33301, USA 905 Martin Luther King Jr Drive, Suite 330, Tarpon Springs, Florida 34689 USA

tel: + 1 305 222 6750 email: [email protected] 24hr tel: + 1 727 934 3999 email: [email protected] tel: + 1 305 222 6751 website: www.hcaeastflorida.com fax: + 1 727 937 0276 website: www.airambulancenetwork.com

Jackson Memorial Hospital International MedEscort International Luis Felipe Arango – Vice President of International Business Craig Poliner – President

Jackson Medical Towers, East Tower, Suite 829, (NORTH AMERICA) 1730 Vultee Street, Allentown, PA 18103, USA 1500 NW 12th Avenue, Miami, FL 33136 - 9998, USA 24hr tel: + 1 305 355 1212 email: [email protected] tel: +1 610 791 3111 email: [email protected] tel: + 1 305 355 5544 website: www.jmhi.org fax: +1 610 791 9189 website: www.medescort.com

University of Miami Health System AMREF Flying Doctor Service Jose Quesada M.D., M.B.A. – Director Finance & Operations Dr Bettina Vadera – Medical Director 1099 N.W. 14th Street, Miami, Florida 33136, USA Wilson Airport, Langata Road, PO Box 18617, Nairobi, KENYA

tel: +1 305 243 9100 email: [email protected] tel: +254 20 6000 090 email: [email protected] fax: +1 305 243 9101 website: www.uhealthinternational.com fax: +254 20 344 170 website: www.amref.org

CareFlight Group StandbyMD Medical and Tasking Centre Alex Sánchez – Managing Director PO Box 5078, Robina Town Centre, Queensland, 4230 AUSTRALIA 777 Brickell Avenue, Suite 1370, Miami, Florida 33131, USA MEDICAL PROVIDER 24hr tel: +61 7 5553 5955 email: [email protected] tel: +1 305 459 4882 email: [email protected] fax: +61 7 5553 5914 website: www.cmsairambulance.com fax: +1 305 421 5575 website: www.standbymd.com

CareFlight International Voyageur Aeromedical Travel Sue Robshaw – Co-ordinator Marc Lucas – General Manager Westmead Hospital Campus, PO Box 159, Westmead, NSW 2145, Voyageur Buildings, 43 Colston Street, Bristol BS1 5AX, UK AUSTRALIA TRAVEL TRAVEL MEDICAL ESCORT ON ON ESCORT MEDICAL tel: +61 1300 655 855 email: [email protected] AGENTS tel: +44 (0)117 927 3554 email: [email protected]

COMMERCIAL AIRLINES COMMERCIAL fax: +61 2 9689 2744 website: www.careflight.org fax: +44 (0)117 925 5940 website: www.voyageur24.com

CATEGORY KEY CLAIMS MANAGEMENT LEGAL SERVICES V Creative Design AIR AMBULANCE CLAIMS SUBROGATION MEDICAL ESCORT ON COMM. AIRLINE Steve Annette – New Media Director AIR AMBULANCE INTERIOR COMMERCIAL REPAT SPECIALISTS MEDICAL PROVIDER AIRCRAFT PERFORMANCE SOLUTIONS CRITICAL CARE PATIENT TRANSPORT MEDICAL SCREENING Voyageur Buildings, 43 Colston Street, Bristol BS1 5AX, UK ASSISTANCE COMPANIES FUNERAL DIRECTORS RE-INSURANCE CATASTROPHIC CLAIMS SPECIALIST HEALTHCARE CLINICS TRAVEL AGENTS tel: +44 (0)117 929 4636 email: [email protected] fax: +44 (0)117 925 2040 website: www.vcreativedesign.co.uk ADVERTISING COST CONTAINMENT HOSPITALS WEB & DESIGN SERVICES WEB & MEDIA 54 REGULARS • GRAPEVINE • GRAPEVINE GRAPE - Diary Dates VINE • GRAPEVINE • GRAPEVINE • GRAPEVINE GRAPEVINE • GRAPEVINE • GRAPEVINE GRAPEVINE • GRAPEVINE • GRAPEVINE 6-9 June 24th Annual Caribbean Insurance Grapevine Conference Marriott Frenchman Reef Hotel St Thomas, US Virgin Islands The naked other crows were 6-9 June picking them up, it IIS Annual Seminar truth was amazing, they Madrid, Spain seemed to have them The Hotel Adaburnu Golmar in in their beaks the Turkey, billed as the Muslim world’s right way round!” 9-11 June first nudist hotel, has been forced to America’s Health Insurance Plans close, just six days after it opened. Institute 2010 The hotel was shut after a local Las Vegas, US authority inspection found that one Dead of the balconies in the hotel did 15-16 June not exactly match the architect’s woman AIRMIC Annual Conference drawing – the hotel’s first 12 Manchester, England sparsely-clad guests were moved lives to more (ahem) conventional 15-17 June accommodation. The hotel owner A Croation woman International Travel Insurance has said that he hopes to modify thought to be dead Conference – Pacific the balcony and re-open as soon as after her family Park Hyatt Saigon, Ho Chi Minh City, Vietnam possible. The hotel is only open to identified a body, has foreigners – Turks are not allowed turned up alive and 21-22 June to stay there, and the staff, who well. Over a month are nearly all male, keep their running at them, yelling and everything. These before, the woman’s 9th Insurance Conference on Catastrophe Insurance in Asia clothes on. guys have turned around and seen five ninjas in mother and father had identified a body in a Seoul, Korea Entrepreneur Ahmed Kosar refused to be drawn black ninja uniforms running at them … they just morgue as being that of their daughter; a funeral on the speculation that questioned whether bolted.” (Wouldn’t you?!) The victim suffered was held and the family mourned its loss. minor injuries as the result However, 39-year-old Tea Buric was still alive. 22-23 July of the mugging, and also lost Police found her when they showed up at 4th Asian Conference on his mobile phone and iPod. an apartment in the southern city of Split to Microinsurance investigate a report of domestic violence. Buric Vietnam did not have any identification on her, so police took her fingerprints and checked it against their 25-30 July Smoke the records, only to find that she had been declared Clinical Considerations in dead. She was returned safely to her family. Aeromedical Transport Course crows University of Surrey, UK A British couple on holiday 30 July-1 August in the Maldives thought Maggot marauders Helicopter Medical Flight Crew their eyes must be deceiving Course them after they spotted a An American holidaymaker got the shock of his University of Surrey, UK crow on the roof of the life recently after finding out that the strange water villa next to theirs bumps that had appeared on his head were not 10-12 August calmly extracting cigarettes bites, or even shingles – they were, in fact, live Vermont Captive Insurance out of a packet it had stolen. maggots. Association Annual Conference Tony and Judie Ellis, who Having been on a trip to Belize, Aaron Dallas Sheraton Hotel & Conference Center are from Crowborough returned home to Colorado where he later Burlington, Vermont, US (seriously) in the UK, took developed large bumps on his head that kept pictures as two more crows bleeding. One doctor thought it was a nasty 8-9 September decided they needed a insect bite, while another thought it was shingles. cigarette break and joined When the bumps started to move, though, both Waypoint AirMed & Rescue 2010 their winged friends on the diagnoses were questioned. London Oxford Airport, Oxford, UK roof where the owner of Another doctor discovered that there were the packet tugged individual five bot fly larvae living inside his head. Aaron cigarettes out for his friends. said: “I’d put my hand back there and feel them 14-15 September Judie said: “It [the crow] moving. I thought it was blood coursing through 2010 Entrepreneurial Insurance officials from the governing AK Part were behind was taking the cigarettes out of the packet and my head. I could hear them.” Symposium the closure – the party has been accused in the putting them on the roof of the villa. Then the The parasites were safely removed by a doctor. Dallas, TX, US past of quietly implementing a more conservative Muslim agenda on some industries in Turkey. 25-28 September Chartered Property Casualty Underwriter Society Meeting Orlando, FL, US Kapow!

29-30 September A German medical exchange student in Sydney, The Reactions US Insurance Australia, had a lucky escape recently … he was Conference 2010 being assaulted by three muggers when the attack The Westin, Times Square, New York, US was interrupted by five black-clad ninja warriors. 24-27 October The muggers had chosen a bad spot for their Property Casualty Insurers attack – the alleyway where they launched their Association America AGM attack happened to be right next door to a ninja Colorado Springs, CO, US training school. One of the pupils raised the alarm after noticing the commotion, whereupon ninja 25-26 October master Kaylan Soto instructed his class to take action. He said: “We just ran outside and started Middle East Brokers’ Summit

Dubai, UAE • GRAPEVINE GRAPE - • GRAPEVINE VINE • GRAPEVINE • GRAPEVINE • GRAPEVINE • GRAPEVINE • GRAPEVINE • GRAPEVINE • GRAPEVINE • GRAPEVINE • GRAPEVINE •

International Travel Insurance Journal ONTHEMOVE 55

Zajac leaves ABTA Sullivan joins Jim’ll fix it

Casia Zajic, the head of communications for the CIGNA board US-based medical tourism company WorldMed Association of British Travel Agents (ABTA), has left the Assist, LLC, has named Jim DiFalco as its new vice association after just under two years in the post. No CIGNA Corporation has announced that Joseph P. president of business development to lead the formal explanation was given for her departure, but Sullivan, former chairman and chief executive officer company’s expansion to self-funded employers and chief executive Mark Tanzer noted: “Casia has brought of Protocare, Inc. (a clinical trials and pharmaceutical insurance companies. Jim joins the company from energy and focus to the communications team at industry consulting firm) joined CIGNA Corporation’s Blue Shield of California, where he managed the ABTA, and she succeeded in raising the association’s board of directors on 26 April. He will be a member development and distribution of self-funded projects public profile. We are grateful for all Casia has done for of the corporate governance committee and the to mid-size and large group employers. ABTA, and wish her well in the future.” people resources committee. Sullivan has been a Speaking of the appointment, Wouter Hoeberechts, private investor since 2003, and currently serves as chief executive of WorldMed Assist, said: “We are a director of Amylin Pharmaceuticals, Inc., HCP, Inc. very excited about adding Jim to our leadership team.

John Boon and Maguire Properties. Jim’s insurance background and extensive work with David Cordani, president and chief executive officer self-funded employers, coupled with his general Obituary of CIGNA, commented: “We’re really pleased management and overall leadership will enable us to John Boon, the head of membership services at to have Joe on our board. He brings a wealth of continue our growth beyond our already dominant the European Tour Operators Association, died experience and knowledge in healthcare and health position in the medical travel retail market.” at the end of April after suffering a heart attack. policy, an appreciation for our commitment to health Boon only joined the organisation in January this improvement and wellness, and a terrific understanding year, following a long and distinguished career of what it takes to be a growth company.” in inbound tourism. He was a former chairman of the then British Incoming Tour Operators Association (now UKinbound), but his career in the travel industry covered roles with Global Tours, American Express, Sovereign Tourism Combined and JAC Travel. Insurance chooses Boon had been working on forging new alliances for the European Tour Operators Harrison Association when he was diagnosed with cancer at the beginning of April. While seemingly Combined Insurance has announced that Chris recovering well from a subsequent operation, Harrison has been appointed as executive vice he sadly suffered a fatal heart attack. president and general manager for Europe, assuming Paul Kaye overall leadership responsibility for the company’s European business – both sales and operations. Cecilia Reyes Aon Benfield boosts Chris has 25 years’ experience leading a number of Six is the magic insurance businesses – including health, accident, Reyes appointed at team protection and travel product lines – as well as number developing growth strategies in the UK and Europe. Zurich Aon Benfield, a reinsurer and capital adviser, has He joins from Simplyhealth Group, where he spent International expatriate insurance company William promoted Paul Kaye to the position of head of actuarial the last 10 years focusing on direct to consumer Zurich Financial Services Group has announced Russell has appointed six new sales professionals and enterprise risk management within its International health insurance. the promotion of Cecilia Reyes to chief investment to ‘enhance broker relationships and generate Analytics team. In his new position, Paul is responsible officer and member of the Group Executive new opportunities for business growth’ – Irena for a team of over 20 people in London that helps Committee. She will be based in Zurich and is Lykiardopoulos joins as broker relations manager; clients to make the most appropriate portfolio succeeding chief executive officer Martin Senn, who Robyn Patterson and Andrew Pletzer form part management and risk transfer decisions. Paul has been assumed his role on 1 January this year. of the company’s global presence in Africa; Fiona with Aon Benfield for 10 years. Senn commented on the appointment: “Cecilia Simpson will be developing relationships with The actuarial team will be further enhanced by combines deep substantive knowledge with a brokers in Europe and worldwide; Gavin Royston the appointments of two senior actuaries: James profound understanding of Zurich’s strategy and will work with UK brokers; and Doreen Moss has Karim, joining the company from ABN Amro; culture. She has played a key role in the Group’s been appointed as corporate account manager for and Thomas Cordier, who joins Aon from successful investment management strategy, and we the company’s global health, global life and global PricewaterhouseCoopers. are confident that she is the right person to continue income plans. Elsewhere, at the Aon Benfield UCL Hazard driving it forward.” Speaking of the appointment, James Cooper, sales Research Centre, David Middleton has been As head of investment strategy implementation director for William Russell, said: “We are very appointed as a visiting professor, enhancing the since 2006, Ms Reyes has extensive experience in excited about our new structure and the more institution’s research with expertise in pool schemes, the development and implementation of Zurich’s focused approach to developing business with our reinsurance and disaster response. Formerly chief investment management strategies, successfully intermediary partners. We are fully committed to executive of the Earthquake Commission, New leading the team of regional investment managers our clients and to our business partners, who can Zealand’s primary provider of natural disaster and driving the Group’s global real estate strategies. continue to rely on William Russell to provide high insurance to residential property owners, Middleton Prior to joining Zurich, Ms Reyes worked for ING standards of customer service and care at all times.” also spent 17 years in the insurance industry. Chris Harrison Asset Management and Credit Suisse.

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