ESSENTIAL READING FOR TRAVEL INSURANCE INDUSTRY PROFESSIONALS WWW.ITIJ.CO.UK NOVEMBER 2011 • ISSUE 130 Investigations unveil extent of fraud Kenyan conundrum The summer holiday season has come to an end in the northern hemisphere, and with it has come more dire warnings from travel insurance Travel insurers basing their coverage decisions on companies that fraud is on the up – both from travel advice from government agencies have hit clinics treating travellers, and from travellers the headlines in the UK recently. Mandy Aitchison themselves. Sarah Watson reports on the problem looks into the issue

In a recent editorial piece in Insurance Insight, The UK’s Foreign and Commonwealth Offi ce (FCO) Mike Keating of AXA Insurance explained that has advised against ‘all but essential travel to coastal the company noticed ‘a worrying trend over the areas within 150 km of the Kenya-Somalia border’. It summer’, stating that AXA’s claims department further explained: “We advise against all but essential received some excessively high medical bills as part travel to coastal areas within 150 km of the Somali of claims for treatment in Spain, Turkey, Bulgaria, border, following two attacks by armed gangs in small Egypt and sub-Saharan Africa. He added: “There boats against beach resorts in the Lamu area on 11 is evidence of overcharging, overdiagnosis and September and 1 October 2011. This advice will be over-treatment of minor problems and collusion kept under review. Both attacks were on beach-front between clinics and holidaymakers. Travellers need properties, with two Westerners kidnapped and one to be warned of the risks involved in using overseas murdered. Beach-front accommodation in that area travel clinics so that they do not end up with a hefty and boats off the coast are vulnerable.” medical bill to add insult to injury.” He noted several Some customers with holidays booked in the area, examples of bills received by the insurer this summer though, are being told they can’t cancel their holiday that were considered to be fraudulent, including an and claim on their travel insurance policy because of £88,000 bill for treatment of a heart attack in Turkey. a ‘disinclination to travel’, and they must approach “The charge was not only excessive,” said Keating, their tour operator to fi nd an alternative destination “but the clinic also ‘persuaded’ the customer to have if they do not wish to go on their planned holiday. extremely risky surgery overseas when he could While for most holidaymakers, re-booking to an safely have been repatriated and admitted to a UK alternative destination would be acceptable, there hospital.” Further examples given of overtreatment are bound to be customers for whom re-booking is and overcharging include a clinic in the Democratic not an option, and they just wish to cancel and get Republic of Congo, which tried to bill AXA for a CT their money back. scan despite the fact there was no scanner at the The justifi cation for the stance taken by travel hospital, and a rash in Thailand, for which the cost insurers, given by esure continued on p.7 was £10,000. The other problem includes collusion with the patient, which is most commonly seen with alcohol-related illnesses, where the clinic knows that if alcohol is cited as having played a part in the claim, the insurer will not pay the bill. One incident reported by AXA involved a pancreatitis case that was exacerbated by holiday binge drinking. The treating doctor stated that, in his opinion, the holidaymaker was suffering from alcoholic pancreatitis, but changed his diagnosis when the family put pressure on him and he realised that he ran the risk of not getting his bills paid. Furthermore, a recent undercover investigation by a reporter at the UK’s Sunday continued on p.6

4 NEWS

ITIJ CONTRIBUTORS

Robin Gauldie has been a freelance journalist since 1989, writing for the travel sections of national newspapers including The Sunday Telegraph, The Observer, The Times, The Sunday Mirror, The Guardian and Scotland on Sunday. He is the author of more than 20 travel guidebooks to destinations including Greece, Scotland, France, Portugal, Egypt and IN THIS ISSUE Morocco.

David Ing is a freelance journalist covering mainly travel and tourism issues REGULARS in Spain. He writes on air transport for a leading international news agency, as well as News continued 5 contributing special features to Newsweek Editorial rant 6 and writing in-fl ight magazine articles and guidebooks. Company brief 10 Insurance matters 11 David Kernek has, for the past four Health matters 18 years, been in a full-time post editing two Travel matters 20 glossy travel magazines – Holiday Villas and Holiday Cottages. He has since converted it IPMI news 22 into a freelance role having become self- Cross-border care 24 employed and now has regular commissions in Air ambulance news 26 consumer, trade or B2B publishing. Profile 42 Service directory 43 Milan Korcok is an award-winning freelance health policy and economics writer Grapevine 50 who covers travel insurance, public health, On the move 51 and medical education issues in Canada and the US. He has been writing about health fi nancing and policy issues in these countries since the 1960s, and is a frequent contributor FEATURES to leading North American professional journals and consumer media. Feature: No place like home 30 ITIJ examines whether the growth of domestic tourism offers opportunities for insurance companies to create and market new products

Feature: US health costs spike: insurers put under pressure 32 If insurers were looking for relief from soaring fees and prices for hospital and doctors’ services, they best put their hopes on hold

Assistance & Healthcare World Markets: Czech Republic 36 If in doubt, go public – is the overriding theme of the feature, which describes the evolution of public and private healthcare facilities in this former Soviet bloc country

ITIJ TEAM

Editor-in-chief: Ian Cameron ITIJ Published on behalf of: Voyageur Publishing & Events Ltd, Editor: Sarah Watson Voyageur Buildings, 43 Colston St, Bristol BS1 5AX, UK Voyageur Buildings, 43 Colston Street, Bristol BS1 5AX, UK Title editor: Mandy Aitchison The information contained in this publication has been published in good faith and every effort has been made to ensure its accuracy. Neither the Copy editor: James Paul Wallis Telephone: +44 (0)117 922 6600 publisher nor Voyageur Ltd can accept any responsibility for any error or misinterpretation. All liability for loss, disappointment, negligence or Editorial assistant: Sophie Cameron-Davies editorial dept: Ext. 3 other damage caused by reliance on the information contained in this publication, or in the event of bankruptcy or liquidation or cessation of Conference manager: Denise Clements advertising dept: Ext. 1 the trade of any company, individual or fi rm mentioned is hereby excluded. The views expressed do not necessarily refl ect those of the publisher. Production: Kirsty Diclaudio subscriptions dept: Ext. 209 Helen Watts accounts dept: Ext. 4 Printed by Pensord Press, South Wales, United Kingdom

Subscriptions: Kate Knowles Copyright © Voyageur Publishing 2011. Materials in this publication may not fax: +44 (0)117 929 2023 Advertising sales: David Fitzpatrick be reproduced in any form without permission James Miller email: [email protected] web: www.itij.co.uk INTERNATIONAL TRAVEL INSURANCE JOURNAL ISSN 1743-1522 Finance: Elspeth Reid Louise Goddard Would you like to make a comment? Design: V Creative Design WOULD YOU LIKE TO SUBSCRIBE? Please get in touch with Ian Cameron, vcreativedesign.co.uk VISIT www.itij.co.uk Editor-in-Chief of ITIJ on +44 (0)117 922 6600 ext205

International Travel Insurance Journal NEWS 5

Brits uncovered Companies ill

One in five UK travellers are still running the risk to reverse FSA regulation as part prepared of sky-high medical bills when travelling abroad of its war on red tape. through not taking out travel insurance, in spite of The ABTA survey also revealed In a recent survey of security and risk recent high-profile cases highlighting the significant that ‘financial protection’ is the managers conducted by Travel Guard risks of doing so to both health and finances, second-highest rated consideration North America, less than a quarter of according to the 2011 ABTA Consumer Trends survey. for British holidaymakers, following those surveyed felt that the company This fact may be partly explained by 21 per cent ‘safe and secure accommodation’ they worked for was ‘very prepared’ to of respondents mistakenly believing that the UK in first place. Mark Tanzer, chief handle emergencies involving employees Government will cover their bills in the event that executive of the organisation, travelling internationally. According to something goes wrong – one in four 15 to 24-year- said: “Even in a year when the survey, general street crimes are olds think that this is the case. customers are tightening their of most concern to travellers, followed Seventeen per cent of survey respondents also belts, the lowest cost is not their by terrorism, kidnappings, identity theft believe that travel insurance is unnecessary when number-one consideration. The and illness/hospitalisation. While 32 per travelling in Europe if they have a European Health message from our customers cent of those surveyed reported that Insurance Card (EHIC), which provides access to is clear: financial protection is a their companies were engaging in more basic state medical care; and a further 26 per cent top consideration when booking their holidays.” The business travel this year as compared to 2010, and mistakenly believe that an EHIC will cover their survey asked consumers which booking elements Grey gappers travel 66 per cent of those surveyed have a travel safety repatriation costs if they fall ill or have an accident are essential or important to them, and the top 10 and security programme in place, a considerable and have to be flown back to the UK. elements given by respondents were: safe and secure more amount of uncertainty about these programmes John de Vial, ABTA’s head of financial protection, said: accommodation; a financial protection scheme; still exists. “It is very worrying that so many people are putting ATOL financial protection; ABTA membership; New research from Post Office Travel Insurance their health and finances at risk by travelling abroad knowledgeable staff; ease of transport connection; in the UK has found that more people in their late without insurance. Many wrongly assume that it is the range of holidays on offer; convenient location; a well- fifties are considering taking a gap year than students. Foreign Office’s responsibility to pay for their hospital known name in travel; and, finally, lowest price. The company’s recent report shows that less than bills, particularly younger travellers. In the current Meanwhile, low-cost Irish airline Ryanair has warned one fifth of college leavers surveyed are considering economic climate, customers should be careful to that over a third of passengers are risking huge taking a gap year, compared to 25 per cent of purchase insurance at the time of booking their holiday medical bills if they have an accident or become ill over-55s. Sarah Munro, head of travel insurance at to obtain cancellation cover for redundancy as well as abroad, after a survey of 4,000 passengers found the Post Office, said age should not be a barrier for any potential illness prior to travelling. ” that over a third travel without travel insurance. people wanting to experience different cultures, but Lynda St Cooke of the Foreign and Commonwealth While half of those surveyed (46 per cent) held grey gappers must take out adequate cover. She Office added: “We remain very concerned at the annual or multi-trip insurance and one in five (19 per explained: “If you’re going abroad for an extended number of people travelling without comprehensive cent) purchased single-trip cover, 82 per cent with period of time, the most vital areas to be insured for travel insurance and then ending up severely out insurance did not know if their policy offered ski, are medical treatment, repatriation in case you need of pocket. If British travellers get into difficulties business travel or sports (golf) cover. Worryingly, 90 to be flown home, and cancellation in case you fall ill overseas, there are things the nearest British per cent of those who travelled without insurance and are unable to travel.” Embassy or Consulate can do, including contacting were unaware that medical repatriation flights could Meanwhile, Sean Tipton of the Association of British friends and family for them, and giving them cost them upwards of c18,000 should they become Travel Agents warned people heading on a gap year information on how to safely transfer money from seriously ill when abroad. Ryanair travel insurance in the near future to read their policy documents the UK. But consular staff cannot pay hospital bills for paid an average of c2,200 for medical expense carefully so that they fully understand their coverage British travellers, nor fly them home if they run out of claims last year, and it urged passengers to protect limitations and exclusions. For example, while many of those surveyed noted holiday money.” their holiday, possessions and health. that their companies use dedicated phone lines, According to ABTA’s survey, less than a half of email addresses and other communication methods consumers – 44 per cent – purchased travel to stay connected with travelling employees in the insurance for trips within the UK, exposing them to event of an emergency situation, nearly a quarter the risk of losing money as they would be unable to were not sure what exact systems and programmes claim for cancellation charges if they fell ill or lost their were in place at their company. Additionally, 22 per job before travelling. Sixty-eight per cent think that cent of respondents were unsure as to what internal travel insurance is more important for trips abroad department at their company is responsible for the than in the UK. safety of travelling employees. All sales of insurance by travel agents have been “In today’s world, security and risk managers regulated by the Financial Services Authority (FSA) are faced with a lot of concerns about how their since 2007, with many agents consequently choosing travellers will fare when it comes to handling and not to sell insurance due to the high cost and extra resolving emergencies that their employees may bureaucracy of regulation. Travel agents now account encounter,” said John Rose, president of business for less than 17 per cent of sales of travel insurance in travel services at Travel Guard North America. the UK and, at the time the law was enacted, ABTA “There is truly a duty of care obligation and a warned that an unintentional consequence of FSA growing need for employers to thoroughly address regulation would be an increase in the number of the safety, health and overall wellbeing of their most uninsured travellers. It has called on the government precious commodity – their employees.” come and join us

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www.itij.co.uk 6 NEWS

Season-pass skiers Traffickers arrested US travel clinic in

protected More than 70 people were arrested in a major contract dispute crackdown on gangs selling designer and other drugs In the US, there has been in an increase in buying on the Spanish holiday island of Ibiza. The majority of A contractual dispute between a travel health clinic season-pass insurance by skiers protecting their those detained by the paramilitary Guardia Civil are in Sacramento, California, and Passport Health Inc. So ... you’ll all be pleased to hear that I’ve purchases in case of injury or illness. Insurance said to be Italians linked to the Camorra mafia, but a has been settled, although the loser in the case has found even more news on the volcano front. for season passes is now readily available from separate round-up also included a number of British appealed against the decision made by the courts. Apparently, those Icelanders have got another the majority of Colorado’s larger resorts, many of and Irish traffickers. David Ing reports In 2007, Maryland-based Passport Health Inc., hot volcano, name of Katla (named after a which are now applying stricter no-refund policies in which bills itself as ‘the largest provider of travel troll we’re informed), which apparently might response to the increase in availability of policies that Among the drugs seized in a series of raids were medical services’ in the US, entered into a franchise be about to spew even more ash into the provide cover in case of injury, illness or a job change 5,500 pills, most of which were of the type known as agreement with Sacramento-based Travel Med Inc. preventing skiing. Pink Rock Star, according to the Guardia. This is the Passport Health runs over 160 franchised travel atmosphere than our beloved Eyjafjallajokul!! Travel Guard, the US-based travel clinics across the US that help people prepare for “OMG,” I hear you cry... “did we remember insurance company, now offers foreign travel, from providing destination information to put in the exclusion clause about volcanoes season-pass coverage for 20 ski areas and immunisations to travel insurance. named after trolls? … and why did they name it across the country. Janet Janseen, Under the terms of the 2007 agreement, Travel Med after a troll anyway?” Travel Guard’s ski resort director, was given permission to use Passport Health’s trade said: “Our growth every year is name and service marks, as well as its methods, in the How should I know? ... I’m not from Iceland. exponential.” Vail Resorts estimates operation of a travel clinic. In addition, the agreement that 30 per cent of its 300,000 pass stipulated that Travel Med pay Passport Health seven In other earth-shattering news, insurers’ claims holders have insurance for their per cent of its gross revenues as royalties for use of the departments have found lots of people are ski passes. Kelly Ladyga, company firm’s trading name. Travel Med, however, stopped trying to rip them off. Really? Dodgy bills from spokeswoman, said: “Like other paying such royalties in March 2009, less than two medical facilities in Spain, Turkey, Egypt, Bulgaria, companies in the travel industry, we years into the 10-year contract, and pulled out of the encourage our guests to purchase deal completely soon afterwards. sub-Saharan Africa and DR Congo ... who’d of pass insurance to protect themselves As a result, Passport Health took Travel Med to court, thought it. And Congo? Congo? Did I say Congo? from unexpected events such claiming, amongst other allegations, that Travel Med A false claim for a CT scan when they don’t as sickness, injuries and job loss had continued to use Passport Health’s trademark really have the equipment. What a surprise! And because our pass products are non- after the agreement had been terminated. In who exactly is mad enough to go to DR Congo refundable.” Bora Bora nightclub in Ibiza February this year, US District Judge Garland Burrell anyway? And, actually, why would you insure Last season at Aspen Skiing, 18 per Jr ruled that Travel Med was liable for breach of the someone who is going there anyway? Have we cent of skiers with passes bought insurance, with 2.5 one believed to be the direct cause of the death of agreement and trademark infringement, and also all lost the plot? per cent of them filing claims. The company, which a young British tourist and to have severely affected decided that Gina Flaherty, Travel Med’s president, has offered insurance for the previous nine seasons, another eight others on the island in July. was liable for breach of her guarantee of compliance expects to sell even more this year. With season-pass The relatively easy availability of designer pills and with the contract. At a non-jury trial on the issue of It’s all beyond me. Ian Cameron Editor-in-Chief insurance policies, resorts are now freed from the harder drugs on what is Europe’s party island par damages in April this year, Flaherty told the judge that [email protected] lengthy and time-consuming task of reviewing and excellence have also been linked with several of the she had stopped honouring the agreement as it was releasing refunds, replaced with a simple no refund deaths from what has become known in the hotel her belief that Passport Health had acted unethically policy, seen to benefit both skier and resort. trade as ‘balconing’. This involves young tourists when it transferred Travel Med’s pharmaceutical jumping from one hotel or apartment balcony to account from one purchasing group to another, another, sometimes even down into swimming pools, without the consent of the company. She did admit, following nights out of drinking and drug-taking. though, that her complaint was rectified and her The Guardia Civil said the mafia operation alone company did not lose any money as a result. In involved 60 arrests. Consecutive swoops were September, Judge Burrell ordered Travel Med and made on 22 different addresses where they seized Flaherty to reimburse Passport Health to the amount large quantities of drugs that included cocaine, crystal of US$437,000 in damages – far higher than the meth, speed and hashish. The scale of the operations $120,000 reimbursement that Passport Health said meant that extra officers had to be drafted in from in June last year it would accept to have settled the mainland Spain. case there and then. Travel Med is appealing the Nine British subjects and three Irish were detained outcome to the 9th US Circuit Court of Appeals. in the second operation against a group that was said to be selling predominantly cocaine and designer pills near clubs and other night spots. A Guardia spokesman said the group went to Ibiza in summer specifically to deal with the demand for drugs from party-goers, with top-up shipments being sent out from the UK. One supplier had been arrested at Ibiza airport carrying a kilo of MNMA (crystal meth), following a combined tracking operation with the UK’s Serious Organised Crime Agency (SOCA).

Investigations unveil extent of fraud continued from p.1 Times newspaper has found that foreign doctors to forge a death certificate for him, while a local tout are selling fake medical certificates to travellers was able to get the certificate signed and stamped. in order to help them claim cash back from their UK-based Linden Claims International sees plenty travel insurer. A reporter from the newspaper was of fraudulent medical claims from India, according able to obtain several different fraudulent medical to the firm’s head, John Saunders. He said that the certificates from doctors in India, all of which gave company usually sees around six false claims from false information. With illnesses ranging from dengue India each month, and in the past 20 years, has fever to stomach upsets to heart problems, the uncovered 120 fake deaths. certificates showed the willingness of certain medical Nick Harris, head of travel law at Simpson Millar, a professionals to abuse their position. UK law firm, said that the problem of false certificates Going even further, the reporter found, paid for and from India is ‘aggravated by the resources needed received a false death certificate in his own name, to mount an investigation’, adding: “According to which had been stamped by a registrar from the insurers, the time and money involved in these northern Indian state of Uttar Pradesh. According to probes can deter companies from pursuing the journalist, the owner of an ambulance was willing prosecutions, even if the claims are discovered.”

International Travel Insurance Journal NEWS 7

Kenyan Credit card cover needs FCO advises conundrum examination Hajj travellers continued from p.1 Jane Drew, a spokesperson for American Express, has told The UK’s Foreign and Commonwealth Office (FCO) to UK newspaper The Guardian, is the Sydney Morning Herald of Australia that travellers has issued advice to British nationals who are travelling that ‘insurers could not base should carefully read the terms and conditions to the Hajj. Around 20,000 Brits are expected to make coverage decisions on warnings of the travel insurance provided by their credit the journey at the beginning of November. The FCO has issued by the FCO because cards. Drew noted that while some policies urged pilgrims to obtain comprehensive travel insurance “these change from one day are issued automatically when a person and essential vaccinations before they embark on their to the next”’. ITIJ read esure’s has a credit card, others stipulate that journey. “It is compulsory,” said the FCO, “for travellers to travel insurance policy wording, in order to activate the travel insurance the Hajj to have a meningococcal meningitis vaccination though, which states under the component, they must book at least part certificate in order to obtain a Hajj visa.” general exclusions part of the of their trip using that card. She urged The FCO will provide the full range of consular services and policy: “This insurance will not consumers planning to buy travel insurance will also be sending a delegation of consular staff. Last year, pay for any deterioration of or to consider going online to first compare the during the Hajj, the majority of cases that the delegation loss or damage to property, or any cover offered by credit card companies. handled were to do with replacement of documents. legal liability, injury, illness, death or expense, directly or indirectly due to, contributed or caused by: Any travel undertaken against Foreign Office advice or where the Foreign Office has deemed it unsafe for you to travel.” So, a policyholder can’t claim for cancellation on their travel policy, but it won’t cover them if they do decide to travel to the area included in the FCO warning?

Damned if you do, damned if you don’t It seems that this is exactly the sort of issue that gives travel insurers bad PR, and insurance haters in the global press a chance to bash insurance companies. Giving conflicting signals over the heeding of FCO travel advice, and leaving uncertainty about the meaning of the word ‘essential’ when referring to ‘all but essential travel’ does little more than alienate consumers who often view insurance companies as, at best, a necessary evil, and at worst, opportunists who make money from other people’s need for peace of mind. Part of the problem the last time the travel insurance industry faced a consumer backlash – when the ash cloud from Iceland was hovering – was that there was no cohesive industry advice, and no common message to consumers, other than ‘check your policy wording’. Again, with the Kenyan situation, different insurers offer different cover to consumers – some providing very limited cancellation cover, some providing cancellation for ‘any reason’, and some naming FCO advice as a peril for cancellation in their policy wording. Some of this cover is offered as an add-on, as is the case with Aviva, which has recently included travel disruption cover add-ons to its travel policies. A spokesperson explained: “This offers wider cover in the event of strike, industrial action or cancellation due to FCO warnings, pandemics or natural disasters, including earthquakes and tsunamis, preventing your departure from the UK; and also similar cover for abandonment of your holiday if you have to return home early due to any of these events.” A blogger on The Guardian’s website posted that Aviva had emailed them to clarify the company’s cover, saying: “This optional add-on will provide cover if the FCO advise against all travel, or ‘all but essential travel’ in the seven days prior to your intended departure date, as well as abandonment cover, if after you are on your trip, the FCO advises UK residents to leave the area in which you are staying.” For those companies, such as esure, who won’t cover for cancellation following FCO advice, but who, at the same time, won’t provide cover if the traveller goes ahead with the planned trip, claims are often covered on a one-by-one basis. ITIJ spoke to esure, who said: “While there is no cover for FCO cancellation under the esure wording, if a customer has been unable to reclaim their outlay or obtain an alternative holiday from the tour operator or airline, we would always look carefully at individual claims, as it is certainly not the intention of the policy to encourage people to travel without any cover.” While it is considerate of insurers to provide such a service, unfortunately, for consumers who face the frustration of choosing between whether or not to travel, based on their policy wording and FCO advice, the damage may have already been done.

www.itij.co.uk 8 NEWS

IFB to launch web portal service NEWSWIRE

The UK’s Insurance Fraud Bureau (IFB) has been Statistics from comparison site deploying its upgraded analytical software, NetReveal Moneysupermarket in the UK have shown that 52 from Detica, which has included partnering with per cent of people who pay for extra benefits such Detica to build a unique web portal service. A as travel insurance on their current bank account do period of successful testing by the IFB and its insurer not make use of the services on offer. Thirteen per partners has been completed, and the IFB is now to cent of packaged account holders weren’t aware of commence the rollout programme of its first web what benefits they were supposed to receive. portal service. The portal will provide the counter-fraud teams The US Travel Insurance Association of insurers and compensators who are partnered has offered advice to agents to help their travellers with the IFB 24-hour access to conduct searches of avoid financial loss and be prepared for developing around 128 million industry records held by the IFB weather emergencies, as the US braces itself for an for fraud prevention purposes. Searches of the portal active hurricane season. will provide end users with automated on-demand fraud risk scoring and the ability to secure supporting Post Office Travel Insurance, in the UK, Word of mouth intelligence reports from the IFB. The secure, user- has moved the boundaries it uses to determine Victim support friendly portal requires no integration and minimal its travel insurance coverage, excluding Turkey A consumer in the UK was recently faced with an end user training. from its European cover. A spokesman said the increased interesting dispute with his travel insurer, when a The portal deployment will be in two phases, with change was ‘made to reflect the increased cost in The Foreign and Commonwealth Office (FCO) has claims handler gave him assurance that he would be additional functionality added in the second phase providing this cover’, adding: “The price charged published a new guide that contains full details of how covered for his claim – but, in actual fact, he wasn’t. and a future road map that includes major new data for the Rest of the World policy is more reflective the FCO can provide support to British nationals Ian Rose found out just before a planned two-week sets. Whilst the existing focus is on providing current of the costs associated with the level of claims we when things go wrong abroad. The publication, holiday to the Caribbean that his nephew had died, IFB partners with portal access, 2012 is planned are experiencing.” called Support for British nationals abroad: A guide, and the funeral was scheduled for when he was to see the deployment extend to firms supplying contains – for the first time – a written Customer away. Rose called InsureandGo, as he ‘thought the counter-fraud services to IFB partners. US comparison site Squaremouth has Charter, which sets out the FCO’s commitment best thing to do was to check with them directly Commenting on the portal deployment, Glen Marr, advised tourists planning a trip that involves extreme to providing a high level of service. The guide also whether the death of a nephew was covered under director of the IFB, said: “Data and technology sports to check their travel insurance covers any provides clearer and updated information for those the policy’. He added: are absolutely critical to activities they intend to do, and reminded them affected by a crisis abroad; clearer information on “It was made very clear preventing insurance fraud. that different companies consider different activities how the FCO can assist people with mental health to me when I asked that Our first portal successfully to be risky. problems; and clearer explanations of why the FCO question, was a nephew combines both, and cannot help in certain situations. covered, the answer is representative of a Three Malaysian tourists and one Thai The FCO has also launched new support and was ‘yes’.” significant level of work national were killed recently when multiple bombs assistance measures for families of people who have Rose therefore this year by the IFB and went off in the insurgency-plagued south of died in suspicious circumstances overseas. Nearly cancelled his holiday, Detica. It is one of many Thailand. A further 100 people were injured in the 6,000 British nationals die abroad each year and but when he phoned enhancements to the IFB attack, which saw explosions near two hotels and a around 60 of those are the victims of a murder InsureandGo again, model and an exciting one Chinese-Thai cultural centre in Sungai Golok. or manslaughter. The Foreign Office is working in this time he was told for the team.” He added: partnership with Victim Support’s National Homicide that his claim was not “We remain absolutely A New Zealand government policy that Service to ensure that families get the practical covered. The insurer committed to our role as stated visas would not be issued or renewed for support they need to deal with the added trauma, relied on a statement the industry platform to pregnant foreign students is being overhauled. complications and costs when a British national is given by the original prevent insurance fraud. Under the 2008 policy, it was considered that murdered abroad. Victim Support is a national charity claims handler at the Over the past 12 months pregnant foreign students would end up as a drain that receives its core funding from the government. end of the conversation, our development has on health resources. To help families cover the exceptional and additional which says: “No claims accelerated and there is costs if a murder occurs overseas, the FCO is are guaranteed over more to come from the An explosion at the Turkish holiday resort providing a £100,000 grant to Victim Support to the phone, but once IFB.” town of Kemer, near Antalya, killed one person and commission services on behalf of bereaved families, received, your claim Imam Hoque, managing injured two others in October. The blast follows a if needed. This will enable the charity to expand the will be reviewed in director of Detica recent upsurge in the level of violence by Kurdish range of services it can provide to bereaved families, accordance with the NetReveal, said: “Helping militants in Turkey. such as travel costs, translation and interpreting terms and conditions the IFB enhance its services, and repatriation costs. of your policy.” In a letter to Rose, the insurer said: capabilities to also become a real-time counter- A plane carrying tourists to view Mount Minister for Consular Affairs Jeremy Browne said: “We apologise if you feel that the agent misled you fraud platform for UK insurers represents a major Everest crashed whilst attempting to land in Nepal “Dealing with the death of a family member who within the claims registration call, but remind you that step forward and ideally positions them to play a on 25 September, killing all 19 people onboard. has been murdered abroad can be an extremely she did confirm no claim can be guaranteed over significant role in the fight to protect UK plc across Ten Indians, two Americans and one Japanese traumatic experience. I have met the families of victims the phone.” Rose’s response was: “This is the claims industry sectors.” tourist were among the victims. The plane was and decided that the FCO could improve its service department number that we called, so we expected also carrying three Nepalese passengers and three to help people in these terrible circumstances. I am to speak to someone at the other end who could crew members. pleased to announce that we are now providing speak with some authority.” more practical and emotional support for families A solicitor for UK consumer group Which’s legal Reasons offered for bereaved by a murder abroad and are working closely service, Espe Fuentes, told the BBC Radio Four with Victim Support’s National Homicide Service to Moneybox programme that she believes Rose could lack of cover improve the assistance available.” contest the decision. In her opinion, the decision Chief executive of Victim Support Javed Khan by InsureandGo not to pay the claim could be In a recent survey conducted by Syndics Research said: “We know through our homicide service the challenged on the grounds that what the call centre and commissioned by Access America about US devastating impact that losing a loved one through staff told him in the original call may have varied the consumer buying habits regarding travel insurance, murder or manslaughter has. In cases where terms of the written contract; that the insurer has it was revealed that of those who don’t purchase the death has occurred in a foreign country, the a duty to be fair and reasonable in its dealing with insurance, 78 per cent think they don’t need it. bereaved not only face coming to terms with losing consumers, and a duty of care in what it tells them; The study further found that while many travellers a loved one, but navigating their way through a and finally, that an insurer cannot protect itself simply think travel insurance is mainly for overseas medical different legal system. In common with deaths in by offering a disclaimer at the end of telephone emergencies only, 48 per cent of those who did buy the UK, the families also require emotional and conversations. She added: “What would be the cover bought it for travel inside the continental US. practical support. This can include assistance with point of phoning people up to ask a question, and More than half the purchasers – 55 per cent – buy bringing their loved one home, financial assistance, everything I say to you, you must take with a pinch of travel insurance for all or most of their trips, and translation of documents and travel to the country salt!” When InsureandGo was contacted by the BBC nearly a third buy it for ‘some’ of their trips. The to attend the trial. We are pleased to be working about the case, it offered to pay Rose the majority of occasional purchasers believe that travelling with with the Foreign Office so we can do more to the cost of the lost holiday, which he is considering. family increases the risk of something going wrong, ensure those bereaved by a murder abroad get the His alternative is to seek full reimbursement through while the survey also found that purchasers of travel help and support they need.” the Financial Ombudsman Service. insurance tend to be experienced travellers.

International Travel Insurance Journal NEWS 9

Business travel boom predicted Vietnamese shun travel cover

Earlier this month, Market consultancy firm Research and Markets in Vietnam but wish to travel elsewhere. Industry MAPFRE Assistance has found that the travel insurance industry experts say that part of the problem regarding low released new in Vietnam remains underdeveloped, despite sales figures is the fact that very few travel agencies research that the Vietnam Tourism Law placing the onus on in Ho Chi Minh City note how important travel disclosed that local travel agencies to offer insurance to their insurance can be, and of those that do, most will offer business people in customers. Figures from the Association of the insurance to foreign customers only. Another the property, leisure, Vietnamese Insurers show that the law is not reason offered is that many foreign travellers say that entertainment and having the desired effect, with 95 per cent of they favour foreign-owned operators working in travel industries around 22.5 million foreign and local tourists Vietnam over local ones, as the foreign firms tend to expect to see a not being offered travel insurance in 2010. be better at offering travel cover. One director of a significant increase There are four main kinds of travel insurance travel firm in Ho Chi Minh City, who did not wish to in the amount of available in Vietnam: insurance for local tours; be named, also said that during this difficult economic overseas travel they insurance for Vietnamese tourists travelling to period, people are opting for low-cost tours, and undertake for work foreign countries; insurance for foreigners visiting travel agents are trying to meet their customers’ over the coming Vietnam; and insurance for foreigners who live needs by keeping costs as low as possible. 12 months. The findings reveal that 42 per cent of business travellers in the property sector expect the amount they travel to increase in the next six months, compared to only 17 per cent who expect it to decrease. This gives the sector an index score of +25 points, the most confident sector surveyed. The leisure and entertainment sector is also very upbeat about the coming months, with an index score of +22 points, and those who work in the travel industry achieved an index score of +12 points. The next most optimistic workers are in the financial services industry, with 28 per cent of them expecting an increase in business travel, compared to 19 per cent who expect a reduction, giving them an index score of +9 points. The findings suggest that overall, the growth in the business travel market is set to continue, supporting recent figures from the Guild of Travel Management Companies revealing a four-per-cent growth in business travel in the three months to June 2011. Leire Jimenez, MAPFRE ASSISTANCE’s head of B2B travel, said: “There is a noticeable difference between the confidence levels of business travellers in different sectors, which should give business travel agencies an indicator as to where they should focus their efforts in the coming months.” She added: “The difference between the responses by sector demonstrates that we are still in very uncertain economic times and we expect there to be keen competition between business travel firms for companies in the most optimistic sectors. Business travel firms may try to drive extra revenue by offering a greater breadth of products, such as emergency assistance and travel insurance, and they should try to ensure they hold on to their customers by partnering with companies they can trust to deliver quality and service wherever their customers go in the world.”

Egyptian facility blacklisted

Eric Grootmeijer, network manager for ANWB Assistance in the Netherlands, has informed the ITIJ team that his company has blacklisted a medical provider in Sharm el Sheikh, Egypt, after alleged malpractice at the facility. The assistance company explained that it has blacklisted the clinic, St Peter Medical Services, due to: “An apparent sexual assault of a (female) patient by her treating doctor; apparently illegally withholding a patient’s passport; and alleged hostage of the patient until financial guarantees were received.” Grootmejier wants to send the following message to assistance companies active in Egypt: “Despite various requests for comment to these serious allegations, this medical facility never reacted. We feel it our duty to inform you … giving you the opportunity to (re-)assess your relationship with this facility.” ITIJ has also contacted the St Peter Medical Services Group in Egypt on a number of occasions, asking for comment but, at the time of going to print, was still awaiting a response.

www.itij.co.uk 10 COMPANYBRIEF

University Saga covers holidays of Michigan at home NEWSWIRE

introduces Saga has adapted its travel insurance products in MDLiveCare, the 24/7 healthcare response to the increase of people over-50 choosing consultation company, has announced a multi- blanket to stay within the UK for holiday. Chief executive of year contract with Europæiske Rejseforsikring A/S, Saga Services Roger Ramsden said: “Many people the Denmark-based travel insurance company, to cover mistakenly believe that travel insurance provides provide doctor telehealth consultations for business the same cover whether you’re travelling in the UK travellers and expats visiting the US. The University of Michigan or abroad, but it’s important to check as this is not has announced that all faculty always the case.” With rail costs due to increase and RBS Insurance has joined with the private and staff members travelling the average nightly cost of a hotel being £83, Saga bank Coutts to offer a new high-net-worth policy on university related business is suggesting competitively priced insurance policies to Coutts clients. The policy will include home, are now covered by a blanket are valuable to travellers. According to the company, motor and travel insurance adapted to the health insurance plan. The 76 per cent of over-50s now decide to incorporate customer’s requirements. coverage, which is of no cost to the person or short trips as part of holiday travel plans. Ramsden Travelex ‘Made Easy’ department, covers any accompanying spouses, claims that many policies do not cover the added The Institute of Customer Service has partners and dependents. The plan includes three costs for partners staying with loved ones who are awarded Europ Assistance’s UK and Ireland Travelex Insurance Services, US-based company, policies for particular populations and nature of travel, hospitalised while on holiday, whereas Saga’s cover offices its respected ServiceMark accreditation has recently added new benefits to its leisure travel as well as blanket coverage for political security provides this as standard. for outstanding customer service. It reflects the protection plans. Travelex’s new ‘Made Easy’ series and natural disaster. The University has partnered company’s constantly high standards in providing offers simpler plan packaging with extensive benefits, with international medical and assistance firm HTH assistance services to the UK insurance industry. making it easier for customers to select the most Worldwide to provide this coverage, which allows suitable plan for their requirements. The series staff and students access to a specially designed plan Mondial Assistance USA has announced it includes three products, with Travel Basic being the for leisure or personal travel. has been included for the first time in the most cost-effective plan for travel protection, while influential InformationWeek 500, an annual Travel Select is aimed at families, with children listing of the nation’s most innovative users of included for free in the plan, whereas Travel business technology. Max is for luxury travellers. Mike Ambrose, president of Travelex, said: “By listening to Nationwide Building Society is including agents, we have become keenly aware that free travel insurance for 65 to 75 year olds to its simple is better when it comes to travel FlexAccount current account. From September, all protection plans. Each of the changes we are existing and new customers under the age of 75 introducing is designed to that end.” received European travel insurance usually worth IGI & IPA partnership £70 a year as part of their ‘main’ current account.

Industrial and General Insurance (IGI) plc of Nigeria has Air Astana of Kazakhstan and travel Consumers announced its partnership agreement with Inter-Partner insurance firm Travel Guard have launched a Assistance (IPA), a subsidiary of Paris, France-based new service for Air Astana customers wishing to create policies AXA. The partnership involves IGI and IPA providing purchase travel insurance when booking tickets improved international and health travel insurance cover online. Air Astana customers will receive an with M&S and reinsurance services to travellers, with particular electronic insurance policy via email once the online focus on those travelling to Schengen countries. IGI’s transaction has been completed. M&S Money, a UK-based company, has executive director, Sina Elusakin, said: “Benefits to introduced a new travel insurance scheme be enjoyed by policyholders under the IGI/IPA travel allowing consumers to create their own and health insurance partnership include payment policy in relation to their specific needs of medical expenses, payment of emergency dental and requirements. The new M&S travel expenses, repatriation of mortal remains, research and Cruiseexpress adds insurance policy replaces its existing replacement of lost luggage, advance bail and legal costs ‘Premier’ and ‘Standard’ options, instead as well as medical emergencies/medical transportation.” travel insurance proposing a range of cover options for the Travelsavers agents booking through Australian consumer. M&S travel customers now have company cruiseexpress now have the option of the choice of varying amounts of excess, selling a variety of travel insurance products offered cancellation and curtailment cover, baggage Disaster Evacuation by Access America and RBC insurance. Makis and trip limits and the option to add travel Xenatos, senior vice-president of cruiseexpress, disruption cover. Director of M&S Money, Rider added said: “Travel insurance is an excellent source of Crawford Prentice, said: “One size doesn’t fit supplemental income and every travel agent should all when it comes to holidays and the same applies to New York International Group has introduced an be selling it to their customers. With cruiseexpress, travel insurance. Our new policy enables customers Evacuation Plus rider to some of its travel health all aspects of the travel sale are quick and easy to tailor their insurance to their holiday so it means I-SOS and insurance plans. This rider allows travellers more to implement, all from one convenient website.” people only pay for the cover they need.” options for protection against natural disasters, which Cruiseexpress, an Internet-based company, supports International in recent years have become a frequent occurrence. Travelsavers agencies by giving live access to the The Evacuation Plus rider is available on Patriot records of major cruise lines along with immediate Health Care unite International travel insurance plans and safeguards booking and management facilities. My Trip File International SOS (I-SOS) and International Health travellers by offering protection even during inevitable Care (IHC), a Brazil-based health advisory provider, severe weather cycles, provided launched have announced the launch of a joint venture to the policy is bought preceding My Trip File is a new private online file system leverage their mutual capabilities and services. IHC storm warnings in hurricane launched by US travel agent Tanya Eldert. The file was established by Dr Ivan Drummond, a Brazilian season. provides easy access to information for travellers in surgeon acknowledging the necessity for healthcare, Doug Polifron, director of New case of an emergency, should they find themselves medical assistance and evacuation services in remote York International Group, said: without their papers or documents. The system locations of the country. International SOS has invested “The possibility of an evacuation enables travellers to quickly link to important trip in a 49-per-cent stake in IHC, where Dr Drummond as a result of a natural disaster is information using a private, secure file through the will remain chief executive officer. a real concern for travellers, and Internet or smart mobile device for only $10 per trip, Dr Drummond said of the venture: “We are proud one that’s not often budgeted or travel agents can get a low-cost package to use on to be partnering with International SOS as we for in advance. This rider gives behalf of their clients. Ms Eldert said: “Good travel both share a commitment to delivering medical policyholders access to a means professionals know this is a service industry and we excellence. Additionally, we look forward to leveraging of evacuation and frees them are always looking for ways to provide value to our International SOS’ global healthcare, medical and up to enjoy their trip without clients. Travel agents can set up an account for only security assistance capabilities and distribution channels concern about how they might $17 per month that can provide private files for up to to support our Brazilian clients, who are increasingly escape a weather-related or 50 clients at a time.” investing in markets outside of Brazil.” environmental emergency.”

International Travel Insurance Journal INSURANCEMATTERS 11

NEWSWIRE Japanese premiums rise The Nikkei financial news organisation has reported Sumimoto Insurance that premium revenue at Japan’s top-five property was bolstered by its MDLiveCare, the 24/7 healthcare Munich Re has revealed that Safe, the and casualty insurance companies increased by 3.8 marketing partnership consultation company, has announced a multi- Chinese state agency tasked with managing the per cent year on year to a combined total of ¥470.8 with Sumimoto Life year contract with Europæiske Rejseforsikring A/S, world’s largest foreign exchange reserves, has billion (US$6.1 billion). All five insurers – Mitsui Insurance. Renewals the Denmark-based travel insurance company, to become one of its most significant shareholders, Sumimoto Insurance, Aioi Nissay Dowa Insurance, of large policies rose provide doctor telehealth consultations for business with a stake of just over three per cent. The Tokio Marine & Nichido Fire Insurance, Sompo at Sompo Japan travellers and expats visiting the US. composition of China’s foreign exchange reserves Japan and Nipponkoa Insurance – recorded double- Insurance, while rate is usually regarded as a state secret, with the digit premium growth for compulsory automobile hikes at the end of RBS Insurance has joined with the private organisation rarely allowing its holdings in public liability insurance. Mainstay auto insurance policy last year boosted bank Coutts to offer a new high-net-worth policy companies to rise above the disclosure threshold. premium income also rose, although it was only auto insurance to Coutts clients. The policy will include home, up 1.1 per cent. Nikkei said: “Of the three non- income at Nipponkoa motor and travel insurance adapted to the The Australian Insurance Industry Awards life insurers reporting increases in this field, Mitsui Insurance.” customer’s requirements. honoured the sector’s best companies and individuals recently, awarding the General The Institute of Customer Service has Insurance Company of the Year and the Life awarded Europ Assistance’s UK and Ireland Insurance Company of the Year accolades to offices its respected ServiceMark accreditation Allianz and CommInsure, respectively. for outstanding customer service. It reflects the company’s constantly high standards in providing Industry executives have repeated their assistance services to the UK insurance industry. belief that microtakaful is an important tool to help increase insurance penetration. However, Mondial Assistance USA has announced it the lack of specific regulations is a challenge to has been included for the first time in the the industry, said speakers at the recent 22nd influential InformationWeek 500, an annual FAIR Conference in Cairo, Egypt. listing of the nation’s most innovative users of business technology. Manulife Financial’s CoverMe website has been awarded the 2011 International Nationwide Building Society is including Business Award for best insurance website. The free travel insurance for 65 to 75 year olds to its site is direct-to-consumer and markets individual FlexAccount current account. From September, all supplemental health insurance, travel insurance, existing and new customers under the age of 75 life insurance and critical illness cover. received European travel insurance usually worth £70 a year as part of their ‘main’ current account. The General Insurance Association of Brunei, Darussalam, is set to be replaced by a Air Astana of Kazakhstan and travel new association called Brunei Insurance & Takaful insurance firm Travel Guard have launched a Association by next year, said chairperson Helen new service for Air Astana customers wishing to Yeo. The move reflects the growing importance of purchase travel insurance when booking tickets takaful in the Sultanate. online. Air Astana customers will receive an electronic insurance policy via email once the online Insurers of the operator of Shanghai’s Line transaction has been completed. 10 subway train line could be faced with public liability claims following the 27 September train collision that saw more than 270 people injured.

The niche art insurance world is getting a boost in India, as young entrepreneurs and art collectors buy impressive collections, helping to drive the sector forward to what is estimated to be worth around US$41 million a year.

Collaboration among several private sector organisations in the Philippines has resulted in the first group cancer insurance plan being added to existing health insurance plans offered by employer-sponsored health maintenance organisations.

US-based catastrophe modelling firm EQECAT has said that Typhoon Roke, which hit Japan in September, caused between US$300 million and $600 million in insured damages. The Sendai area hit by the massive earthquake and tsunami in March were largely unaffected by the typhoon.

Malcolm Steingold, chief executive of the Asia Pacific region for Aon Benfield, said that reinsurers are expected to reimburse insurers for up to two-thirds of their direct loss payments from the natural catastrophes seen this year in Australia and New Zealand.

MedGulf BSC of Bahrain has announced plans to acquire 75 per cent of Allianz Takaful, giving the company further access to the takaful markets of Bahrain and Qatar. No financial details of the deal were revealed, as it is still awaiting regulatory approval.

www.itij.co.uk 12 INSURANCEMATTERS

Experian reveals how ‘Facebook Spanish hopeful NEWSWIRE generation’ engages with insurers The Spanish government has begun seeking buyers for a Barcelona-based insurance company A new report from Experian sheds new light on how Jo Buxton, insurance general manager at Experian, that has been under the control of the Directorate the UK’s young adults engage with insurers. Defi ned commented: “Our report shows that the Facebook General of Insurance for the past two years. The Life Insurance Association of Malaysia, by Experian as the ‘Facebook generation’, this group of generation has a new set of expectations around David Ing has the latest on the 110-year-old Persatuan Insurans Am Malaysia, and the savvy 18 to 25-year-olds has taken social media and its how they should be served by insurers and Agrupacio Mutua Malaysian Takaful Association, have all entered into ideologies into adulthood, infl uencing how they deal other fi nancial services providers. Social media an agreement to form the Joint Insurance-Takaful with insurance companies; while six out of 10 admit to makes young adults better informed, more able Two of Spain’s major national insurers, MAPFRE and Council, which has the aim of ‘further liberalising relying on friends and family for fi nancial advice. to share grievances and more open to infl uence Mutua Madrileña, are reported to be among the and creating harmony in the insurance sector’. A common goal amongst the Facebook generation from peers and providers than ever before. They front-runners in the bidding to take over Agrupacio is to obtain good value on their insurance facilities, want immediate information, instant decisions, Mutua, which fell victim to the country’s property GIC Re, India’s national reinsurance fi rm, and cheap premiums for motor price collapse in 2009. Another has recently launched its Straight-Thru-Processing or home insurance rate highly Barcelona mutual society, Fiatc, e-platform, which aims to ensure effi cient, among this customer segment. which on several occasions transparent and prompt trading between the Driven by the ‘price comparison in the past tried to arrange a company and its business partners. The platform culture’ of aggregators and merger with Agrupacio, has also provides a web interface for submission of high-profi le consumer websites, expressed interest, going so far as transaction data. 42 per cent of the Facebook to register a brand name for the generation requiring motor new entity if it gets the go-ahead. The Indian Insurance Regulatory and insurance changed their provider Agrupacio released a statement Development Authority is said to be planning at their last renewal, compared saying it is looking for ‘projects several regulatory changes in the areas of to 34 per cent of all adults. with future viability’ through distribution, bancassurance, reinsurance and Data from Experian Hitwise alliances that could ‘bring added pension products. reveals that young adults are the value’ and reinforce its position in fastest-growing segment of society the face of ‘market and regulatory Takafol South Africa, the country’s only for visits to insurance websites, challenges’. Founded in 1902, Islamic insurance operator, has been bought by increasing by 40 per cent in the Agrupacio Mutua had some South Africa’s Absa Group. Takafol SA will become last year alone. Experian research 380,000 clients, mainly in the part of Absa Islamic Banking and operate under also shows that of the 48 per cent Catalonia region, when it ran into the new brand Absa Takafol. of young adults with some form of motor insurance, faultless customer service and the ability to manage fi nancial problems. Its former president resigned in July nearly half (46 per cent) arranged cover directly – via their policies on the move. Insurers with a deep 2009, and three months later the Directorate General Hannover Re announced at a recent press the Internet – with the insurer (compared with 38 per understanding of how their customers are interacting of Insurance, which comes under the Economy briefi ng that ‘vigorous growth’ in retakaful is a cent of all adults), and a further quarter (26 per cent) around their brands online will be well placed to Ministry, named two independent administrators to factor leading to the growing international need for used a price comparison site (compared with 19 per capitalise on the opportunities this demographic take control of the company. The Directorate said the reinsurance protection. Andre Arrago, member of cent of all adults). presents now and in the future.” move was necessary because of ‘the body’s signifi cant the executive board for Global Reinsurance said: This trend is echoed in the fi gures for buildings and The challenge for insurers is to capture the attention defi ciencies in internal control and its investment “We see growth of 20 per cent every year in our contents insurance, with almost a third (31 per cent) of of this segment as well as fi nd new ways to assess policies’ – mainly in a property market that felt the full Middle East portfolio so it’s a good contribution for young adults arranging cover direct with the provider risk. Those insurers collecting more data on the brunt of the economic crisis in Spain. us and we see that trend continuing.” over the Internet, and a further 12 per cent through insurance proposal form will be at an advantage, Whether Agrupacio is simply absorbed by whichever an aggregator. The corresponding fi gures for all adults whether the individual’s credit risk details are being buyer steps in, or whether its portfolio is sold on, will Lloyd’s Insurance Co. (China) Ltd has were 23 per cent and nine per cent respectively. used to assess premiums or the information shows need to be decided by a meeting of members of the released its fi rst direct insurance policy in an Social media is second nature to the Facebook the type of car being driven. Making maximum use mutual society, which is scheduled to be held before attempt to become more dominant in the nation’s generation and they are 14 per cent more likely to of all data available will also ensure risk assessment the end of the year. At a meeting in June, there were fi nancial centres. Eric Gao, chairman and chief use Facebook than the average UK Internet user. around crucial pricing decisions happens quickly and moves to promote a fusion with other mutual groups executive offi cer of Lloyd’s China, said: “Although Members of the Facebook generation are in their more accurately. in the fi ercely nationalist Catalonia region. reinsurance will continue to be our main source of fi rst job, some even having their fi rst foot on the Insurers choosing to target this demographic, However, since the intervention, the Directorate of business for some time, [we see] huge potential for property ladder. As detailed in Experian’s Banking on concludes the report, should use social media to Insurance has put Agrupacio Mutua in the hands of our insurance business.” the Facebook Generation report, only a few in this engage and communicate by encouraging the sharing directors from outside the regional insurance sector. group have a car and most do without. Extensive of information, offers and advice with friends and Javier Verges, formerly with Asemas and March Masaaki Shirakawa, governor of the users of mobile phones and technology, the group’s family. Lastly, embracing technology and utilising Vida, took over as director general last year, and Bank of Japan, has said there should be ‘less overriding characteristic is its appetite to always fi nd online channels for customer service opportunities Luis Gomez Terroba, ex-Aresa-Mutua Madrileña regulation and more supervision’ of insurance the best fi nancial deal, from insurance through to is vital for insurers who have the desire to deal with and Agrupacion Mutual Aseguradora, became companies, and that a one-size-fi ts-all approach credit cards and mortgages. this demographic. director of marketing. could have adverse and unexpected effects. ITIJ is moving office… …to Lisbon

LIVE‘11 lisbon

International Travel Insurance Journal INSURANCEMATTERS 13

Industry reports released

Aon Benfield, the global reinsurance intermediary estimates from Impact Forecasting – Aon Benfield’s and capital advisor of Aon Corporation, has recently wholly owned catastrophe model development released two new reports. The first is itsReinsurance centre of excellence – for recent events. Market Outlook – Value Creating Capital report, The figures reveal that the Tohoku earthquake which reviews major events in the year to date on 11 March is estimated to have resulted in an and highlights key considerations for insurers in insured loss of between US$30 to 40 billion ($15 the approach to the 1 January 2012 reinsurance to 25 billion net of Japanese non-life insurer and renewals. In its analysis of the industry, the 50-page government earthquake insurance scheme (JER)) study examines standard predictive pricing variables and an economic loss to Japan of $300 billion; such as reinsurer and insurer capital, rating agency while the sum of the New Zealand earthquakes standards, and actual catastrophe losses. It also caused approximately $17 billion in insured losses contains dedicated commentary on trends in the and economic losses of $24.8 billion. Insurer and financial markets, insurance-linked securities (ILS), reinsurer capital are both expected to end 2011, and mergers and acquisitions, as well as reviewing in the absence of significant additional catastrophe both catastrophe activity by sector and geography, or other losses, with more capital than they held and the 2011 reinsurance renewal periods. at year-end 2010. Insurer capital is likely to show a more meaningful level of growth than that of Flooding in Queensland reinsurers in 2011, despite reasonable levels of retained catastrophe losses and continued S&P shows confidence share repurchases. Bryon Ehrhart, chairman of Aon Benfield Analytics, In a report published in September, Standard & Poor’s rating action or changed the outlook on reinsurers said: “Throughout the significant insured catastrophe Ratings Services (S&P) said it believes the impact of the incorporated in Asia-Pacific recently.” events of 2011, reinsurance has once again proved series of natural disasters between September 2010 Insured claims from these Asia-Pacific events could its inherent ability to add value as an earnings and and June 2011 on reinsurers’ overall financial profiles amount to as much as US$51 billion, according to capital protection tool. Reinsurers provide value- can be managed. In its report, Asia-Pacific Reinsurers information from AIR Worldwide. “Prospectively,” creating capital to insurers that desire efficient capital Start To Push Through Higher Prices In Wake Of Regional adds S&P, “we could see higher property catastrophe structures to support risk taking at competitive and Catastrophes, the company states that despite natural reinsurance premiums and tighter terms and conditions accretive terms. There is still plenty of opportunity catastrophe challenges to the industry, it is prepared to – especially in Japan, Australia, and New Zealand – as for insurance and reinsurance partners to deal with the fallout. international reinsurers attempt to claw back some of collaborate, innovate, add more value to insureds The S&P report states: “Underwriting results for the losses.” and profit together.” a number of global reinsurers with operations in It further adds that reinsurance pricing in the rest of Asia Aon Benfield also recently released its 2011 Asia-Pacific were hit by the disasters, which included (outside Japan) is uncertain, reflecting the counteracting Insurance Risk Study. The study, now in its sixth an earthquake and tsunami in Japan, two major effects of shrinking global reinsurance capacity and the edition, provides underwriting volatility benchmarks earthquakes in New Zealand, and floods and a cyclone competitive but rapid growth of primary insurance in that are a valuable resource to chief risk officers, in Australia. However, outside Japan, regional domiciled the region. Nevertheless, soft reinsurance pricing is actuaries and other economic capital modelling rated reinsurers have limited or manageable exposure likely to continue in some Asian markets, especially in professionals, as well as comprehensive analyses of to the region’s catastrophe events as they write mostly those not as prone to catastrophes, such as Singapore, notable specific risks to the industry. Its data spans domestic business. As a result, we have not taken Malaysia, and Thailand. 47 countries and key business lines, representing more than 90 per cent of global property-casualty insurance premium. Again this year, the study ranks global underwriting volatility by line of business and by territory. It reveals that property remains substantially more volatile than other major lines. In Germany and Spain, property is nearly twice as volatile as motor, the most stable line; in the US, property is nearly three times as volatile; and in France, it is four times as risky. Overall, volatility parameters are in line with last year’s study, but they do not yet reflect 2011’s significant catastrophe activity. The study also provides a detailed summary of US Insurer and reinsurer risk parameters and reserves, and highlights that despite recent favorable development in the P&C capital are both expected industry’s reserves position, reserve risk remains a potential significant source of leveraged cyclical to end 2011, in the absence uncertainty and a continued threat to insurer solvency. Based on historical variance in reserve of significant additional patterns, the study estimates that aggregate US industry reserve development of more than $60 catastrophe or other losses, billion can occur once every fifteen years, or roughly once per cycle – consistent with experience from the with more capital than they last two soft markets. Meanwhile, it ranks the top-50 global markets by held at year-end 2010 P&C gross written premium (GWP), and reveals that the US market leads the way with a GWP of $455.98 billion and 3.1 per cent insurance The report reveals that reinsurers remain well penetration (defined as the ratio of premium capitalised and have the ability to continue to provide to GDP), followed by Japan ($76.93 billion), value-creating capital to insurers at terms that are Germany ($67.79 billion), the UK ($62.66 billion), accretive to the earnings and capital of insurers. and France ($59.76 billion). China ranks 6th, with Reinsurers, assuming only modest additional insured a GWP of US$45.83 billion and 0.8 per cent catastrophe events in the balance of 2011, are likely insurance penetration. to have sufficient capital to meet the demands of International premium growth remains a challenge insurers globally. for the industry, with none of the top-10 countries The influence of catastrophe model changes and showing an increase in insurance penetration. related rating agency capital requirements are not Absolute premiums decreased in five of the top-10 expected to drive new demand for capacity in excess countries, and – other than China – showed only of reinsurers’ supply for January 2012 renewals, modest increases in the others. Combined with according to the report. For the first time, the depressed investment yields, insurers remain under Reinsurance Market Outlook contains insured loss significant pressure to expand their top-line results.

www.itij.co.uk 14 INSURANCEMATTERS

Spanish fraud Moody’s outlook revised NEWSWIRE problems continue Moody’s Investors Service has changed the outlook on the global reinsurance sector to stable from The number of fraudulent claims uncovered by negative refl ecting the momentum for a hardening Reuters has reported that European major insurance companies has soared by 64 per in reinsurance rates, a refocusing on the value of insurers Allianz and AXA are among the cent in Spain in the last three years of economic reinsurance, and the good risk management and companies sounded out as potential bidders for crisis, according to fi gures released by the discipline across the sector in response to recent HSBC Holding’s sale of its general insurance industry’s research group ICEA. David Ing reports catastrophe losses. A new Moody’s Industry Outlook business, which could fetch more than US$1 report predicts that, over the coming 12 to 18 billion. Australia’s QBE Insurance, China’s Fraudulent claims rose from 72,424 to 76,569 in months, these positive trends should neutralise the PICC Property & Casualty, and Japan’s Tokio 2008 before leaping over the 100,000 mark to challenges facing the industry. Marine Holdings were also mentioned as 101,615 in 2009, and reaching 118,470 in 2010. “Recent catastrophe losses loom large in our possible bidders. Obligatory by law, car insurance accounts for more decision to revise the outlook to stable, as they than three-quarters of the attempted scams, although have provided momentum for reinsurance rates Aon Benfi eld, the global reinsurance the sub-sector’s share fell slightly last year to 89,248. to harden,” explains Dominic Simpson, a Moody’s adviser, has said that Australia’s insurers will The biggest growth in fraudulent claims has been seen vice-president and senior credit offi cer and lead have to pay almost A$10 billion (US$9.7 in the life, accident and health sector, nearly tripling author of the report. However, over the longer billion) themselves to cover the costs of 2011’s from 1,295 cases in 2008 to 4,153 two years later. term, it remains uncertain whether this expected unprecedented level of natural disasters. “Nearly all the cases that are detected correspond to plateau is a temporary halt to further pricing private individuals,” says ICEA’s programme director weakness or whether it will be followed by sustained At the recent Middle East Healthcare José María Olazabál. But although the number of cases market improvements. Insurance Conference, Dr Finn Martin has soared, ‘the amount that is reclaimed per case is The revision of Moody’s outlook on the sector to Goldner of the Abu Dhabi Health Authority usually quite low’. stable refl ects several drivers, including moderation short-tail, non-loss affected areas have also seen said that governments wishing to introduce What worries the industry most is the involvement of the supply/demand imbalance. The report states: pricing stability. Moody’s is seeing momentum for mandatory health insurance should clarify of criminal gangs. “They represent a small amount of “Growth in the supply of reinsurance has been a hardening in reinsurance rates, a view that is their intentions, properly regulate the sector cases, but with each fraud they obtain much higher checked by recent catastrophe losses, and future reinforced by reinsurers’ generally good underwriting and weigh the costs and benefi ts of public- quantities,” said Olazabál. The gangs work mainly supply could be constrained by more expensive discipline. Furthermore, prices have stabilised for US private partnerships. in the car sector, often buying up wrecked vehicles retrocessional cover and by consolidation for which commercial lines (Moody’s has recently revised its to later use to fake conditions are outlook to stable from negative for this sector).” The China Insurance Regulatory an accident and then favourable. On The company also noted that despite pressure on Commission is said to be reviewing the claim for a total write- the demand profi ts, loss ratios look set to stabilise, explaining possibility of opening overseas investment off. Suppliers such as side, Moody’s that 2011 profi tability is under meaningful pressure. channels further for domestic insurance garages, doctors and believes that Investment returns remain suppressed, and even companies, allowing them to invest in assets workmen rarely take insurers may before the end of what is predicted to be an listed in Hong Kong. part in the scams against not be able active hurricane season, reinsurers have already insurance companies, to further far exceeded their catastrophe budgets for 2011. Total gross premiums of the Hong Kong but agents and brokers reduce their However, Moody’s believes that underlying loss insurance industry amounted to HK$114.7 were found to be reinsurance ratios for reinsurers will at least stabilise during 2012. billion (US$14.7 billion) for the fi rst half of involved in eight per uptake, despite In addition, reserving levels are considered adequate 2011, representing an increase of 14 per cent of fraudulent cases tight reinsurance despite the depleting reserve cushion, and the cent over the same period in 2010, according detected in the life, budgets. generally short average duration of reinsurers’ fi xed to statistics released by the Offi ce of the accident and health sub- Furthermore, income portfolios may mean that investment income Commissioner of Insurance. sector in 2010. demand cannot decline much further. While more members of the public have helped could be stimulated by insurers seeking more Moody’s central concern is that low equity Zurich Financial Services Group in recent years to uncover fraud, many people still protection further to the roll-out of the updated valuations, which have persisted for nearly three announced that as part of its long-term try to claim on their policies because they know RMS catastrophe model. One large hurricane could years, could signal a more discriminate investor pool, alliance with Banco Santander SA in Latin that even if they are found out there are rarely tip the balance in favour of demand over supply.” raising concerns about the ability of some fi rms to America, it has closed the acquisition of prosecutions, said Olazabál. The 21 companies that Another reason given for the revised outlook was replenish equity capital following a major catastrophic 51-per- cent participation in the life insurance, took part in the study spent some c6.7 million on a move towards price stabilisation. Moody’s said: event. Security would be weakened for the pension and general insurance operations of investigating possible frauds in 2010, saving c341 “Not only have signifi cant price increases been policyholders and bondholders of those reinsurers Santander in Brazil and Argentina. million in payouts. reported for some loss-affected regions/lines, but that cannot reload capital. Come and visit us at our booth in the Exhibition Hall

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International Travel Insurance Journal INSURANCEMATTERS 15

www.itij.co.uk 16 INSURANCEMATTERS

Fitch: stable outlook for insurers FSA commitment

Fitch Ratings says the rating outlook for the Dutch higher equity-market valuations and the tightening could result in insurance sector is stable, indicating that the vast of credit spreads in 2010, in the medium term majority of Dutch insurer ratings are likely to be Fitch expects profitability to be lower than pre-crisis significant savings affirmed over the next 12 to 24 months. Fitch’s levels as a consequence of lower interest rates and outlook assumes a continued, but weak, economic insurers’ more cautious investment portfolios. A decision by the UK’s Financial Services Authority recovery in the Netherlands, with modest gross Fitch considers that the main risks to Dutch (FSA) to begin the implementation of Solvency II domestic product (GDP) growth. The outlook does insurers’ ratings over the next 12 to 24 months will requirements in 2013 despite the expected European not take into account potential outside shocks to the be a failure to report sufficient operating profits, Union delay until 2014 would result in significant Dutch economy, but will be updated to reflect such most likely caused by an inability to cut costs, and savings for the UK insurance industry, according to events if they occur. potentially unsustainable price competition. These new research by Marketforce. Initial results from the “The Netherlands insurance market is well risks are exacerbated by muted GDP growth and, survey, which will be launched in full at Marketforce established, sophisticated and highly competitive,” for life insurers, the threat of prolonged low interest and the IEA’s 11th annual The Future of General says David Prowse, senior director in Fitch’s rates. However, established insurers continue to Insurance conference in November, show that 75 insurance team in London. “Ratings already take into have strong market positions and will be well placed per cent of the insurance industry expects to incur account the severe pricing pressure threatening the if they succeed with their efficiency programmes. additional costs in the event of an extension to the profitability and even the viability of certain product The Dutch insurance sector is the fourth-largest in Solvency II deadline until January 2014. Furthermore, lines. However, ratings also reflect the ambitious of around c40 billion. However, the report explains the euro zone after France, Germany and Italy, with while the industry broadly supports the aims of the cost-cutting that insurers are carrying out to bolster that most of this insurance is, in effect, underwritten total assets in excess of c400 billion at end-March new regulations, 73 per cent do not believe that the their profitability. Successful implementation of these by the Dutch government, with insurers undertaking 2011. Total premiums in 2010 amounted to c76.9 overall costs of implementation will be proportionate measures will be essential for insurers’ prospects and a lot of the administration associated with healthcare, billion, comprising c21.5 billion for life insurance, to the benefits that the new measures will achieve. is likely to be the main driver of ratings.” but taking on little risk. Profitability is instead driven c13.1 billion for non-life insurance and c42.4 billion Tom Woolgrove, managing director of personal lines at The life insurance market in the Netherlands has by market presence (important for negotiating for accident and health insurance. RBS Insurance, said: “There is understandable concern declined sharply since 2007 as a consequence of tax contracts with employers), scale (important for Fitch also recently released its report into the in the industry over the implications, both in terms of changes allowing banks to compete on equal terms bargaining power to minimise procurement costs for UK’s insurance sector, which found that the rating opportunity costs and real costs, of having prepared with insurers in the savings market. The effect has health services), economies of scale, and customer outlook for the UK life insurance sector remains for compliance a year early. Solvency II will deliver been exacerbated by a slump in insurers’ products service. Fitch believes the market will become stable, indicating that a vast majority of UK life tangible benefits for the UK market, but we need sold through banks, as banks are increasingly increasingly competitive with the growing use of insurer ratings are likely to be affirmed over the improved clarity over the timescales and expectations promoting their own savings products. Low interest price comparison websites. next 12 to 24 months. of regulators to ensure current implementation efforts rates have also depressed profitability, particularly for Overall, Dutch insurers look set to be well capitalised Fitch’s outlook assumes a continued, but weak, remain relevant and to avoid the need to replicate life products with investment guarantees. under Solvency II. Aggregate capital surplus for the economic recovery, with modest GDP growth. The efforts in the interim period.” In the non-life sector, crucial success factors are Dutch market under the fifth Quantitative Impact outlook does not take into account potential exterior Amanda Blanc, chief executive officer of AXA disciplined underwriting, lower expense bases Study (QIS5), which captures more risks than the shocks to the UK economy but, as always, will be Commercial, said: “AXA is fully supportive of Solvency and cost-effective sales platforms. Fitch expects current regulatory capital requirements, was c17.5 updated to reflect such events if they occur. II and already manages its business on an economic established insurers to develop web-based platforms billion. This figure is around c7.5 billion lower than Fitch’s ratings recognise that insurers have basis with a strong internal model in existence. We in response to competition from increasingly popular under the current regime, broadly mirroring the strengthened their balance sheets and reduced their are making good progress on our transition to the Internet providers. Europe-wide trend of reporting a reduced level of exposure to equity markets. Direct shareholder new regime. However, we are disappointed with The Netherlands has the largest private healthcare surplus capital under Solvency II. exposure to the sovereign debt of Greece, Ireland, the extended implementation deadline as it creates insurance market in Europe, with annual premiums Although Dutch insurers’ earnings benefited from Portugal, Spain and Italy is generally minimal. ongoing uncertainty around the FSA’s expectations and However, the agency expects earnings in the medium leaves material issues outstanding.” term to be below pre-crisis levels as a consequence With 73 per cent of UK insurers uncertain as of lower interest rates and insurers’ more cautious to whether the cost of implementation will be investment portfolios, despite the cost cutting that proportionate to the benefits that the new measures many insurers are undertaking to bolster profitability. will achieve, it is not surprising that the industry is “Although sales volumes do not generally drive ratings openly opposed to a delay that would penalise them in the short term, they are a barometer of consumer for being on-schedule for implementation. A decision confidence in the life insurance industry,” says David by the FSA to enforce the introduction of the Solvency Prowse. “Sales are likely to be held back as lower II rules as of January 2013 would be welcomed by wage growth and higher price inflation squeeze UK insurers then, many of whom have remained disposable income, consumers continue to deleverage committed to the initial deadline from the outset. at the expense of saving, and demand for mortgage- John O’Roarke, managing director of general related protection products continues to suffer from insurance at LV=, said: “After such a lengthy period the slow housing market. However, the bulk annuity of preparation, the prospect of a deferral to 2014 is market looks set to grow, giving insurers an avenue to unhelpful. At LV= we have decided to press ahead bolster otherwise flagging sales.” and operate on an ‘as if’ Solvency II basis from January 2013 in order to sustain our focus on the programme and to minimise costs.” CIRC issues transfer rules

The China Insurance Regulatory Commission (CIRC) has released interim measures for the voluntary transfer of insurance business by insurance companies, which are aimed at improving exit options for the companies. The interim rules state, among other provisions, that insurance companies are obliged to seek the approval of policyholders, insured parties and beneficiaries if they want to transfer insurance business. In addition, the rules stipulate that during the transfer process, the ‘legitimate rights and interests of the interested parties should not be affected’. The CIRC was moved to change the existing insurance law as it did not contain any provisions related to the transfer of all or part of the primary risks that form the business of one insurance company to another. Previous to the new measures being introduced, a transfer of the business portfolio of one insurer could only be conducted through reinsurance or when a life insurance company became insolvent.

International Travel Insurance Journal

18 HEALTHMATTERS

InterHealth Australian Bahamas warn launches travellers taking about dengue

Crosscard health risks The government of the Bahamas has issued a public service advisory announcing heightened dengue InterHealth, the UK-based medical charity, An Australian survey by Fit2Travel has activity in New Providence, which is the most has announced the launch of Crosscard, revealed that the majority of travellers are populous island and includes the city of Nassau. a new personal electronic medical record not getting the sufficient essential health As a result, the US Embassy in Nassau issued an card from Advanced Health & Care advice they require before venturing emergency message for US citizens in the Bahamas (AHC). Over the next few months, the abroad. The survey revealed 73 per cent related to dengue. In August, the Ministry of Health Crosscard will be given out on a trial basis of the 1,000 Australian participants were reported that more than 100 cases were being to individuals. not vaccinated before travelling out of the reported daily, while approximately 1,000 cases of The credit card-sized USB device holds country, despite the fact that 87 per cent dengue-like symptoms had been reported as of 9 a person’s medical records securely, of those travellers had been medically August. Mosquito bite prevention measures, such as allowing them to take this information advised to be vaccinated prior to travel. fogging and communication campaigns, are under way with them when they are travelling abroad. There Professor Peter Leggat, tropical disease expert at James in densely populated areas. are two different areas for data to be stored on Cook University, said: “All Australian travellers who Dengue fever is the most common cause of fever the card – one for emergency purposes, which US bedbug have not sought health advice before travelling may in travellers returning from the Caribbean, Central can be publically obtained, but the second area of epidemic be at risk because of the different health conditions America, and South Central Asia. Dengue is reported information is protected by entering a password. abroad.” commonly from most tropical and subtropical The medical information could include a person’s The survey highlighted that Asian destinations are the countries of Oceania, Asia, the Caribbean, the blood group, blood pressure readings, allergies or In the US, there has been a continuing growing most popular with Australian tourists, with 33 per cent Americas, and occasionally Africa. This disease medical conditions and any current medication. bedbug epidemic in hotels. Following the 2010 of participants visiting the region. With the common is caused by four similar viruses (DENV-1, -2, Once plugged into a PC, the card owner’s details bedbug plague, the number of individual hotels occurrence of hepatitis A and hepatitis B known -3, and -4 ) and is spread through the bites of can be accessed by medical staff and emergency reporting bedbug problems has increased by 250 per to be a significant threat in Asia, Professor Leggatt infected mosquitoes. services, allowing them instant knowledge of vital cent. 2011 has already revealed 660 per cent more medical information. reports than 2010 from horrified travellers seen on Peter Jones, IT and database manager at InterHealth, sites such as the Raveable.com. Philip Vaughn, chief said: “Travellers and relief workers are often located executive of the hotel review website, said: “It is a in very remote parts of the world. We therefore groundbreaking year for bedbugs.” He mentioned recognised the need for an electronic patient record that some of the most popular summer destinations solution that would enable quick and secure access have suffered from the largest bedbug infestations, to medical information when on the move without including Las Vegas, where there was a 330-per-cent requiring access to the Internet.” increase in bedbugs from 2010 to 2011.

Legionnaires’ cluster in Corfu travellers

The UK’s Health Protection Agency (HPA) has said 14 days after exposure to a source of the legionella it is aware of nine cases of Legionnaires’ disease in bacterium, often with an initial ‘flu-like’ illness people who have travelled to Corfu since August. leading on to pneumonia. Legionnaires’ disease is The HPA is currently working with colleagues in the uncommon in the UK, but can be a nasty infection UK, the European Centre for Disease Prevention and can lead to complications, and could be fatal. and Control (ECDC) and the Greek Public Health Early antibiotic treatment is important. authorities to collect and share further information Professor Nick Phin, head of the Legionnaires’ emphasised the importance of vaccination prior to Typhoid growth regarding a possible source or sources. department at the HPA, said: “We are concerned travel: “People might stay in a glitzy hotel and assume Although these cases all have a history of recent travel that UK residents travelling to Corfu should be aware they are safe, but travel-related diseases do not in Africa to Corfu, the HPA said that a UK source of infection of this potential risk. However, we are not suggesting discriminate. Travellers can get hepatitis A in a hotel could not be ruled out. As a precautionary measure, that people change their holiday plans. Legionnaires’ with five stars, or one.” Regardless of the predominant The recent International Conference on Vaccines though, the HPA will investigate possible sources in disease is very rare and cannot be spread from travel destination being Asia, 52 per cent of the survey for Enteric Diseases, held in France, revealed new the UK, as well as collaborating with the authorities in person to person so the risk is low.” He added: respondents did not think any vaccination would be evidence of high levels of typhoid in certain areas of Greece to investigate possible sources in Corfu. The “We are continuing our investigations so that we can needed for their overseas travel. Africa. Global health experts and scientists presented patients, whose ages range from 39 to 79, had visited provide the best advice for travellers and minimise Dr Ed Bajrovic, medical director of Travelvax figures from a study that also confirmed the presence a number of different areas of Corfu. the risk of further cases. We will also assist the Greek Australia, has criticised television travel programmes of the disease in two per cent of African children The HPA is advising people going on holiday to Public Health authorities in their investigations into a for the lack of medical awareness from travellers. between two and nine years of age. This data proves Corfu to be aware of the signs and symptoms of possible source or sources within Corfu. Sometimes He said: “I think these programmes should clearly the vital necessity to make typhoid vaccination a Legionnaires’ disease, which is a form of pneumonia. a source for the infection is never found, because tell viewers: ‘We recommend that you see your priority in Africa, with typhoid fever rapidly increasing If a tourist develops symptoms in Corfu, or within the bacteria can live in a very wide variety of types of doctor for advice on the travel-related health in the makeshift townships surrounding sub- two weeks of returning from Corfu, they are being water supply.” risks of this destination while planning your trip’.” Saharan Africa’s cities. Furthermore, it highlights the advised to seek medical advice. The HPA is issuing a briefing note to all general Instead, he believes travel programmes promote importance of vaccinations for travellers, as the US Legionnaires’ disease can lead to severe pneumonia, practitioners asking them to be alert to returning such destinations as India and Africa with a severe reports an average of 400 cases a year, 75 per cent caused by the legionella bacterium. It is able to travellers from Corfu with relevant symptoms. lack of any information on the localised health risks of which are obtained during international travel. survive in water, and may be spread through The HPA is also working with the Foreign and and diseases. Furthermore, he suggests that: “With Dr Ed Bajrovic, medical director of Travelvax exposure to water droplets from cooling systems, Commonwealth Office and the Federation of Tour much holiday booking now done on the Internet, an Australia, commented: “In Australia, two vaccines shower heads, taps etc., and it is important to note Operators to ensure travel agencies are aware of the increasing number of people are getting no advice at are available, an oral and an injectable type. These that Legionnaires’ cannot be spread from person potential risk to travellers. all about potential health risks.” vaccines protect only against Salmonella typhi, to person. Symptoms may start between two and although the oral vaccine may offer some protection against Salmonella paratyphi type B. That makes it the preferred vaccine against typhoid for travellers Disease outbreaks continue in NZ to Asia, particularly India.” With antibiotic resistance a growing concern in both India and Africa, the The measles outbreak in Auckland continues to grow, further cases in Wellington – which is on the southern need for travellers to receive these vaccinations with latest figures showing that 179 people have tip of the North Island – and in the capital of Aukland, is reinforced. And with treatment medication not caught the disease since the outbreak began in May. where the latest diagnosis has been in a toddler. necessarily readily available to a traveller who catches Twenty-six of those have been hospitalised, and the Furthermore, Dr Stephen Palmer, medical officer of typhoid abroad, the importance of prevention is Auckland Regional Public Health Service has been health in Wellington, said there is normally a blip of further highlighted. Tonia Buzzolini, a registered urging people with the highly contagious disease to meningococcal cases about this time of year, but it’s nurse and national operations manager of Travelvax stay away from public places including work, school of concern that there have been two deaths in the Australia, advises: “While it is important for those at and doctors’ waiting rooms. past month. In the Nelson region alone, there have risk of infection to be vaccinated, travellers should Meanwhile, on the South Island’s West Coast, over 150 been 28 cases in two months and another 13 are be careful about what they eat and drink when cases of whooping cough have been recorded, with being investigated. travelling.”

International Travel Insurance Journal

20 TRAVELMATTERS

Japanese recovery Tourists tempted to Caribbean attraction remains continues Gulf of Mexico At the recent World Travel Awards ceremony in Jamaica, Graham Speaking at the Special International Symposium on Not surprisingly, tourists kept away from the Cooke, president and founder the Revitalisation of Japan’s Tourism Sector and Quake picturesque coastlines of Florida, Alabama, Louisiana of the awards, highlighted the Affected Regions, David Scowsill, president and chief and Mississippi in the US following the massive oil ongoing strength and depth of executive of the World Travel & Tourism Council spill from the Deepwater Horizon oil rig for fear the Caribbean region’s tourism (WTTC) announced the launch of the second of four of contamination. Rick Scott, governor of Florida, offering. He told attendees at quarterly reports about Japan’s recovery for the travel said that even the state’s famous Panhandle suffered the ceremony: “The region has and tourism industry following the from a drop in the number shown remarkable resilience to Tohoku Tsunami in Japan this year. of tourists it saw this overcome the challenges of recent According to the report, The Tohoku summer – despite the fact times, with an exceptional focus Pacific Earthquake and Tsunami: that most of the popular on excellent customer service and Impact on Travel & Tourism – Update beaches were untouched facilities that are second to none.” September 2011, Japan’s tourism by the oil. He added: He added: “The Caribbean is also industry is showing a strong recovery. “Around the state, people capitalising on the tremendous Data from the Japan National think that BP could be doing opportunities afford by BRIC Tourism Organisation (JNTO) and more to help market the nations (Brazil, India and China), STR Global suggest that the recovery entire state, but what I said especially with traditional source is broadly in line with WTTC’s ‘low impact scenario’ to them is ‘Look, you need to help the whole state, markets stuttering. However, to (presented in WTTC’s report from May 2011), which but you need to make sure the Panhandle gets back unlock this potential, accompanying states that international tourist arrivals will recover in on its trajectory’. We have a plan and BP has helped government support remains vital, numbers by early 2012, along with a faster recovery in fund that plan and it’s heading in the right direction, including the easing of restrictions Japan’s own domestic travel and tourism demand. but we’re not there with regards to seafood. It’s my that currently limit intra-Caribbean Such grounds for optimism are partly the result of belief it’s in their best interests to make sure tourism travel.” the appreciating yen boosting overseas travel and has come back.” BP has given the state of Florida Other industry experts who positive news on the containment at the Fukushima US$30 million to help fund tourism attraction attended the ceremony were nuclear plant. A forceful marketing campaign by the campaigns. BP also contributed to an $18-million equally fulsome in their praise of Japan Tourism Agency, which will include public-private advertising drive undertaken by Alabama, which the region’s tourist potential. John partnership initiatives, is also helping to ensure the seems to have done the trick, according to Mike Lynch, chairman of the Jamaica speedier recovery of Japan’s inbound tourism. Foster, marketing vice-president at Gulf Shores and Tourist Board, said: “Many of David Scowsill stated: “As the world’s third-largest Orange Beach Tourism, who said: “We dramatically the world’s premium brands are travel and tourism economy, the recovery of Japan is got hit in terms of people coming to our area. available within the region, and one of the most compelling issues facing the industry When we got our initial allotment of marketing these are complimented by brands that developed whose time has come – and gone. It must be phased anywhere in the world.” In a meeting with Japanese dollars, we were thinking that this was going to be a in the Caribbean and have earned world-renowned out now or at least redesigned, he said. Prime Minister Yoshihiko Noda, Scowsill was told of three-to-five-year project, but at this point it doesn’t status. Caribbean people are also naturally “APD has always been a blunt instrument and a bad the government’s gratitude that WTTC will bring the appear that way. It appears the visitors are back.” hospitable, and throughout history, have had to tax. The distance-based system is discriminatory to industry’s leaders to Sendai and Tokyo during the Not only did tourist numbers in Alabama recover, conquer several challenges. Our resilience is well the Caribbean and the Caribbean people living in Global Summit in April 2012. they actually rose by 30 per cent year-on-year. honed.” the UK. The Caribbean is closer to the UK than the In related news, speaking at the Caribbean’s State of US west coast yet it is in a higher band,” explained the Industry Conference in St Martin recently, David Scowsill. He added: “The UK Government is choking Scowsill, president and chief executive of the World the growth of travel in the form of APD. APD is Travel & Tourism Council (WTTC), called on the UK cited numerously as the reason for the withdrawal Government to abolish Air Passenger Duty (APD) as of marginal air routes, and the losses or failure of it harms the Caribbean economy and the Caribbean travel companies. More importantly, it is dampening community living in the UK. He said that APD distorts demand for travel out of the UK, as many British the tourism market and damages the economic consumers just cannot afford the extra amount levied prosperity of the Caribbean, which is the most on the price of each ticket.” The WTTC claims that tourism-dependent region in the world. the taxation costs the industry £2.5 billion each year According to a report by the Caribbean Tourism and threatens the UK’s international competitiveness Organisation, arrivals from the UK to the Caribbean status as a tourism destination. Scowsill went on to are already declining, while those from other source say: “The UK should learn from its neighbouring markets are increasing. In November 2010, it was countries such as the Netherlands, who repealed estimated that the average decline in UK arrivals to the a US$412-million departure tax because it cost the Caribbean would be in the region of 15 per cent once economy $1.6 billion. The Irish also plan to cancel the full impact of the latest rise in APD has taken effect. their $165-million travel tax because it costs them During the first half of 2011, the impact was even $594 million and 3,000 jobs.” The UK Government greater – 20-per-cent lower than 2008 passenger claims that the system is designed to offset aviation’s levels. Scowsill believes that with the adoption of the environmental impact and reduce emissions, but EU Emissions Trading Scheme from 2012, it is time critics say that there is no evidence the money raised for the UK Government to recognise that APD is a tax is used to offset any such impact.

Generation differentiation

A new study from Post Office Travel Insurance although European countries are the most common has shown that today’s 18 to 24-year-olds have destinations for travellers from the younger travelled three times as much as their grandparents, generation, they have also gone as far afield as Africa the baby boomer generation, and has revealed (17 per cent), North America (15 per cent) and generational gaps when it comes to travelling habits. South/Central America (four per cent). In addition, While 77 per cent of baby boomers had never left the study made the assertion that package holidays, the UK before the age of 16, a total of 79 per cent introduced in the 1950s, had a significant impact on of those from Generation Y have travelled abroad travelling abroad. an average of four times before reaching 16. The Sarah Munro, head of travel insurance at the Post Post Office has estimated that three in five Britons Office, said: “Whilst their parents and grandparents under the age of 16 have been on their first flight weren’t able to travel so freely, children today have by the age of four. The study also shows that over the opportunity to experience different cultures, half of 45 to 54 year-olds never travelled abroad as countries and ways of life for themselves.” The children, and, of those that did, an overwhelming Post Office is urging younger travellers to consider 94 per cent had never left Europe. the need for travel insurance for their trips away, Regarding destinations, the study showed that especially if they travel without their parents.

International Travel Insurance Journal TRAVELMATTERS 21

UNWTO Bali’s paradise report released reputation tainted

The most recent report issued by Officials on the island of Bali have warned that the the United Nations World Tourism destination is becoming ever more popular with Organization (UNWTO) shows that international drug gangs seeking to sell their wares to international tourism grew by almost five per cent the growing number of international tourists taking in the first half of 2011, totalling a new record of 440 vacations there. In recent months, the island has million arrivals. The results confirm that, in spite of witnessed an increasing number of smuggling incidents multiple challenges, international tourism continues – the most severe involving the death of a Ugandan to consolidate the return to growth initiated in 2010. woman who was found with a kilo of plastic-sheathed International tourist arrivals are estimated to have crystal meth in her stomach. In August, a South African grown by 4.5 per cent in the first half of 2011, woman was arrested at the island’s Ngurah Rai Airport consolidating the 6.6-per-cent increase registered with a similar amount found in her underwear. in 2010. Between January and June of this year, the Official figures show that drug-trafficking arrests are total number of arrivals reached 440 million, 19 rising quickly – from 200 cases throughout the whole million more than in the same period of 2010. of 2010 to over 700 for the first half of this year. Growth in advanced economies (up by 4.3 per cent) has maintained strength and is closing the gap with emerging economies (up 4.8 per cent), which have been driving international tourism growth in recent years. This trend reflects the decreases registered in the Middle East and North Africa, as well as a slight slowdown in the growth of some Asian destinations following a very strong 2010. “The sustained growth registered in tourism demand in such challenging times clearly makes the case for the sector and reinforces our call to consider tourism as a priority in national policies. Tourism can play a key role in terms of economic growth and development, particularly at a moment when many economies, for the most part in Europe and North America, struggle for recovery and job creation,” said UNWTO secretary-general, Taleb Rifai. The report states that nearly all the world’s regions showed positive trends, with the exception of the Middle East and North Africa. Results were better than expected in Europe (up six per cent), boosted by the recovery of Northern Europe, which rose by seven per cent, and Central and Eastern Europe, which witnessed growth of nine per cent, and the temporary redistribution of travel to destinations in Southern and Mediterranean Europe – up seven per cent due to developments in North Africa, which saw visitor numbers drop by 13 per cent, and the Middle East, which suffered an 11-per-cent drop. Sub-Saharan Africa continued to perform soundly with a nine-per-cent rise. The Americas’ growth of six per cent was slightly above the world average, with remarkably strong results for South America in particular, with growth of 15 per cent. Asia and the Pacific region grew at a comparatively slower pace of five per cent, but this more than consolidates its 13 per cent bumper growth of 2010. Results from recent months show that destinations such as Egypt, Tunisia and Japan are seeing declines in demand clearly reverting. “We are very encouraged to see demand picking up in such important tourism destinations and call for continued support to these countries, which are today fully ready to receive travellers from all over the world,” added Rifai. So far, the growth of international tourism arrivals is very much in line with the initial forecast issued by UNWTO at the beginning of 2011 – four per cent to five per cent for the full year 2011, a rate slightly above the four-per-cent long-term average. As international tourism receipts were more affected by the 2008-2009 crisis and recovered somewhat slower than arrivals in 2010, this year should also see their further improvement. Following an encouraging first half of 2011, growth in the remainder of the year is expected to soften somewhat as recent months have brought increased uncertainty, hampering business and consumer confidence. “We must remain cautious as the global economy is showing signs of increased volatility,” said Rifai. “Many advanced economies still face risks posed by weak growth, fiscal problems and persistently high unemployment. Simultaneously, signs of overheating have become apparent in some emerging economies. Restoring sustained and balanced economic growth remains a major task.”

www.itij.co.uk 22 IPMI NEWS

Chinese hit healthcare barrier Healix selected Incentives

It has been reported that Chinese students Healix Health Services has been chosen to act introduced who go to study at US universities are as a medical claims third-party administrator fi nding it diffi cult to negotiate the complex for Freedom Healthnet, the UK-based private International private medical insurance (IPMI) US healthcare system. International health and medical insurance provider. Freedom provider Now Health International has launched students are required to purchase a health Healthnet was established in 2003 and this year a six-month incentive campaign that includes insurance plan through the university they launched Freedom Worldwide, an international offering a five-per-cent discount on all existing are attending before enrolling in classes, but private medical insurance policy. Previously, all and new individual quotations. The campaign, the nature of the Chinese health system claims had been managed in-house, but the which applies to individuals and family businesses is so different from the US system that growth and success of the new plan means only, covers all new quotations and brokers can understanding benefi ts and limits is still that claims handling services now need to be apply for the new terms on existing quotations extremely diffi cult. outsourced. One of the key features of the that have not yet been taken up. Boynton Health Service, part of the company’s products is that policyholders can Tim Mutton, business development director, University of Minnesota, has addressed the transfer between domestic UK health plans explained the move: “We’re taking advantage problem by holding orientation sessions and the international option, without a loss in of our flexible pricing and underwriting for international students in order to help underwriting or benefi ts. infrastructure to run a short-term campaign to them understand what the health insurance Hooshiar Mines, operations director for Freedom encourage more individuals and their families to policy they have bought covers, how to see Healthnet, explained: “We needed a claims experience the many advantages of insuring with a doctor in the US, what clinics Boynton provider that could offer international expertise, as Now Health.” contains and how students can access well as the ability to handle UK medical claims. This The company has only been in operation for six those clinics. Snow Wang, a graduate of procedure – something that could cause problems partnership with Healix means we can provide a months, and throughout that time, has consistently the University who volunteered as an international for international students due to cultural differences. consistent level of claims management as we grow our met or exceeded six key service promises it set student representative on Boynton’s Student For example, she explained, in the US, making an business.” He added: “In particular, the level of medical when it launched. Mutton commented: “The Health Advisory Committee, said that while the appointment to see a doctor is common, whereas in knowledge at Healix, and its extensive experience publishing of a set of stringent standards in key orientations were helpful to give students a whole China most healthcare delivery is done on a walk-in of managing healthcare incidents across different areas of service was a challenge to both ourselves, picture about how healthcare works in the US, she basis. Some students, therefore, fi nd it very annoying healthcare systems around the world, means we can as a young company, and to the market. Our new was concerned that students still need to go and see not to be able to see a doctor immediately, as that is be sure that appropriate treatment is authorised and technology platform has performed extremely well a doctor themselves if they want to understand a what they are accustomed to. claims costs effectively managed for the benefi t of our and allowed us to push at the service boundaries customers and the business.” in the IPMI market.” Richard Saunders, sales director for Healix Health In related news, Now Health International’s Services, commented on the partnership: “All our network of approved hospitals, clinics and medical Mercury launches global register front-line staff are qualifi ed nurses who act as named practitioners around the world has now broken case managers in order to provide a superior through the 1,400 barrier. Mutton said: “Our As an added benefi t to its Global Access Passport recall. The mutual collaboration on an international level of medical case management and high quality team has worked incredibly hard in a short space members, Mercury Healthcare International has registry of implants of all kinds will be essential in customer service, which was crucial to Freedom of time to build what is already an extensive launched a brand-agnostic, globally integrated implant order to gather complete and accurate data related Healthnet. The company also benefi ts from access network of approved suppliers and we are adding registry, which tracks costs, effectiveness, clinical to the full scope of implants related to various to our comprehensive international and UK provider to this every day. We are particularly pleased to outcomes and patient satisfaction, as well as assisting manufacturers used around the world in a relatively networks, taking advantage of our negotiated add clinics and consultants recommended by our in contacting patients in the event of a manufacturer’s short space of time. discounts and cashless billing arrangements.” customers and will continue to encourage this.”

International Travel Insurance Journal IPMI NEWS 23

New corporate plan Cigna offers AXA unveils Gulf wellbeing programmes in Abu Dhabi dedicated portal AXA Insurance Gulf has announced the launch of company has opened a new AXA ICAS Wellbeing its employee wellbeing and assistance programmes, offi ce in Dubai, which is its fi rst Arabic-speaking intake Expacare has announced the launch of its new International medical insurance provider Cigna which can be offered in tandem with international centre anywhere in the world. international plan, appropriately licensed as required has launched a dedicated intermediary portal health insurance or as an independent plan for The employee wellbeing programme is based by local Abu Dhabi legislation. Working in association for its Cigna Global Health Options (CGHO) corporate fi rms seeking to reduce healthcare costs on three pillars – human capital management with local insurer Al Ain Ahlia, the company’s international medical plan. Intermediaries can and absenteeism. The programme launch comes at (reduced absenteeism, improved productivity), partner in the region, the new plan offers a licensed now purchase CGHO plans on behalf of their an opportune time for international employers in the healthcare costs (reduced by early and appropriate insurance solution for employers seeking to cover clients, entirely online, with a full application and Gulf region: according to a recent study by McKinsey intervention), and organisational benefi ts (skills their employees in Abu Dhabi. The benefi ts offered real-time underwriting process. The company’s & Co., healthcare costs in the Gulf Co-operation development, crisis intervention and management in the policy include full cover for cancer treatment Global Intermediary Zone also makes use of Region (GCC) are expected to increase from the support). Said Firth: “To maximise performance, and chronic conditions. the intermediary support team, who have the current US$12 billion to $60 billion by 2025. the corporates need to ensure that the health of In related news, the company has said it is now able capability to set up quotes and policies on behalf Paul Firth, head of wellbeing services at AXA Insurance employees meets the demands put upon them. to accept payments online for mid-term installments of intermediaries. Mike Ross, Cigna International’s Gulf, said: “The health risks statistics in the region This will not only reduce the healthcare costs of the and renewal premiums, as well as announcing senior vice-president of individual private medical are a major concern. Changing health issues and corporates, but also benefi t them through improved another enhancement to its online facilities through insurance and business development, said: “The individual lifestyles – especially in the Gulf – require a employee productivity and engagement, which the addition of its new online claims service, Cigna Global Intermediary Zone is another new approach to how we manage health.” He further ultimately will affect the bottom line.” available to members covered under Expacare’s key milestone that demonstrates our ongoing explained: “Governments in the region are making worldwide plans. Members can register on the commitment to evolving and enhancing not only a concerted effort to address the challenges, but the website and then benefi t from being able to view all our online servicing capabilities, but our CGHO private sector will also have an increasing role to play reimbursement statements. product offering. Importantly, we believe in working in healthcare delivery. The AXA Wellbeing offering closely with our intermediary partners and – employee assistance programmes – provides this getting their feedback to develop innovative approach that empowers individuals to make healthy products and e-commerce capabilities choices and give them the tools to address their own that not only support their needs, but particular needs.” In an effort to offer all services mutually extend our joint reach to support locally, and using where possible local intake centres the healthcare needs of globally mobile and clinical and account management teams, the individuals around the world.” The company has appointed Mark Massey and Eng-Boon Tan as CGHO business development managers to support the European and Asian regions respectively. UAE changes screening rules Ross added: “The fact that we’re also placing As part of a plan to halt the spread of contagious to be screened for 16 medical conditions, including dedicated business development managers diseases amongst migrant workers in the UAE, the tuberculosis, hepatits B, HIV/AIDS and malaria in their in the fi eld means that intermediaries can UAE government has decided to increase the level home nations. People who test positive for any of the be confi dent that we are as dedicated to of medical screening international workers from specifi ed illnesses would be refused entry into all of the supporting them offl ine, providing a personal Indonesia and Sri Lanka must undergo before their visa Emirates. Workers who passed the tests in their own point of contact to offer holistic support to enter the country is approved. The new measures countries would still be subject to further screening on across the spectrum.” mean that workers from those countries will have arrival in the UAE in order to confi rm the results.

www.itij.co.uk 24 CROSS BORDER CARE

Medical tourism set Germans reach out Costa Rican Apollo teams to double to GCC numbers up with GHV

India has become a significant destination for medical The German National Tourist Office (GNTO), the According to the latest Global Health Voyager (GHV), travellers and according to market estimates, in local affiliate of the German National Tourist Board statistics available from the Inc., a web-based medical the next four years, the industry looks set to more in the Middle East, has concluded its road-show International Council for tourism facilitator in the US, than double. For those who do not have the in the Gulf Co-operation Council with an event in the Promotion of Medicine has announced a tie-up with protection of insurance cover in countries like the Dubai, which involved a series of workshops held (Promed), around Apollo Hospitals Enterprises US, medical care has become significantly more by institutional, medical and tourism representatives. 36,000 medical tourists Ltd, an integrated healthcare expensive and hospitals in India provide a cheaper The staged activities included one-to-one visited Costa Rica for organisation that includes alternative with expert doctors. Kishor Joshi, a workshop sessions, group discussions and extensive medical tourism in 2010, owned and managed hospitals, deputy general manager at Fortis Hospitals said: “We networking opportunities. generating around US$295 diagnostic clinics, dispensing are flooded with enquires from the US, Europe In 2010, Germany saw 968,336 overnight stays from million in revenue. Records pharmacies and consultancy and African countries as we can offer advanced Gulf Arab medical tourists – an increase of 26.4 per show that each medical services in India. Ali Moussavi, medical procedures like bariatric surgery at as low cent on 2009. Statistics also show that the country tourist arrived on the island GHV president and chief as one-tenth of the cost in those countries.” Fortis was the second most visited European nation for with at least one companion, and spent around six executive, said: “India is a leading destination on the has a series of 62 hospitals across the country tourists from the Arabian Gulf. Over the past few times more than the average Costa Rican tourist. medical tourism map, with over one million medical offering a large range of clinical specialities with years, Germany has made increasing efforts to target Massimo Manzi, director of Promed, attributed the travellers expected by 2012, thanks to its attractive accreditation from the US-based Joint Commission tourists in the Gulf region, adding extra direct flights rise in the number of medical tourists seeking care pricing and dedication to high-quality medical care. International. “We are strong and specific hospitality on the island to increased demand from North Apollo is an important addition to the GHV network in joint replacement surgery services that cater to American consumers, which is driving the industry’s and reflects our mission to provide medical travellers like hip resurfacing and Arabian visitors. growth at around 20 per cent year-on-year. with access to exceptional healthcare services.” replacement. We also receive Antje Roeding- Explaining the statistics further, Manzi said that dental As one of India’s largest hospital groups, Apollo a lot of international patients Boudier, the GNTO’s treatments are the most common procedures offers over 8,500 beds across its network of seeking cardiac surgery and director of marketing sought by medical tourists to Costa Rica, with 36 per hospitals, providing clinical and diagnostic services, neurosurgery,” said Joshi. and sales for the Gulf cent of such tourists also undergoing orthopaedics, medical business process outsourcing, third-party According to the Associated countries, said of the cardiovascular and plastic surgery. administration services and health insurance. Chambers of Commerce and combined efforts: Industry of India, the current “With this itinerant market for Indian medical promotional tool [the tourism is Rs45 billion and by road-shows], we Multilingual site offered 2015 this is expected to be over aimed to combine Rs108 billion when the inflow and highlight, in the The US-based Medical Tourism Association (MTA) dollars every year travelling for healthcare, so it was of medical tourists exceeds 3.2 million. Joshi said: Arabian Gulf, the traditional as well as the innovative has recently re-launched its website with a new look important for us to make sure our patient website “Healthcare spend is going up in developing countries pillars of the German travel industry. Germany’s and feel, and has added multilingual functionality, was translated into Arabic. Also, a large portion of and we can attract many more tourists to India by healthcare system benefits from its unrivalled with the site now being translated into both Arabic people who speak Spanish also travel for healthcare, taking advantage of the competency of our doctors reputation abroad, thanks to its highly trained doctors and Spanish. Rene-Marie Stephano, president of the so for the MTA, these were the two most important and healthcare workers, as well as the excellent and medical staff, the excellent medical infrastructure Association, said: “Many patients from the Middle languages for us to have working and live on infrastructure facilities available with our hospitals.” and the great diagnostics we offer.” East and Gulf Co-operation Council spend billions of [the website].”

International Travel Insurance Journal CROSS BORDER CARE 25

UK numbers US employers not embracing medical tourism could rise Aon Hewitt’s made of potential cost-saving implications for US are covering domestic centers of excellence (also 2011 Health employers concerned about rising health insurance known as domestic medical tourism) under their higher Care Survey costs, employers are seeking alternatives to sending plans, tightly managing the health of the chronically has revealed employees out of state, or out of country, for ill, and adjusting vendor compensation based on Government austerity that US medical care. specific performance targets. And in each of those measures could lead to employers Aon’s survey said: “Certain strategies that have areas, nearly half of employers are considering such a rise in the number are not received attention in the popular media do not approaches in the near future.” of UK patients embracing seem to be key areas of focus for employers. A When asked whether or not their employees’ health travelling abroad for the concept strong majority of participants reported that they insurance covered international medical tourism, medical treatment, if of medical are not interested in covering international medical only three per cent of respondents said they had the National Health tourism for tourism (travel to global centres of excellence such a plan in place; one per cent were going to Service’s (NHS) their workforce for major medical treatments at lower costs) or add such cover in 2011; 24 per cent said they might waiting lists start to – either domestic medical directly contracting with health providers as a way add an international medical tourism provision to lengthen. Many could tourism in the US itself, or to reduce healthcare expenses (72 per cent and their policy in the next three to five years; while the end up going to newer international medical tourism. The 68 per cent, respectively, report no interest).” It overwhelming majority – 72 per cent – said they are European Union (EU) survey results show that although much has been further states: “About one-quarter of employers not interested in adding such cover. member states such as Poland and Bulgaria, finds a new report from the Economist Intelligence Unit. The report, entitled Travelling for health: the potential for medical tourism, looks at the push and pull factors behind the growth of the medical tourism industry. It predicts that, thanks to ageing populations and restricted healthcare budgets, the flow of medical tourists is shifting. Whereas rich patients from developing countries used to come to prestigious hospitals in the UK and elsewhere for treatment, now UK patients are starting to travel abroad for lower-cost care. Often patients travel overseas to access care that they cannot obtain under the NHS, either because it is not funded or because waiting lists are too long. This trend could be encouraged by the EU Directive on Cross-Border Healthcare, which was passed in January 2011 and comes into force in 2013. The Directive establishes patients’ rights to be reimbursed for treatment they receive in other EU countries, and could lead to more West Europeans travelling to Eastern Europe for care. The report also looks at the US, where it predicts that the US healthcare reforms – despite meaning that more Americans will have healthcare insurance – will encourage medical tourism, as hard-pressed companies and insurers look for cheaper treatment options in an attempt to keep down premiums. Overall, the report concludes that low costs, as well as medical expertise, are becoming the main drivers of the industry. This should play into the hands of developing countries that are keen to develop a medical tourism sector, not only to bring in revenue, but also to develop expertise inside their own nascent healthcare systems. To benefit, countries need to offer a combination of medical expertise, low costs, and an environment that offers security both for patients and for the private healthcare companies that drive the medical tourism business. The report uses data on 60 countries to pinpoint which offer the best combination of these factors. Top of the ranking comes France, while other developed countries such as the US and Germany also scored highly on the back of their medical skills and general business environment. The UK is less well-placed to benefit, partly because of comparatively high healthcare costs and partly because it has only a small private healthcare sector. A number of developing countries also came nearer the top of the rankings, by offering a combination of medical expertise and low costs. Among them were Mexico, Poland, Bulgaria and India, which will also benefit from growing wealth levels. The report suggests that these countries are well-placed to develop medical tourism industries that will create much-needed healthcare jobs and expertise, as well as generating revenues. But the report warns that to make the most of this opportunity, governments and private companies will need to work together to ensure that the benefits from medical tourism trickle down to the wider population. The industry will also need to develop consistent hospital accreditation and a legal framework, so that patients can be sure that they will receive the standard of care they are expecting.

www.itij.co.uk 26 AIRAMBULANCENEWS

Hamilton Medical Medevac contract award disputed Repatriation and Rega team up Adlair Aviation Ltd, from Egypt a provider of air Swiss firm Hamilton Medical recently launched the ambulance services German air rescue provider DRF Luftrettung Hamilton-T1, its new intelligent solution for ventilation in the northwest has reported on a recent mission to repatriate for use in mobile intensive care units. Rega is the first territories of Canada, a seven-year-old German boy from Hurghada, air rescue service in the world to equip its fleet of air has appealed against Egypt, back to Germany. The boy, Louis P., was on ambulances with this mobile intensive care ventilator a decision by the holiday in Egypt with his mother when, after a trip as launching partner. The device features a compact, Government of to Luxor for sightseeing, their car collided with a powerful design that increases the availability of Nunavut (GN) to truck travelling on the same road and overturned. appropriate modes of therapy for ventilated intensive award the state Suffering from severe abdominal injuries, Louis was care patients outside the hospital. The makers say it medevac services taken by ground ambulance to the nearest hospital, covers the full range of clinical requirements: invasive contract to Air Tindi and operated on immediately. Following nearly ventilation, automated ventilation with Hamilton and its partner two weeks of recovery, his condition was deemed Medical’s own Adaptive Support Ventilation (ASV), and Arsaniq. General stable enough for flight, and DRF Luftrettung was non-invasive ventilation (NIV). manager of Adlair called on to transport the boy home in a dedicated Rega’s decision to partner with Hamilton Medical Paul Laserich said air ambulance. was made because Hamilton-T1 delivers an intensive on 6 September On 14 August, pilot Torsten Beierlein and his Adlair Aviation uses Beechcraft King Air 200 and Lear Jet 25B aircraft for medevac missions care ventilation solution in a transportable platform that his company Cambridge Bay Weather colleague Peter Schroth arrived in Hurghada with that’s appropriate for all patients – from paediatric to had lodged a formal the accompanying medical crew. Having examined adult, said the company. appeal with GN about the contract award. The medical evacuation services in Nunavut since 1999 the boy’s condition in hospital, paramedic Sven state’s Contracting with the GN, and before that, provided the service Duda agreed that he was stable enough to undergo Appeals Board met under the Government of the Northwest Territories. the transport. Louis and his family were transferred on 12 September, After the GN decision not to award the contract to to the airport in a ground ambulance, where the reconvened on Adlair was made public, an open Facebook group DRF Luftrettung aircraft was waiting. Throughout 26 September, was formed to support the company’s retention the flight, the patient was treated as if he were still and adjourned the of the contract. At the time of writing, the group in the hospital’s intensive care unit. The flight went hearing until 11 comprised over 400 members. off without incident, and the patient was taken to October. University Hospital Leipzig for ongoing treatment. Laserich told reporters: “We’re not saying anything. It’s all in the hands of the politicians in Iqaluit right now.” Adlair has previously held the contract for the provision of The Hamilton T-1 in use by Rega’s staff Hamilton Medical

One of the Learjet 35A aircraft used by DRF Luftrettung for international patient repatriation Juergen Lehle Paramedic-patient privilege examined

A legal case in Nevada has prompted close doctor in a doctor-patient relationship’. examination of doctor-patient and patient-paramedic Nevada’s Supreme Court ruled that the paramedic privacy laws, after a man was convicted of driving discovered the patient had smoked as part of his under the influence of a controlled substance based, role to document the patient’s history. However, the in part, on evidence given by the paramedic that police did not request a drug test as a result of the treated him after an accident. The paramedic said in information being found on a document – instead, court that his patient had admitted smoking marijuana the paramedic informed one of the investigating before the accident occurred. police officers what he had been told by his patient. The issue was brought to the fore after the man There are concerns that in doing so, the paramedic appealed his conviction on the grounds that when he violated the Health Insurance Portability and told the paramedic he been smoking, the statement Accountability Act (HIPPA), but even if it were ruled was private and therefore protected by the state’s that he had done so, it is likely that the information patient-doctor privilege law. The Supreme Court would still be allowed in court. of Nevada disagreed, however, and said that there As is a common problem in the US, while some is no paramedic-patient privilege in the state – only states do have laws governing the relationship doctor-patient privilege. between paramedics and patients, they are Nevada’s law states: “A patient has a privilege to not uniform and do not apply outside of that refuse to disclose and to prevent any other person state. For example, the law in Texas says: “A from disclosing confidential communications among confidential communication is [one] between the patient, the patient’s doctor or persons who are certified emergency medical services personnel participating in the diagnosis or treatment under the or a physician providing medical supervision and direction of the doctor, including members of the a patient that is made in the course of providing patient’s family.” emergency medical services to the patient is The convicted man argued that the paramedic confidential and privileged and may not be treating him immediately after the accident was disclosed except as provided by this chapter.” It one of the people ‘participating in the diagnosis or goes on to say that exceptions to the rule exist treatment under the direction of a doctor’, but the where the confidentiality or privilege is relevant in court said the paramedic was acting independently, as court or administrative proceedings and when the ‘there was no doctor present at the scene and [he] proceeding is a criminal prosecution in which the was not acting under the supervision or direction of a patient is a victim, witness or defendant.

International Travel Insurance Journal AIRAMBULANCENEWS 27

AirLink Ambulance EURAMI accredited The African challenge

Mexican firm AirLink Ambulance has announced Operating an air ambulance service in Africa, with hospital then take him to Mwanza, from where he perilously close to the spinning rotors, forcing the its successful completion of European Air Medical its long distances and geographical remoteness would be transferred with the same team onto the pilot to take off and land on the edge of a football Institute (EURAMI) accreditation. This designation poses special challenges. Medical facilities are waiting Beechcraft King Air. pitch nearby, where the crowd could be controlled. certifies AirLink Ambulance as Latin America’s first air few and far between, and in rural areas there are Given the weight limits of the helicopter, the team In hospital, the patient was assessed, and a head ambulance company accredited by EURAMI. inadequate treatment facilities. Conflict zones had to consider carefully what equipment to carry injury with possible spinal injury and a broken EURAMI approved the level of ‘Full Accreditation - with violence-related instability often add to in the helicopter and what to position in the King arm were diagnosed. After stabilisation and Special Care’ for the fixed-wing operations of AirLink the problems. AMREF Flying Doctors, based at Air prior to departure from Wilson Airport. This immobilisation, the patient was transferred to the Ambulance after a thorough on-site audit of its Wilson Airport in Nairobi, Kenya, gives details of was particularly challenging, as details of the patient’s waiting helicopter. The pilot confirmed via radio that operations in Guadalajara, Mexico. The accreditation a recent evacuation that demonstrated some of condition were vague and the team needed to the King Air had arrived in Mwanza and they took states that AirLink Ambulance has a high level of the challenges that are so typical for the African be prepared to provide intensive care, including off for an uneventful 15-minute flight. AMREF Flying safety and quality in terms of capabilities, medical environment and the flexibility that has to be mechanical ventilation. A schedule was worked out Doctors’ control centre in Nairobi had organised for management and qualifications, aircraft configuration employed to get the job done the helicopter to be permitted and equipment, operational issues, communications, to land next to the King Air in management policies and quality management. An employee of a mining company Mwanza and both air crews Additionally, it recognises the company’s specialised had been badly injured in a road assisted the medical staff in neonatal capabilities. traffic accident in rural Tanzania transferring the patient onto “Being EURAMI accredited is a remarkable and was in a small hospital with the aeroplane. accomplishment for AirLink Ambulance,” said Dr very limited facilities. AMREF Flying After a two-hour flight to Dar Juan Pablo Preciado, the company’s medical director. Doctors was asked to provide air Es Salaam, the team was met “The full AirLink team has worked very hard to evacuation to a hospital where by a ground ambulance. In develop our mission of being the most professional more advanced care could be case of any problems during air ambulance company in Latin America with the given. The best trauma and the transfer to hospital, all highest level of quality standards in terms of safety, neurosurgical facilities in the region medical equipment had to be medical practice, ethical and human factors. We’re are in Kenya, but the patient carried along to complement pleased that EURAMI recognises our constant efforts was a Tanzanian national with no the rather basic equipment to deliver superior air medical services.” travel documents. Additionally, his of the Tanzanian ambulance. insurance only covered him within The heavy rush hour traffic Tanzania. The option to take the in Dar Es Salaam provided patient to Nairobi did, therefore, a considerable impediment, not exist and the decision was but the driver was up to made to transfer the patient to the challenge and most of Tanzania’s capital, Dar Es Salaam, the journey was spent on for treatment. the wrong side of the dual Our evacuations are usually carriageway, with lights and carried out by fixed-wing aircraft. details of the patient’s condition were sirens on, swerving in and out In this case, however, the dirt to avoid oncoming vehicles. Drpreciado AirLink Ambulance’s hangar airstrip close to the hospital was vague and the team needed to be prepared It was dark by the time the unserviceable following the closure crew and patient reached the of the main road nearby, which to provide intensive care hospital, a full 24 hours after FAI’s fleet to expand had transformed the airstrip into a the accident had occurred. road diversion with heavy traffic. Not unusually, the hospital FAI rent-a-jet AG, the Germany-based operator, Limited communications with the had misplaced the patient’s now holds one of the largest aircraft fleets in Europe. rural hospital and little-to-no support from the local to ensure that the King Air would be on the ground details and claimed that there was no agreement After adding the latest Learjet 40XR, the company police force to clear the airstrip left only one option in Mwanza in time to receive the patient. between them and the patient’s insurer. AMREF now operates a Learjet fleet of 14. CL 604s, Global – to dispatch the medical team in a helicopter from On arrival at the town where the small hospital was, Flying Doctors had to make several phone calls to Express, CRJ 200LR and Falcon 900 DX EASY Wilson Airport. Instead of 50 minutes flying time in a the helicopter circled overhead to identify a safe co-ordinate between the hospital and the insurer are also operated by FAI, providing a total fleet of Beechcraft King Air to the patient’s location, the team landing spot. (The crew could see the airstrip from before the patient was finally accepted and handed 20 business jets. Siegfried Axtmann, chairman and was now looking at a two-hour flight by helicopter. above with lots of cars driving up and down it!) A over to the hospital team. founder, said: “With our brand new company-owned Due to the patient’s critical condition and the level of dirt field right next to the hospital was identified for Complex medical problems, combined with hangar and FBO facilities at Nuremburg International medical support required during the flight, a further landing and everything looked calm and peaceful logistical constraints and uncertain communications Airport in Germany, FAI now is more attractive for onward transfer to Dar Es Salaam, with a four-hour from the air. To the crew’s surprise, however, when are a regular occurrence for AMREF Flying Doctors. aircraft owners looking for a professional turnkey- ride in the helicopter, was not an option. AMREF the dust cleared from the landing area, there were The entire team – from control centre staff to management including maintenance, and there are Flying Doctors decided to position a fixed-wing air hundreds of local people who had gathered around medical crew, air crew and aircraft operations some owners around not quite happy with their ambulance at Mwanza, an airport only 15 minutes by to witness the spectacle of a helicopter arrival, which staff – all have to work together as a team, have existing management company.” FAI is expecting annual helicopter from the patient’s location, for a wing-to- for them was probably the most exciting thing that confidence in each other and accept the fact that revenues for 2011 of more than c50 million reflecting wing transfer. The plan was that the medical team had happened all year. Initially, the crowd kept a any plan is just something that will almost certainly a growth of approximately 20 per cent from 2010. would stabilise and pick the patient up from the rural distance, but soon curious children were running have to be amended.

www.itij.co.uk ITICamericas-ITIJ129-full-p21.pdf 1 17/10/2011 16:55

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The leading global travel & health insurance conference Insurance Assistance Hospitals For full details & registration please visit Air Ambulance www.itic.org.uk/neworleans 19-21 March 2012 - Sheraton Hotel - New Orleans ITICamericas-ITIJ129-full-p21.pdf 1 17/10/2011 16:55

CONFERENCE SCHEDULE 2011/12

INTERNATIONAL TRAVEL INSURANCE CONFERENCE The leading global travel & INTERNATIONAL TRAVEL INSURANCE CONFERENCE health insurance conference INSURERS • ASSISTANCE • HOSPITALS • AIR AMBULANCE

New Orleans 2012 INSURANCE • ASSISTANCE • HOSPITALS • AIR AMBULANCE For full details & registration please visit www.itic.org.uk/neworleans 19-21 March 2012 - Sheraton Hotel New Orleans 2012 19-21 March

LONDON OXFORD AIRPORT KIDLINGTON, UNITED KINGDOM MAY 1-2 www.airmedandrescue.com

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The leading global travel & health insurance conference Insurance Assistance Hospitals For full details & registration please visit Air Ambulance www.itic.org.uk/neworleans 19-21 March 2012 - Sheraton Hotel - New Orleans 30 FEATURE

No place like home for the German trade show company Messe Berlin, disproportionately strong outbound tourism market Danger lurks shows a six-per-cent decline in outbound travel when compared with most other developed But domestic tourism is not without its issues – a from the UK, a 3.4-per-cent fall from the US and economies. For the travel industry, selling Britain factor that many people taking a holiday in their zero growth from Germany. The latest British to British holidaymakers means contending own country fail to consider. According to the latest Lifestyles report from the UK market intelligence with factors such as an uninspiring climate and annual consumer trends survey carried out by the company Mintel says British sales of foreign holidays high accommodation costs. Until recently, it has research company Arkenford for the Association hit a 10-year low last year. sometimes seemed cheaper for Britons to holiday of British Travel Agents (ABTA), 55 per cent of UK abroad than to stay in the UK, but a weak economy holidaymakers do not purchase travel insurance Domestic bliss and a shaky pound have made England, Scotland, when holidaying in the UK, leaving them without he world economic downturn has The outbound sector’s loss, though, has been Wales and Northern Ireland look more attractive to cover for cancellation charges and other costs. In prompted many more consumers to domestic tourism’s gain. For many, a holiday in their own citizens. contrast, only 19 per cent of UK holidaymakers risk Tholiday within their own country, but their own country has never been more attractive, The trend towards domestic tourism is also travelling abroad without insurance. accidents can* happen even at home. Robin and many national and regional tourist authorities observed in other countries where the domestic “Although taking out travel insurance should be one Gauldie examines whether the growth of are keen to reinforce the trend by increasing their market has always been very strong, such as of the first things on the list when travelling abroad, domestic tourism offers opportunities for promotional efforts in the home market. France and the US, which are demonstrably an it is often not even considered for trips made within insurance companies to create and market new “The UK travel and tourism market felt the full force easier sell for their own nationals than is the UK. the homeland,” warns Alexandra Honore, sales and products to cover people holidaying in their of the UK and global recession in 2009,” notes the French holidaymakers seeking summer sun can marketing co-ordinator at International Passenger homeland 2010 Travel and Tourism Market report published by choose from the shores of the Mediterranean Protection, a specialist in insolvency protection cover. the market intelligence provider Keynote. In the first or the Atlantic; in winter they can enjoy skiing In 2011, holidaymakers from around the world fell three months of 2010, Keynote said, the number on Alpine or Pyrenean pistes; and France is of victim to attacks by sharks in the Seychelles, Australia of trips increased by 3.7 per cent to 21.8 million, course an inexhaustible cultural destination. and the Russian Pacific, polar bears in Svalbard, car and most sources agree that despite blips, the Similarly, Americans have their pick of palm-fringed and coach crashes in Turkey, the bombing of a casino trend continues. Caribbean, Pacific and Atlantic beaches virtually by narco-terrorists in Mexico, kidnapping in Kenya “The top line is that during 2010 there were 56.6 all year round, scenery that ranges from Rocky and other dramatic, headline-grabbing events. million overnight holiday trips taken by Brits in the Mountain range, to the deserts of the southwest, or However, it’s not the fear of accidents abroad UK,” says Sarah Long, strategic communications the lush farmlands of New England, and the world’s “Domestic tourism is that has driven the recent surge in domestic manager at VisitEngland. That figure is actually down greatest purpose-built visitor attractions. holidaymaking around the world. It’s simple by seven per cent compared with 2009, but Long As any actuary knows, the home is where a great experiencing double- economics. Higher taxes and soaring fuel costs have says this needs to be put into context, because many accidents happen, not least because people pushed up the cost of flying, just at a time when 2009 was the best year ever for leisure tourism in feel safe and secure there and, as a result, take fewer digit growth” many families in key outbound tourism markets the UK. “2010 figures are actually higher than any precautions than they should. The same mindset such as the UK, US, France and Germany are being year pre-recession,” she says. “Domestic tourism influences people travelling within their home forced by recession and inflation to cut back on is still experiencing double-digit growth and we are country: language, traffic rules, road signs, food household spending. The ITB World Travel Trends confident that it is a long-term trend.” and drink, and all the rest of the holiday and travel Report 2010/2011, produced by IPK International Traditionally, the UK has always been a infrastructure are familiar.

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British holidaymakers travelling abroad on a Management Agency (FEMA). “For Americans, attendant risks, and even apparently easy-going package holiday are covered by the UK’s Air Travel preparedness must now account for manmade activities such as hill walking or a trip to the seaside Organisers’ Licensing (ATOL) provisions, but ATOL disasters as well as natural ones.” can lead to drama. There is a commercial does not apply for trips within the UK, as Honore Just a couple of miles off the coast of points out: “Not all providers include insolvency Awareness on the up Northumberland in northeast England lies advantage for insurers to cover, so there is a commercial advantage for Travel industry spokespeople report an increasing Lindisfarne. Home to a small island community and a insurers to complete their range of cover by fulfilling awareness of the need for travel insurance on the picturesque ruined abbey, it is a popular destination. complete their range of their customers’ needs according to the new part of US consumers, including those planning Around 100,000 visitors each year drive across the domestic holiday trend,” she says. to travel domestically. The US Travel Insurance causeway that connects it to the mainland – and each cover according to the Ben Smart, corporate and travel sales director Association’s Travel Insurance Market Survey indicates year, some are caught on the causeway by the rising at Mondial Assistance UK, warns clients against growth in sales of travel insurance of 14 per cent tide on their return journey and must be rescued by new domestic holiday being lulled into a false sense of security: “It’s easy between 2008 and 2010. “No vacation is immune to local lifeboat or Royal Air Force helicopter. In the first to think you don’t need cover for a holiday in the the possibility of cancellation, interruption or delay,” eight months of 2011, 29 people were rescued and trend UK, but it’s better to be safe than sorry,” Smart said Mike Ambrose, president of Travelex Insurance nine vehicles written off. says. “Whether they are forced to cancel a trip Services. However, Ambrose notes growth in sales In destinations such as the US and France, domestic due to illness, unemployment or other unforeseen of travel insurance in the US, partly due to innovative holidaymakers are well aware that services such as circumstances, insurance can cover otherwise non- insurance products tailored to the needs of clients helicopter rescue or mountain stretcher recovery a 21-per-cent increase between 2008 and 2009. refundable deposits and charges such as car hire taking shorter trips. “Most travellers have first- may come with a hefty price tag attached. In France, He asked: “Could that be a consequence of the and accommodation.” hand experience with unplanned expenses such as helicopter medevac for an injured skier or walker recession and the advent of the ‘stay-cation’?” The items people are packing for holidays have also cancelled flights, lost baggage or missed connections may cost around c2,500 per hour. In the US, a Amid concerns that domestic tourism is putting changed in recent years, and expensive high-tech due to weather,” he says. “They realise that travel medevac flight out of the Grand Canyon, one of the an ever-increasing strain on Britain’s emergency items need to be taken care of too. “In addition,” insurance is a smart investment even for their less nation’s iconic natural wonders, can cost more than infrastructure, how long can the UK taxpayer be added Smart, “people have so many gadgets these costly excursions.” US$4,000. In Australia, search and rescue services expected to go on footing the bill for services such as days, that the cost of replacing smartphones, MP3 Worldwide, vacation activities ranging from winter are, by and large, operated by charitable foundations, mountain rescue teams and search and rescue (SAR) players and ebook readers could really break the sports to climbing, caving, kayaking, diving and which would not charge a domestic holidaymaker for helicopter missions carried out by the RAF and Royal holiday budget. Many of these items could be covered mountain biking are all on the increase, leading to their rescue. Navy? Last year (2010) Ministry of Defence (MoD) by household insurance, but it’s best not to assume an increase in claims and demand for emergency In Britain as well, people are long accustomed teams were called out on almost 2,000 SAR missions. protection. We urge people to check the terms and medical services. Arguably, holidaymakers are more to free provision of emergency medical services. Even if each mission lasted just one hour, the annual conditions of a home or annual travel insurance policy likely to take part in such activities in their own Within the UK, a comprehensive network of cost of such operations is at least £25 million. The before they take a UK holiday, as it will be well worth country – where they may feel more confident in voluntary or state-provided emergency rescue MoD does not recover costs for rescues where life is it if the worst should happen to gadgets like laptops safety procedures – than abroad. But all have their services operates free of charge to accident victims at risk, but can recover costs from other government and digital cameras. Holidaymakers need to be aware (and insurers). Military and Coastguard helicopter departments and, in the case of medical evacuations, that leaving travel insurance off the holiday checklist medevacs are free, although each helicopter rescue from health authorities that request military assistance could be a costly mistake.” mission costs the taxpayer around £12,400 per in transferring patients between hospitals. Granted, the UK is less subject to natural calamity flying hour. And it seems that while holidaymakers A case could be made that the taxpayer – and than many long-haul holiday destinations, but it is are becoming more adventurous, many are failing the charity volunteers who provide services such not immune to heavy weather. Last winter, blizzard 55 per cent of UK to provide cover for themselves. as mountain rescue and lifeboat operations – are conditions caused chaos over much of Britain, According to the UK Mountain Rescue service’s in effect subsidising holidaymakers who require paralysing road, rail and air transport and disrupting holidaymakers do 2009 annual report, Mountain Rescue teams were aeromedical rescue. In some ways, that might be no the travel plans of thousands of people. In the US, called to 1,054 incidents in 2009, compared with bad thing for the insurance industry, concentrating where major cities as well as remoter areas may be not purchase travel only 609 in 2004. Over the same period, the the minds of domestic holidaymakers on the need affected by extreme weather events, earthquakes, number of fatalities resulting from such incidents for travel insurance. wildfires or volcanic eruption, travel plans are even insurance when increased from 25 to 37, whilst injuries increased As the global economy claws its way out of the more vulnerable. from 376 to 667. Helicopters attended some 449 latest trough, international travel is recovering – but “Emergency preparedness is no longer the sole holidaying in the UK incidents in 2009. not at the expense of domestic tourism. Homeland concern of earthquake-prone Californians and “There seems to be no let-up in the annual increase holidaymaking continues to grow, and in key markets those who live in the part of the country known as in incident figures,” notes Mountain Rescue (England it offers new opportunities for the broader travel ‘Tornado Alley’,” states the US Federal Emergency and Wales) statistics officer, Ged Feeney, pointing to insurance industry. n

www.itij.co.uk 32 FEATURE US health costs spike: insurers put under pressure

or international travel insurers doing workers’ wages and, according to Dr Drew Altman, business in the US, reports about Kaiser president and chief executive officer (CEO), a spiking of healthcare costs under is ‘especially painful for workers and employers President Obama’s newly imposed struggling through a weak economy’. He also noted AffordableF Care Act are not good. If insurers were this was one of the largest premium increases seen looking for relief from soaring fees and prices for since the annual survey has been done, but said: “I hospital and doctors’ services, they best put their don’t know if this is a one-term hike or whether it hopes on hold, says Milan Korcok signals a return of sustained increases in premiums.” To put this increase into a broader perspective: From all indications, insurers – foreign as well as since 2001, family premiums have increased 113 domestic – need to be prepared for a renewed per cent compared with 34 per cent for workers’ series of price hikes, a sustained period of health wages and 27 per cent for inflation. The saving payments that are part of every visit or service. And What has caused the report to generate headlines cost inflation, and a serious shifting of the cost spiral grace in this scenario is that employers will pay, on these are the most favoured families. Those who rely in American media is that the Kaiser Family to the private insurance sector. They should also be average, $10,944 of those premiums: but that still on individual, non-employer sponsored plans, or the Foundation – the nation’s leading health policy prepared to catch much of the blame for contributing leaves families with $4,129 to pay – $344 per month self-employed, must pay the full tariff and their costs analysis source – is perceived as a supporter of to soaring health costs – a tactic the Obama on average, not counting the deductibles and co- are even higher. President Obama’s Affordable Care Act, and so the Administration has pursued relentlessly. revelation that the initial reform provisions in the Recent confirmation of the cost inflation trend Act may, in fact, have contributed to a cost spike comes in an exhaustive report from the Kaiser Family instead of the expected moderation, caused some Foundation and the Health Research & Educational agitation in the White House. Trust*, released on 27 September 2011, which [International insurers] benefit from, and some count heavily on, the shows that the average annual cost of employer- International impact provided health insurance for a family of four deep price discounts that the BUCAs and PPOs can deliver to them by The cost of employer-based health insurance is widely increased by nine per cent to an average of $15,073 cost-savings arrangements they could never hope to achieve on their own accepted as the most sensitive gauge of the cost, as in 2011 – up sharply from $13,770 last year. That is well as the integrity, of America’s healthcare system. It much faster than both general inflation and rises in is tangible; more meaningful to the person in the street than are the more abstract references that healthcare

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costs the nation 17.6 per cent of GDP. in 2010 had an average profit margin of only 4.4 per insurers seeking to increase their rates by 10 per Kathleen Sebelius, secretary of health and human Employer-based health insurance is responsible cent and was not a primary driver of rising health cent or more in one year are now required to services, said of the review programme: “For far for providing cover for nearly 160 million people costs, a contention supported by Kaiser, which adds submit their requests to state or federal authorities too long, families and small employers have been at under age 65. The remainder are covered by the mercy of insurance rate increases that often put government-sponsored Medicare (65 and older), coverage out of their reach. Rate reviews will shed Medicaid (for the poor), government programmes a bright light on this industry’s behaviour and drive for veterans and some government workers, and market competition to lower costs.” (The Act also private insurance plans for individuals and the self- that some international insurance payers, who have been enjoying requires health insurance plans to show medical employed. In addition, approximately 17 per cent of ‘unrealistically low rates of reimbursement’ designed only for the domestic loss ratios of 80 per cent or better.) She added: “As Americans go without health insurance for at least of today, insurers proposing double-digit increases part of the year – depending on whether or not they market, will have to shoulder their share of the burden will have to provide clear information that indicates are employed. what factors are causing proposed increases. Though the Kaiser report focused primarily on Experts will closely examine information about the insurance premium increases as indicators of underlying cost trends in healthcare to flag instances health cost inflation, the insurance industry quickly that the elimination of insurers’ profits and executive for a determination of ‘reasonableness’: a job that when insurance companies are unjustly raising retaliated by saying that blaming private insurers for compensation would lower healthcare spending by insurers say is far beyond the capabilities of most costs. This means consumers will no longer have the increasing cost of healthcare (which has been just 0.5 per cent. federal or state bureaucrats. The requirement kicked to take the word of their insurance company; they a cornerstone of the president’s reform initiative) Still, as part of the Affordable Care Act, all health in on 1 September. will have an independent expert reviewing their seriously deflects attention from the real core of the problem. In response to the Kaiser report, Karen Ignani, president and CEO of America’s Health Insurance Plans (AHIP), said in a statement: “Policymakers in Washington and the states need to focus on all of the factors that are driving premium increases: soaring prices for medical services, changes in the covered population that has resulted in an older and sicker risk pool, and new benefit and coverage mandates that add to the cost of insurance.” For many international insurers and their cost containment representatives, domestic insurers such as Blue Cross/Blue Shield, UnitedHealthcare, Cigna, and Aetna (collectively referred to as BUCA) are important conduits in their relationship with American hospitals and doctors. They benefit from, and some count heavily on, the deep price discounts that the BUCAs and PPOs can deliver to them by cost-savings arrangements they could never hope to achieve on their own. The BUCAs are also the frontline troops in establishing contract trends with hospitals, setting discount benchmarks, and defining usual and customary reimbursements. Without these benchmarks and cost savings, international insurers would have a hard time dealing with the price hikes that seem inevitable – in the short term and into the misty future as well. Dr Colin Plotkin, medical director at Dr Colin Plotkin & Sons Consulting Inc. (DPC), which specialises in settling medical claims on behalf of insurers, reinsurers and TPAs, asserts that as the US moves to provide health insurance coverage for all its citizens, someone besides government will have to pay the price. “Providers of medical care, with the emphasis on hospitals, will still have to balance their books,” he says. “In other words, someone will have to pay for this. Logically, this means an increase in premiums for the insured, be they domestic or international.” He warns that some international insurance payers, who have been enjoying ‘unrealistically low rates of reimbursement’ designed only for the domestic market, will have to shoulder their share of the burden. In effect, they can’t go on forever expecting to receive Medicare-based rates, which are money- losers for hospitals, and which are subsidised by taxpayers for the purpose of supporting elderly Americans and the disabled. “Even multiples of these base levels of reimbursement, often used as a standard to calculate reimbursement levels, are not being accepted by the vast majority of providers,” he adds; especially as the international insurers or their intermediaries can’t provide the volumes, the steerage, or the strict payment deadlines that the major domestic insurers are routinely expected to meet.

Insurers under siege In pushing healthcare reform, the Obama Administration effectively demonised the insurance industry, blaming it for greedily raising premiums that only served to push up healthcare costs. Health insurers, on the other hand, responded that their average profit margins were far below those of most other sectors of the US economy. America’s Health Insurance Plans reported that the health plan industry

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proposed rate increases.” sources. According to the government’s own dollars Americans produce will go to paying for The rate review programme has been widely Centers for Medicare & Medicaid Services, which hospitals, doctors, drugs, medical technology, public Where does the money go? criticised by industry as well as many state tracks all health spending, the average annual health and private health insurance, and medical research – government sources as being an overly simplistic spending growth (5.8 per cent) over the next decade all the elements of the nation’s single, largest industry. International travel insurers with heavy approach to a complex problem. Even the federal is anticipated to outpace average annual growth in Will these costs, in time, become unmanageable exposure in the US market often find government’s Congressional Research Service the prices charged for medical services in (Congress’ think tank) has warned: “The complexity the US are hugely different from those of making such a determination (reasonableness) charged in their own countries – or any generally requires analysis of multiple factors ‘international insurers that understand the US healthcare system and other country, for that matter. Much of this by actuaries and accountants. Such a review higher cost is attributed to higher fees by generally does not lend itself to the use of simplistic protocols, and manage their claims, will always do well’, and ‘the ones that doctors and other health professionals, more benchmarks such as merely prohibiting double-digit deny too many claims and increase their prices to cover their unsophisticated intensive use of high-tech equipment and percentage rate increases.” So far, 41 states have specialised staff per case, more diagnostic established rate review boards that meet federal ways will always do poorly and eventually will exit this complex business’ tests, higher pharmaceutical prices (which specifications. The remainder will have to submit in most other countries are regulated by their rates to federal authorities until they can pass governments), higher administration costs, federal muster. the overall economy by 1.1 percentage points (4.7 for international insurers? Can they be expected to and a host of other factors. In the meantime, insurers will have to deal with per cent). And by 2020, national health spending is winnow out the number of players in this complex According to data collected by the a healthcare system that continues to grow expected to reach $4.6 trillion and comprise 19.8 market? J. Ross Quigley, president of Medipac International Federation of Health Plans, exponentially, with demands far outstripping funding per cent of GDP. In effect, one out of every five International, travel insurance provider for the an association comprising 100 of the largest health insurance plans in 31 countries, US hospitals and doctors charge insurers and their patients multiples more for given health procedures in the US than hospitals and doctors in other countries. Examples: (All prices quoted are in US dollars) The estimated average price charged to an insurer or patient for a routine office visit in the US in 2009 ranged from $59 to $151: in Canada it was $30, Germany $22, and the Netherlands $32. (The ‘average’ range in the US accounts for different types of hospitals in different parts of the country.)

A CT head scan in the US was priced at between $950 and $1,800; in France $212, Canada $530, Spain $161, the UK $179.

A one-month dose of Lipitor in the US ranged from $125 to $334; in Germany $48, UK $40, Netherlands $63.

An appendectomy in the US was charged between $629 to $1,803; in France $114, Spain $285, Netherlands $494, Canada $313.

Total hospital and physician charges for an appendectomy in the US were between $11,997 and $40,680; in Canada, France Germany, Netherlands and the UK they ranged from $2,436 to $2,595.

The average charge for a hospital day in the US was between $3,818 to $12,708; in Canada $837, France $1,050, Germany $550.

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Canadian Snowbird Association, says ‘international insurers that understand the US healthcare system and protocols, and manage their claims, will always do well’, and ‘the ones that deny too many claims and increase their prices to cover their unsophisticated ways will always do poorly and eventually will exit this complex business’. He adds that travel insurers’ bottom lines depend on many complex issues: “First responder (assistance) … competence, critical mass of business to keep costs low, international currency exchange rates, flu and pneumonia patterns, and removal of fraud are all bottom-line drivers, and a little luck never hurts. You must be able to shrug off several $500,000 claims in a year and survive the ‘million dollar babies’. Most insurers are not up to the task with their ever increasing focus on narrow business lines and profitability.” As for the likelihood that accelerating US healthcare costs will seriously impact international travel insurance premiums, Quigley says: “The only way to avoid significant Canadian premium increases is to have a much lower US dollar,” a reference to the frequent fluctuations between US and Canadian currencies, which, when favorable to Canadians, can offset the higher US medical costs. Certainly, the prospect of high US health costs is a concern, says Quigley, but he adds that a 10-per- cent currency shift in one month is significant compared to the prospect of US healthcare costs increasing to 20 per cent of GDP over eight years. Nonetheless, premium prices do matter, even to staunch, uncompromising snowbirds who see winter-long vacations as a rite of elderly passage. Says Quigley: “We do see a decline in participation to) continue travelling.” the help of a crystal ball – how such a dynamic Certainly, clarity is one of the missing elements right every time prices (premiums) increase and there Juliann Martyniuk, affinity markets, Manulife Financial system will change,” she said, adding it is clear that now in trying to see where American health costs are certainly declines as the significantly higher prices – one of Canada’s largest providers and underwriters travel insurers ‘may have to increase their focus are headed. Perhaps a more probitive question is arise when the older age bands are reached. Moving of international travel insurance – believes that trying on risk management of claims; that is, managing ‘how high’ are they headed? n from an 80-84 age band to an 85+ age band is a to predict what will happen to healthcare costs their medical cases to control or reduce healthcare very expensive proposition: people cease to be in the US and how they may affect international charges’. “As the US healthcare system evolves, *The Kaiser Family Foundation is an independent, non-profit snowbirds due to insurance costs, and the US dollar travel insurance costs in coming years is ‘a difficult the answers will hopefully become much clearer,” organisation. The Health Research & Educational Trust is a private, not-for-profit research organisation affiliated with the decline will not cushion them enough to (allow them question’. “It is not at all easy to predict – without Martyniuk concluded. American Hospital Association.

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International Travel Insurance Journal ASSISTANCE&HEALTHCAREWORLDMARKETS 37

In case of emergency, go public!

Famed for its lager, spas and post-Cold War European manufacturer of high-quality healthcare At everyday ground level, the country damaged privatisations, the Czech Republic has one of the equipment; at its plant in Bohemia, the Japanese- by half a century of ruthless occupation – fi rst best hospital systems in the former Soviet bloc. owned Olympus Medical Systems Company makes by the Nazis and then the Soviet Union – runs David Kernek fi nds out what visitors can expect endoscopes used in non-invasive surgery. The acute health services that, (although not without from its emergency health services fi rst-class skills of Czech medics and scientists in the serious problems such as over-worked hospital biomedicine fi eld were recognised internationally in doctors deeply discontented with low salaries, staff Two brains aren’t needed to work out what it 2008, when the US’s Mayo Clinic teamed up with shortages, insuffi cient state funding, and controversial was that two Czech towns – Pilzen and Ceske St Anne’s University Hospital (founded in 1784) reforms designed to increase the role of the private Budejovice – gave the world. But this pint- in Brno to establish a clinical and research centre sector,) match in care and expertise most of the size country in the middle of Europe also has specialising in cardio and neurovascular diseases. countries in the western half of the European Union achievements in the health sphere that, along with (EU). its world-beating lagers, cannot be dismissed as The European Health Consumer Index produced small beer. by a Swedish think tank1 puts Czech hospital care ‘For severe illness or among the fi ve best in Europe after adjustments for Complex medical history capital spending. It has the seventh-shortest waiting Its fi rst university medical school was founded in injuries, public teaching periods, 8.7 beds per 1,000 population – that’s the 1348, and a Czech scientist won the Nobel prize eighth-best in Europe and more than twice the US in 1959 for pioneering work on the separation hospitals offer the most score – and its infant and maternal mortality rates of blood types. It’s the country in which the are among the lowest in the EU. Life expectancy at contact lens was invented, and it’s a leading sophisticated care …’ 76.8 years compares respectably well with the UK’s

Pribam Regional Hospital, Czech Republic

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Old Town Square, Prague Most of the medical care … is concentrated in the public sector, with private clinics and hospitals providing mainly outpatient care and operations during short hospitalisations

80.5 and the EU average of 78.82. Whether that is as complex investigations and sophisticated care are a result of having the world’s highest per capita beer treated in public hospitals.” However, there have consumption is open to debate. been over-charging problems, says Hanes, chiefly In an average year, AXA Assistance Czech Republic, with local clinics in the country’s mountain ski which provides medical and travel assistance resorts, but private facilities in the big cities, though services for 37 per cent of the country’s travel more expensive, ‘are very flexible in dealing with insurance market, handles 2,600 outpatient cases, assistance services’. 50 hospitalisations and 110 repatriations. Most of At Mondial Assistance in Prague, medical director the medical care, reports Dr Cai Glushak, medical Dr Lidmila Vondrakova agrees that the level of the director of AXA Assistance Group and chief medical medical care in the Czech Republic is comparable officer of AXA Assistance in Chicago, is concentrated with that in Western Europe. “Medical staff are in the public sector, with private clinics and hospitals well trained and have a high level of knowledge. providing mainly outpatient care and operations Their medical equipment and technology is during short hospitalisations. modern and widely available. Tourists are normally “The quality of care and hygiene and the medical directed to private [doctors], outpatient clinics and experience of staff and availability of equipment public hospitals.” depends on the type of the hospital,” he says. “In Mondial Assistance in the Czech Republic handled large cities, it’s at a higher level than in small regional 8,243 medical cases in 2010, with gastroenteritis facilities. In our experience, the overall level of care and respiratory disease topping the diagnoses chart. in Czech public hospitals is comparable with those in Trauma, ear, nose and throat, and cardiovascular Austria. Medical facilities have advanced rapidly, and and gynaecology emergencies were also frequent. certainly in the major cities they are equal to those in The vast majority of patients – 7,802 – were Western Europe. For severe illness or injuries, public treated in outpatient clinics, while 254 patients were teaching hospitals offer the most sophisticated care. repatriated by air ambulance, medical transport and Private clinics often have better amenities, but they commercial flights. do not usually do not handle critical cases.” This year, the company has established a specialised Often, where foreign tourists in trouble are taken assistance platform staffed 24/7 by trained co- depends on their health problems, says Marian ordinators and doctors to help clients who call with Hanes, the company’s Czech Republic operations medical problems. The company says that 99 per director. “Trivial problems such as common cent of clients wait on the phone for less than 20 respiratory infections are treated in private facilities, seconds, with an average waiting time of seven but people with serious conditions that require seconds. Updated telephony and assistance systems

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40 ASSISTANCE&HEALTHCAREWORLDMARKETS

Municipal House and Powder Tower, Prague have enabled faster and improved processing of proprietary MA Group assistance application will be In addition to standard medical services, the company requests, while a new communication system based in operation during the first three months of next offers a domestic health service that provides, by “Trivial problems such on its existing Genesys Call Centre system and its year (2012). phone, advice and information about local clinics, hospitals, pharmacies and preventive programmes. It is also planning a Second Medical Opinion service, as common respiratory details of which are expected later this year. Knowledge of the local standards of care and levels infections are treated of treatment available in various facilities is, of course, key for any assistance company operating in the in private facilities, but country. Although both the state and private sectors are used for treating foreign patients, Dr Vondrakova people with serious commented: “There are sometimes shortcomings with hotel services in state hospitals. They are better conditions that require in the private sector, but on the other hand the level of the medical care is not guaranteed there in complex investigations all cases.” The Czech state health service is funded largely by compulsory, wage-based payments to and sophisticated care quasi-public health insurance funds, plus employers’ contributions, nominal cash payments by patients are treated in public for doctor consultations, emergency treatment and hospital stays, and direct state financing. The private hospitals.” sector currently accounts for 15 per cent of the country’s hospital beds – a share that is likely to grow as government privatisation reforms kick in. The relationship between hospital doctors and the government reached crisis point last winter over protests about low pay and long hours, which the The EHIC in the Czech Republic doctors’ unions claimed threatened patient safety and The European Health Insurance Card (EHIC) covers breached the country’s working time laws. The basic almost all acute healthcare provided in the Czech monthly salary of a newly-qualified doctor stood at Republic. Says AXA’s Marian Hanes: “In the public CZK17,590 (GB£623) – lower than the average sector, the card is generally accepted without any national wage – fully-qualified specialists were on problem, and foreigners from EU countries are CZK24,450 (£866) and senior department heads treated in the same way as Czech citizens. But in were paid CZK39,530 (£1,400). the private ambulatory sector, some facilities refuse “A doctor can work as much as 300 hours a month to accept it and prefer cash payment from patients with all the overtime and double shifts they are or a payment guarantee from their private insurance expected to do,” said a doctors’ union leader. “They company.” end up being paid the same hourly rate as someone Along with Czech citizens, patients with EHICs who works in a fast-food outlet.” More than 4,000 issued by EU governments have to make recently- doctors answered a union call for a mass resignation increased but still nominal payments – known as protest – known as the Thank you, we’re leaving standard patient contributions for medical treatment: campaign – and followed up with applications for CZK31 (£1.10) for visits to doctors, outpatient hospital jobs in the US, Britain, and neighbouring clinics and dentists; CZK93 (£3.30) for accident and Germany and Austria. The resignations were emergency (A&E) hospital treatment; and CZK103 withdrawn when the government found CZK2.1 (£3.67) for each day’s stay in hospital. The card, billion (£73.4) million for salary increases. plus these cash payments, covers foreigners for

International Travel Insurance Journal ASSISTANCE&HEALTHCAREWORLDMARKETS 41

emergency treatment needed to allow patients to lung transplants; operations annually; University Hospital Motol has a ‘foreigners’ continue their stay until their planned departure date. Hospital Na Homolce, Prague – recipient of the Military Hospital, Prague – best neurosurgical unit; department’, where English and German-speaking Long-term expatriates are required by Czech Czech Medical Association’s Hospital of the 21st Charles University Hospital, Prague – best burns staff register overseas patients, liaise with medical staff law to have proof of insurance – minimum cover Century award, its high level hotel services make it department; and and process insurance documents and payments. CZK564,000 (£20,000) – for emergency hospital popular with expatriates; University Hospitals in Brno, Pilzen and Ostrava. Reception staff at Hospital Na Homolce – described treatment, and £20,000 for repatriation. by one overseas patient as ‘outstanding … on a par with the best Germany has to offer’ – are fluent in Top hospitals the level of the medical care in the Czech Republic English, German, French and Russian. In fact, English These university hospitals are among the best in the and German-speaking doctors can be found in most country, according to AXA Assistance in the Czech is comparable with that in Western Europe public and private hospitals and clinics. n Republic and Mondial Assistance: University Hospital Motol, Prague – specialises in children’s medicine and is a major centre for Institute of Cardiovascular Medicine, Prague Most of the large public hospitals are classed as References: – largest cardiosurgical department in the Czech trauma centres, but the major ones are in Prague * Health Consumer Powerhouse, Danderyd, Sweden Republic, performing approximately 1,500 and Brno. **United Nations, 2005-2010 Medical tourism – old and new

Hoorah for spas: Prague is a major venue for British hen and stag parties, but an industry that booms alongside it – and on past performance is likely to be far more long-lasting – is medical tourism, a modern version of the Czech health spa culture that boomed in the 18th Century and is still going strong. Then, the hot and cold mineral springs, hydrotherapy clinics and clean air in towns such as Karlovy Vary and Marianske Lazne (also widely known as Carlsbad and Marienbad) attracted Europe’s aristocracy. They sought rest, recuperation and cures for everything from respiratory, digestive and nervous diseases to gout and gunshot wounds. Notable spa visitors included J.S. Bach, Beethoven, Frederic Chopin, Casanova, Russian czars and the UK’s Edward VII who, perhaps doubting the benefits of plunging into baths of freezing water, opened one of the region’s first golf courses. Today there are 38 health spas – hotels with attached clinics, and mostly in the hills and valleys of Bohemia and Moravia – offering a wide range of treatments for body, mind, and soul and staffed by qualified health practitioners awaiting, as they have been for 300 years, the wealthy world-weary. The spa resorts attract approximately 650,000 Czech and foreign guests, with Germany accounting for 60 per cent of overseas visitors. Prices in Karlovy Vary start at around £67 and rise at luxury hotel level to £175+ a day, depending on room type and occupancy and season, for packages including a health check- up, prescribed treatments, three meals a day, service charges and taxes. The spas are such an established part of the country’s culture that Czech health insurance companies cover the cost of many spa treatments. Super surgery: visitors in search of new noses, mouths, breasts, waists and almost everything else head for Prague’s state-of-the-art private clinics, at which there is hardly a part of the human anatomy – male and female – that cannot be re-modelled at prices considerably lower than those charged in Britain, Germany and the US. Even after travel expenses, patients from western Europe can pocket worthwhile cost savings. The Association of Czech Tourism Agencies noted a significant increase last year in the number of foreigners booking breast enlargements and facelifts, and pointed to a rise in medical tourist visits from 6,000 in 2008 to 9,000 in 2010. “Foreigners now account for a fifth of the total number of cosmetic surgery clients in the country,” the association commented. “The economic crisis helps us, because people want cosmetic surgery that is less expensive – prices are about three or four times lower than in the West – but of a quality comparable to that in western Europe and the United States. Most of the foreign clients are German, followed by Brits and Austrians.” In-vitro fertilisation treatment and dental surgery are other flourishing Czech specialities.

www.itij.co.uk 42 PROFILE

A good sport

ITIJ recently caught up with Alistair Hardie, If you could work in any other industry chief executive officer of FirstAssist Insurance or any other role, what would you be Services in the UK, to talk about his company’s and why? recent acquisition by Cigna, his views on some As a ‘promise to pay’, insurance is ultimately of the issues currently being faced by the travel an intangible product; in a different life I would insurance industry, and what he gets up to when have liked the opportunity to apply my skills to he’s not cheering on his children from the sideline something more tangible – I have a passion for sport, and would be intrigued by the unique Where were you born, where were you challenges of managing a business in that field – you educated, and where do you live now? often see people trying to apply sporting analogies I was born in Liverpool and educated at St Paul’s to business, but not so often do you see business School in London, and Warwick University. I currently principles taken into the sporting arena. live in Sunningdale, Berkshire with my family. What are you most proud of – both How did you come to work in the personally and professionally? insurance industry, and how did you On a personal level, and like most fathers, come to your current role? my children are my biggest source of pride. My first job was as an IFA for the Falcon Partnership Professionally, I am proud of the work I have done in Bristol. After several years learning the trade, at FirstAssist and the strong results the team has I was one of the founders of a management delivered in the last four years. In particular, I think consultancy that focussed on helping clients with it has been an exceptional performance to grow distribution, business development and management our travel insurance market share by 500 per cent processes when many were struggling with in that short time. increasing regulation. We then sold this business to Marlborough Stirling, which at that time was one How do you spend your free time? of the leading providers of software and services to Free time is not something I have a huge amount the life, pensions and insurance industry. In 2006, of but I like to get out for a run as often as possible. whilst working for one of their competitors, I was My wife puts me to shame here as she disappears approached by FirstAssist, with the challenge of for a run at 6am on a dark winter’s morning. At growing and developing its affinity insurance business. the weekends I can normally be found cheering my children on from the sidelines in their various You have been the managing director football, cricket and netball matches. Having a son at FirstAssist Insurance Services for a and a daughter with busy sporting calendars can number of years. How have you seen often throw up the challenge of being in two places the company grow in that time? How at once, which creates some interesting logistical has this growth reflected broader problems to unravel! developments in the global travel insurance industry? What motivates you? Since 2006, premium income has grown strongly, I believe in making the most of your own abilities and we have improved margins at the same time. There has undoubtedly been a dip in demand for travel and am motivated by getting the best out of both This performance has been driven by our complete myself and those around me, which in turn drives focus on customers’ and partners’ needs, and insurance in the UK driven by the economic downturn better performance and fosters the desire to developing a suite of products and services built on push on. I am a competitive person and working flexibility and innovation. Our growth is not reflective to overcome new challenges and make inroads of the developments in the wider UK travel market, will remain in place for the immediate future, but Sophisticated needs require sophisticated solutions and into new markets brings out the best in me. At which has actually contracted during this time, and we will have to evaluate how best to combine two [my company] is working hard to deliver the more a practical level, pushing to create an excellent instead it is a direct result of executing a carefully successful brands in the long term. complex products and services required by today’s outcome for every single one of our customers designed strategy to win market share. We have had travel insurance purchaser. In difficult economic is what underpins all of my efforts as this, after a good five years in difficult external circumstances Has FirstAssist noticed a dip in out-of- conditions, converting every potential customer is all, is what they want when they buy one of our and the team at FirstAssist has grown the business country travel insurance sales over this a key ingredient to success and that is why catering policies and what will make them renew with us into a top-three UK travel insurer; there are further period of economic downturn? How are effectively for issues around age, pre-existing medical in the future. exciting growth opportunities in store with Cigna. travel insurers adapting to any current conditions and hazardous pursuits is so important. change in travel patterns and travel The issue of alcohol remains one of the most hotly If you were having a ‘dream’ dinner Yes, FirstAssist Insurance Services has just policy sales? debated topics in the travel insurance market and we party, who would be there and what been acquired by global health services There has undoubtedly been a dip in demand for are working with other insurers to improve the clarity would you eat? company Cigna. How do you feel about travel insurance in the UK driven by the economic of what is and isn’t covered in this area. For flamboyancy, I’d invite the irrepressible James this, and how will this move benefit your downturn. However, this has not resulted in any real Hunt, while I would be fascinated to understand offering in the travel insurance sector? growth for stay-at-home policies because consumers The UK’s Financial Ombudsman how Steve Jobs had the vision and confidence to Cigna’s acquisition of FirstAssist is an incredibly are less aware of the need for this type of cover. Service (FOS) has been criticised by create what he did. To make sure no one took exciting development for both our staff and Travel insurers need to be more focussed on changing the insurance industry recently for themselves too seriously, I’d also have Rhod our customers. Cigna is keen to explore the consumer requirements and more flexible in the ‘inconsistencies’ in its handling of travel Gilbert adding his brand of humour to the mix. opportunities in the global travel market, while markets they seek to serve and the cover they offer. insurance disputes, with some travel Seafood is my food of choice, so that would make providing an avenue through which it can deliver its We will need to see macro economic conditions insurers going so far as to say the FOS is up the menu. broad range of health-related products and expand improve and consumer confidence increase before ‘not fit for purpose’. Do you think this is its footprint in the UK. Combining FirstAssist’s we see sales in the overseas travel market really begin a fair criticism? Where was the last place you went on affinity and travel insurance expertise with Cigna’s to pick up, which will naturally follow any pick-up in Describing the FOS as ‘not fit for purpose’ is a step too vacation, and where would you like to international network and significant resources will consumer foreign travel patterns. far, as it has a useful role to play for both policyholders visit next? help us develop new products for clients, both in and insurers. However, I am sure all involved would Our last holiday was to Sarasota on the Gulf Coast the UK and in the 30 countries globally where Cigna Are consumer expectations being met agree that an improved level of consistency would be of Florida, which I would highly recommend for a has a presence, and also create opportunities for when it comes to travel insurance helpful, along with a more balanced view on the rights family. In the future, I think I’d like to head east – our staff. Looking to the future, the FirstAssist brand coverage? of insurers and consumers. Japan and China are definitely in my top five.n 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 44 SERVICEDIRECTORY To have your company listed in the Service Directory email: [email protected]

AMREF Flying Doctor Service ADAC-Ambulance Service Dr Bettina Vadera – Medical Director Robert Glueck – Marketing & Sales Director Wilson Airport, LangataRoad, PO Box 18617, Nairobi, KENYA Am Westpark 8, 81373 Munich, GERMANY

tel: +254 20 6000 090 email: [email protected] tel: +49 89 76 76 52 85 email: [email protected] (AFRICA)

fax: +254 20 344 170 website: www.amref.org (EUROPE) 24h Alarm: +49 89 76 76 50 05 website: www.adac.de/ambulance

Netcare 911 International Air Medical Ltd Jacques Pienaar – Fixed Wing Operations Manager Glenn Salt – Director of Operations AIR AMBULANCE AIR AMBULANCE Riverview Park, Janadel Avenue, Midrand, SOUTH AFRICA Oxford Airport, Kidlington, Oxfordshire OX5 1RA, UK

tel: +27 10 209 8392 email: [email protected] tel: +44 1865 842 887 email: [email protected] fax: +27 10 209 8405 website: www.netcare911.co.za tel: +44 1865 370 642 website: www.airmed.co.uk

West African Rescue Association Augsburg Air Ambulance Florian Zagel – Managing Director Roland Schoberth – Director Klotey Cresent 6, North Labone, Accra, GHANA Roseggerstr 17, D-86368, Gersthofen, GERMANY

24hr tel: +233 243 666 111 email: [email protected] tel: +49 821 299 1020 email: [email protected] tel: +233 302 781 258 website: www.westafrican-rescue.com tel: +49 821 299 2030 website: www.ambulanzflugdienst.de ) AeroMed Asia Inc. Capital Air Charter Cindy Wong / Lorraine Paul – International Account Management Lisa Humphries – Sales Director SINGAPORE BANGKOK THAILAND Hangar 68, Exeter International Airport, EX5 2BA, UK

tel: +603 7965 3883 email: [email protected] tel: +44 845 055 2828 email: [email protected] fax: +603 7629 8810 website: www.aeromed-asia.com fax: +44 1392 350 039 website: www.capitalaircharter.co.uk AUSTRALASIA

( AirMed International LLC DRK Assistance Jeffrey T Tolbert – President Andreas Speich – Managing Director Airport World Trade Center, 1 Sky Plaza Road, Aufm Hennekamp 71, 40225 Düsseldorf, GERMANY Hong Kong International Airport, HONG KONG tel: +852 3756 3680 email: [email protected] tel: +49 211 301805-0 email: [email protected] fax: +852 3756 3681 website: www.airmedasia.com fax: +49 211 301805-21 website: www.drkassistance.com

CareFlight Group European Air Ambulance Medical and Tasking Centre Patrick Schomaker – Director Sales & Marketing PO Box 5078, Robina Town Centre, Queensland, 4230, AUSTRALIA 175A, rue de Cessange, L-1321, LUXEMBOURG

24hr tel: +61 7 5553 5955 email: [email protected] 24hr tel: +49 711 7007 7007 email: [email protected] fax: +61 7 5553 5914 website: www.cmsairambulance.com fax: +49 711 7007 7009 website: www.air-ambulance.com

CareFlight International FAI – rent-a-jet AG Paul Smith – National Manager Volker Lemke – Director Sales & Marketing Westmead Hospital Campus, PO Box 159, Westmead, NSW 2145, AUSTRALIA Flughafenstrasse 100, D-90268 Nuremberg, GERMANY

tel: (+61) 2 9893 7683 email: [email protected] tel: +49 911 36009 31 email: [email protected] fax: +61 2 9689 2744 website: www.careflight.org fax: +49 911 36009 59 website: www.rent-a-jet.de

Flying Doctors Asia IFRA Assistance GmbH – Austria Prithpal Singh – CEO , Director Mr. Christian Steindl M.D. – CEO 313 Old Bird Cage Walk, #01-15/02-16, Seletar Airport, IFRA Assistance GmbH, Schießstattring 21, A-3100 St. Pölten, AUSTRIA SINGAPORE 24hr tel: +65 9297 7757 email: [email protected] tel: +43 (0) 2742 49 11 email: [email protected] fax: +65 6483 5407 website: www.flyingdoctorsasia.com fax: +43 (0) 27 42 89165 website: www.ifra.at

Hope Medflight Asia Pte Ltd Jet Executive International Charter Dr Charles Johnson – Medical Director Irena Dimitrijevic – Marketing & Sales Mündelheimer Weg 50, D-40472, Düsseldorf, GERMANY 2 Loyang Lane 03-01, Singapore 508913, SINGAPORE “Homebase FRA & MUC” 24hr tel: +65 6100 1911 email: [email protected] tel: +49 211 602 7775 email: [email protected] fax: +65 6400 5254 website: www.hope-flight.com fax: +49 211 602 77766 website: www.jetexecutive.com

Medic’Air International 每递安国际 Mayoral Executive Jet Dr Huaqun Gao – Medical Director Juan Carlos García Caparrós – Commercial Director 885 Renmin Road, Huaihai China Building, Room 808, 200010 Shanghai, CHINA Dominguez Toledo S.A., 118 La Orotava, Malaga 29006, SPAIN

tel: +86 2163 558289 email: [email protected] tel: +34 952 048 609 email: [email protected] fax: +86 2163 558285 website: www.medic-air.com fax: +34 924 048 612 website: www.mayoralaviation.com

Medical Wings Medic’Air International Dr Sommart Somsiri – Medical Director Dr Herve Raffin – General Manager 222 Room 3259, Bangkok Int Airport, Viphavadee-Rangsit Rd, Sikan, 35 rue Jules Ferry, 93170 Bagnolet, Paris, FRANCE Don Muang, Bangkok 10210, THAILAND NEW tel: +662 247 3392 email: [email protected] tel: +33 141 72 1414 email: [email protected] fax: +662 535 4355 website: www.medicalwings.com fax: +33 148 57 1010 website: www.medic-air.com

CATEGORY KEY CLAIMS MANAGEMENT INSURERS North Flying a/s AIR AMBULANCE CLAIMS SUBROGATION MEDICAL ESCORT ON COMM. AIRLINE Jesper Kragelund – Sales Manager AIR AMBULANCE INTERIOR COMMERCIAL REPAT SPECIALISTS MEDICAL PROVIDER AIRCRAFT PERFORMANCE SOLUTIONS CRITICAL CARE PATIENT TRANSPORT MEDICAL SCREENING North Flying Terminal, Aalborg Airport, DK-9400, Nørresundby, DENMARK ASSISTANCE COMPANIES FUNERAL DIRECTORS RE-INSURANCE CATASTROPHIC CLAIMS SPECIALIST HEALTHCARE CLINICS TRAVEL AGENTS tel: +45 9632 2900 email: [email protected] fax: +45 9632 2909 website: www.northflying.com COST CONTAINMENT HOSPITALS WEB & DESIGN SERVICES

International Travel Insurance Journal call +44 (0) 117 925 5151 To make an alteration to a listing email: [email protected] SERVICEDIRECTORY 45

) Redstar Aviation AIMS Mustafa Atac – CEO Bernadette Breton – Managing Director Sabiha Gokcen International Airport, J Blok Kurtkoy, 34912 Istanbul, TURKEY Private Bag X5, Benmore Gardens 2010, Johannesburg, SOUTH AFRICA

tel: +90 216 588 0216 email: [email protected] (AFRICA) tel: +00 27 11 783 0135 email: [email protected] EUROPE

( fax: +90 216 588 0225 website: www.redstar-aviation.com fax: +00 27 11 783 2950 website: www.aims.org.za

Swiss Air Ambulance / Rega AMREF Flying Doctor Service Peter Meierhans – Director of Sales Dr Bettina Vadera – Medical Director AIR AMBULANCE PO Box 1414, Zurich Airport, CH-8058, SWITZERLAND Wilson Airport, Langata Road, PO Box 18617, Nairobi, KENYA

tel: +41 333 333 333 email: [email protected] tel: +254 20 6000 090 email: [email protected] fax: +41 44 654 3590 website: www.rega.ch fax: +254 20 344 170 website: www.amref.org ASSISTANCE COMPANIES ASSISTANCE

Tyrol Air Ambulance Interhealth Technologies Jakob Ringler – Managing Director Kevin Thomas – Director - International PO Box 81, A-6026, Innsbruck Airport, AUSTRIA P O Box 3058, Bedfordview 2008, SOUTH AFRICA

tel: +43 512 224 220 email: [email protected] tel: +27 11 622 8010 email: [email protected] fax: +43 512 288 888 website: www.taa.at fax: +27 11 622 8264 website: www.interhealth.net

Aero Jet International Medical Services Organisation (MSO) Stuart Hayman – President Vernon Pillay – Operations Director - International Division 4631 NW 31st Avenue, #220 Ft Lauderdale, FL 33309, USA PO Box 1578, Gallo Manor, 2052, SOUTH AFRICA

tel: +1 954 730 9300 email: [email protected] tel: +27 (0)11 259 5403 24hr email: [email protected] fax: +1 954 485 6564 website: www.aero-jet.com fax: +27 (0)11 259 5001 website: www.mso.co.za

Air Ambulance Professionals, Inc. Netcare 911 International Brian L. Weisz – President Louis Mabele – International Assistance Operations Manager

(NORTH AMERICA) Ft. Lauderdale Executive Airport, 1535 South Perimeter Rd, Riverview Park, Janadel Avenue, Midrand, SOUTH AFRICA Hangar 36B Ft. Lauderdale, Florida 33309, USA tel: +1 954 491 0555 email: [email protected] tel: +27 (0)10 209 8387 24hr email: [email protected] fax: +1 954 491 6114 website: www.airambulanceprof.com fax: +27 (0)10 209 8405 website: www.netcare911.co.za

Air Ambulance Specialists West African Rescue Association Tom Cox – Director of Business Development Florian Zagel – Managing Director 345 Inverness Drive South, Suite A110, Englewood, Colorado, 80112, USA Klotey Cresent 6, North Labone, Accra, GHANA

tel: +1 720 875 9182 email: [email protected] tel: +233 244 312 496/7 email: [email protected] fax: +1 720 875 9183 website: www.airaasi.com fax: +233 21 781 259 website: www.westafrican-rescue.com

AirMed International LLC On Call International

Jeffrey T Tolbert – President Michael J. Kelly – President & CEO 1000 Urban Center Drive, Suite 470, Birmingham, AL 35242, USA One Delaware Drive, Salem, NH 03079, USA NEW tel: +1 205 443 4840 email: [email protected] tel: + 888 289 0567 email: [email protected] fax: +1 205 443 4841 website: www.airmed.com fax: +1 603 328 1770 website: www.oncallinternational.com (AMERICAS) Global Jetcare, Inc. GORAL ASSISTANCE CANADA INC. Bart Gray – President David Ohayon – Local Manager 16479 Runway Drive, Brooksville, FL 34604, USA 2335 Stevens St, VSL, Montreal, QC H4M 1H1, CANADA

tel: +1 352 799 7771 email: [email protected] tel: +1 514 4481343 email: [email protected] fax: +1 352 799 7776 website: www.globaljetcare.com fax: +1 514 4481835 website: www.goralassist.com

JET ICU SelectCare Worldwide Mike Honeycutt – President Magdi Riad – President 2561 Rescue Way, Brooksville, FL 34604, USA 2100 - 250 Yonge Street, Toronto, Ontario M5B 2L7, CANADA

tel: +1 352 796 2540 email: [email protected] tel: +1 866 261 4441 email: [email protected] fax: +1 352 796 2549 website: www.jeticu.com toll free: +1 416 340 7152 website: www.selectcareworldwide.com

Latitude Air Ambulance World Travel Protection Jeff McIntosh David McLean – Vice President, Sales & Marketing CANADA 400 University Avenue, 15th Floor, Toronto, ON, M5G 1S7, CANADA USA tel: +1 289 426 1133 email: [email protected] tel: +1 416 205 4646 email: [email protected] fax: + 1 289 426 1134 website: www.latitude2009.com fax: +1 416 205 4676 website: www.wtp.ca

LIFESUPPORT Patient Transport To have your company listed in our service directory Graham Williamson – CEO #9-1009 Allsbrook Road, Parksville, British Columbia, V9P 2A9, CANADA contact the sales department now: tel: +1 250 947 9641 email: [email protected] [email protected] or telephone: +44 (0)117 922 66 00 fax: +1 877 288 2908 website: www.LifeSupportTransport.com

Skyservice Air Ambulance CATEGORY KEY CLAIMS MANAGEMENT INSURERS AIR AMBULANCE CLAIMS SUBROGATION MEDICAL ESCORT ON COMM. AIRLINE David Ewing – VP International Business Development AIR AMBULANCE INTERIOR COMMERCIAL REPAT SPECIALISTS MEDICAL PROVIDER Montreal/PE Trudeau Int Airport, 9785 Avenue Ryan, Montreal (Quebec), AIRCRAFT PERFORMANCE SOLUTIONS CRITICAL CARE PATIENT TRANSPORT MEDICAL SCREENING H9P 1A2, CANADA ASSISTANCE COMPANIES FUNERAL DIRECTORS RE-INSURANCE tel: +1 514 497 7000 email: [email protected] CATASTROPHIC CLAIMS SPECIALIST HEALTHCARE CLINICS TRAVEL AGENTS fax: +1 514 636 0096 website: www.skyservice.com/airambulance COST CONTAINMENT HOSPITALS WEB & DESIGN SERVICES

www.itij.co.uk 46 SERVICEDIRECTORY To have your company listed in the Service Directory email: [email protected]

Assistance Online DRK Assistance Bertrand Guichoux – CEO Andreas Speich – Managing Director Zendai Cube Edifice 6/F, 58, Changliu Road, Pudong, 200135 Shanghai, CHINA Aufm Hennekamp 71, 40225 Düsseldorf, GERMANY

tel: +86 21 6104 9500 email: [email protected] tel: +49 211 301805-0 email: [email protected]

fax: +86 21 6104 9484 website: www.assistanceonline-china.com (EUROPE) fax: +49 211 301805-21 website: www.drkassistance.com

Dynamiq Global Assistance a.s.

(AUSTRALASIA) Janine Benson – Director of Emergency Assistance Petr Bold – General Manager Level 5/33 York St, Sydney 2000, NSW, AUSTRALIA Dopraváku˚ 749/3,184 00 Prague 8, CZECH REPUBLIC

tel: +61 (0) 2 9978 6600 email: [email protected] tel: +420 266 799 770 email: [email protected] fax: +61 (0) 2 9888 3609 website: www.dynamiq.com.au/assist fax: +420 266 799 797 website: www.1220.cz ASSISTANCE COMPANIES ASSISTANCE ASSISTANCE COMPANIES ASSISTANCE East West Rescue Global Voyager Assistance - Russia Dr Kimberley Chawla – Program Director Costas Danilenko – CEO 37 Prithviraj Road, New Delhi 110011, INDIA PO Box II, 125124 Moscow, RUSSIA

tel: +91 11 2469 0429 email: [email protected] tel: +7 495 775 0999 email: [email protected] fax: +91 11 2469 0428 website: www.eastwestrescue.com fax: +7 495 775 0998 website: www.gvassistance.com

First Assistance Global Voyager Assistance - Black Sea Mary-Jo McDonald – CEO Olga Turubarova – General Manager PO Box 17-310, Greenlane, Auckland, NEW ZEALAND NEW 77-79 Nezhinskaya Str., 65023, Odessa, UKRAINE tel: +64 9 356 1650 email: [email protected] tel: +38 048 7373 441 email: [email protected] fax: +64 9 525 1278 website: www.firstassistance.co.nz fax: +38 048 7373 442 website: www.gvassistance.com

Global Assistance & Healthcare IFRA Assistance S.r.l. – Romania Mario Babin – Chief Executive Officer Ms. Mariana Nadban – Director Cilandak Commercial Estate - # 111 GC, Jl. Raya Cilandak KKO, S.C. IFRA Assistance S.r.l, Calugareni Street 2, RO-310181 Arad, ROMANIA Jakarta 12560, INDONESIA tel: +62 21 299 78 999 email: [email protected] tel: +40 257 21 82 91 email: [email protected] fax: +62 21 299 78 9555/66 website: www.global-assistance.net fax: +40 257 20 10 20 website: www.ifra.at

ADAC-Ambulance Service Marm Assistance Robert Glueck – Marketing & Sales Director Jill Atac – CEO Grup Center Is Merkezi, Mustafa Akyol Sok No. 158, Yenisehir Mah, Am Westpark 8, 81373 Munich, GERMANY Kurtkoy 34912, TURKEY tel: +49 89 76 76 52 85 email: [email protected] tel: +90 216 560 07 24 [email protected] (EUROPE) email: 24h Alarm: +49 89 76 76 50 05 website: www.adac.de/ambulance fax: +90 216 560 07 07 website: www.marmassistance.com

Altas Assistance med con team GmbH Saulius Stepsys – Director/CEO Michael Weinlich – Managing Director Lentvario Str. 7, Lt-02300 Vilnius, LITHUANIA Gerhard-Kindler-Str.6, 72770 Reutlingen, GERMANY

tel: +370 5 264 4020 email: [email protected] tel: +49 7121 433 660 email: [email protected] fax: +370 5 264 4021 website: www.altas-assistance.lt fax: +49 7121 433 619 website: www.medconteam.com

AP Companies ONE Assist Natalya Butakova – Business Development Manager Linda Norman – Group Client Relationship Manager C/Cardenal Rossell No.1, Esc. A 2˚. Desp 8-9, 17 Varshavskoye Shosse, Moscow 117105, RUSSIA Palma de Mallorca 07007, Baleares, SPAIN tel: +7 495 989 1120 email: [email protected] tel: +44 (0) 1992 708 700 email: [email protected] fax: +7 495 989 1130 website: www.ap-companies.ru 24 tel: +44 (0) 1992 405 718 website: www.oneassist.com

ARC Europe SA Save Assistance France Hans Biekmann – Network Director Franck Molinier – Director of Business Development 6 Rue Jean-Pierre Timbaud, Le Campus, Bat. B1, Avenue des Olympiades 2, 1140 Brussels, BELGIUM 78180 Montigny-Le-Bretonneux., FRANCE NEW tel: +32 2 706 6660 email: [email protected] tel: +33 13062 6752 email: [email protected] fax: +32 2 706 6601 website: www.arceuropemedical.com 24 tel: +33 13062 1122 website: www.saveassistance.com

To have your company listed in our service directory Savitar Lydia Semchenkova – Business Development Manager contact the sales department now: 25/1, 7th Floor, Trubnaya Str., Moscow, 127051, RUSSIA [email protected] or telephone: +44 (0)117 922 66 00 tel: +7 495 987 1775 email: [email protected] fax: +7 495 987 1776 website: www.savitar-gr.com

CNAS SOS International Carole Luisy – Managing Director Helle Drager Sandahl – Communications & Marketing Manager 80 rue des alliés, 38100, Grenoble, FRANCE Nitivej 6, DK-2000 Frederiksberg, Copenhagen, DENMARK

tel: +33 438 49 83 49 email: [email protected] tel: +45 7010 5055 email: [email protected] fax: +33 438 49 83 40 website: www.cnas-assistance.com fax: +45 7010 5056 website: www.sos.eu

CATEGORY KEY CLAIMS MANAGEMENT INSURERS TBS Team 24 d.o.o AIR AMBULANCE CLAIMS SUBROGATION MEDICAL ESCORT ON COMM. AIRLINE AIR AMBULANCE INTERIOR COMMERCIAL REPAT SPECIALISTS MEDICAL PROVIDER Edvard Hojnik – General Manger AIRCRAFT PERFORMANCE SOLUTIONS CRITICAL CARE PATIENT TRANSPORT MEDICAL SCREENING CROATIA, SLOVENIA, SERBIA, MNE, BH, KOS, MAC ASSISTANCE COMPANIES FUNERAL DIRECTORS RE-INSURANCE CATASTROPHIC CLAIMS SPECIALIST HEALTHCARE CLINICS TRAVEL AGENTS tel: +386 2616 5819 email: [email protected] fax: +386 2618 5800 website: www. tbs-team24.com COST CONTAINMENT HOSPITALS WEB & DESIGN SERVICES

International Travel Insurance Journal call +44 (0) 117 925 5151 To make an alteration to a listing email: [email protected] SERVICEDIRECTORY 47

CONNEX Assistance Middle East Lara Helmi – International Network Director Office 703, Block B, Belrasheed Towers, Qusais, Dubai, UAE

tel: +97 14 257 82 84 email: [email protected] fax: +97 14 257 82 85 website: www.connexassistance.com

GORAL ASSISTANCE LTD (MIDDLE EAST) Marcel Kadoche – International Network and Development Manager Maskit 27 str. Herzeliya Industrial Park 46733, ISRAEL

tel: +972 9 9579930 email: [email protected] fax: +972 9 9579931 website: www.goralassist.com ASSISTANCE COMPANIES ASSISTANCE IES Medical Eitan Kariv – CEO 2 Yagea Kapaim Street, Tel Aviv, ISRAEL

tel: +972 3 639 9990 email: [email protected] fax: +972 3 687 2950 website: www.iesmedical.co.il

Dr Colin Plotkin & Sons Consulting INC. Dr Colin Plotkin – Managing Director 27-3088 Francis Road, Richmond, British Columbia V7C 5V9, CANADA

tel: +1 604 241 9677 email: [email protected] fax: +1 604 241 0733 website: www.plotkinconsulting.com

Global Excel Management

CATASTROPHIC CATASTROPHIC Michael Drew – Vice-President Sales 73 Queen St, Sherbrooke, QC J1M 0C9, CANADA 17548 Deer Isle Circle, Winter Gdn, FL 34787 USA

CLAIMS SPECIALISTS tel: +1 866 566 1130 email: [email protected] fax: +1 819 566 8335 website: www.globalexcel.ca

AIMS Bernadette Breton – Managing Director Private Bag X5, Benmore Gardens, 2010 Johannesburg, SOUTH AFRICA

tel: +00 27 11 783 0135 email: [email protected] (AFRICA) fax: +00 27 11 783 2950 website: www.aims.org.za

Interhealth Technologies Kevin Thomas – Director - International P O Box 3058, Bedfordview 2008, SOUTH AFRICA

COST CONTAINMENT tel: +27 11 622 8010 email: [email protected] fax: +27 11 622 8264 website: www.interhealth.net

Medical Services Organisation (MSO) Vernon Pillay – Operations Director - International Division PO Box 1578, Gallo Manor, 2052, SOUTH AFRICA

tel: +27 (0)11 259 5403 24hr email: [email protected] fax: +27 (0)11 259 5001 website: www.mso.co.za

ChargeCare International Christiane Burniston – Managing Director Monument Business Park, 1D Park Offices, Warpsgrove Lane, Chalgrove, Oxford, UK

(EUROPE) tel: +44 1865 400 007 email: [email protected] fax: +44 845 003 9923 website: www.chargecareinternational.co.uk

Marm Assistance Jill Atac – CEO Grup Center Is Merkezi, Mustafa Akyol Sok No. 158, Yenisehir Mah, Kurtkoy 34912, TURKEY tel: +90 216 560 07 24 email: [email protected] fax: +90 216 560 07 07 website: www.marmassistance.com

Medical Claims International Spain Fatima Guillen Grande – Managing Director C/Ciudad de Aguilas No.2, Local 2A, Madrid 28030, SPAIN

tel: 00 34 913 016 145 email: [email protected] fax: 00 34 913 016 160 website: www.mcimanager.com

Active Care Management David Rivelis – Senior Vice President 3600 Rhodes, Windsor, ON, N8W 5A4, CANADA

tel: +(519) 945 8256 #4226 email: [email protected] fax: +(519) 251 5165 website: www.active-care.ca (N AMERICA)

www.itij.co.uk 48 SERVICEDIRECTORY To have your company listed in the Service Directory email: [email protected]

Coalition America, Inc. Interhealth Technologies Matthew Lungen – Director, National Sales Kevin Thomas – Director - International Two Concourse Parkway, Suite 300, Atlanta, GA 30328, USA NEW P O Box 3058, Bedfordview 2008, SOUTH AFRICA tel: +1 404 459 7201 email: [email protected] tel: +27 11 622 8010 email: [email protected] fax: +1 404 459 4408 website: www.coalitionamerica.com fax: +27 11 622 8264 website: www.interhealth.net

Dr Colin Plotkin & Sons Consulting INC. ONE Claims Dr Colin Plotkin – Managing Director Linda Norman – Group Client Relationship Manager

(NORTH AMERICA) 27-3088 Francis Road, Richmond, British Columbia V7C 5V9, CANADA 1-4 Limes Court, Conduit Lane, Hoddesdon, Hertfordshire EN11 8EP, UK

COST CONTAINMENT tel: +1 604 241 9677 email: [email protected] tel: +44 (0) 1992 708 700 email: [email protected] fax: +1 604 241 0733 website: www.plotkinconsulting.com 24 tel: +44 (0) 1992 405 718 website: www.oneassist.com CLAIMS MANAGEMENT

Global Excel Management SelectCare Worldwide Michael Drew – Vice-President Sales Magdi Riad – President 73 Queen St, Sherbrooke, QC J1M 0C9, CANADA 2100 - 250 Yonge Street, Toronto, Ontario M5B 2L7, CANADA 17548 Deer Isle Circle, Winter Gdn, FL 34787 USA tel: +1 866 566 1130 email: [email protected] tel: +1 866 261 4441 email: [email protected] fax: +1 819 566 8335 website: www.globalexcel.ca toll free: +1 416 340 7152 website: www.selectcareworldwide.com

Global Medical Management Star Healthcare Raija Itzchaki – COO Gigi Galen – President 1300 Concord Terrace, Suite 300, Sunrise, Florida 33323, USA 850 7th Avenue, Suite 803, New York, 10019, USA

tel: +1 954 370 6404 email: [email protected] tel: + 1 212 581 8228 email: [email protected] fax: +1 954 370 8613 website: www.gmmusa.com fax: + 1 212 581 8272 website: www.starhealthcarenet.com

Olympus Managed Healthcare Voyageur Aeromedical Travel Steven Jacobson – CEO Marc Lucas – General Manager 777 Brickell Avenue, Suite PH70, Miami, Florida 33131, USA Voyageur Buildings, 43 Colston Street, Bristol BS1 5AX, UK

tel: +1 305 530 8600 email: [email protected] tel: +44 (0)117 927 3554 email: [email protected] fax: +1 305 530 0766 website: www.omhc.com fax: +44 (0)117 925 5940 website: www.voyageur24.com SPECIALISTS OneWorld Assist To have your company listed in our service directory Taka Katsube – Director Assistance & Cost Managment 10th Floor, 6081 No.3 Road, Richmond, BC V6Y 2B2, CANADA contact the sales department now: tel: +1 604 303 2113 email: [email protected] COMMERCIAL REPAT [email protected] or telephone: +44 (0)117 922 66 00 fax: +1 604 276 4593 website: www.oneworldassist.com

SelectCare Worldwide ADAC Magdi Riad – President Christoph Ullrich – Director of Purchase / International Network 2100 - 250 Yonge Street, Toronto, Ontario M5B 2L7, CANADA Am West Park 8, 81373 Munich, GERMANY

tel: +1 866 261 4441 email: [email protected] tel: +49 89 7676 2912 email: [email protected] toll free: +1 416 340 7152 website: www.selectcareworldwide.com 24hr Alm: +49 89 7676 5005 website: www.adac.de/ambulance

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

UnitedHealth International To have your company listed in our service directory Philip Brun – Vice President of Sales & Service 3100 SW 145 Avenue, Miramar, FL 33027, USA contact the sales department now: tel: +1 954 378 0694 email: [email protected] [email protected] or telephone: +44 (0)117 922 66 00 fax: +1 954 378 0771 website: www.uhgi.com CRITICAL CARE PATIENT TRANSPORTCRITICAL CARE PATIENT

Global Assistance & Healthcare Albin Repatriation Ltd Mario Babin – Chief Executive Officer Emerson De Luca – General Manager Cilandak Commercial Estate - # 111 GC, Jl. Raya Cilandak KKO, 83 Westbourne Grove, Bayswater, London W2 4UL, UK Jakarta 12560, INDONESIA tel: +62 21 299 78 999 email: [email protected] tel: +44 20 7313 6920 email: [email protected] fax: +62 21 299 78 9555/66 website: www.global-assistance.net fax: +44 20 7313 6999 website: www.albininternational.com

Global Excel Management Flying Home Pte Ltd Michael Drew – Vice President of Sales Mr Ang Ziqian – Director 73 Queen St, Sherbrooke, QC J1M 0C9, CANADA Blk 4 Lorong 8 Toa Payoh #01-1345A, SINGAPORE 17548 Deer Isle Circle, Winter Gdn, FL 34787, USA

tel: +1 866 566 1130 email: [email protected] FUNERAL DIRECTORS tel: +65 6253 0001 email: [email protected] fax: +1 819 566 8335 website: www.globalexcel.ca fax: +65 6353 5801 website: www.flyinghome.com CLAIMS MANAGEMENT

CATEGORY KEY CLAIMS MANAGEMENT INSURERS Funeral Home AURIGA Ltd. AIR AMBULANCE CLAIMS SUBROGATION MEDICAL ESCORT ON COMM. AIRLINE AIR AMBULANCE INTERIOR COMMERCIAL REPAT SPECIALISTS MEDICAL PROVIDER Helena Sulikova – Chief of International Department AIRCRAFT PERFORMANCE SOLUTIONS CRITICAL CARE PATIENT TRANSPORT MEDICAL SCREENING B. Nemcové Street 1052/1, 412 01 Litomerice, CZECH REPUBLIC ASSISTANCE COMPANIES FUNERAL DIRECTORS RE-INSURANCE CATASTROPHIC CLAIMS SPECIALIST HEALTHCARE CLINICS TRAVEL AGENTS tel: +420 724 257 899 email: [email protected] COST CONTAINMENT HOSPITALS WEB & DESIGN SERVICES fax: +420 416 732 582 website: www.funeral-assistance.cz

International Travel Insurance Journal call +44 (0) 117 925 5151 To make an alteration to a listing email: [email protected] SERVICEDIRECTORY 49

Funeralcare International CareFlight International Louisa Killen – Repatriation Specialist Sue Robshaw – Co-ordinator Westmead Hospital Campus, PO Box 159, Westmead, NSW 2145, 221 Upper Richmond Road, Putney, London, SW15 6SQ, UK AUSTRALIA tel: +44 20 8788 5303 email: [email protected] tel: +61 1300 655 855 email: [email protected] fax: +44 20 8788 2525 website: www.co-operativefuneralcare.co.uk fax: +61 2 9689 2744 website: www.careflight.org

John Allison Monkhouse Co., Ltd (Thailand) Medic’Air International 每递安国际

Pim Karnasuta – General Manager (AUSTRALASIA) Dr Huaqun Gao – Medical Director 89/7 MOO 19, Soi Yingcharoen, Bangplee, Samutprakarn 10540, THAILAND 885 Renmin Road, Huaihai China Building, Room 808, 200010 Shanghai, CHINA tel: +86 2163 558289 email: [email protected]

FUNERAL DIRECTORS tel: +66 2382 5345-7 email: [email protected] fax: +66 2261 7939 website: www.monkhouse.com.au fax: +86 2163 558285 website: www.medic-air.com

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 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

Mortuary Brussels Airport | Worldwide Funeral Repatriations part of DELA AMREF Flying Doctors Greta Plas – Repatriations Manager Dr Bettina Vadera – Medical Director

Ringlaan 49, 1930 Zaventem, BELGIUM MEDICAL ESCORT ON COMMERCIAL AIRLINES Wilson Airport, Langata Road, PO Box 18617, Nairobi, KENYA

tel: +32 2 720 80 00 email: [email protected] (AFRICA) tel: +254 20 6000 090 email: [email protected] fax: +32 2 720 88 22 website: www.repatriations.com fax: +254 20 344 170 website: www.amref.org

Rowland Brothers International LIFESUPPORT Patient Transport Melanie Walkling – Partner Graham Williamson – CEO 299-305 Whitehorse Road, West Croydon, Surrey CR0 2HR, UK #9-1009 Allsbrook Road, Parksville, British Columbia, V9P 2A9, CANADA/USA

tel: +44 20 8684 2324 email: [email protected] tel: +1 250 947 9641 email: [email protected]

fax: +44 20 8684 8000 website: www.rowlandbrothersinternational.co.uk (AMERICA) fax: +1 877 288 2908 website: www.LifeSupportTransport.com

Servilusa Greek Flying Doctors Vanda Castro – Manager International Department Dimitris Kanellis – Manager Agencias Funerarias SA, International Dept. Rua do 3 Doukisis Plakentias Str, 152 34 Halandri, Athens, GREECE Entreposto Industrial, 8-2 Esq, 2610-135 Amadora, PORTUGAL

tel: +35 121 470 6300 email: [email protected] (EUROPE) tel: +30 210 674 0600 email: [email protected] fax: +35 121 470 6499 website: www.servilusa.pt fax: +30 210 674 0634 website: www.greekflyingdoctors.gr

USP Hospitales S.L Redstar Aviation Francisco Rico – International Relations Manager Mustafa Atac – CEO C/Miguel Angel, 23 3˚, 28010 Madrid, SPAIN Sabiha Gokcen International Airport, J Blok Kurtkoy, 34912 Istanbul, TURKEY

tel: + 34 951 91 30 30 email: [email protected] tel: +90 216 588 0216 email: [email protected]

(EUROPE) fax: + 34 951 91 30 40 website: www.usphospitales.com fax: +90 216 588 0225 website: www.redstar-aviation.com HOSPITALS HOSPITALS Baptist Health South Florida International Services Voyageur Aeromedical Travel Yohandra Fuentes – Assist V-P/Int. Insurance Dev. & Revenue Mangement 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] fax: +1 786 596 5979 website: www.baptisthealth.net/international fax: +44 (0)117 925 5940 website: www.voyageur24.com

Jackson Memorial Hospital International AMREF Flying Doctor Service Luis Felipe Arango – Vice President of International Business Dr Bettina Vadera – Medical Director

(NORTH AMERICA) Jackson Medical Towers, East Tower, Suite 829, Wilson Airport, Langata Road, PO Box 18617, Nairobi, KENYA 1500 NW 12th Avenue, Miami, FL 33136 - 9998, USA 24hr tel: + 1 305 355 1212 email: [email protected] tel: +254 20 6000 090 email: [email protected] tel: + 1 305 355 5544 website: www.jmhi.org fax: +254 20 344 170 website: www.amref.org

University of Miami Health System StandbyMD Jose Quesada M.D., M.B.A. – Director Finance & Operations Alex Sánchez – Managing Director 1099 N.W. 14th Street, Miami, Florida 33136, USA 777 Brickell Avenue, Suite 1370, Miami, Florida 33131, USA MEDICAL PROVIDER

tel: +1 305 243 9100 email: [email protected] tel: +1 305 459 4882 email: [email protected] fax: +1 305 243 9101 website: www.uhealthinternational.com fax: +1 305 421 5575 website: www.standbymd.com ) Vejthani Hospital Voyageur Aeromedical Travel

ASIA Lauranee Sirikasem – Assistant Marketing Director Marc Lucas – General Manager

( 1 Ladprao Road 111, Klong-Chan Bangkapi, Bangkok 10240, Voyageur Buildings, 43 Colston Street, Bristol BS1 5AX, UK THAILAND NEW TRAVEL TRAVEL

tel: (+66)-2-734-0000 email: [email protected] AGENTS tel: +44 (0)117 927 3554 email: [email protected] fax: (+66)-2-370-1596 website: www.vejthani.com fax: +44 (0)117 925 5940 website: www.voyageur24.com

O CareFlight Group V Creative Design Medical and Tasking Centre Steve Annette – New Media Director PO Box 5078, Robina Town Centre, Queensland, 4230, AUSTRALIA NEW Voyageur Buildings, 43 Colston Street, Bristol BS1 5AX, UK 24hr tel: +61 7 5553 5955 email: [email protected] tel: +44 (0)117 929 4636 email: [email protected] fax: +61 7 5553 5914 website: www.cmsairambulance.com fax: +44 (0)117 925 2040 website: www.vcreativedesign.co.uk COMM AIR. WEB & MEDIA ADVERTISING MED. ESC. www.itij.co.uk 50 REGULARS

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the next tee. Some tourists who witnessed Jei’s successful X-ray Scott Wagstaff, climb to the top of the wall attempted to follow Carbrook’s her – with predictably disastrous results. Two fell catches general manager, soon afterwards, breaking both their legs when diamond said: “You can’t they landed, while another tourist got stuck on believe how the wall and had to be rescued by police. thief close you are One eyewitness said: “She ran up the wall like … just six feet a goat and made it look easy. But when people News has emerged of a away. There’s tried it for themselves, they saw it wasn’t quite thief in Spain who stole no drama, as simple as they thought.” a diamond from a British it’s become a tourist and was caught after positive thing for police X-rayed his stomach. the golf course. A police spokesman said the I’m sure they are theft occurred in a restaurant aggressive when in Marbella, after one of two you are in the women enjoying a meal out water, but when left her handbag on the floor. you are out here Hours later, police stopped feeding them, a car at a routine checkpoint they are beautiful near the city, and found, to watch.” upon investigation, that the four men inside all had previous criminal records. Inside the vehicle, the woman’s bag Golf safari Cheap tourism was discovered, along with cash and belongings that could be confirmed as the possessions of More and more travel companies around the With the worldwide economic malaise not the woman whose bag had earlier been stolen. world are adding particular ‘niche’ holiday seeming to let up its steady stream of bad news Police said: “During the operation, officers offerings to their portfolio – from golfing, to – the US debt crisis, Eurozone bailouts and the noticed one of the men putting his hand to safaris, to scuba diving. Now, though, for shark- like – everyone is feeling their pockets being his mouth. This gesture, and the fact that they loving golfers, there is a new option. squeezed. However, people are still taking had found the pendant without the diamond, Carbrook Golf Club in Brisbane, Australia, has holidays, but are cost-cutting on their vacations made the police think he may have swallowed six man-eating bull sharks in one of the lakes on – some people more seriously than others, it it. To find the stone, those arrested were taken its 18-hole course, after a nearby river burst its would appear. to a medical centre, where they underwent banks and the sharks ended up in the lake once Tourists in China were astonished recently X-rays, and the diamond was located inside the waters receded. They have become minor to see a woman climbing the wall of a castle the stomach of one of them, who admitted celebrities in the area, and golfers are now in order to avoid paying the £2.50 entry fee. swallowing it.” being asked to take Shark Lake Challenge – no, Ma Jei, who lives near Zhonghua Castle, Good to know that Spanish medical centres not going into the lake to retrieve a ball, thank said that she scales the 70-foot wall on a are good for more than simply treating a goodness – but instead they get the chance to regular basis, with no support, ropes or other VCD-121-qtrstrip-p39.pdf 1 24/01/2011 16:08 holidaymaker’s illness and injury! see if they can spot the sharks on their way to safety equipment. VINE • GRAPEVINE • GRAPEVINE • GRAPEVINE • GRAPEVINE • GRAPEVINE VINE • GRAPEVINE •GRAPEVINE • GRAPEVINE • GRAPEVINE • GRAPEVINE • GRAPEVINE • GRAPEVINE • GRAPEVINE • GRAPEVINE VINE • GRAPEVINE • GRAPEVINE • GRAPEVINE • GRAPEVINE • GRAPE-

email: [email protected]

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International Travel Insurance Journal ONTHEMOVE 51

Banks in new global Coles named as Jorge Luzzi elected president of FERMA

Aviva role LMRC chairman Jorge Luzzi, group risk management director for president of the Latin American risk management Pirelli worldwide, has been elected as the next association Alarys and an active member of the Aviva, in the UK, has appointed Martin Banks to the The British Insurance Brokers’ Association (BIBA) has president of the Federation of European Risk Italian risk management association ANRA. He has new role of global relationships director. He will be appointed Tim Coles, chief executive of Howden Management Associations (FERMA). His mandate as had a wide-ranging career in insurance and risk based in London and report directly to UK strategic Broking Group, as the new chairman of its London president started at the end of the FERMA Forum management, and today is group risk management partnerships director Ant Middle. Working closely Market Region Committee (LMRC) with immediate on 5 October 2011 and will continue until the end director for Pirelli worldwide, executive director with colleagues across the Aviva Group, Martin will effect. Tim succeeds Ken Davidson, chairman of of the Forum in 2013. Michel Dennery, deputy of Pirelli Insurance and Reinsurance Company in be responsible for strengthening relationships with Crispin Speers & Partners Ltd, who was instrumental chief risk officer for GDF SUEZ, has been elected Dublin, Republic of Ireland, and managing director of key strategic partners who both distribute products in leading the LMRC through its first two years and as FERMA’s vice-president with a two-year mandate Pirelli Group Reinsurance in Switzerland. Says Luzzi: manufactured by Aviva and provide services to the will remain on the committee. until June 2013. Julia Graham, chief risk officer for “I am delighted to be able to take forward the work Group and its businesses. Coles said: “I’m delighted to take up the reins of the the global law firm DLA Piper, continues as vice- of FERMA, which now represents the interests of risk Ant Middle commented: “This is a new role, created LMRC. We will continue to represent BIBA’s London president until June 2012. managers in 19 countries with our new members to gain a deeper and broader understanding of our market members and influence BIBA’s industry and The current president of FERMA, Peter den from Malta and Slovenia. I would like to pay tribute strategic partners’ operations and enabling us to lobbying initiatives. As an industry, we face myriad Dekker, will preside over the 2011 FERMA Forum to the work of Peter den Dekker, who has played identify and maximise global opportunities.” issues and changes arising from the current economic in Stockholm from 2-5 October. He congratulated such an important role in increasing FERMA’s stature Martin has worked in various posts across Aviva, and and regulatory environment. As chairman of the Luzzi on his election: “I am delighted to be handing and profile in his two years as president.” was previously commercial development director in LMRC, my priority will be to seek engagement from over to Jorge, who has already done a great deal to the European business. Prior to that, he spent over the BIBA membership and wider broking community raise FERMA’s standing on the international stage.” three years in Aviva North America as senior vice- in order that, together, we ensure the best possible Den Dekker added: “Michel Dennery is president of strategy and corporate development. outcomes for the industry.” strengthening FERMA’s role as a voice for the Eric Galbraith, BIBA chief executive, said: “It has European risk management community, especially been a pleasure working with Ken, and I would with his work for FERMA on corporate governance like to thank him for leading LMRC and for his and risk issues, and I welcome his election as FERMA IRM appoints José guidance over the last two years. I am delighted Tim vice-president.” has accepted the chairmanship position and I look Luzzi is currently vice-president of FERMA, chair of Morago as director forward to working with him.” the International Federation of Risk and Insurance Ken Davidson, outgoing chairman of the LMRC, Management Associations (IFRIMA), honorary The Institute of Risk Management (IRM) has recently said: “I am delighted to have been involved from announced the appointment of José Morago to its the very beginning of LMRC and to see it prosper. board of directors with immediate effect. José is the I am confident in handing over to Tim who is a European enterprise risk director for well respected Aviva, where he is responsible for market Adrian Starr risk oversight, governance and capital practitioner.” management of Aviva’s European Tim joined Lorega hires Starr operations in 12 countries. He is also Howden, part responsible for Aviva’s Solvency II of the Hyperion Loss recovery insurance (LRI) specialist Lorega has (Pillar 2) compliance at European level. Insurance appointed Adrian Starr as a chartered loss adjuster José brings extensive international Group, in within its loss-adjusting subsidiary, Lorega Solutions. experience in insurance, banking February 2002 Starr joins from Merlin, where he was an adjuster, and management consulting to the as director of major and complex loss, and managed a large Alex Minajew role. Prior to Aviva, José was chief marketing. He portfolio of commercial fire, perils and business risk officer for Groupama Insurance. soon established interruption claims. During his 25-year loss-adjusting He has also played senior roles for and became New post for Minajew career, he has also worked for Ellis & Buckle and RSA McKinsey & Company, Moody’s managing (formerly Sun Alliance). Investor Service, Liberty Mutual director of Alex Minajew has joined Blue Insurances, a leading Launched in 2010 as a chartered loss adjusting and Banco Santander. José holds Howden supplier of travel insurance in the Reublic of Ireland company, Lorega Solutions was created to provide an MBA from Instituto de Empresa Risk Partners, and Northern Ireland, to head up the company’s the skilled resource required to support the increased (Madrid), a master of science in a division business development in the UK. Blue Insurances level of claims handled by the business. The additional finance from Boston College, and specialising in announced that the former head of business claims have been generated by increased penetration a bachelor’s degree in business the provision of development at Europ Assistance for the UK and of LRI both in commercial and personal lines and the studies from University of Castilla-La management Ireland has joined the team to further expand its move from being an add-on product only to being Mancha (Albacete, Spain). José is also liability business operation. He will take responsibility for all written into insurer’s policy wordings. a Chartered Financial Analyst (CFA) products to channels and products in the UK, ranging from travel Angus Tucker, operations director of Lorega Solutions Tim Coles charter-holder and IRM member. the investment insurance to motor breakdown. and a past president of the CILA, said: “Lorega Alex Hindson, IRM chairman, commented: “The industry. Tim became CEO of Howden Insurance Joint managing director Ciaran Mulligan commented: Solutions is going from strength to strength and it is Institute continues to grow in both numbers and Brokers with responsibility for the UK retail business “We are delighted that Alex is joining Blue Insurances. therefore vital that we recruit the best chartered loss influence in the UK and overseas. José’s appointment and the global wholesale and reinsurance operations With the wealth of experience that Alex brings, we adjusters to support our growth. With over 25 years brings valuable additional expertise to help us fulfill in 2006. He took the reins as CEO of Howden are looking forward to working together to generate in the market, Adrian is a well-recognised expert and our strategic objectives.” Broking Group in January 2010. significant growth in the UK market.” will make an excellent addition to our specialist team.”

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