ESSENTIAL READING FOR TRAVEL INSURANCE INDUSTRY PROFESSIONALS WWW.ITIJ.CO.UK AUGUST 2011 • ISSUE 127 Spanish stats show growth

began to bite. Even a ‘slight reactivation’ in tourism in 2010 failed to reignite the insurance sector as it fell a further 2.1 per cent to c139 million. DBK says total spending on travel policies now represents 0.44 per cent of all non-life policies, and 44.1 per cent of those Underwriting award involving assistance. Agents are the main spotlights travel channel for selling policies, accounting In a sign that could herald a new industry acceptance for a 39-per-cent of niche travel insurance suppliers that cater to share based on sales, customers with serious pre-existing medical followed by brokers conditions, specialist underwriter InsureCancer has at 37 per cent, and been voted ‘Underwriter of the Year’ at the British then direct sales at Insurance Awards. Mandy Aitchison reports 21 per cent, with ‘the travel agents The prestigious British Insurance Awards, held this carrying out an year on 6 July in London, recognise outstanding increasingly relevant achievement within the industry, and this year has role’ in deciding presented its annual Underwriter of the Year award to which policy to buy. InsureCancer for: “Insurance innovation, underwriting A resurgence in tourism this year is expected to looking for coverage on long-haul and specialist niche DBK forecasts a general expansion of the Spanish expertise and customer-focused ethos – making lead to Spanish holidaymakers spending nearly holiday trips. travel insurance market as tourism activity begins a unique contribution to those affected by cancer. three per cent more on travel insurance in 2011. While the ongoing problem with the economy to pick up again, which should ‘encourage more InsureCancer is an outstanding example of an insurer David Ing analyses the fi gures is expected to continue to have an effect on insurers to enter’. At present, the market is covered making an invaluable contribution to the community.” sales in 2011, it will not be enough to prevent by 15 companies, eight of which are based in Dr Krish Shashtri, managing director of the company, There are promising signs of an overall expansion the fi rst positive year-on-year growth after two Madrid, six in Catalonia and one in the Basque said: “It is an honour to be voted Underwriter of of the Spanish travel sector in the coming years, negative years. Country region. “Only six of the 25 leading insurance the Year by colleagues and insurance professionals following two consecutive years of falls as a result In what is its fi rst-ever report published specifi cally on groups operating in the Spanish market have a recognising our specialist expertise.” Shashtri added: of the economic crisis, according to a report the travel insurance sector, DBK expects the increase presence in the sector of travel assistance,” DBK “As this is the fi rst time a travel underwriter has been published in July by leading market analysts DBK. to be 2.9 per cent this year and as much as 4.2 per points out, and with so few companies involved, the recognised in this way, I am delighted that travel “The favourable expectations for tourism and the cent in 2012. It will be good news for a sector that, concentration of activity in the travel sector is higher has fi nally taken its rightful place at the top table of increase in the tendency to take out travel insurance following the record year of 2008 when sales grew than that in the insurance market as a whole. The insurance. It is in this context that travel underwriters among the Spanish population will contribute to by 2.7 per cent to c153 million, had seen turnover two biggest companies account for 44.7 per cent of should draw great satisfaction that our insurance the development of the insurance market for travel slump by 7.2 per cent to c142 million in 2009, the market, and the top fi ve 75 per cent. Only six colleagues have fi nally recognised that our market is assistance in the next few years,” says the company. refl ecting the ‘weakness in private consumption companies surpassed c10 million in annual sales, equally complex and requires high levels of technical Growth is predicted, in particular, from people and in particular spending on travel’ as the crisis with four breaking the c15 million-barrier. expertise to operate effectively.” 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 IN THIS ISSUE and Morocco.

David Ing is a freelance journalist REGULARS covering mainly travel and tourism issues in Spain. He writes on air transport for a News continued 4 leading international news agency, as well as Editorial blog 4 contributing special features to Newsweek and writing in-fl ight magazine articles Company brief 8 and guidebooks. Insurance matters 9

Health matters 12 David Robinson has worked in business Travel matters 14 journalism for more than a decade. He worked as a reporter at the South China IPMI news 16 Morning Post newspaper in Hong Kong, and Cross-border care 18 as a London-based investigative journalist at Air ambulance news 20 Chambers Magazine, a quarterly journal on the global legal market. He recently worked as Service directory 35 deputy editor at South West Business Insider Grapevine 42 in Bristol. On the move 43

FEATURES

Feature: Electronic evaluation 24 Improvements in online medical screening technology have provided benefi ts for both insurers and consumers; ITIJ takes a closer look at the latest offerings

Feature: All risks included? 26 The challenging economic environment has led to a boom in all-inclusive holidays, but are holidaymakers and tour operators considering all the risks?

Assistance & Healthcare World Markets: Ireland 30 The Irish health system is undergoing an upgrade, including its emergency and medical evacuation services, meaning better service for tourists in need

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 Telephone: +44 (0)117 922 6600 The information contained in this publication has been published in good faith and Copy editor: James Paul Wallis every effort has been made to ensure its accuracy. Neither the publisher nor Voyageur editorial dept: Ext. 3 Ltd can accept any responsibility for any error or misinterpretation. All liability for loss, Conference manager: Denise Clements disappointment, negligence or other damage caused by reliance on the information advertising dept: Ext. 1 contained in this publication, or in the event of bankruptcy or liquidation or cessation Production: Kirsty Diclaudio of the trade of any company, individual or fi rm mentioned is hereby excluded. subscriptions dept: Ext. 209 Helen Watts

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

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

4 NEWS

Weather Bank finds seniors worries still struggling

Many unexpected occurrences Despite the fact that getting older is no longer a have made the last 12 months barrier to travelling far and wide, 26 per cent of unpredictable for travellers, and adults over 50 surveyed by Lloyds TSB Bank said Well, a month without an ash cloud ... a recent survey carried out on they find it hard to find adequate travel insurance. now there’s a novelty. behalf of Travel Guard North According to the research, 90 per cent of British American has shown that the adults aged 50 and over say that they go on As the summer season in the northern unusually harsh winter is still holiday, with almost half taking multiple holidays in hemisphere gets into full swing, sales of fresh in the minds of cruisers at a year. In addition, 32 per cent of holidaymakers travel insurance, on initial statistics anyway, the height of the cruising season. in this categrory say that they are travelling more seem to be holding up nicely. According to the Travel Beat now than in previous years. However, one in four Survey, 43 per cent of cruisers travellers say they have experienced difficulties ... and the debt crisis? What debt crisis? polled responded that their when buying cover for their holiday. The research Having just returned from a brief sojourn biggest concern surrounding reveals how the main cause for holidaymakers in the Greek islands, you’d be hard pushed cruising is the potential that aged 50 and over being refused cover is an to believe there was any such thing, if you weather-related flight cancellations existing illness or injury, with 15 per cent being were looking for any evidence of hardship or delays will cause them to refused cover for this reason, rising to 16 per ... no Greek citizens looking like they miss their ship’s departure. In cent for those aged 60 or more. Similarly, 11 per needed a loan (or any other nationality for comparison, only 25 per cent cent of those aged 50 or over have had difficulty that matter) – in fact, most people looked feared missing their cruise due to buying cover because of their age, rising to 17 per like they could lend me a few euros and an illness or injury. cent for the over-70s. not notice it. Surprisingly, despite highly publicised events occurring Jatin Patel, director of personal current accounts at while ships are at sea or in port, only 20 per cent of Policies sold via ATM Lloyds TSB, said: “No one should be grounded from And it would appear that this optimism is respondents were worried about becoming ill once travelling because of their age. It is clear that age holds mirrored in most of the popular European on the ship, just 10 per cent of respondents were A new system allowing anybody to take out a no barriers for those wanting to explore new frontiers, Mediterranean resorts, which is all good concerned about safety while in port, and less than travel insurance policy via an ATM began to go so age shouldn’t prevent older holidaymakers from for the travel insurance industry. one per cent of respondents were concerned about nationwide in Spain in July. David Ing reports accessing adequate travel cover at a reasonable price.” potential mechanical issues on board. Lloyds TSB added value current accounts all come So, for the moment, the ‘economic With 38 per cent of those polled planning to spend The move to sell travel insurance through Spanish with comprehensive travel insurance policies that downturn’ appears to be as elusive as a more than US$5,000 on cruising this year, many are cash machines followed an agreement between cover travellers up to the age of 79. News International (N.o.W) editor who choosing to cover their investment against potential MAPFRE Seguros and leading savings bank Caja knew about phone hacking ... interruptions such as weather, with an overwhelming Madrid, which has now joined six others in a new 97 per cent of travellers polled saying they intend entity called Bankia. Initially, the policies will be Ian Cameron to purchase travel insurance. Carol Mueller, vice- available only through the 3,000 branches of Caja EHIC validity Editor-in-Chief president of Travel Guard, said: “An incident as Madrid, but they will be accessible to any bank card [email protected] seemingly minor as a flight delay can wreak havoc on holder. It will depend on the new Bankia board highlighted cruise plans, so it pays to be prepared.” whether the service is extended to the other 4,700 outlets that will make up the new combined bank, a European Health Insurance Cards (EHIC), which Caja Madrid spokesman told ITIJ. many travellers within the European Union rely on to The Viaja Seguro (literally Travel Safe) system was receive free or reduced-price healthcare while they launched on a trial basis between the two companies are abroad, have a five-year shelf life, and as they in 2010. They initially chose the showpiece T4 were introduced in 2006, many of the people who terminal at the country’s main hub airport, Madrid, initially applied for the cards and received them in and later extended it to two more terminals. The that year risk carrying invalid cards on their summer bank said around nine per cent of its travel insurance holidays this year. policies were sold via Viaja Seguro last year. In Bob Atkinson of insurance comparison site extending the system to all its branches, Caja Madrid Moneysupermarket said: “Brits hitting Europe this says it has designed the programme to be ‘easy and summer without an EHIC could end up facing a immediate’, and is already looking at making the hefty bill if they need medical care while thery’re on service available on mobile phones as well. vacation.” He warned that there are still plenty of A nationwide policy offering basic services such as consumers who do not understand how the EHIC loss of luggage, transport delays and missing flights is works, and more who think that they still need to available on a one-day basis for c1.90, and it’s said obtain the E111 form, which the EHIC replaced. that consumers can complete the application process According to research from Moneysupermarket, in just three-minutes. 58 per cent of Other examples given are Britons surveyed c31.90 to cover a 10-day trip are unaware of the to Italy, and for beyond Europe benefits offered prices start from c6.30 per by the EHIC, day. Extra medical treatment but Atkinson cover – up to c30,000 – can warned that it is be included. still no substitute Customers book through four for taking out basic steps – choosing the type comprehensive of policy, then their destination travel insurance. and dates, and then inserting He told customers: passport numbers and an “The EHIC only email address, before paying offers relatively on their bank card. A printed low level access to receipt gives basic details, while medical treatment. a complete policy and contact Holidaymakers numbers are sent on to the shouldn’t view it as client’s email address. a replacement for Countries that are not included travel insurance, in the policy are those dictated and travellers by the Spanish Foreign Ministry’s should also be travel advisories as being ‘not aware that any recommended’ for travel. non-essential care Currently, they include Pakistan, or treatment can Afghanistan and Yemen. cost extra.”

International Travel Insurance Journal NEWS 5

Water sports warning

Essential Travel in the UK has Travel, 40 per cent of its customers admitted to culprits. Many policies are invalidated if the correct launched a summer water embarking on dangerous water sports activities equipment isn’t worn or when alcohol has been sports safety campaign after whilst abroad without knowing about the terms consumed. Many also don’t realise that if they are research revealed that 40 per and conditions of their policy. In addition, 56 per taking part in a sporting activity numerous times cent of holidaymakers indulge cent confessed that they had been caught up in the during their holiday they may need to increase their in water sports activities holiday spirit and taken part in an unplanned water sports cover level.” abroad without checking to sports activity, demonstrating that it’s not just those Lynda St Cooke of the UK’s Foreign and see if they have adequate who go on pre-planned water sports holidays who Commonwealth Office agreed that people should insurance coverage first. need to think about cover. take more care about checking their travel insurance The company’s Sea Sense Stuart Bensusan, head of sales and one of the before jumping onto a jetski. She told holidaymakers: campaign is being fronted by British Kite Surfing founders of the company, commented on the “Check the small print of your travel insurance policy etfs purchase champion Kirsty Jones, and aims to encourage findings of the research: “This is an incredible risk to be sure that it covers all water sports activities. It’s holidaymakers to plan ahead by offering money off to take if you consider that the accident rate to UK all too easy to make a spur of the moment decision finalised the cost of their travel insurance policy. citizens travelling abroad has doubled in the past to hop on a jet ski or hire a boat for the day, and In a recent in-house survey conducted by Essential four years with water sports being one of the main realise too late that you’re not covered.” RSA Travel Insurance Inc./Assurance Voyage RSA Inc., part of RSA Canada, has completed its acquisition of the business assets and insurance expertise of travel distributor etfs and the etfs trademark. RSA president and chief executive officer Rowan Saunders said: “We are delighted to welcome etfs into the RSA Canada family. Together, RSA and etfs are a strong presence in the Canadian travel insurance marketplace and a leader in this sector within the RSA group globally.” RSA’s Adrian Hall, who currently heads the personal speciality insurance business, has been named managing director of RSA Travel, which includes the etfs brand. He said: “I am very excited about the opportunities ahead of us. We are now well- positioned to achieve our goal of becoming the leading travel insurer in the country.”

Unveiled: secrets of a successful claim Squaremouth, the US-based travel insurance comparison site, has offered travellers advice about making successful claims on their travel policy, after saying that many travellers are unaware of the essential steps they must take when filing a claim. The company said: “Understanding those steps will eliminate a traveller’s frustration, as well as lower the possibility of a denied claim.” The first hint to customers is that communication is key to making a successful claim, with travellers being urged to contact their travel insurance provider as soon as they can if they intend to make a claim. Judy Sutton, director of product management at Travel Insured International, commented: “Contact with the assistance services company for an emerging situation is not only important, but serves as a valuable resource for our insured clients when faced with any situation when they are on their trip. Think about some of the situations that might arise: Where do I turn if I lost my passport? Where is the nearest hospital? Calling the assistance services puts the insured in touch with a professional who can manage every aspect of the insured’s needs effectively and efficiently.” Another essential step in making a successful travel insurance claim, said Squaremouth, is obtaining relevant documentation. Sarah Byrne, marketing manager for the website, said: “If a medical situation causes a traveller to end the trip early and come home, a traveller will need to provide evidence of the illness or injury with documentation. Without it, a traveller’s claim will be denied.” Along with receiving documentation, travellers were also told that they would be expected to recoup some expenses – travellers were encouraged to notify authorities if their bags are stolen, or request payment from an airline if their bags are damaged or lost. Chris Harvey, chief executive officer of Squaremouth, told travellers: “Most travel insurance policies will reimburse travellers for food and lodging during a delay; however, a traveller must remember to save all receipts. Travellers will not be refunded for expenses that cannot be proven.”

www.itij.co.uk 6 NEWS

Fraud register Claim excess warning for consumers ATOL consultation approved Customers of insurers in the UK have been warned for.” highlights cover gap that claiming on their insurance policy could cost One reason for the heightened levels of excess was The Association of British Insurers (ABI) has formally them more than they originally thought, as insurers given to be the increasing use of price comparison International Passenger Protection (IPP), a provider given its approval to the Insurance Fraud Register raise the level of excess that customers are expected websites for insurance products, most of which are of financial insurance solutions to the UK travel (IFB), and has agreed to an industry-funded police to pay. According to British newspaper The Telegraph, focused solely on price, not cover. In order to appear trade, has said that the recent Air Travel Organisers’ unit that will be dedicated to tackling organised ‘it is becoming commonplace for travel insurers to higher up the list of providers offering cheaper cover, Licensing (ATOL) reform consultation paper, issued insurance crime. The police unit will be headed up charge more than one excess per claim’. The article insurers are pushing up the excess levels so that they by the Department of Transport, highlights the gap in by the City of London Police, with the number of continued: “About eight in 10 policies now apply an can afford to lower their premiums. consumer protection under the government scheme, officers expected to be dedicated to the team said to excess for each section of our insurance under which Leighann Burtrand, spokesperson for the British even after the proposed extension in cover. The be in double figures. you make a claim – and in some cases this will be Insurance Brokers’ Association, warned consumers: reform, which it is hoped will be introduced at the The register will enable insurers to share information per person.” “Whatever type of insurance you are buying, you start of next year, is estimated to leave over half of on known fraudsters, as well as help them to identify Two popular UK travel insurers were mentioned, shouldn’t buy solely on price. Cheaper policies very travellers from the UK unprotected, which equates to anyone who fails to declare a previous with the article noting that InsureandGo would often have more restrictive terms, and can often have tens of millions of travellers that would be financially fraudulent insurance claim. It is hoped that charge £75 to a exposed during what is an extremely volatile time in the register will be fully operational by customer making a the industry. Tickets purchased directly with airlines, early next year. medical claim, a further UK trips, and non-air travel (such as car ferries), are Nick Starling, director of general £75 for a claim for just three of the significant travel groups that remain insurance and health at the ABI, said: damaged clothing, and outside the protection in the proposals. “This initiative a further £100 for a Michael Ward, director at IPP, said: “The consultation demonstrates how personal liability claim. document highlighted what a complex issue seriously insurers As readers know, the consumer protection in travel has become.” He take reducing vast majority of travel praised the consultation paper, however, saying: insurance fraud, and insurance consumers “Especially commendable is providing clarity to their determination to protect do not read their consumers on what is and is not protected through honest customers. The database will policies, so it could a newly designed ATOL certificate. Hopefully build on existing industry databases that help come as something of consumers will then be directed to where protection insurers check previous claims history to ensure that a shock to many, who can be sourced and make an informed decision as to there is no hiding place for anyone caught making a will simply have seen whether to make a purchase.” bogus or exaggerated insurance claim.” the ‘£75 excess’ term The reform refers to potential future legislation that David Neave, chairman of the Insurance Fraud on the policy and not will include airlines, and makes strong reference to a Bureau, said: “This important initiative is the next read any further. Europe-wide survey on consumer protection in the key strategic step in strengthening insurers’ tough Defaqto, the research aviation sector. IPP believes that such an extension approach to this problem. The IFB is at the forefront firm that compiled the would be fiercely opposed by airlines, as Ward of a concerted drive to tackle organised insurance figures showing how much customers would be larger or multiple excesses.” She went on to add: explained: “The report states that the Air Transport fraud. The work of the IFB with insurers and police expected to pay in the event of making a claim, said: “Always check the terms and conditions to make sure Trust (ATT) is currently at a deficit of around £42 forces throughout the UK has led to the prosecution “Most people don’t realise how complex excesses the policy is suitable. A cheaper policy can be a false million; that’s without the huge additional liabilities of many organised insurance fraud gangs, so helping are. There isn’t just one per policy. The amount you economy if it doesn’t provide the cover you need.” that the inclusion of airlines would bring. It’s such a save money for insurers and honest customers alike.” pay would depend on exactly what you are claiming hugely competitive market, where profit margins are being squeezed to breaking point, leading to record losses in 2011. An extra levy would add to the long list Customers miss out of challenges facing airlines, which include oil prices, industrial action, low fares, political unrest, natural on benefits disasters, and terrorism. Would the ATT sustain an airline collapse? It would be an enormous risk.” Thousands of consumers are losing out on the The annual report from the ATT shows the deficit of full benefits of travel insurance by leaving it right the organisation to be £42.3 million, despite that fact until the last moment to buy cover, according to that the Trust received income of £47.7 million during research from UK insurance comparison website the financial year ending March 2011. A statement comparethemarket. A sample of 65,000 quotes from the ATT reads: “The most significant impact on from the website revealed that many consumers the Trust arose from the insolvency of Goldtrail Travel are purchasing their travel insurance just before they Limited, going into administration at the height of the go on holiday. Twenty per cent of consumers take 2010 summer holiday season. The circumstances out holiday cover just two days before going away, around this failure are under investigation. The and therefore miss out on a number of key benefits, failure highlighted the poor standards of customer including cancellation and curtailment cover – which documentation issued by some in the travel applies right from the point of purchase. industry, leading to unacceptable delays in refunds Jeremy Moll, commercial director at to holidaymakers.” The organisation’s annual report comparethemarket, commented on the findings, noted that 29 ATOL holders failed during the financial saying: “Travel insurance is a must-have purchase year, and because of the ATOL scheme, over 47,000 for people travelling in the UK or abroad, but as ATOL-protected passengers were able to complete our research shows, many are leaving it right to their holidays and around 146,000 received refunds of the last minute and therefore losing out on many of advance payments. the benefits the cover can provide. Compare and Roger Mountford, chairman of the ATT, said: “Despite choose the right travel insurance cover for you well the Trust facing an increase in its deficit, largely in advance of travelling to ensure you can benefit caused by the failure of Goldtrail Travel Limited, from the full cover should you ever need it.” it has continued to meet its objective of providing refunds to customers affected by the failure of their ATOL holder. This past financial year has seen the Trust either repatriate or refund a record 193,000 UK holidaymakers. Government has published its consultation on reforming the scope of ATOL and bringing clarity to consumers, the trade and the ATT as to who is covered by the ATOL scheme.” As if the travel industry needed further confirmation of the difficult trading situation in which it finds itself, as ITIJ went to press, news came in of another travel firm, Dream Holidays, which ceased trading on 19 July. The Civil Aviation Authority (CAA) said that the 525 people who were on holiday at the time of the collapse would be able to complete their holidays and return to the UK thanks to ATOL protection.

International Travel Insurance Journal NEWS 7

Taiwan should Award for MAPFRE require cover Leire Jimenez, programme for high potential managers. head of travel Jimenez joined the company in 2005 and since then Keynes Chen, managing director of insurance B2B has played an important role in projects that have International SOS Taiwan, has suggested at MAPFRE supported the company’s development in the UK, that the country should consider making Assistance, including new sector entry strategies, acquisitions the purchase of comprehensive travel has won the and joint ventures. She said of the award: “I am very insurance a requirement for visitors from Women in fortunate to work in an organisation as forward- mainland China in case they fall ill during the City’s thinking as MAPFRE Assistance and it is testament to their trip. According to the Taipei Times, Future Leaders the support I have received from everyone within Chen said: “Only one in 10 Chinese award, and the company that I am still motivated to develop my visitors will purchase a comprehensive with it a place leadership potential and promote positive change insurance package that covers all kinds of on Cranfield within the insurance industry. These awards are medical expenses.” The reason behind Univserity’s hugely important for encouraging women to strive the lack of cover, he added, is a lack of Accelerate to reach their career potential and become leaders understanding about insurance products development in their respective industries.” among visitors from mainland China. Already in existence is the Free Independent Traveller (FIT) programme, which began on 28 June this year and allows visitors from mainland China to visit Taiwan without having to be part of a guided tour group. Under the FIT rule, each independent Chinese visitor is required to purchase travel cover with a minimum coverage of NT$2 million (US$69,985); however, this insurance is only for accident-related expenses. Chen said that due to this regulation, tourists seeking medical care not as a result of an accident could have difficulty paying their medical bills or returning to the mainland. He added that this could cause social problems and bring unpaid bills for hospitals and clinics in Taiwan. He concluded: “More than a reasonable fraction of hospitalised Chinese tourists intentionally extended their stay in Taiwanese hospitals, which have long been known for their top-notch medical services.”

Don’t panic!

Jonathan Rees, director general of the UK’s Government Equalities Office, has moved to reassure insurance companies that there will not be an all-out ban on age-based insurance risk pricing in the near future, although he refused to rule out the possibility of such a decision from regulators in the European Union. The possibility of travel insurers and other sectors of the industry not being able to use age as a determining risk factor was mooted in March this year, after the European Court of Justice ruled that the use of gender for determining the underwriting of policies would be banned from 21 December 2012. The basis for the judgement was the European Union Gender Directive, which enshrines gender equality in law. Rees, speaking at the Association of British Insurers’ conference recently, said: “There is not an age or disability directive, but only treaty and case law, so this ruling on gender will not lead to an automatic read-across to age and there will be no immediate impact here. However, we are not saying ‘do not worry at all’, but it is not an immediate concern.”

www.itij.co.uk 8 COMPANYBRIEF

Tripinsurance CNinsure teams site starts up with Sunshine NEWSWIRE

US-based Online Trip Insurance P&C US-based AmWINS Group Benefits Services, Inc. has recently launched has enhanced its suite of No Borders Tripinsurance.com, a new website CNinsure Inc., an independent insurance international benefits products, providing that allows consumers to buy directly intermediary company in China, has coverage for international employees and for from travel insurers and save up announced that Shenzhen Inscom those living and travelling abroad for work or to 25 per cent or more on travel E-Commerce Co. Ltd, an affiliated subsidiary leisure. Part of the improvement is providing policies. Exclusive consumer direct of CNinsure, has entered into a strategic a patient advocacy service, designed to help pricing with some of the country’s partnership in e-commerce with Sunshine patients secure second medical opinions on leading travel insurers provides lower Property & Casualty Insurance Co. Ltd. As a decisions and diagnoses. prices for comparable coverage result of the alliance, customers have direct available elsewhere, according to the access to travel insurance and car insurance Aviva in the UK has launched company. By organising quote results underwritten by Sunshine P&C Insurance travel disruption cover, an optional add-on to for consumers, the website makes and can receive real-time quotes through its existing travel policy. The add-on offers wider it easier for clients to choose travel Inscom’s e-commerce platform. CNinsure cover in the event of strike, industrial action or insurance policies that fit both budget and Sunshine P&C Insurance’s network cancellation due to Foreign and Commonwealth and coverage requirements. platforms will be interconnected with each Office warnings, pandemics or natural disasters, The site offers plans from United other to facilitate transaction processing and including earthquakes and tsunamis. The States Fire Insurance Company, Old improve efficiency. In addition, Inscom and company also recently introduced medical Republic Insurance Company, Nationwide Mutual MAPFRE deals done Sunshine agree to enhance co-operation on market screening to its website. Insurance Company and BCS Insurance Company. Dan development, product design and customer services. Skilken, founder, president and chief executive of Online MAPFRE Assistance has been awarded a contract Commenting on the partnership, CNinsure’s UK-based Healix Insurance Services Trip Insurance Services, said: “We wanted to make it to provide travel insurance and assistance services chairman and chief executive Yinan Hu said: has seen its annual revenue increase by 32 per cheaper and easier to buy travel insurance. With more to Avanti Travel Insurance customers in the UK. “We have been gearing up for rolling out our cent year-on-year, with premium income rising organised quotes and great customer service, we help The three-year contract is estimated to exceed £5 e-commerce insurance business and feel very excited above £30 million. New capital partnerships take the hassles out of buying insurance.” million gross written premiums (GWP) a year, and about the chance to establish extensive and in-depth with underwriters such as MAPFRE and Ace sees MAPFRE Assistance providing single trip, annual co-operation in e-commerce with Sunshine P&C have contributed to the growth of the business. multi-trip, winter sports, backpacker and business Insurance. Through this online insurance platform, travel insurance to Avanti’s customers, who are we are committed to offering a convenient, cost- EU Claim, a company dedicated Cruise cover offered travellers over 50. effective and efficient online shopping experience to to airline consumer rights, has launched a new Glen Smith, managing director of Avanti, said: our customers.” website with a suite of ‘do it yourself’ products, Cruise Vacation Discount Company in the US has “Travel insurance for the over-50s is a growing in response to Ryanair’s claim that it will only announced that effective immediately, every cruise market and it is vital that we have an underwriting deal with passenger claims directly. reservation made through CruiseNow.com that is partner that recognises our requirements in order five nights or longer comes with free cruise travel to ensure we share in that growth. MAPFRE Sweden’s foreign ministry has insurance to protect the customer’s investment. Assistance has demonstrated the flexibility required launched a smart phone app that allows its According to the company, the offer is unique for the for this market and is certainly living up to its nationals to stay up to date on travel advisories cruise industry, where trip insurance is one of the reputation in this respect.” during their international journeys. The app most important elements of the cruise reservation. Elsewhere, MAPFRE Assistance has been awarded was launched to meet the strong demand for The savings for consumers can be significant – for a contract to provide travel insurance to OINC. information seen following the Arab Spring. example, a cruise holiday costing $2,500 for a com and InsuranceRepublic.co.uk, both fast- 60-year-old passenger would ordinarily cost that growing web-based travel insurance brands. The NatWest/RBS in the UK has customer an additional $162 in insurance premiums, contract, which is in place for the next three years, introduced a new packaged bank account which is now taken care of by the company. John is estimated to bring in £1.8 million of GWP a year. called Select Silver that costs £8 a month, and Keen, chief executive officer of CruiseNow, said: The agreement sees MAPFRE provide a full travel includes annual travel insurance for Europe, “We are very excited to offer this value to our insurance proposition for both brands, including worldwide mobile phone assistance and ID customers. Cruise insurance is something every single-trip and annual policies, winter sports cover theft assistance. passenger needs and our ability to offer it free of and specialist policies at three different levels of charge is a real benefit for our clients.” cover, and emergency assistance. Kevin Hedges, managing director for the websites, said: “Both Blue teams with [sites] have grown very Mondial expands fast in the past two years Travel Counsellors and are well positioned Allianz tie-up to keep doing so. It’s One of Ireland’s leading suppliers of travel cover, important that we have a Mondial Assistance Middle East has expanded its Blue Insurances Ltd, has announced a recent strong relationship with an partnership with Allianz SNA-Lebanon to deliver partnership agreement with Travel Counsellor underwriting partner that added benefits to its travel insurance offering. The Group, with Irish Travel Counsellors selling Blue can support that growth new agreement will ensure Allianz SNA-Lebanon Insurances travel cover from 1 June. The policies and offer the flexibility and customers gain access to quality medical assistance available from Blue include travel disruption cover for network that we need.” around the world, according to the companies. volcanic ash, strike cover, flight cancellation cover and MAPFRE Assistance was Mondial Assistance has provided medical assistance cruise connection cover. In addition, the insurance also recently selected by services to Allianz SNA-Lebanon since 2002, provides airline insolvency cover and third-party the International Student bringing affordable medical support to over 75,000 supplier cover. Identity Card (ISIC), along customers. Ciaran Mulligan, joint managing director for Blue with Mondial Assistance, Xavier Denys, chief executive officer of the Lebanon Insurances, said the company was ‘delighted’ to be as their preferred branch of Allianz, said of the tie-up: “Mondial working with Travel Counsellors, adding: “Their insurance partner for Assistance is a global leader in travel insurance and growth and success in the Irish market in difficult student travel insurance medical assistance, bringing us the expertise we need trading times is a testament to the dedication and products worldwide. to be able to expand the customer experience within professionalism of the organisation. Blue Insurances Furthermore, the the Allianz brand. This agreement forms a key part of has always sought to bring innovative and quality company has also recently our ongoing growth strategy, as we continue to lead insurance products to the travel trade, which we launched two new the market in Lebanon, bringing our customers a believe sets us aside from others in the Irish market.” websites – one tailored range of products to suit their specific needs.” Cathy Burke, general manager of Travel Counsellors, to its travel insurance, Madjid Banchaiba, Middle East general manager added: “I have always found Blue Insurances to be emergency assistance, and for Mondial Assistance, added: “We are delighted very innovative and they offer excellent services specialty risks business, to be working with Allianz SNA-Lebanon, bringing to the travel trade and as customer service is at and the other, MAPFRE added benefits to their travel insurance products. the heart of what we do at Travel Counsellors, ABRAXAS, for automotive The contract builds on our growing presence in the we are really looking forward to a strong working insurance needs. Middle East.” relationship with the team at Blue.”

International Travel Insurance Journal INSURANCEMATTERS 9

NEWSWIRE Swiss Re reveals industry growth According to Swiss Re’s latest World Insurance in Global non-life insurance premiums rose by 2.1 per cent, compared to 101 per cent in 2009. Given Yoshinobu Tsutsui has been elected as 2010 sigma study, world insurance premium volume cent in 2010. In emerging and newly industrialised recent catastrophe loss events, it is clear that global the new chairman of the Life Insurance Association increased 2.7 per cent on an inflation-adjusted basis Asian countries, the strong economic rebound underwriting results will deteriorate further in 2011. of Japan. He told members of the Association that last year. Life premiums rose by 3.2 per cent and increased demand for insurance cover, whilst This indicates that prices are inadequate. In some the industry still has potential demand, particularly non-life premiums by 2.1 per cent. Premium growth premium volume rose in Europe and the US as well. markets, such as Italy and the UK, rates began to in certain segments of the market, such as the in emerging markets accelerated, and the industry’s According to the company, industry capital continued mount, most notably in the personal motor business, senior, female and young sectors. capital and solvency improved, whilst low interest signalling that the underwriting cycle is at long last rates weighed on investment income. beginning to turn,” said Staib. LexisNexis Risk Solutions has announced The overwhelmingly good news is that the insurance The dominating picture is that the Despite lingering uncertainty, the economic recovery its entry into the UK’s insurance market. The industry is back to growth, as shown by Swiss Re’s should continue and bolster premium growth in the company says it will help UK insurers better assess annual assessment of global insurance markets, industry is on the way back to the life and non-life sectors globally in 2011. However, risk, bringing new insight and information about with premium volume growing in three-quarters long-term-growth trend investment income in both the life and non-life applicants to the point of quote. of the 78 markets covered in the publication. sectors will remain low given that interest rates will Growth was particularly strong in only rise slowly, at best. “In Taiwan’s Financial Supervisory Commission emerging markets. At the same terms of the mature markets, has approved the sale of American International time, capital and solvency in the growth in life insurance is Group’s Taiwanese unit, Nan Shan Life, to a local insurance industry improved expected to turn positive in consortium, Ruen Chen Investment Holding. The robustly, but low interest rates the US, while in Western approval brings to an end the American insurer’s still had a negative impact on Europe, premium growth attempts over two years to sell its subsidiary. profitability. Life insurance could slow down slightly, premiums, globally, grew 3.2 per as rising interest rates will The Qatar Insurance Company has obtained cent to US$2,520 billion in 2010. make life policies with approval from the Arab state’s regulator to establish Growth was especially strong interest rate guarantees less a life and medical insurance subsidiary with a starting in Asian emerging markets and attractive,” says Staib. Over capital of QAR100 million (US$27.5 million). robust in some large European the longer term, the fact that markets. In the US and the UK, ageing societies increasingly Controversy has been caused in the UK by premiums declined, though at a need provisions for old age the revelation that some insurers are being paid by more modest pace than 2009. continues to be positive personal injury law firms for policyholders’ details. While low interest rates negatively for life insurers. In non-life, Home secretary Jack Straw said the practice had impacted life insurers’ profitability, the trend is towards higher driven a surge in no-win, no-fee claims that serve to they contributed to a strong premium growth in 2011. put up premiums across the insurance industry. improvement in the life industry’s This trend will strengthen as accounting capital position by premium rates begin to get In order to help them broaden their increasing the value of life insurers’ adjusted upwards. revenue streams, China may allow insurance bond portfolios. China is likely to become the The global market share of emerging countries is companies to directly set up fund management Daniel Staib, one of the authors of the new sigma study, second largest insurance market expected to continue to increase strongly from units, according to local media reports. said: “The dominating picture is that the industry is on today’s 14 per cent over the next 10 years. China is the way back to the long-term- growth trend. In fact, within a decade likely to become the second-largest insurance market Indian insurance industry experts have said in some continental European countries, growth in within a decade (in 2010 it is the sixth largest). The that the recent terror attacks in Mumbai failed to the past year could be said to be very strong because its positive development and rose to a record high main risks to the outlook are an escalation of the cause major damage to property, and they do not sales of single premium products with comparatively in 2010, although underwriting results deteriorated euro sovereign debt crisis or a major oil shortage expect any major claims as a result, meaning that attractive guarantees increased strongly.” In emerging by the highest amount in the US and turned negative caused by turmoil in major oil producing countries. the chance of a rise in premium rates for terrorism markets, life premiums rose by 13 per cent. South and in large European markets, in the latter case due to The study is the first public assessment of the cover is low. East Asia was the region that had the strongest growth, dismal motor results. performance of global insurance markets in 2010. at 18 per cent, led by China, with strong demand for In the eight largest markets, premium income did The 78 markets, where data or estimates for 2010 According to the Sydney Morning Herald, both traditional and investment-linked products. Latin not fully cover claims payments and other costs for are available, account for 98 per cent of global Insurance Australia Group and Suncorp – two America and the Caribbean were not far behind, at 12 the second year in a row. “The average combined premium volume. Overall, the report is based on of the country’s biggest insurers – are expected per cent, led by Brazil. ratio of these leading markets worsened to 103 per 147 insurance markets. to introduce full flood cover by early 2012, substantially boosting the number of households that will have automatic protection from a full range of natural disasters. Industry leaders warn of tough times ahead Life insurance premiums in the Middle Otto Thoresen, director general of the Association is helping customers in their time of need, closely customer trust. Over half of customers believe that East, Central Asia and Turkey continued to witness of British Insurers (ABI), has set out the challenges followed by its contribution to the country’s they are responsible for the products they buy, while strong growth, with premiums growing by 12 per and opportunities facing the UK’s insurance industry economy. It also showed that executives believe that only 44 per cent think this is the job of the regulator. cent to US$4 billion in 2010, while non-life markets at the recent ABI Biennial Conference. He told the industry’s greatest weakness is its reputation, It also demonstrated the growing impact of European in the region saw premiums increase by 7.3 per delegates that the industry has a key role to play cited as top by one-third of respondents, ahead of regulation, with 98 per cent of industry leaders saying cent to $27 billion, according to Swiss Re. in helping UK consumers manage their financial how the industry interacts with customers. Two- they are ‘somewhat’ or ‘very’ worried about the commitments, but first it needs to improve its thirds of executives polled said they recognise that impact of the European Union on UK companies. Research from the Boston Consulting Group reputation. His call for action came on the same more needs to be done to show customers that Nearly 50 per cent are worried about ensuring a has found that although the use of social media day that the ABI and KPMG published a survey of the industry delivers a good service. Thoresen coherent regime, with one-third very concerned is growing at a significant rate in the Gulf Co- 57 insurance leaders, which highlights concerns that the EU does not understand the need for a cost/ operation Council, the potential of this medium is about the new regulatory structure, the influence of benefit analysis when proposing new regulations. largely untapped by insurers, with just 14 per cent the European Union (EU), and how the industry is Consumers are also sceptical, according to the of surveyed consumers saying they are linked to viewed by the public. The reputation of UK financial survey, with only one in 10 people thinking that their agents online. Thoresen said: “The reputation of UK financial services firms was undoubtedly regulatory intervention from the EU is appropriate, services firms was undoubtedly harmed by the harmed by the banking crisis and 57 per cent believing that the EU intervenes too The Financial Supervisory Service, South banking crisis. Insurers are not banks, [but] despite much in Britain’s financial services industry. Korea’s financial regulator, has announced plans to this, we have to tackle our reputation head-on Elsewhere in the survey, it is shown that over half inspect large local insurers and banks every other and we have a good platform to do this from.” He of those polled did not put the UK in the top-three year, a change from the current annual audit, in an added: “Consumers recognise the importance of said: “Unprecedented reforms in how we sell to locations in which to base their business, based on effort to ease the burden placed on financial firms insurance, and every day insurers pay out £173 our customers and how people save present real onerous tax and regulatory regimes. Drew Fellowes, in the country. million in pensions and life insurance and £58 million opportunities to raise our reputation and improve UK head of insurance at KPMG, commented: “The in general insurance claims, such as on motor and understanding of insurance. We need to grasp these insurance sector is undoubtedly facing a period of Under revised rules issued by Thailand’s Office household. Yet, despite the valuable role insurance opportunities with both hands, and make sure that unparalleled change. It is likely that the industry of the Insurance Commission, insurers will be allowed plays in millions of people’s lives, the public we create an environment where our reputation we will see over the next three to five years will to invest no more than 40 per cent of their total assets perception of our industry is not high. We need to reflects our value to society and the economy.” be structurally very different to what we have in high-risk vehicles. The amendments are said to be do something about this.” On regulation, the survey data showed that almost today. However, with this change comes a unique aimed at better reflecting risk-based assets. Key findings of the ABI/KPMG survey are that half of those polled said the new UK ‘Twin Peaks’ opportunity for the insurance sector to strengthen industry leaders think the sector’s greatest strength regulatory structure would do nothing to improve itself and become more competitive.”

www.itij.co.uk 10 INSURANCEMATTERS

Revival for brokers predicted Insurance gap NEWSWIRE Increased sales of motor insurance and home He added: “It is encouraging news that after the reduced contents insurance are expected to lead a revival difficulties of the past 18 months, insurance brokers In a recent customer satisfaction survey in insurance broker business over the coming 12 are now confident that they will see business growth Australia’s life insurance gap has reduced over the amongst motor insurance policyholders in India, months, according to a new survey from MAPFRE from a wide range of different policies. The challenge last six years, according to a new report from Rice state-owned New India Assurance and Oriental Assistance. However, the insurance provider noted now is to ensure that consumers get the policy Warner Actuaries. As of June 2010, the overall Insurance were awarded the top-two places, followed that while traditional insurance products are expected that best suits their needs and their budgets and to level of underinsurance is A$669 billion (US$724 by privately owned ICICI Lombard in third place. to see the strongest growth, brokers also expect ensure they feel they are getting real value for their billion) to meet the subsistence needs of families to see a wide range of protection and alternative money. Clearly, the role of the insurance broker can and dependants after death, which compares with Aon Benfield has released new findings insurance products driving sales as consumers look to be critical in ensuring this happens.” $1,000 billion in 2005 on a like-for-like basis – a that show 60 per cent of European insurers safeguard themselves from the uncertain reduction of 33 per cent. On an income replacement attending its recent International Analytics economic environment. basis, the level of life underinsurance is $3,073 conference think that 2014 would be a better Forty per cent of the insurance brokers billion. Meanwhile, for total and permanent disability starting date for Solvency II. By contrast, 31 per polled for the company’s survey said (TPD), the level of underinsurance sits at $7,182 cent of delegates did not want to see the beginning they expected motor insurance to lead billion and income protection underinsurance at of the regulation delayed. growth over the next 12 months, with $437 billion. more than one-third expecting growth Richard Weatherhead, director and head of life The China Daily newspaper has reported to come from home and contents insurance of Rice Warner Actuaries, attributes this that premium rates for directors and officers liability cover. A further one in five expected to shift to significant demographic, financial and life insurance in China have risen by more than 20 per see a growth in travel insurance sales. insurance market changes over the past six years and, cent already this year, after a series of class action Around 12 per cent of insurance brokers in particular, an increased focus on personal financial lawsuits against US-listed Chinese companies were expected to see growth in income risks post-global financial crisis. “Increased levels of filed. In some cases, premiums have almost doubled protection product sales over the next personal insurance have been driven by an increase for mainland Chinese companies listed or seeking a year, with five per cent also expecting of default cover within superannuation, a greater listing in the US. to see mortgage payment protection focus on risk insurance by financial advisers and leading sales growth, with a further five superannuation fund trustees, as well as the growing ACE Synergy Insurance, a non-life insurer, per cent expecting to see GAP insurance direct life insurance market,” said Weatherhead. has become a 100-per-cent subsidiary of Zurich- sales increasing. However, while the report points to a welcome headquartered ACE Group, after the Group bought Charles Coburn, head of sales at development in the face of Australia’s continuing the remaining 49 per cent of the equity in the MAPFRE Assistance, said: “Given the underinsurance problem, Mr Weatherhead warns Malaysian unit that it did not already own, for continuing squeeze on consumer ‘we’re not out of the woods yet’. “While the US$39 million in cash. incomes and concerns about job market is now providing a substantial proportion security, it is perhaps unsurprising that of subsistence life insurance cover, this is still only The Office of the Insurance Commission consumers are looking to safeguard their half the amount of cover required to ensure that in Thailand has said that the life insurance industry in incomes and protect themselves from family members and dependents can maintain the country is thriving and expanding, with competition unexpected expenditure by taking out their standard of living after the death of a parent becoming more intense. It released a report showing a wider range of insurance policies.” or partner,” he explained. “Apart from individual that life insurance sales in the first quarter of this year detriment, underinsurance also comes at a grew by 12.5 per cent year-on-year. substantial cost to the government. Currently, the total cost to the government of life underinsurance Following its initial public offering, Insurance across Australia is calculated to be $140 million House has listed on the Abu Shabi Securities Industry relies on Indian turnover a per year as publicly funded social security benefits Exchange and officially launched its operations. fill the gap. Meanwhile, the situation regarding paper-based systems concern disability underinsurance is even more serious, Chief executive of Zurich-based Echo Re, costing the government nearly nine times this Juergen Gerhardt, has said in an interview that the Many UK-based insurers are operating at a Asia Insurance Review, citing sources from The amount.” Weatherhead believes there are things company plans to continue its strategy of cautious competitive disadvantage due to an over-reliance Economic Times, has said that the high rate of churn the government could do in the short term to expansion through the establishment of a solid on paper-based systems, according to a new survey of top insurance company executives in India has led remove glaring distortions and inequalities in the portfolio with reliable and long-term relationships in by Hyland Software. The research, which was some to question whether the industry is heading in market in order to solve this ever-present problem. the Middle East. commissioned to create a snapshot of the current the right direction. According to the newspaper, at “The underinsurance issue would benefit from the climate for the industry, polled insurers operating least 10 insurance companies have recruited three government considering the removal of stamp duty Communications provider Qtel has in the UK and internationally across a range of chief executives in the past eight years. from all life, total and permanent disability (TPD) signed a contract with SEIB Insurance on an sectors, including motor, home, property, health and Industry experts have speculated over the and income protection policies; removal of GST estimated US$600-million worth of directors and commercial, on topics including investment priorities, reasons behind such a high rate of turnover of on TPD and income protection products sold by officers liability insurance, which is thought to be one responsiveness, legislation and overall priorities chief executives, with some saying that impatient general insurers; equalisation of the tax treatment of the largest ever placements for a single company and trends. shareholders are putting a great deal of pressure of risk insurance inside and outside superannuation; either in Europe or Asia. Over half of those questioned said they did not have, on the people holding these positions to deliver and implementation of the proposed ‘scaled advice’ or were not aware of having, an electronic content immediate returns in what is an extremely model with a particular focus on risk insurance.” A report from Qatar National Health management (ECM) system. Thirty per cent of those competitive market. Currently operating in India are Accounts has found that reforms to healthcare, that had invested in the technology felt that their 24 life insurers, yet only eight of the companies are including the upcoming social health insurance systems were not being used to full potential, and actually profitable, and with the state-owned Life scheme, will increase the share of private funding for in many cases, this was as a result of the system not Insurance Corporation commanding a 70-per-cent the nation’s healthcare from the 33-per-cent share being enforced, leading to a continued reliance on share of the marketplace, progress for private firms Willis fined it has currently. paper files, which in turn were delaying up to 74 is difficult. per cent of claims processing. The poll also showed Also aggravating the situation, according to those in £7 million Stephen Catlin, chief executive of the that, as margins continue to grow tighter and more the industry, are constantly changing regulations for international Catlin Group, said at the 47th IIS insurers are competing at a global level, as many insurers. Siddharth Raisurana, executive director of Willis Limited, an arm of the global insurance Annual Seminar that altering the way the industry as 37 per cent had gone as far as to change their ABC Consultants, said: “After the new guidelines, brokerage Willis Group, has been fined a record is viewed is key to creating and seizing new business model growth and revenue margins have shrunk. £7 million by the UK’s Financial Services Authority opportunities. He believes that steps need to be by diversifying The new guidelines have led to many (FSA) for failing to put in place robust anti-bribery taken to improve the value insurance companies into new sectors, feeling hopeless and thus quitting the measures, following an investigation that uncovered provide to their clients. increasing product industry. People tend to lose patience as ‘suspicious’ payments in Russia and Egypt. The and service the break-even horizon has increased.” fine, according to the FSA, was punishment for the The state-run New Zealand Earthquake lines. Even Vikram Mehmi, former chief executive of company failing to monitor £27-million worth of Commission has confirmed it has sufficient reserves more insurers, Birla Sun Life Insurance, offered another payments to overseas third parties who had helped to cover claims in the event of another disaster however, (53 reason for the rate of change at the top the company to win business in those countries. hitting the country. per cent) said level of insurers in the country: “The In a statement to the press, the FSA said: “These their firms had industry has been growing at a rapid failures contributed to a weak control environment Senior executives at Aon Risk Solutions been forced to speed, and new competitors are coming surrounding payments to overseas third parties have said that buyers of political violence and reduce head in, so there is a natural demand for people and gave rise to an unacceptable risk that these terrorism insurance are seeking broader coverage count in order to at the senior level.” He added, however: payments could be used for corrupt purposes, to deal with the growing complexity of political save money. “There is a lack of talent in the industry.” including paying bribes.” environments.

International Travel Insurance Journal INSURANCEMATTERS 11

No Solvency II Bancassurance in delay Spain In a recent customer satisfaction survey amongst motor insurance policyholders in India, Carlos Montalvo Rebuelta, executive director The sale of insurance policies by banks in Spain state-owned New India Assurance and Oriental of the European Insurance and Occupational could have accounted for as much as 15 per Insurance were awarded the top-two places, followed Pensions Authority (EIOPA), has said rumours that cent of their pre-tax profits in 2010, according by privately owned ICICI Lombard in third place. the implementation of Solvency II regulation will to a new study carried out by consulting group be delayed are not true. At a recent reinsurance Cognodata. David Ing has the details Aon Benfield has released new findings conference in Zurich, he told delegates: that show 60 per cent of European insurers “There are no plans to delay Solvency attending its recent International Analytics II. However, EIOPA has suggested the conference think that 2014 would be a better implementation of certain transitional starting date for Solvency II. By contrast, 31 per rules for a period of one year to the cent of delegates did not want to see the beginning European parliament.” He explained of the regulation delayed. that during the transition year, insurance regulators from each of the European The China Daily newspaper has reported Union member states would collect the that premium rates for directors and officers liability appropriate data, but not necessarily insurance in China have risen by more than 20 per take action, if companies were found cent already this year, after a series of class action not to be fulfilling their Solvency II lawsuits against US-listed Chinese companies were obligations. He added, though, that filed. In some cases, premiums have almost doubled Solvency II would take effect immediately in one The figure obtained from the banks’ own-branded for mainland Chinese companies listed or seeking a area: “If an insurer has less than the minimum capital products or as a distributor for specialist insurance listing in the US. requirement (MCR), then the national regulatory companies is estimated to have been between body must take action.” c2.2 and c2.5 billion. ‘Spanish banking has found ACE Synergy Insurance, a non-life insurer, In related news, investment management and a refuge in the insurance sector to save its results’ has become a 100-per-cent subsidiary of Zurich- business management software company DST Global in the face of the current economic crisis, said the headquartered ACE Group, after the Group bought Solutions has published a white paper that addresses group’s director Javier Yuste. Money has also been the remaining 49 per cent of the equity in the the importance of operational efficiency in the build raised from the coninuing trend of selling off part of Malaysian unit that it did not already own, for Japanese focus on up to the revised regulatory requirements in Solvency the banks’ insurance businesses to specialist groups, US$39 million in cash. Indonesian II. The company said: “Most of the time and effort a move that brought the industry ‘substantial capital ’quake cover expended by insurers on Solvency II so far has been gains’ that could keep growing through 2011. The Office of the Insurance Commission potential recognised spent on implementing systems and procedures for The Cognodata report, released in late June, also in Thailand has said that the life insurance industry in Shuzo Sumi, head of the General Insurance measuring and calculating levels of capital and prime highlighted how non-life policies are gradually gaining the country is thriving and expanding, with competition According to a straw poll carried out by international Association of Japan (GIAJ), has issued a call for risk. But without adequate processes and controls importance in the range of services offered by both becoming more intense. It released a report showing law firm Clyde & Co., Indonesia has been identified further efforts to be made to improve the market in place in business operations, the capital adequacy the main banking groups and the country’s savings that life insurance sales in the first quarter of this year as the fourth-most-popular place where foreign penetration of earthquake insurance in Japan. levels required could be adversely impacted by banks. However, the effects of new European Union grew by 12.5 per cent year-on-year. insurers operate or are looking to operate, falling just Current figures from catastrophe modelling firm AIR operational risk weightings, with consequent impact (EU) norms on both sectors mean that the profits behind China, Malaysia and Thailand. The survey Worldwide suggest that penetration of earthquake on competitiveness.” Tony Armour, managing director obtained by banks from the sale of insurance policies Following its initial public offering, Insurance of underwriters and brokers based in the UK was insurance policies in the country lies between 14 for business process solutions at the company, added: are likely to dip over the next few years, even if House has listed on the Abu Shabi Securities aimed at getting a better understanding of the view of and 17 per cent – not high considering the frequent “Solvency II is about change of behaviour, managing the actual amount collected through such sales is Exchange and officially launched its operations. the London-based companies about where to seek nature of earthquakes in the region. your business better and proving that you are doing expected to rise. opportunities for the future, given that established Sumi, who has only recently been voted into the so.” He added that in order to better understand the The move towards selling a wider spectrum of more Chief executive of Zurich-based Echo Re, markets are becoming increasingly saturated. The post of chairman of the GIAJ, told consumers that risk management processes that underpin the new general policies began with house coverage, usually Juergen Gerhardt, has said in an interview that the firm focussed only on the emerging markets of there is an earthquake insurance policy available that regime, organisations should look beyond the use linked directly with the loans arranged by the banks company plans to continue its strategy of cautious China, Indonesia, Malaysia, the Philippines, Thailand is offered jointly between the government and the of traditional tools such as spreadsheets, and utilise for new home buyers. But the consultancy now expansion through the establishment of a solid and Vietnam. insurance industry, adding: “Due to the fact that Japan more sophisticated solutions. “Deploying a solution sees other areas as ripe for growth, in particular car portfolio with reliable and long-term relationships in Respondents to the survey who already have is prone to earthquakes, we recognise the need to that enables the end-to-end automation, distribution insurance. Cognodata calculated that the eight to the Middle East. operations in Asia were asked where they were further promote earthquake insurance for the stability and recording of processes not only enforces their use 10 per cent of non-life payments that are currently taking on business, with China topping the list and protection of people’s lives under this public- and facilitates adoption, but allows production of audit channelled through banks could reach as much as 20 Communications provider Qtel has (67 per cent), followed by Malaysia (50 per cent) private partnership.” At a press briefing where he trails and digital documentation. Solvency II should be per cent over the next three years. signed a contract with SEIB Insurance on an and Thailand (42.2 per cent). The rankings of the outlined the top priorities of the Association, Sumi seen as a competitive imperative, and those who are It is said that a key role is being played by the number estimated US$600-million worth of directors and companies remain the same when respondents said: “The GIAJ will make every effort in our post- able to demonstrate sound operations control and of inter-sector alliances between the insurance officers liability insurance, which is thought to be one who have yet to open a business in Asia were asked disaster responses centred on encouraging prompt efficiency will benefit from reduced operational risk as companies and banks that have been set up in recent of the largest ever placements for a single company where they would prefer to start up. payment of insurance claims.” The total amount of well as capital adequacy requirements.” years. Among major deals that have gone through either in Europe or Asia. Andrew Holderness, global head of the corporate claims paid out on earthquake insurance on dwelling since Banco Sabadell sold 50 per cent of its insurance insurance division of Clyde & Co., said that the risks, as of 29 June, reached ¥1.03 trillion (c11 business to Zurich back in 2008 has been La Caixa, A report from Qatar National Health results of the survey reinforce the message that billion or US$16 billion). Sumi continued: “Moreover, which this year is selling a controlling stake in its Accounts has found that reforms to healthcare, foreign investors view Chinese operations as ‘the through our member companies and relevant agents, subsidiary Vidacaixa-Adeslas to Mutua Madrileña for including the upcoming social health insurance key first step to expanding in Asia’. On the other we are reaching out to customers who have suffered c1.07 billion. scheme, will increase the share of private funding for side, he added, there are concerns about operating from the disaster but have not reported the damage Mr Yuste thought it unlikely that any of the existing the nation’s healthcare from the 33-per-cent share in Indonesia, particularly regarding the fragmented to their insurance companies. We are encouraging sales agreements between insurers and the smaller it has currently. insurance industry, high levels of unemployment, the members to report and make claims, particularly in savings banks would change in the near term, despite threat of terrorism, and a lack of transparency. the case of earthquake insurance.” the current wave of mergers and restructuring Stephen Catlin, chief executive of the among the latter to meet tighter controls set by international Catlin Group, said at the 47th IIS Spain’s central bank, the Banco de España. “The Annual Seminar that altering the way the industry tremendous cost that a break in these alliances could is viewed is key to creating and seizing new have makes the rupture of the agreements unviable,” opportunities. He believes that steps need to be EU watchdog warns insurers he said. taken to improve the value insurance companies The banks – or cajas as they are known in Spain provide to their clients. According to the European Insurance and shortfall on capital required of around c4.4 billion. – are still widely used by many people, especially Occupational Pensions Authority (EIOPA), almost one Nonetheless, the organisation said the small size outside the big cities, and have been the most The state-run New Zealand Earthquake in 10 European insurance companies would be forced of the estimated capital shortfall with the sector’s affected by the collapse of the housing market in the Commission has confirmed it has sufficient reserves to raise fresh capital in the event of a serious economic c4.25-billion surplus before the stress tests were last few years. This, in turn, has had a severe effect to cover claims in the event of another disaster incident. The regulator, which was created after the applied, demonstrated that the insurance industry on the national economy and has led to fears over hitting the country. financial crisis caused havoc across world markets, overall is financially sound. Spain’s credit rating, and fears that the country could warned that 13 unnamed insurers across the 27 EU Gabriel Bernadino, chairman of EIOPA, said: eventually be forced to follow fellow EU-members Senior executives at Aon Risk Solutions member states would become insolvent under new “This shows that, overall, the European insurance Greece, Ireland and Portugal in having to seek a have said that buyers of political violence and solvency rules if another crash were to occur. industry has a good shock absorber in its capital financial bail-out. Mr Yuste said that larger insurance terrorism insurance are seeking broader coverage A statement from EIOPA predicted that a perfect position, now each company will have an analysis of companies may even take shareholdings in some to deal with the growing complexity of political storm of a drop in share prices, falling interest the areas where they are more exposed, and they of the new savings banks, although he didn’t expect environments. rates and a property market crash could lead to a can take action.” them to take a direct part in their management.

www.itij.co.uk 12 HEALTHMATTERS

Study identifies HK suffers scarlet fever outbreak plane ‘hot zone’ The Hong Kong Centre have been in children under 10 years old, and most for Health Protection have only had mild symptoms, although two deaths A study by the US Centers for Disease Control (HKCHP) has reported have been reported – a five-year-old boy and seven- and Prevention (CDC) into the transmission of a surge in the number year-old girl. Both patients presented with clinical influenza on international flights has identified of scarlet fever cases in features of scarlet fever and later developed toxic that those most likely to catch flu from someone the country, with a total shock syndrome. already infected sit within the ‘hot zone’ – two of 526 cases confirmed After news of the outbreak emerged, it was seats in front, behind or either side of someone by the end of June. The confirmed that there were also cases in Singapore, with the virus. The study was undertaken figure surpasses the annual prompting the following warning from the UK’s to better understand the dynamics of flu number of cases seen in Foreign and Commonwealth Office: “Healthcare transmission on international flights, which the the past decade, and was in Singapore is of a high quality and expensive. authors say is necessary for prioritising public more than three times Local hygiene standards are high. Anyone health responses to pandemics. The study that for the whole of suspected of having scarlet fever should see a took place on two long-haul flights that entered 2010. Similar increases doctor immediately.” It also noted that for entry Australia during May 2009. Combined results, in the number of scarlet into Singapore, a valid yellow fever vaccination including survey responses from 319 of the 738 fever cases have also been certificate is required from travellers over one year passengers, showed that 12 had an influenza- reported in mainland of age who, within the preceding six days, have like-illness (ILI) in flight and an ILI developed in China and Macau. The been in or have passed through any country where 21 passengers during the first week post-arrival. majority of cases so far yellow fever is endemic. It was concluded that passengers were at 3.6-per-cent higher risk of contracting H1N1 if they sat Legionnaires’ in the same row as or within two rows of people who Measles alerts were symptomatic pre-flight. A closer exposed zone disease prompts – two seats in front, behind and either side, increased The high incidence of measles the risk for post-flight disease to 7.7 per cent. travel warning around the world is continuing, The ‘hot zone’ is definitely the highest-risk zone, although there is some hope according to one of the study’s lead authors, Dr Paul Australian travellers to Bali have been warned that the number of new cases is Kelly, an associate professor at the Australian National to avoid an area of central Kuta following the dropping, according to figures from University in Canberra. He said: “My advice to confirmation of two new cases of Legionnaires’ the World Health Organization and travellers is to change seats if you find yourself within disease. The new cases bring to 15 the number of local health authorities around the two seats of someone who is sneezing, coughing, or Australians who have contracted the pneumonia-like globe. The third measles epidemic looks like they have a fever. If you have a mask, wear illness in the heart of Bali’s popular tourist district in France since 2008 is now it – or suggest your sick neighbour wears it.” since last August, with 10 of the victims coming subsiding, but not before pushing With the Southern Hemisphere flu season now well from Western Australia (WA). As a result, the WA the number of cases to almost underway, people planning international travel should health department has renewed a warning that first 20,000 – a third of them in 2011. consider being vaccinated soon, according to Dr appeared in January, naming the intersection of Jalan So far, there have been 14 cases Ed Bakrovic, who added: “You can’t know if you’ll Signosari and Jalan Kartika Plasa as the epicentre of with neurological complications, be sitting near someone with the flu. A flu shot will the new outbreak. The department did not disclose if 444 with severe pneumonia, and significantly lower a traveller’s risk of infection, even the most recent victims were guests at the Ramayana six deaths this year. As the UK’s if a fellow passenger is coughing and sneezing nearby Resort and Spa, which is near the intersection, or measles tally reaches 500 for the throughout the flight.” had visited the same shopping centre as some of year, vaccination rates are also steadily increasing as The length of the flight also affects the level of risk the earlier victims. Figures show that at least nine more parents have their children immunised. SA imposes yellow posed to travellers, according to Dr Neil Schachter, of the 10 victims who contracted the disease in In Chad, Africa, a mass vaccination campaign has medical director of the respiratory care department late 2010 stayed at the above resort and visited the been launched to stem an epidemic among measles- fever requirements of Mount Sinai Medical Center in New York City. shopping centre. infected refugees escaping the conflict in Libya. He said: “There have been a growing number Tests have been conducted on water samples from There have been 5,311 cases (63 deaths) in 20 of South African authorities have decided to impose of anecdotal reports that people develop upper the hotel and shopping centre by Indonesian and Chad’s 22 regions this year. In Tanzania, measles strict new requirements on international visitors, respiratory infections after flights longer than five Australian health authorities, along with experts is impacting on the nomadic Maasai of the vast asking them to show proof of vaccination against hours. While the study found that the range of from the World Health Organization. However, northern Ngorongoro district, with 20 deaths among yellow fever before they are allowed into the infection is no larger than two rows in each direction, these tests have so far failed to identify the source 650 cases. country. The new regulation will affect all passengers, there were several people with upper respiratory tract of the disease, according to Dr Paul Armstrong, Elsewhere, the disease has had devastating effects including those just transiting the country, and those infections on each plane – which certainly covered a WA’s communicable disease control director. He – Nepal, for instance, has seen measles sweep who are travelling to or from some of Africa’s most large portion of the aircraft.” He believes that better added, though, that all those infected had stayed at through a Muslim community in Sikwakataiya, a popular tourist destinations, including Zambia’s pre-flight surveillance of passengers could stop a hotels located in central Kuta. He advised travellers: village in south-central Mahottari District. Most Victoria Falls and Tanzania’s Serengeti. number of ill people boarding flights in the first place, “Legionnaires’ disease most often affects middle-aged of the community had not been vaccinated and In response to the new requirement, Tonia Buzzolini, which would lower infection rates: “Better airport and elderly people, particularly those who smoke the outbreak has affected 80 per cent of the Travelvax Australia’s national operations manager, controls are certainly a step in the right direction, but or who have lung disease, diabetes, kidney disease local children. said: “We understand the new requirement will this type of policy change takes time. I would advise or a weakened immune system. People with these Despite generally high take-up rates of the vaccine apply regardless of how little time passengers spend high-risk patients with underlying health problems ask risk factors who visit Bali should avoid the central in the US, measles is spreading in Indiana (Noble in transit – even those who are simply changing for to be moved to another area if they are seated close area of Kuta in the vicinity of the intersection of Jalan County, LaGrange County) and New Jersey (Bergen connecting flights, which is common with Australians to someone who is coughing and sneezing.” Signosari and Jalan Kartika Plasa.” County). On average in Europe, the number of new visiting Victoria Falls.” Travel agents should advise cases is falling, while in New Zealand the opposite is their clients that they will be required to show true. With 39 cases, Auckland’s measles epidemic is an official International Certificate of Vaccination worsening and health officials say new cases coming against yellow fever, which must be dated at least from overseas are adding to the tally. In Hawke’s Bay, 10 days prior to arrival in South Africa. Buzzolini children without a measles immunisation certificate added: “As yet, we don’t know what will happen if a will be banned from attending schools and early passenger cannot show proof of vaccination. They childhood centres where cases have occurred to may be required to get vaccinated or they could be help stem a local outbreak. There have been 25 refused entry – we’ve seen both scenarios in Africa. cases at district schools. Obviously, neither option is desirable, so we are The advice to tourists from Travelvax Australia is: monitoring this situation.” “Measles is a highly contagious airborne disease Yellow fever virus is transmitted by infected that can cause severe illness. Australian travellers mosquitoes, primarily the Aedes or Haemagogus who have not had measles or have not received types. For Western travellers, the risk of yellow fever two documented doses of live virus vaccine should is considered to be very low – estimated at 10 in consider a booster as part of their pre-travel 100,000 in Africa and the same in South America. vaccination regime – regardless of their destination. However, the disease has a high mortality rate, Travelvax recommends travellers also check their according to Travelvax – of the nine cases of yellow immunisation status for childhood diseases such as fever reported by unvaccinated travellers from the whooping cough, diphtheria, mumps, and polio, as US and Europe who travelled to West Africa or Kuta, Bali part of their pre-travel medical preparations.” South America from 1970 to 2002, eight died. International Travel Insurance Journal

14 TRAVELMATTERS

Aussies online Business travel up

A new report from PhoCusWright in Australia has New research from MAPFRE Assistance found that traffic to travel websites in the country is has shown that the number of overseas growing rapidly, rising by more than 30 per cent in trips taken by UK business travellers is set 2010 compared to the year before. The company’s to increase by two per cent over the next report into online travel sites show that the websites six months. The company’s poll of business are the most popular Internet category and also the travellers reveals that nearly one in three fastest-growing type of site. The report also showed business travellers (29 per cent) expect the that almost one in every two users of the Internet amount they travel to increase over that visit travel websites, which equates to an average 5.8 period, 22 per cent expect it to increase million user visits. slightly, and seven per cent dramatically. This Douglas Quinby, PhoCusWright’s senior director compares to just one in five who expect of research, said of the research: “Online travel is a the amount of business travel they do to mature Internet category in Australia, but it is also decrease, with 14 per cent expecting a slight growing much more quickly than it is in similarly decrease and seven per cent a dramatic developed markets such as North America.” drop. The remaining 43 per cent of business Other sources have corroborated the findings in the travellers said they expect the amount of report, with Frank Grasso, chief executive of Internet business travel they do in the coming six advertising agency Search, saying that the results of the months to stay the same as the previous half- report are consistent with his company’s client base year. One in three business travellers said growth. He added: “Australian online travel agencies, they had done more business travel in the accommodation properties and other travel providers first six months of 2011 than during the same are significantly growing their online presence through period of 2010, compared to only 23 per online advertising. It is positive to see a growing cent who said they had done less, while 44 number of Australian travel and accommodation per cent said the amount they travelled had providers leveraging on this dynamic growth.” remained static. Of those who have been on a business trip abroad in the last six months, Europe is by far the most regular destination, with 81 per cent of Association has shown that business travel spending those polled saying they have been on a business trip and volume remained steady in the second quarter to the continent in that period. Meanwhile, 12 per of this year, reaching an estimated $62.2 billion in cent of travellers have visited Asia,10 per cent North spending, and representing growth of 6.3 per cent America and five per cent the Middle East. Just two compared to the same quarter in 2010. The forecast per cent of business travellers said they had been to for total business travel spending growth in 2011 Africa, Australasia or South America in the past six also remains strong at 6.9 per cent, according to months, and only one per cent of travellers polled the research. visited Central America. Michael McCormick, executive director and chief Leire Jimenez, MAPFRE Assistance’s head of B2B operating officer for the Global Business Travel travel, said: “Our research suggests that the business Association, said: “By the end of 2010, it looked travel market is on the up and business travellers like the light at the end of the ‘recession tunnel’ expect that trend to continue. This should provide was becoming brighter as the economy overall and an opportunity for business travel firms to increase business travel specifically were gathering positive revenue from an increase in passenger numbers.” momentum. We’ve now hit a soft patch in the She added: “We expect there to be a lot of economic revival, but business travel spend levels tell competition between business travel firms as more us the recovery should continue as companies invest companies seek opportunities for import, export in driving future growth. Now is the time when and overseas expansion and the business travel companies will absolutely call on their strategic travel market consequently improves. It will be important programmes to help offset rising costs and keep for business travel firms to drive extra revenue travellers doing business.” by offering a greater breadth of products such as The Outlook report shows that travel prices are emergency assistance and travel insurance, and on the rise, with increases expected to continue ensure they have the right partners to deliver quality throughout the rest of the year, but at a more products and services wherever their customers go moderate pace than earlier in the year. Airfares have in the world.” swelled due to rising energy prices, constrained Another study undertaken by travel management capacity and relatively strong demand. Higher lodging Asians head firm GetThere found that Asia was leading the rates are also driving increases in company travel market in the resurgence of business travel, with 54 costs, while corporate demand also continues to down under per cent of poll respondents in the East expecting grow, particularly for luxury hotel rooms. As a result, According to figures released by the Australian an increase in demand this year. The GetThere business travel prices are expected to increase by 4.5 Bureau of Statistics, increasing numbers of tourists Corporate Travel Benchmark Survey found that 47 per per cent to five per cent in 2011. While higher rates from China are serving to balance out the fall in cent of respondents from the US believe an increase contribute to the rising cost of each trip, the Business numbers from more traditional inbound markets. in business travel is on the cards, while for Europe Travel Quarterly Outlook also revealed that in 2010, Incoming tourism from the UK and Japan is lower and Latin America 37 per cent of respondents were companies actually spent 1.4 per cent more per than has been seen in previous years, meaning that hopeful for the future, and finally only 29 per cent of trip than in 2009 when adjusted for price increases. China has for the first time entered into the list of those polled in the Middle East predicted an increase So far in 2011, it is estimated that when adjusted top-three source markets by volume, with over in the number of business travellers this year. for price increases, spending on business trips will 39,000 visitors in May this year. When it comes to Grant Rattray, Asia-Pacific manager for GetThere, remain relatively flat, meaning that companies will spending, China leads the list of source countries. said: “Even though the economy is rebounding and keep putting their travellers on the road at a similar Felicia Mariani, managing director of the Australian business travel is growing, corporations are using the pace to 2010, but will be paying more per trip due Export Tourism Council, said: “These figures confirm lessons learned during the recession to continue to to higher rates. what we have now recognised as tourism’s ‘Chinese push for cost savings in their travel programmes.” The report goes on to state: “As international trade Dragon’, with not only the value of Chinese tourism He pointed out that as airlines introduce more continues to drive global growth, US companies expenditure in Australia growing rapidly, but now ancillary fees for extras such as Wi-Fi, corporations are upping their investment in international travel. the volume is beginning to increase too.” Mariani are increasing their reimbursement rates to meet the Total spend on trips abroad is estimated to hit $31.8 also pointed out that as the numbers of tourists from costs: “Ancillary fees are here to stay and corporations billion in 2011, a 9.1-per-cent increase over 2010 the UK and Japan have been falling over the past 12 are developing smart, thoughtful travel policies for and a substantially higher rate of increase than total months by 10 per cent and 25 per cent respectively, these extras that maximise travel budgets and meet spending growth.” McCormick said: “Corporate this has been offset by growth from countries employees’ needs while on the road. Onboard Wi-Fi and management confidence remains high, which including India, Malaysia and Singapore. She added: is clearly viewed as a valuable productivity tool by is why we’re still seeing companies put employees “The challenge for our industry is to embrace and more and more corporate travel managers.” on the road. We think there is good reason to grow these emerging markets and to find new ways Meanwhile in the US, the latest Business Travel maintain measured optimism about the growth of to attract our domestic market back on-shore.” Quarterly Outlook from the Global Business Travel the economy.”

International Travel Insurance Journal TRAVELMATTERS 15

Travel spending UK gains rises in the US popularity

Improving economic conditions and a pent-up A study conducted by hotel price demand for travel are moving US citizens to spend comparison website Trivago that centred nearly US$16 billion more on summer travel in 2011 on tourist travel trends in Europe has found than they did in 2010, according to a survey by global that the UK is more popular among other travel assistance company Mondial Assistance USA European travellers this summer than in and its Access America brand of travel insurance. The past years. The analysis of summer trends survey results show that 45 per cent of Americans say for travel in 2010 and 2011 has shown they are confident that they will take a summer holiday that many more travellers are considering this year, up five points from last year’s survey, and up the UK as a holiday destination this year. 10 points from two years ago. In all, Americans plan to In 2010, the UK was in 15th place on the spend $86.4 billion on summer vacations in 2011. list of most popular summer destinations, The report from the company shows that not only but this year it has jumped 10 places into are more Americans intending to travel on vacation fifth position, beating Greece, Portugal, this summer, but those that are anticipate spending Belgium, Egypt and Turkey, according to more this year. The average family intends to spend travellers from France. A similar trend was $1,704 this year, up from the $1,567 those who seen in other major European countries as were confident they would travel last year anticipated well – for Spanish travellers, the UK took spending. With more Americans confident they will seventh place, while for Italian travellers travel this summer, and with anticipated spending US airlines must submit more data the UK was eighth. higher, the overall projected spend on vacations this When considering the most popular destinations for summer is up by 22 per cent this year over last year. The US Department of Transportation (DOT) has entertainment, among other ancillaries, are not European travellers, in first place was Spain, followed However, despite the positive message coming from proposed a new rule that would require airlines based identified as separate sales. The DOT’s Notice of by Germany, Italy, France and then the UK, which most Americans, among those who are confident in the country to report more information on the Proposed Rulemaking proposes that airlines report was two places higher in the list than it was a year they will go on holiday this year, 54 per cent say that amount and types of fees collected from passengers, 16 additional categories of fees in addition to the earlier. high fuel prices are a concern, making fuel prices far as well as figures showing the number of bags checked information they already provide. For British travellers, staying in the UK seems more concerning on the whole than other issues in and the number of mishandled wheelchairs. The According to the DOT, the changes to baggage to be the most popular option for this summer, such as bad weather, rising travel costs, economic DOT said it wants the information in order to improve reporting requirements would improve information with 27.1 per cent of respondents saying they uncertainty or terrorism. It was shown in the survey data collection on airline revenue. that passengers can use to help them decide which are staying within the country for their holiday. that events of the past year, including dramatic Ray LaHood, US transportation secretary, said: “Our airline to fly with. At the moment, the information Spain was next on the list, followed by the US, weather, terrorism and civil unrest, have led 16 per goal is to improve the quality of data we collect from provided allows the DOT to compare the number Italy, France, Greece, Turkey, Germany, Egypt and cent of those surveyed to say they are more likely to airlines and make airline pricing more transparent. of mishandled baggage reports to the number of finally Portugal. In their approach to their summer buy travel insurance this year, while among Hispanic In an era of rising fees, passengers deserve better passengers on the aircraft. With passengers checking holidays, British holidaymakers differed widely Americans the proportion of people more likely to information about how airlines are performing, fewer bags due to higher fees, the DOT believes that from their European counterparts – 67 per cent buy cover rose to 33 per cent. particularly when it comes to fees, baggage and passengers would be better served by information of Spanish, 58 per cent of Italians, 41 per cent of accommodating passengers if the comparison were based on the number of Germans and 37 per cent of French people would in wheelchairs.” checked bags. prefer to holiday in their own countries. Under the current rules, airlines submit information on a quarterly basis that reports on revenue from baggage fees and reservation change fees, while revenue earned from seating assignments, onboard sales of food and drink, pillows and

Luggage fees prompt change

The Co-operative Travel Company has found that Trevor Davies, retail distribution director for the there has been a significant rise in the number of company, said: “Budget airlines have been around for people who travel with just hand luggage. Around 26 quite some time now and people are getting smarter per cent of passengers polled by the company said and minimising the cost of their flights. While not they are travelling light in order to reduce the overall everyone will want to go to the extremes of holidaying cost of their trips, with an estimated 16,000 families with just carry-on baggage, it does allow people to taking just one suitcase between four people when decide exactly what they’re prepared to pay for.” He they are flying with a budget airline. The Co-operative added: “For the airlines, this is probably the desired Travel Company estimated that the average family of outcome, lowering the weight of the flight and time four that chooses to go abroad with just hand luggage, spent handling people’s luggage.” Travel insurers rather than a suitcase each, could save an average of may also be hoping that fewer people travelling with £233 through not checking in any bags. checked-in bags will result in fewer bags being lost.

Spain to receive Singapore boost The Spanish tourist board and Singapore Airlines committed to spending money on marketing and have signed a memorandum of understanding (MoU) advertising campaigns. that will bring the two parties together in order to Angela Castano, director of Spain’s Tourism Board, boost tourist traffic from Asia to Spain. commented on the agreement: “The signing of Singapore Airlines marketing senior vice-president this MoU means a lot to us since it’s the first of its Tan Chik Quee asserted: “This agreement kind signed by Singapore Airlines with a European underscores our confidence in the potential and destination to cover several target markets. We allure of Spain, as well as our commitment to hope that it will encourage people from Southeast developing and promoting tourism from Southeast Asia and other parts of the Asia Pacific to travel to Asia and other parts of the Asia Pacific to Spain.” a destination where they can enjoy what they love Under the terms of the MoU, both parties are most – culture, food and shopping.”

www.itij.co.uk 16 IPMI NEWS

New services from Lonmar teams with Now Health Catlin Group

A brand new international health insurance Lonmar Global Risks (Lonmar) and the Catlin Group proposition has been launched in the United Arab Limited have announced that they have negotiated Emirates (UAE) by international private medical a new facility for Lonmar’s specialist MediCare insurance provider Now Health International, International division. The initial three-year contract which has teamed up with AXA Gulf to offer the provides each organisation with access to the other’s product. The product, system, pricing and service respective global network and will expand MediCare’s infrastructure has been made available in the UAE product range to include complementary non- through an exclusive arrangement between the medical Catlin products. MediCare has traditionally two companies, meaning that there are now two provided international medical and health insurance international health insurance offerings under the for expatriates and their families. Commenting on AXA banner in the UAE. AXA Gulf will continue the arrangement, David Pexton, managing director to offer its own proposition, while at the same of Lonmar’s non-marine division, said: “This is an time, under a separate and stand-alone agreement, important and growing business sector for Lonmar. provide the Now Health product with AXA’s MediCare has more than 25 years’ experience underwriting capability. of providing healthcare cover to expatriates. This Sonja de Pattenden, associate business new relationship provides us with access to Catlin’s development director for AXA Insurance (Gulf), extensive global distribution network, with 50 offices said: “This product is one of the benefit-rich in the worldwide, combined with significant support from international health insurance market today. It has an acknowledged industry leader.” He added: “Much generous levels of cover, high benefit limits and of the work on this project has been undertaken an extensive range of optional benefits – all designed and facilitated by our new accident and health team, specifically to suit a high-net-worth client base.” Aetna widens web Aviva extends cover headed up by David Gray, who recently joined us Cover is available to both expat and local UAE from HSBC Insurance Brokers.” customers, and at the heart of the proposition offering Aviva has extended the spread of cover in its is an aim to provide unparalleled service with all new Group Personal Accident (GPA), Sickness turnaround times quoted up-front, ensuring fast and Aetna, the global healthcare benefits company, has and Business Travel policy as it seeks to grow its accurate service. Customers will have their own announced multilingual capabilities across all public underwriting appetite in this area. Aviva’s revamped online secure portfolio area, which they can access pages of its international business website. The ‘People and Places’ product offers a number of new 24 hours a day from anywhere in the world. They public website was manually translated into simplified extensions including closure of airspace, kidnap can view and download all their plan documents Chinese, traditional Chinese, Japanese, Spanish and and ransom cover, nuclear, chemical and biological and track all their claims, past and present, as British English, with plans in place to add Arabic as an cover and war cover outside a customer’s country well as being able to add and delete members, option in the near future. The translations were done of domicile. Lisa Wild, underwriting manager for introduce a medical provider and order replacement by local translators around the world in order to speciality lines at Aviva, said: “Recent research membership cards. help capture regional dialects and nuances, resulting from Aviva Healthcare suggests that 50 per cent Now Health International has also recently in a more accurate overall translation. Sandip Patel, of employers consider long-term absence to be introduced a free SMS service for customers to head of Aetna International, said: “[The company] an issue for their business and 34 per cent worry tell them when important events happen on their is committed to being accessible for our members about how, should an accident happen, they would plan. Texts to notify when plans are live, when across the globe. Our web translation capabilities balance obligations to employees while managing membership cards have been dispatched and continue our efforts to provide resources that the needs of their business.” She added: “Our when members have been added are automatically are easy to use and to understand, and allow our revamped ‘People and Places’ product will go generated. The company said that the service is the members to access their information when and how some way towards alleviating these concerns, with first of its kind in the IPMI marketplace, and is being they want to see it.” extended cover introduced following feedback from offered as an optional service to all customers. Since launching the new site in March this year, brokers and their customers. Cover will be beneficial

Alison Massey, marketing and e-commerce director Aetna had continued to add functions that aim to businesses with more than five employees Debbie Purser at Now Health International, said of the service: to make it easier for customers and members and bespoke solutions are also available for more “We are pleased to introduce this first tranche of to access information about their benefits. New complex cases. GPA, Sickness and Business Travel Debbie Purser, divisional managing director of what is a really useful way of communicating with functionality added to the secure member pages customers will continue to benefit from a dedicated MediCare, said: “We are already a well established our customers. Our customer base are the kind of allows customers to access and manage member team of claims experts, who are based in the UK and successful brand in a highly competitive market people who embrace mobile technology so it makes information as well as to customise useful tools such and offer a guaranteed two-day response to all new with a broader product offering than traditional sense to use SMS functionality. People are now as a currency converter and world clock. claims. We also have in place a new team of business healthcare providers. It is also an expanding area of regularly communicating by text with suppliers and Meanwhile, Aetna has also announced that Krishnan development managers, who have underwriting business, reflecting the growth in travel and increased it’s exactly the kind of thing our customers expect Sridharan has been appointed to the new position authority to help brokers meet their individual international job mobility. We are planning for rapid from us.” of vice-president and head of sales, Latin America, customers’ requirements.” growth using our own and Catlin’s distribution Now Health International has also staked its claim as for the company’s international business. In his new Other extensions added by Aviva as part of the channels as well as developing online sales.” the first IPMI provider to offer instant online help to role, Sridharan is responsible for expanding the new product Under the terms customers in choosing their preferred plan option. company’s international business in the Central and include cover of the deal, With its ‘help me decide’ function on the website, Latin American regions, which includes providing for rehabilitation MediCare will individual and company customers answer three international health benefits and health management expenses, search issue all policy simple questions about solutions under the Aetna and rescue and documentation and their needs and Now International brand. David Corkum, evacuation from be responsible for Health’s system provides group managing director of Aetna life-threatening the settlement of an option that best suits the International, commented on the situations. Wild all claims on behalf circumstances they have appointment: “The Latin America continued: “With of Catlin direct selected. Massey said of region is a strategically important both a new product with their clients the move: “Now Health’s market for Aetna’s international and team in place, and intermediaries online offering is designed to business. By appointing Krishnan we aim to reinforce under a binding make choosing international to lead our overall efforts, we can Aviva’s reputation authority provided health insurance quick capitalise on growth opportunities as a credible GPA by Catlin. The and easy. With so many in the region and put even greater partner with a policy Catlin Syndicate options out there, we emphasis on our existing valued that can rival the at Lloyd’s will think it’s important that customers and brokers in Latin best available in the underwrite some of customers can find their America.” Most recently, Sridharan marketplace.” Aviva’s the business arising preferred plan in a clear served as vice-president of strategy GPA, Sickness and from the new facility and straightforward way. and business development for Business Travel cover and the balance will We therefore created the Aetna International, leading is available as part be underwritten ‘help me decide’ function to several key international expansion of its commercial by Catlin Insurance provide a way of saving time initiatives such as the creation of a combined product Company (UK) Ltd, and keeping the process broker sales channel for expatriate set as well as a dependent on the simple.” Krishnan Sridharan medical coverage in India. standalone policy. location of the risk.

International Travel Insurance Journal IPMI NEWS 17

InterGlobal launches assistance arm King to retire from Bupa

International private medical insurance (IPMI) provider and tested before Bupa’s chief executive, Ray’s leadership, Bupa has gone from strength to InterGlobal has launched an integrated 24/7 assistance we formally Ray King, has announced strength. During his time with Bupa, he has helped to division, InterGlobal Assistance, in collaboration with launched the he is to retire in 2012. reinforce the Group’s position as a trusted healthcare New Zealand-based firm First Assistance, to deliver a new service. Our The Board of the partner to all our customers. He has delivered strong highly personalised assistance and claims management systems have now company has said it will results, growing revenue and underlying profit year- service to its clients around the world. InterGlobal been thoroughly shortly commence an on-year during the global economic downturn. The Assistance operates from centres in the UK and tested, our team internal and external Group is now recognised as a major international New Zealand to provide 24/7 service, accessed of assistance search process to healthcare business.” Ray King added: “It has been by members on a toll-free number, offering help, specialists appoint King’s successor. a privilege to serve as chief executive of Bupa and guidance and emergency medical assistance. rigorously trained, King has been chief I am honoured to have worked with such talented Stephen Hartigan, chief executive of InterGlobal, said and we have been executive since May and dedicated people. As the group enters the next of the move: “By bringing InterGlobal Assistance in- operating in a live 2008, and before that phase of its development, now is the right time to house, supported by the expertise and global reach environment for was Bupa’s group finance hand over to the next generation of leadership. I of First Assistance, with whom we have enjoyed an a period of six director for seven years. have been at Bupa for over a decade, as both chief excellent and very successful relationship for several months, pre- Lord Leitch, Bupa’s executive and group finance director, and I am very years, we are now fully in control of the service we launch.” chairman, said: “Under proud of all that we have achieved.” deliver to our members. We work hard to deliver high standards of customer service and wanted to be sure that our members would receive the same standards of commitment, responsiveness and personalised service when they need immediate medical assistance.” InterGlobal appointed Marie-Christine Exon- Gallé to develop and head InterGlobal Assistance, which became operational in 2010 and is being launched now following a period of training, system development and live operation. Ms Exon-Gallé said of the venture: “We wanted to be sure that the integration of our assistance services within the remit of InterGlobal Assistance was fully embedded

Allianz rewarded Allianz Worldwide Care has been awarded the highly coveted title of ‘Best International Private Health Care Provider’ for the second consecutive year at the 12th International Fund & Product Awards 2011, which were held in London in June. The prize was awarded to Allianz Worldwide Care following an assessment by an independent judging panel of industry practitioners and experts, including Deborah Benn, ex-editor of Financial Times Magazine’s Investment Advisor and Malcolm Kerr, a director at Ernst & Young. The judges commented that Allianz Worldwide Care had ‘an extremely organised and professional approach to business positioning, which included well-structured product and service improvements’, adding, “Full marks for an excellent training and technology programme.” Speaking about the award, Claude Daboul, director of sales, marketing and operations at Allianz Worldwide Care, commented: “To be identified once as the best international healthcare provider is a great achievement, but to receive the accolade for a second consecutive year is testament to the client-focussed service we consistently provide. We are known within the industry for our high levels of client care and we constantly strive to improve our client offering, whether through the flexibility of our approach to client requirements or the speed with which we assist them on a day-to-day basis.”

Expacare appointment

UK-based international private medical insurer Expacare has recently announced the appointment of Rachel Sawyer to the position of sales administrator within the company. Rachel brings with her extensive experience in the insurance industry, and her appointment will help to strengthen the quality of service the company provides to its brokers. A statement from Expacare read: “We are very much looking forward to welcoming Rachel to the team, and wish her every success in her new role.”

www.itij.co.uk 18 CROSS BORDER CARE

BDMS seeks iElixir signs Taiwanese ambitions opportunities providers As the new Free Independent Traveller (FIT) scheme believes that Taiwan should target specific treatments, is rolled out in Taiwan, allowing Chinese visitors from including physical check ups and cosmetic surgery, and Bangkok Dusit Medical Services (BDMS), one of US-based medical tourism website iElixir has the mainland to travel independently in Taiwan, hopes should also move further to relax restrictions placed on the largest private hospital operators in Thailand, announced its recent sign-ups of some of the top are high that the new regulation will bring forth hordes the length of time Chinese tourists are allowed to stay is reported to be in the market for health software hospitals and medical tourism facilitators throughout of medical tourists from the mainland. Legislative in the country in order to allow them time to properly and technology from New Zealand as it seeks to the world. The list includes top-tier healthcare Speaker Wang Jin-pyng, who is also founder of the recover following major surgery. capitalise on Thailand’s successful medical tourism providers in India, such as Fortis Hospitals, Naryana Institute for Biotechnology and Medicine Industry, said At the same medical tourism forum, Wang Chih- market. According to Veerasak Kritsanapraphan, Hrudayalaya, AyurVaid Hospitals and Knee Surgery that he expects medical tourism arrivals from mainland kang, chairman of the Taiwan External Trade deputy managing director of BDMS’s IT services India. It also includes key medical tourism facilitator China to number between 2,000 and 9,000 people Development Council, said that of the 3,700 subsidiary, the company is already using business companies, such as MedVoy in the US, Qdays each year. In an address to an international medical medical tourists to visit the island in the last two intelligence software from Auckland-based Cortell Medical Holidays in Romania, Surgeon and Safari of tourism forum, he said: “This will create NT$5 billion years, the vast majority were Chinese visitors. He in order to calculate the profitability of certain South Africa and The HealthClinic of Estonia. (US$173.12 million) in revenues.” He added: “With believes: “Language is Taiwan’s edge in developing procedures, while its doctors are using digital A recent addition to the growing number of sites Taiwan’s superior medical professionals, its medical medical tourism. Taiwanese medical professionals dictation software from Auckland-based company catering to medical tourists, iElixir helps care-seekers services – which are on a par with those in Europe and can communicate with overseas Chinese and they Winscribe. Kritsanapraphan said that companies he find medical treatment at an affordable price. The the US – and comparatively lower fees, medical tourism can also speak English to communicate with non- is researching include Orion, Nexus6 and Adept platform provides information about treatments will become a major industry for the country.” He Mandarin-speaking foreign patients.” Medical, adding: “We can’t find some of these offered in facilities around the world, along with solutions in Thailand so we are now trying to find important pricing, quality of care and service rating them in other countries. The US seems to provide details for free. all these applications, but they are Barbadian hospital opening to serve focused on their own market. That leaves the market open for medical tourists New Zealand companies.” Invest Barbados has announced that a new world- world – board certified American physicians – and we Kritsanapraphan explained that class hospital will be built on the site of the former St believe that Barbados has the quality of life, educational around 30 per cent of patients Joseph Hospital as part of a long-term development facilities, and technological resources, to enable us that use BDMS hospitals are programme that will also bring several speciality to achieve our strategic goals as quickly as possible.” medical tourists who come to treatment centres, biotechnology research companies Robert Priddy, president of AWC, added: “We have Thailand for elective surgery and patient accommodation facilities to the country been particularly impressed by the prudence and combined with a holiday, and over the next five years. Wayne Kirton, chief executive sophistication that the Government of Barbados has added: “Last year, we had almost of Invest Barbados, said: “This exciting initiative brings demonstrated in considering our proposal. We intend two million international patients. a national asset back into productive use in a way to work with its officials closely in the years ahead to That will increase to close to five that will generate foreign exchange, international meet the interests not only of our physician members, million by 2015. Most come from investment and tax revenue, as well as employment but also of the people of Barbados.” the Middle East, Myanmar, Britain and skills training and technology transfer.” The primary market for AWC’s hospital and care and the US. They come for the The project is being undertaken by American World services and facilities in Barbados will be patients whole range – hip replacements, Clinics (AWC). Dr Paul Angelchik, chief executive from the UK and North America, but treatment will knee replacements, heart surgery, of AWC, said: “Our role is to support what is, we be available to locals and other international clients dental work and cosmetic work.” believe, the most respected healthcare brand in the seeking private medical and surgical care.

International Travel Insurance Journal CROSS BORDER CARE 19

Asian report Indian potential Malaysian hopes released recognised are high

Research & Markets has recently released its latest Irish company Research & Markets has Confidence that medical tourism numbers will continue report, which focuses on the current medical announced the addition of the Medical to rise in Malaysia is high, according to Rajan Azlan tourism market in Asia, as well as looking forward Tourism in India report to its offering, and Shah Raja Azwa, managing director of Sime Darby to see what the future holds for the industry. stated: “The medical tourism industry in Healthcare Sdn Bhd. At a recent press briefing, he According to the report, medical tourism is the new India is all set to be the next big success said that medical tourism contributes between three buzzword in the tourism industry around the globe story after software in India. According and five per cent to the company’s total revenue as it helps in enhancing the revenue portfolio of to the prediction of the Confederation and, in a bid to increase this percentage, the firm has various other associated sectors. Medical tourism of Indian Industry (CII) and McKinsey, built two new hospitals. The first, a 220-bed medical has emerged as one of the fastest growing segments the industry will grow to earn additional centre, will be operational from the third quarter of this of the Asian tourism industry. The cost of medical revenue of US$2.3 billion by 2012.” year, and the second will be in business in the second treatments in developed countries, particularly in The CII-McKinsey study shows that half of 2012. Azwa said: “The investment in the two the US and the UK, has been significantly high, medical tourism in India could contribute hospitals has been identified as part of the Entry Point which has prompted the patients from these between Rs50 and Rs100 billion (Rs100 Project (EEP) Four. Under the EEP Four, the target is to regions to visit cost-effective destinations. Moreover, = c1.60 or US$2.24) in additional revenue for attract two million health visitors to Malaysia by 2020.” growth in wellness tourism in Asian countries is Website redesign for upmarket tertiary hospitals by 2012, and will account The government-led plan is ambitious, and requires supporting the medical tourism industry. Presently, for three to five per cent of the total healthcare significant investment from the private sector to add the although medical tourism in the region is at its nascent US firm delivery market. The industry is growing at an annual necessary beds. Added Azwa: “At full capacity, the two stage, it holds enormous potential for future growth rate of around 30 per cent, catering to patients new hospitals will add another 520 beds, or more than and development. As per this new research report – Medical Tourism Arizona LLC has announced that it chiefly from the US, Europe, West Asia and Africa. 25 per cent of the additional capacity required under Asian Medical Tourism Analysis 2008-2012 – the Asian has launched a new website, structured to engage “Although in its nascent stage,” continues the report, EEP Four. Coupled with the 393 beds in Sime Darby medical tourism industry’s revenue is projected to and educate current and future patients as they make “the industry is outsmarting similar industries of other Medical Centre Subang Jaya, our total number of beds grow at a combined annual growth rate of over 20 per travel plans to arrange safe, affordable orthopaedic countries such as South Africa, Jordan, Malaysia, the will increase to more than 900.” cent during 2010-2013. Asian countries, such as India, surgery. The new site has moved from a static, Philippines and Singapore.” Azwa also explained that the company’s target was Malaysia, Singapore and Thailand have been pouring ‘brochure’ format to a data-driven design, making it The scope of the report includes information on to attract around 900,000 patients in the coming five investments into their healthcare infrastructure to meet easier for consumers and prospective patients to find market size and share, revenue trend analysis and years, compared to the current average of around the demand for supreme quality-assured medical care the right solution for their healthcare needs. future forecasts. It identifies the major area of focus 500,000 patients, boosting revenue for the firm to through first-class facilities and highly trained medical Steven Greene, chief executive officer of Medical for the medical tourism industry, giving detailed RM700 million (RM5 = c1.18 or US$1.66). specialists, including tertiary hospital care. Tourism Arizona, said: “Medical tourism is a growing information about the development of services such In related news, Malaysia Airlines is to promote medical The Asian medical tourism industry has been growing field, but there is so much misleading and just plain as heart surgery, orthopaedic surgery, cosmetic tourism to the nation having signed a memorandum at a double-digit growth rate for the past few years. false information on the Internet. Our site’s goal is surgery, spa treatments and IVF treatment. The of understanding with Tropicana Medical Centre and Thailand, India, and Singapore dominated the to provide truth and transparency when it comes to report also reveals who the key players are in the MAS Holidays. Dr Amin Khan, senior general manager region’s medical tourism industry, with a combined professional orthopaedic and medical travel services. Indian medical tourism sector, naming The Taj, Leela of network and revenue management for the airline, market share of over 89 per cent in 2010. However, The truth is, you don’t have to travel overseas to get Group, The Oberoi, ITC, AIIMS, Fortis Hospitals, said: “We are expecting more than 200,000 passengers this research foresees India emerging as one of the inexpensive, quality healthcare.” Apollo Healthcare, Tata Memorial Hospital, Manipal coming to Malaysia as medical tourists next year. It is fastest growing medical tourism industries, accounting A recent editorial in Inc. Magazine described a trend Group, Narayana Hrudalaya, Sahara Hospital, Kuoni, essential that we begin partnering with hospitals to take for around 38 per cent of the region’s medical among US employers to ask for more help from Cox & Kings, and Thomas Cook. advantage of this growing trend.” tourism industry by 2013. their healthcare providers to save money in-country, The report provides research and analysis of the confirming Greene’s assertion. He went on to say: current market performance and future outlook of “There are so many financial and safety reasons to the key Asian medical tourism markets – Thailand, have your surgery done right here in Scottsdale. Singapore, India, Malaysia, the Philippines, and South We can eliminate the middlemen and red tape Korea. It acknowledges the fact that the six Asian and ensure that patients save so much money, markets covered in the report have vast differences they can easily cover travel costs and luxury hotel in terms of cost, infrastructure, human resources, accommodation and experience the trip as a resort patient perceptions, competencies, and level of vacation to the beautiful Grand Canyon state, as government support. opposed to your basic hospital stay.”

Study shows consumer spending

Research from Custom Assurance Placements, claim seen by the company has been for thrombosis a US-based insurance broker selling insurance to or blood clots, and the firm noted that all claims cover medical tourists, has thrown light onto where were filed whilst the patient was still away on their the firm’s customers are coming from, where they trip; none have been received after the patient has travel to for care and how much they spend on returned home. procedures. Using data gathered over the last three years of the company’s operations, the results show that 37 per cent of people who bought the insurance were from Canada, 31 per cent from Australia and New Zealand, 13 per cent from the US, six per cent from Europe and 13 per cent from the rest of the world. When it comes to where the patients head to for treatment, Thailand tops the list, with 57 per cent of patients going there for care, followed by India, which captured 30 per cent of the medical tourists. The next most popular destination was Mexico, with eight per cent of patients going there for treatment. The research also showed that the primary reason for medical travel for the company’s clients is that the medical procedure they want is not available in their home country, or if it is, the cost is prohibitive. The average cost of treatment was calculated to be between $10,000 and $12,000, and the average cost of the insurance policy to cover the travellers is around three per cent of the medical cost. The company said that the average insurance premium is $315, although it varies widely – from $72 to $1,892. In the past three years, the most common

www.itij.co.uk 20 AIRAMBULANCENEWS Turbulent times Flight nurse training in the spotlight A team of researchers from Case Western Severe unexpected turbulence can lead to and long-distance commercial flights) that severe Reserve University’s Frances Payne Bolton serious injuries for passengers and crew on turbulence doesn’t occur to any serious extent. School of Nursing has called for new scheduled airline flights. How likely are such Nonetheless, it should be planned for and the competencies and training for flight nurses, as incidents and what should medical escorts do medial escort needs to be alert at all times. The the number of flights and complexity of cases to minimise the risks to patients? Stewart Farr patient should be made secure with an appropriate handled continues to increase. Andrew Reimer, investigates harness or seat belt and extra pillows, and any a flight nurse, and Shirley Moore, associate baggage that does not need to be to hand should be dean of research at the University’s School Turbulence, instigated by sudden changes in air stored out of the way. “Equipment that is required of Nursing, have outlined their goals for new movement that cause the aircraft to pitch, yaw and must be stored safely but in a manner that is easy to training in the Journal of Advanced Nursing in an roll, presents as two types. Clear air turbulence see and get to,” says Linda. “This includes having the article entitled Flight Nursing Expertise: Towards a (CAT) occurs when different bodies of air meet at best equipment for this type of travel and situation; Middle-Range Theory. high altitudes, for instance near mountain ranges or for instance, an electrically-run ventilator rather than In the article, the researchers propose a theory on the fringes of jet streams in the north Atlantic. an oxygen-driven one that requires huge numbers that takes into consideration the unstructured Such turbulence is often predictable and shown in of potentially dangerous oxygen cylinders. IV bags medical environment and the need for fast the pilot’s weather chart, allowing for the possibility can become missiles in a heaving aircraft so lines thinking that being a flight nurse entails, and of a higher/lower level of flight or a rerouting. need to be secure, and also the IV site, which can claim that some medications and practices used The other variant, storm turbulence (ST), though otherwise be easily dislodged.” in emergency rooms are either ineffective or not so predictable, is more easily detected because Different protective measures may be needed cannot be performed inside an aircraft, with care its moisture can be picked up by the aircraft’s radar. according to the nature of the patient’s illness or often relying on visual clues and patient patterns. Reimer said that as flight nursing is still a relatively new discipline, ‘the knowledge about what works is limited’. In order to develop new theories of flight nursing, Reimer combined a review of research literature with his own experiences. He found that flight nurses need different skill sets from those used in hospital settings in order to access a patient’s vital signs – for example, nurses may have difficulty hearing a patient’s heartbeat in a helicopter due to the noise, and could have difficulty distinguishing a pulse from the vibrations of the rotor blades. Flight nurses have learnt, on the job, how to combat such obstacles, but Reimer said they should have the knowledge before they board the aircraft. As such, the researchers have called for more training that focuses on the uncertain environment of the patient and crew. Reimer also believes that practising in simulated environments, where fast assessments and quick decision-making is needed, is essential to prepare Single-engine flight nurses for the pressure they are put under A wired jaw fracture becomes a serious risk if during urgent missions. He concluded: “You can air ambulances take an ICE nurse with 20 years of experience and the patient becomes nauseous from turbulence put them in the permitted helicopter to care for the patient, and the learning It was a key factor in the Air France Flight 447 physical trauma. Good timing and planning are curve will disaster off the coast of Brazil last year; the plane essential when getting a patient repatriated. For be similar to went through the inter-tropical convergence zone example, for a patient with a bone fracture that is someone with (ITCZ) – most pronounced across the Atlantic – not surgically fixed, turbulence may cause the edges only two years The Indian Directorate where storm clouds and lightning are prevalent. of the bone to ‘rub’ together, causing pain, bleeding of experience.” He General of Aviation (DGCA) has Luckily, turbulence-related air crashes only happen and delayed healing. A wired jaw fracture becomes believes that targeted training confirmed that single-engine aircraft about once a decade (according to aviation a serious risk if the patient becomes nauseous from would shorten the learning period for flight nurses. can operate air ambulance flights in the domestic consultancy Ascend); they’re examples of the top turbulence, needs to vomit and cannot open his/her aviation sector as well as for international transfers, turbulence category, six, rated as ‘extreme’. One mouth. A diabetic must have food after taking insulin after there was some confusion surrounding the rung below, at five, is the ‘severe’ rating. so a medial escort needs to be equipped with food regulations governing air ambulance aircraft in the Light to medium turbulence is a minor and drink at all times as turbulence could prevent country. The confusing wording of the DGCA’s rules inconvenience for passengers and crew, while the belted-in flight attendants from serving it. Mercy dash under had led to a lack of clarity over whether or not the extreme variant can entail injuries, possible fatalities, Patients with heart problems, stroke victims, those air ambulance that crashed in Faridibad recently was, and aircraft structural damage. Severe turbulence with angina, and such like, are more likely to be ash cloud for RFDS in fact, operating lawfully when the crash occurred. provides a very rough, rollercoaster-like ride and prone to increased anxiety during turbulence, At first, some reports suggested that it was not, injuries may arise if everybody and everything especially if a ‘fear of flying’ syndrome is already The Royal Flying Doctor Service (RFDS) in Western as it was believed that single-engine planes were is not fastened down. That said, the chance of present. Drugs should be administered as Australia made a mercy dash from Perth to not allowed to run as air ambulances performing encountering the severe variant appears to be low. appropriate; sedative injections should already have Melbourne on 15 June, flying under a drifting volcanic domestic transfers. However, the DGCA has now Dr Michael Weinlich of Med Con Team Gmbh, who been drawn up, ready to give. ash cloud, to get a three-month-old baby suffering clarified its position and the company that operated has co-authored the research paper Telemedical The anxiety factor is an important consideration. from a serious heart condition to specialist cardiac the plane that recently crashed, Air Charter Services assistance for in-flight emergencies on intercontinental Linda Gormly finds that patients in business or surgery available in only two major hospitals on the Lvt Ltd, is in the clear from authorities. commercial aircraft, believes that the chance is first class, with a correctly trained medical escort, east coast. The tiny patient and her parents left Perth The confusion arose as one of the DGCA’s rules about seven times a year for a large airline. “Using settle well. Her sympathy is reserved for patients at 1.00 p.m. WST and arrived in Melbourne at 6.30 reads: “Operations with single-engine aeroplanes seat belts is the most suitable prevention method. I on stretchers who are often placed at the rear of p.m. EST – a flight time of three hours (assisted shall be conducted only on domestic sectors except have not heard of passengers or patients using seat the aircraft, a prime spot for maximum turbulent by strong tailwinds). The mission was made on for medical evacuations flights,” while another rule belts – also available on stretchers – ever having impact. Where long bone and pelvic fractures are the RFDS Rio Tinto Life Flight jet, the only RFDS states: “Single-engine aircraft will not be allowed injuries. Effects on the patients’ conditions were not concerned, a ‘bean bag’ works well to keep the emergency aeromedical jet in Australia. The drifting to operate to international destinations except for published in any studies, so I have the feeling that stretchered patient secure. However, positioned ash cloud from a Chilean volcano stopped passenger medical evacuation flights.” A source at the DGCA there were no relevant findings.” as it is on top of the stretcher it can make the aircraft flying in or out of Perth, but did not affect said: “But if the two rules are read together, it can Linda Gormly, a flight nurse contracted to First patient ‘too high’ to fit under the overhead lockers normal WA RFDS turboprop services or the jet, a be interpreted that single-engine aircraft can fly as Assistance in New Zealand, has also found in her or so close as to induce claustrophobia and Hawker XP2, which was able to fly safely at 12,000 medical evacuation flights, not just on domestic experience (17 years’ worth in both air ambulance further distress. feet across the south-west of the state, where the routes, but also on international routes. The strange ash cloud was drifting at around 15,000 feet. wording of the rules is unfortunate.”

International Travel Insurance Journal AIRAMBULANCENEWS 21

Take-off for Victoria’s new ambulance planes NEWSWIRE

Ambulance Victoria’s fleet of fixed-wing air from regional Victoria to Melbourne, the state capital. the aircraft equipment, a dedicated battery runs all A Life-Flight air ambulance plane in New ambulances has been upgraded with the arrival of Davis explained that the new layout on the planes the medical systems for a minimum of 30 minutes Zealand was inspected by engineers after being four new planes to respond to medical emergencies means the aircraft can now transport two neonatal on the ground and can be used to start the aircraft forced to make an emergency landing at Wellington and patient transport across the state. emergency cots, each weighing 140 kgs. In addition, in the event of main aircraft battery problems. The Airport. The fixed-wing aircraft was carrying five people Victoria Minister for Health David Davis officially the planes have an upgraded stretcher system, which communications abilities include VHF midband, including a child when it reported a possible fire in one launched the new King Air B200 planes on 10 June allows them to carry patients weighing up to 240 kg, state trunking high-band VHF, satellite phone, and of the engines, prompting the emergency landing. at the Ambulance Victoria and Victoria Police Aviation 50 per cent more than the previous set up. The new analogue UHF, and the crew can converse with Facility at Essendon Airport. He commented: “The standard fit has two stretchers that can take patients ambulance, police, fire and marine services. An unidentified flight paramedic has charged four new King Air B200s replace the existing fleet of up to 160 kg each, or a single bariatric stretcher Pel-Air, a subsidiary of Regional Express Holdings, her 83-year-old male patient with assault, after he of 16-year-old aircraft and will provide transport for can take a patient of up to 240 kg. Another feature will provide the new aircraft, along with pilots and allegedly fondled her breast, and, when she asked urgent and non-urgent patients.” is that most of the medical crew seats are capable of aircraft maintenance. Davis also acknowledged the him to desist, allegedly answered: “I can do whatever The new planes will commence from 1 July and are sliding along tracks to better access the patient. long-standing relationship with the Royal Flying I want. This is my airplane.” The paramedic has custom designed with a modern fit-out to maximise Davis continued: “[The planes] will also incorporate Doctor Service, which has provided support for Air asserted that the incident occurred on 21 September, patient safety and care, said Davis. He added: “This an improved stretcher-loading system, which will Ambulance Victoria since 2000. as she and another unidentified medic were onboard a will assist paramedics and doctors in the treatment mean that the same stretchers will be able to be Ambulance Victoria chief executive officer Greg Gulfstream Aerospace G-1159A transporting a patient of patients in flights across Victoria, Tasmania and used on the planes as in a road ambulance for Sassella said that the new planes represent an from Arizona to Rochester, home of the Mayo Clinic. southern New South Wales.” critically ill patients. This will significantly improve important link in the state-wide health plan: “For Air Ambulance Victoria fixed-wing aircraft transported patient safety. The aircraft also have improved our flight paramedics, these planes are their offices. Charity workers for the Midlands Air 4,383 patients in 2009-10, with most trips being communications and avionics equipment.” Among The fact that we can custom fit the aircraft means Ambulance in the UK were held hostage by masked it suits the way our paramedics work and for what robbers armed with a Taser gun at the charity’s our patients need. These planes ensure that we headquarters on 21 June. Around 20 members of have a comprehensive service to reach all parts of staff were held by three men for around half an hour the state and can bring people to specialised care while money bags full of public donations were stolen. in Melbourne. It’s the first time we have ever had brand new planes, so that is very exciting.” Andrea Robertson has joined STARS of Canada as the new president and chief operating officer (COO), responsible for the direction of STARS’ operations including clinical operations, aviation, education and Skyservice/AAS deal emergency medical communications, reporting to the cancelled chief executive officer, Dr Greg Powell. The proposed deal between Air Ambulance Specialists Hawker Beechcraft Corporation (HBC) has and Skyservice Air Ambulance is officially off, according announced a product enhancement for its late to both companies. In January 2009, Emergency model Beechcraft King Air 350 turboprops that Medical Services Corporation (EMSC) – the parent provides significantly more electrical power for corporation of American Medical Response, Inc. and special mission applications. The increased electrical Air Ambulance Specialists, Inc. (AASI) – entered into power system includes two 400-amp starter an agreement to purchase Skyservice Air Ambulance. generators with paralleled output of 760 amps, an The purchase was reviewed by the Canadian Air additional mission electrical bus with cockpit control Transport Agency and approval was granted in and automatic load shedding. October last year. However, during the nearly-two- Air Trek mechanic threatened year period from the time of the original agreement Norwegian Air Ambulance has recently A man was arrested on 16 June after he threatened to leave. The man then picked up a piece of glass to regulatory approval, the economic climate changed launched an app for Android and iPhones, 113- an Air Trek mechanic with a shard of glass at Punta from the floor and, reports say, ‘walked toward the dramatically in North America for both services, GPS, which allows users to give their exact location Gorda Airport, Florida, US. The Charlotte County mechanic in a threatening manner and held the glass making the economics of the proposed transaction to rescuers in an emergency. The app has already Sheriff’s Office received a call at 6:30 a.m. from a near the mechanic’s face’. Immediately afterwards, less attractive to both parties, according to a joint been downloaded more than 15,000 times. mechanic working on a jet engine, who said he saw he threw the glass on the floor and walked out, announcement. Therefore, Skyservice Air Ambulance, a man walk into the hangar and when the mechanic subsequently driving away in his car. AASI, and EMSC have agreed to terminate the ADAC in Germany has accepted delivery of challenged the man as to why he was there, the man The Air Trek employee told police that the only item pending acquisition, with both choosing to remain the 1,000th EC135 helicopter to be made responded by saying he was investigating a break-in missing from the office was the company’s county tax independent operators. by Eurocopter. The latest purchase brings the at Air Trek. However, no identification was offered receipt, which had been framed on the wall, but all organisation’s rescue fleet up to a total of 15 by the man, and he was asked to leave the hangar. that was left was the frame and some broken glass. aircraft, including a BK117 a EC145. The mechanic subsequently followed the man out of Soon after, the man was arrested and identified by the the hangar and into the front office – to ensure he had mechanic. On his person at the time of the arrest was German air ambulance company DRF left the premises – where he noticed broken glass on an Air Trek pamphlet, and in his car was the tax receipt. Luftrettung flew 19,189 helicopter missions in the first the floor. The unidentified man then said that this was The man, named afterwards as 21-year-old Adam half of 2011. The firm, together with Luxembourg Air the reason for his presence and needed to investigate. Richard Jones, was charged with aggravated assault with Rescue, also performed 389 international fixed-wing According to the mechanic, the man then pushed him a deadly weapon, battery, petty theft, trespass after repatriations, 25 more than the first six months of in the chest several times after repeatedly being asked warning and driving with a suspended licence. 2010. Six aircraft flew to 77 countries worldwide.

www.itij.co.uk ITIClisbon-127-dps-pp22-23.pdf 1 27/07/2011 11:44

INTERNATIONAL TRAVEL INSURANCE JOURNAL 31 OCTOBER - 3 NOVEMBER INTERNATIONAL R R FOUR SEASONS HOTEL RITZ LISBON INDUSTRY AWARDS 2011 ------TRAVEL FOR FULL DETAILS & REGISTRATION INSURANCE

After the phenomenal success of the Istanbul PLEASE VISIT: WWW.ITIC.ORG.UK/LISBON CONFERENCE 2010 ITIJ Awards, we are proud to announce that this year’s ceremony will once again provide the industry with an outstanding occasion that celebrates excellence and achievement in the global travel insurance industry.

ITIJ is read by the top players in travel insurance today and it is this readership that allows us to compile the most comprehensive vote available. Each individual that subscribes to ITIJ will have the opportunity to vote for their top-rated company in each of the nominations categories.

Once all the votes are in, a shortlist of the top three to five companies in each category will be drawn up (based on the number of votes received). Each of these finalists will then be asked to create a presentation that will be considered by an independent judging panel,

C which will then decide the ultimate winners on the night. M

Y The finalists’ presentations will be screened CM at the ITIC Finale Dinner awards evening in

MY Lisbon on Thursday 3rd November 2011. ITIJCY AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 CMY R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS K 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R TheITIJ AWARDS rules: 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDSOne vote per 2011 category R per ITIJsubscriber AWARDS to ITIJ 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS R Votes/nominations must be receivedR by R R R R 2011 ITIJ AWARDS16th September 2011 2011 ITIJ AWARDS 2011 ITIJ AWARDS 2011 ITIJ AWARDS 2011 ITIJ AWARDS 2011 ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R Only registeredR company domain names will R R R R ITIJ AWARDS 2011be accepted. Hotmail, ITIJ AWARDSyahoo and other 2011 ITIJ AWARDS 2011 ITIJ AWARDS 2011 ITIJ AWARDS 2011 ITIJ AWARDS 2011 R ITIJ AWARDSWeb-based 2011 emails R will notITIJ be AWARDSaccepted 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJThe AWARDSfinalists within each2011 category R will ITIJ be AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ contactedR on 19th September 2011 and R R R R R AWARDS 2011provided withITIJ the AWARDS criteria and deadline 2011 for ITIJ AWARDS 2011 ITIJ AWARDS 2011 ITIJ AWARDS 2011 ITIJ AWARDS 2011 submittingR their presentation R R R R ITIJ AWARDS 2011 (details ITIJ available AWARDS online) 2011 ITIJ AWARDS 2011 ITIJ AWARDS 2011 ITIJ AWARDS 2011 ITIJ AWARDS 2011 R ITIJ AWARDS 2011 www.itic.org.uk R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS The2011 categories: R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R Air Ambulance provider of the year

R Assistance/Claims Handler of the year

R Cost Containment company of the year (to include PPOs and general services)

R Insurer/Underwriter of the year

R Intermediary of the year (to include all retailers of travel insurance)

R Hospitals/Medical Provider of the year

For further information/advice contact us at: [email protected] or telephone the conference department on: +44 (0)1179 22 66 00 (#204) ITIClisbon-127-dps-pp22-23.pdf 1 27/07/2011 11:44

INTERNATIONAL TRAVEL INSURANCE JOURNAL 31 OCTOBER - 3 NOVEMBER INTERNATIONAL R R FOUR SEASONS HOTEL RITZ LISBON INDUSTRY AWARDS 2011 ------TRAVEL FOR FULL DETAILS & REGISTRATION INSURANCE

After the phenomenal success of the Istanbul PLEASE VISIT: WWW.ITIC.ORG.UK/LISBON CONFERENCE 2010 ITIJ Awards, we are proud to announce that this year’s ceremony will once again provide the industry with an outstanding occasion that celebrates excellence and achievement in the global travel insurance industry.

ITIJ is read by the top players in travel insurance today and it is this readership that allows us to compile the most comprehensive vote available. Each individual that subscribes to ITIJ will have the opportunity to vote for their top-rated company in each of the nominations categories.

Once all the votes are in, a shortlist of the top three to five companies in each category will be drawn up (based on the number of votes received). Each of these finalists will then be asked to create a presentation that will be considered by an independent judging panel,

C which will then decide the ultimate winners on the night. M

Y The finalists’ presentations will be screened CM at the ITIC Finale Dinner awards evening in

MY Lisbon on Thursday 3rd November 2011. ITIJCY AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 CMY R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS K 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R TheITIJ AWARDS rules: 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDSOne vote per 2011 category R per ITIJsubscriber AWARDS to ITIJ 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS R Votes/nominations must be receivedR by R R R R 2011 ITIJ AWARDS16th September 2011 2011 ITIJ AWARDS 2011 ITIJ AWARDS 2011 ITIJ AWARDS 2011 ITIJ AWARDS 2011 ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R Only registeredR company domain names will R R R R ITIJ AWARDS 2011be accepted. Hotmail, ITIJ AWARDSyahoo and other 2011 ITIJ AWARDS 2011 ITIJ AWARDS 2011 ITIJ AWARDS 2011 ITIJ AWARDS 2011 R ITIJ AWARDSWeb-based 2011 emails R will notITIJ be AWARDSaccepted 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJThe AWARDSfinalists within each2011 category R will ITIJ be AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ contactedR on 19th September 2011 and R R R R R AWARDS 2011provided withITIJ the AWARDS criteria and deadline 2011 for ITIJ AWARDS 2011 ITIJ AWARDS 2011 ITIJ AWARDS 2011 ITIJ AWARDS 2011 submittingR their presentation R R R R ITIJ AWARDS 2011 (details ITIJ available AWARDS online) 2011 ITIJ AWARDS 2011 ITIJ AWARDS 2011 ITIJ AWARDS 2011 ITIJ AWARDS 2011 R ITIJ AWARDS 2011 www.itic.org.uk R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS The2011 categories: R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R ITIJ AWARDS 2011 R Air Ambulance provider of the year

R Assistance/Claims Handler of the year

R Cost Containment company of the year (to include PPOs and general services)

R Insurer/Underwriter of the year

R Intermediary of the year (to include all retailers of travel insurance)

R Hospitals/Medical Provider of the year

For further information/advice contact us at: [email protected] or telephone the conference department on: +44 (0)1179 22 66 00 (#204) 24 FEATURE Electronic evaluation

he integration of online medical details of her mother’s illnesses online; other risk based on a series of carefully worded health a history of cancer or heart problems, have screening into the travel insurance sales insurers had required her to phone. The website questions. Customers logging onto Fish’s website traditionally had to telephone the insurer. Tprocess has intensified in recent times then provided her with an on-the-spot quote. complete a handful of eligibility questions that Moreover, the premiums have often been huge as due to advances in risk assessment technology. To her delight it was £400 – 60-per-cent less – where appropriate – trigger the risk-rating insurers sought to cover their backs in the event David Robinson looks at what makes for than the competition. “When I told mum she’d tool. Healix’s IP is essentially a detailed medical of a worst-case scenario. successful online screening be coming on holiday with us after all she was questionnaire that seeks to gauge the severity But Healix’s most recent rating tool over the moon,” the daughter says. “We were of their condition, and then determine a risk – Black Box 2 – has been designed The family was getting desperate. Mother, father all so happy.” category (Typically from zero to 10). The ‘risk for easy integration into insurers’ and daughter had planned a holiday in Turkey websites. “The presentation of this summer; fearing it could be one of their last the questions is far more web- as a unit. But booking travel insurance for the friendly,” explains Healix Risk 78-year-old mother – who had been seriously Rating’s client services manager ill – had turned into a nightmare. Her ailments the trend has also been driven by improvements Lara Suttie-Sims. included angina, osteoarthritis and ischaemic Similar risk rating software heart disease. The family had contacted a raft of in technology that allow for easier integration of providers include Travel and leading insurers, but the quotes were exorbitant. Medical Services, with its TAMIS A premium of more than £1,100 so the mother medical screening into customer-facing tools system, and Mediquote – both of could go on holiday seemed ridiculous. “It was which strive to produce systems getting to the point where mum might not have that give users a simple and been able to go,” the daughter recalls. effective purchasing experience and At home in the UK, the daughter trawled Fish Insurance’s online booking system uses a score’ helps the insurer generate a quote, and the provide insurers with a tool that the web. She found a niche insurer – Fish risk-rating tool created by Healix, a healthcare customer can complete the purchase online. will reflect their underwriting needs. Insurance – that specialised in pre-existing solutions company. The system utilises medical It has not always been this simple. Consumers As Travel and Medical told ITIJ: conditions. To her surprise, she could enter algorithms to predict and score underwriting with serious pre-existing conditions, such as “Understanding that distruption to the

International Travel Insurance Journal FEATURE 25

score that reflects the severity and stability of medical conditions in conjunction with the area of travel,” an AXA spokesperson says. “Typically, we would not cover somebody who has had a number of heart attacks and was planning to travel to the US. However, we may cover somebody with angina travelling to France. It depends on the severity and stability of the health conditions.” In certain situations, AXA Direct refers customers it deems as ‘high risk’ to specialist provider Goodtogoinsurance, which launched in September last year. Like Fish Insurance, Goodtogoinsurance specialises in providing travel insurance to people with pre-existing medical conditions. It has no age limits, and also uses Healix’s technology to aid in the medical screening process. “The company aims to provide affordable cover for conditions that other insurers shy away from,” says managing director Iain Sykes. Its customers include people that have had cancer, heart attacks, or strokes, as well as people undergoing chemotherapy or who have been diagnosed with HIV. “The levels of cover available to those with pre-existing conditions slowly increases every year and many insurers are covering more serious medical conditions than before,” Sykes says. “However, there are still very few specialist providers that are able to cover very high-risk travellers with no age limits. As a result, a fair proportion of our customers are referred by mainstream providers who have not been able to offer cover for reasons of health or age.” Aviva Travel Insurance has also enhanced its online ‘quote and buy’ journey,

“The levels of cover available to those with pre-existing conditions slowly increases every year and many insurers are covering more serious medical conditions than before” customer’s application must be minimised and will both return asthma as a search result) and that screening should never be viewed as a barier variant spellings have been included such as to a sale has driven TAMIS’ development.” anemia instead of anaemia. Innovative ‘smart technology’, it says, enables TAMIS offers a similar service. Users of insurers and brokers to integrate medical the system benefit from instant upgrades, screening seamlessly into their existing sales improvements or adjustments, and, its ever- systems. expanding medical database and risk-rating “The last few years have seen more customers engine can be updated ‘in seconds’ to reflect review and compare a multitude of insurance medical advances or issues such as civil unrest to products to find the one that best fits their ensure each assessment is ‘reflective of the true needs,” says Mondial Canada’s president and immediate risk’. A close relationship between chief executive officer Scott McKellar. “The Travel and Medical and Specialty Group’s increasing availability of online medical screening International Medical Screening has allowed is a response to this trend.” But the trend has also the companies to combine their knowledge, been driven by improvements in technology that and the hope is to very soon enable insurers allow for easier integration of medical screening to benefit from a searchable drug index and into customer-facing tools. “The questionnaires synergistic scoring of medications and conditions, themselves have evolved as well, with clearer and provide the opportunity to link hazardous wording and direction to help facilitate the activities with medical history. process for the end user,” McKellar adds. Suttie-Sims says Healix is constantly Industry improvements tweaking its system to improve In February, AXA Direct relaunched its website customers’ overall online sales after integrating an updated version of Healix’s experience. This year, it system. The move has allowed it to do 100 per released Black Box version cent of its medical screening online, without 2.2. “We recognise how the need for any telesales. Also this year, retailer important it is for people Insure&Go integrated Healix’s latest medical risk to be able to purchase assessment tool into its web sales channel. “This their travel insurance and enhancement maximises our sales opportunities conduct their medical and reduces the chance of us losing business due screening online in the to a break in the sales process,” says Simon Tagg, shortest time possible and IT development manager at Insure&Go. “It also with the least amount of supports our profitability, as online screening hassle,” she says. is more cost effective than handling quotations The latest version allows the through our call centre.” user to search for a medical Yet despite these improvements to the online condition by typing any sales process, the mainstream insurance market three letters from any part remains reluctant to cover more serious pre- of the name of a condition existing conditions in certain situations. “The (i.e. entering ‘ast’ or ‘hma’ Healix medical screening system produces a risk

www.itij.co.uk 26 FEATURE

which aims to make it easier for customers to While some ask just four or five basic trip- purchase travel insurance. Said Kate Niven, related questions before beginning their online a senior travel underwriting manager at the medical questioning, others ask for the user’s company: “The introduction of online medical name, address, and even car and home contents screening ensures [we] offer greater flexibility renewal dates before asking their first medical- around [our] underwriting criteria and means related question. This key idea of keeping the new business customers can search for and select process simple is lauded by insurers including the name of their pre-existing medical condition Goodtogoinsurance, who say that by keeping the and fully medically screen for themselves during online purchasing process simple and efficient, a single transaction.” Only site users with more ‘there is no need for customers to stop or break complex medical conditions will need to contact away from the buying process, for instance to the insurer to complete the buying process, make a phone call or go off to another site’. she added. Keeping the screening Another specialist supplier and sales process seamless of travel insurance for has shown to improve people with pre-existing conversion rates and, medical conditions in the ultimately, impact UK is AllClear Insurance it is not possible to insurers’ bottom lines. “If Services. In December last a customer is unable to year, it launched AllClear simply screen and complete their purchase Options, the UK’s first quickly online, you are specialist travel insurance pigeonhole patients far more likely to lose comparison site. The site them,” says Sykes. The aims to gives customers to price risk integration of online with medical conditions medical screening has the ability to choose and been extremely successful compare deals. “Customers for the company, who can go straight to the says 66 per cent of its AllClear Options website, policies are sold online. input their medical Successful online medical conditions and obtain quotes from a range screening also saves insurers money by allowing of leading specialist medical travel insurance policies to be sold to medically impaired travellers providers,” says Chris Blackman, head of 24 hours a day, seven days a week without product development at AllClear. “With just one the expense of keeping a call centre open for screening, we can match the customer’s particular long hours. conditions with those products that best meet Peter Dingle, commercial director at Europ their needs at the best price,” he says. Assistance in the UK, agrees that web-based This ease of use and also access to the online online solutions for medical screening mean medical screening function contained within that the entire sales process is quicker and more travel insurers’ websites is something that efficient for the customer. “In addition,” he does, however, vary between different sites. says, “The ability to include and assess a wide

Keeping the screening and sales process seamless has shown to improve conversion rates and, ultimately, impact insurers’ bottom lines

International Travel Insurance Journal FEATURE 27

range of conditions means that the majority of customers do not need to be referred for manual underwriting.”

Taking lessons from others Canada, with its legions of well-heeled senior citizens fleeing to the US every year to escape the country’s freezing winters, has a well-developed travel insurance market for customers with pre- existing conditions. It provides a useful test case on how this growth market might develop in the UK. Many Canadian insurers claim they will cover pre-existing conditions, but only if they are stable and controlled according to tight definitions. Leading insurers like Mondial and GMS Insurance require customers to complete detailed questionnaires to determine whether they are eligible to buy travel insurance online and to weed out people with more severe pre- existing conditions. As a result, many Canadian travellers with pre- existing conditions – including elderly travellers – buy cover from just a handful of insurers, such as RBC Insurance, Travel Guard and Etfs, which target products at their demographic. But such companies remain well-established players and provide travel insurance to a wide range of customers – not just the old and infirm. In fact, Canada has very few specialist insurers that primarily focus on customers with pre-existing conditions. There may be a reason for this. Businesses that have targeted this area of the market in the past have struggled, according to Vancouver-based insurance industry consultant Dr Colin Plotkin. “Many companies providing insurance for pre-existing conditions have fallen by the way side [in North America] for a number “This enhancement maximises our sales opportunities and reduces the of reasons,” he says. “Emergency medical travel insurance targets a specific segment of the public, chance of us losing business due to a break in the sales process,” and is therefore devoid of the basic requirements in insurance, that of a dilutionary factor. In other words, there are insufficient people contributing to a pool of money to fund the level of claims providing adequate cover,” he says. that will flow as an absolute, from claims relating Other specialist insurers, such as InsureCancer, to pre-existing conditions,” Dr Plotkin says. don’t offer online medical screening, as the “Irrespective of whatever premium is charged to cover they provide is uniquely tailored to each cover a pre-existing eventuality, be it £10, £20, customer’s condition, making it entirely suitable or £30 for a week, two weeks, or a month of for the traveller’s needs and often more affordable, travel to the US, a single claim of US$500,000 with risks based on very precise technical can never be balanced by an equivalent premium medical underwriting. Said Krish Shastri, income. This also assumes that there are people the company’s founder: “As a cancer patient’s rich enough, and desperate enough, to travel in response to treatment is individual and unique, order to fund the premiums, which are ten or it is not possible to simply screen and pigeonhole more times that of the cost of the plane ticket.” patients to price risk. This is particularly the In the UK, insurers selling travel insurance on case with those patients with advanced cancer in the web for people with serious pre-existing palliative care.” conditions is a relatively recent phenomenon. It’s not denied that pre-existing conditions Goodtogoinsurance began trading in September will continue to provide a challenge to travel 2010, while the AllClear Options website insurers, but how they’re dealt with going launched in December. Fish Insurance started forward may determine how well the travel selling travel insurance in January. AllClear – insurance industry fares in its quest to provide which claims it goes further than its rivals in an efficient and cost-effective sales process in the terms of severity of medical risk that can be form of online medical screening. As AllClear’s accepted on a travel insurance policy – has seen Chris Blackman said to ITIJ: “The sharp rise its business triple in size in the last three years, in the number of people with Alzheimer’s and driven by strong growth in online sales of 45 per diabetes type 2 and other pre-existing conditions cent year-on-year. However, as the number of should ensure that the kind of specialist travel specialist travel insurers that cater to customers insurance we provide sees strong growth for with pre-existing conditions in the UK rises, many years to come. With the web continuing the Canadian example may provide a salutary to dominate as the preferred sales channel warning to the UK sector and booming online for the travel insurance market, integrated sales industry. online medical screening will continue to form Fish Insurance operations director John an important part of the customer journey, Garrard concedes that travel insurance is a enabling a one-stop shop for the whole policy ‘tricky business to underwrite’ because medical sales process.” Whether seeking a standard travel repatriation can – occasionally – be extremely policy or more specialist cover, customers being expensive. But he maintains that the volume able to complete the medical screening process of customers the company pulls in balances in their own time, in a more private manner, the risk of the odd huge payout. “Our main without the pressure of a phone call, will always concern has always been whether our premiums be a more popular sales route. With the advent reflect the losses and we remain confident that of advanced online medical screening, this is we provide insurance at the right price for the becoming increasingly possible for a growing risks that customers come to us with, whilst still number of people. n www.itij.co.uk 28 FEATURE All risks included?

As one of the world’s biggest tour operators registered nurses at all resorts during regular over-indulgence of food, climate change, heat bookings last summer (2010) were up 21 per cent boards a seemingly unstoppable industry office hours, with a qualified MD on call 24 or an airborne virus, and any advice given to the compared with a lacklustre three per cent for the bandwagon by making one of its favourite hours daily. contrary would be irresponsible,” notes Simpson rest of the holiday business. brands all-inclusive, what does the boom in To date, most all-inclusive resorts have grown up Millar’s holiday illness claims supervisor, Simon First Choice is the first major British tour these all-in resort packages imply for the travel in destinations that have an adequate standard of Lomax, on the firm’s website. operator brand to commit itself completely insurance sector? Robin Gauldie investigates emergency healthcare by international standards. The Holiday Village Turkey is one of the all- to selling all-inclusive holidays, says Johan All inclusive resort developers generally choose inclusive resorts in the portfolio of First Choice, Lundgren, TUI’s UK and Ireland managing Born in Jamaica almost 30 years ago, the all- to build not at remote locations, but on sites one of the UK brands of the German-owned TUI director, who describes the move as ‘a major travel inclusive concept has expanded from there to close to or within existing resort areas, so they group, and Lomax says Simpson Millar has also industry milestone’. “All-inclusive is becoming other Caribbean isles, and to destinations in have access to medical emergency and evacuation handled compensation claims relating to other the holiday of choice for many British consumers, Mexico, the Pacific, the Mediterranean, the facilities that is as good as access to those facilities First Choice Holiday Villages in Rhodes, Egypt but to date no mainstream holiday company Red Sea and the Indian Ocean. Security and from conventional resort hotels. In many cases, and Spain. has offered a complete all-inclusive portfolio,” peace of mind are big selling points, and are medevac access may be even better, as many But these and other claims from its all-inclusive Lundgren says. coupled now with value for money and ease of upscale all-inclusives have their own helipad. clients have not deterred TUI – which also owns Could it even be argued that – by fostering an holiday budgeting. the UK’s largest tour operator, Thomson – from in-resort, 24-hour holiday drinking culture – all- But does this sense of security within a cosy ‘Ambulance chasers’ cocoon where all needs are provided for – plus Meanwhile, the growth of the all-inclusive the temptations of a virtually round-the-clock sector has been paralleled by a mini-boom in booze and fun culture – actually create issues or the number of law practices offering ‘no-win, opportunities for travel insurers? no-fee’ legal actions in pursuit of compensation According to the 2010 Consumer Trends survey payments for everything from ‘holiday tummy’ to carried out for the Association of British watersports accidents. “The Dominican Republic Travel Agents (ABTA), 19 per cent of UK is often sold as a luxury Caribbean destination, holidaymakers fail to buy travel insurance. And but the experience of tourists in recent years some all-inclusive resorts are not as squeaky has shown that standards of health and safety clean as they claim to be, leading to a growing are often sadly lacking,” says Andrew Morton, a ‘compensation culture’ from clients who become specialist holiday claims solicitor at international ill or are injured within the resort. law firm Pannone. Might all-inclusive clients who believe that they Egypt is another popular destination where all- will be vacationing in a risk-free environment inclusive resorts have blossomed (accounting for be even less likely than most holidaymakers to 78 per cent of bookings from the UK last year), take out adequate cover? Sean Tipton, ABTA with a concomitant increase in compensation senior press officer, thinks the reverse is true. “As claims, Morton adds. with all other package holidays, tour operators In 2008 and 2009 and again in 2010, Pannone selling inclusives do insist that clients have travel was instructed in group actions against one insurance,” he points out. Tipton suggests that Egyptian all-inclusive, the Movenpick Resort because most all-inclusive clients buy the whole Taba, from guests who suffered food poisoning package through a tour operator – who must symptoms, he says. In April 2011, another insist that they have some form of travel cover – holiday claims legal practice, Simpson Millar they may actually be more likely to be adequately Solicitors, said it had been instructed by clients insured than independent travellers. returning from the Holiday Village Turkey in According to Gordon ‘Butch’ Stewart, founder the resort of Sarigerme after a food poisoning of the Sandals luxury all-inclusive empire and outbreak caused by the salmonella bacterium. self-styled ‘King of the All Inclusives’: “The From the ambulance-chasing lawyer’s point winning formula is to find out what people want, of view, all-inclusive resorts are sitting ducks. give it to them, and exceed their expectations.” Selling safety, security and value for money, It’s a concept that in these cash-strapped times is capturing more hearts and minds than ever before: pay one all-inclusive price for your flights, accommodation, food, drink, activities operating costs are and entertainment and you won’t need to spend another cent throughout your stay. But, seductive as it seems, the all-inclusive concept squeezed, and in has its special risks and not all its operators manage to make Stewart’s ‘winning formula’ some places quality, work for them or their guests. Sold on value for money, there is relentless health and safety pressure on tour operators to keep prices down. That pressure is passed on to the resorts, which are at risk of being contract their beds to holiday companies. Inevitably, operating costs are squeezed, and compromised in some places quality, health and safety are at risk of being compromised. Some popular all- inclusive destinations have become bywords for claims for compensation after outbreaks of food they implicitly lay themselves open if they fail re-branding First Choice as a purely all-inclusive inclusive operators could share some of the blame poisoning, salmonella and other infections. The to provide any of these. “They do tend to be a brand in its 2012 programme. for alcohol-related illness and injury? Dominican Republic, for example, where tourism more attractive target for ambulance chasers just Around 68 per cent of holidays in the company’s “Our members’ advice to consumers would is overwhelming dominated by the all-inclusive because of the sheer numbers of people they existing 2011 programme are all-inclusive always be ‘don’t do anything you wouldn’t do at sector, has struggled for years to throw off a serve,” agrees ABTA’s Sean Tipton. packages, and highly publicised compensation home’,” says Rachael Sharrocks, press officer at reputation for such outbreaks. Since guests rarely leave the property, it is harder cases do not seem to have deterred potential the Association of British Insurers. She points Around the world, standards of medical care for for the resorts to shift the blame for outbreaks of clients. The all-inclusive sector within the British out too that travel insurance providers routinely all-inclusive clients vary widely between brands illnesses related to poor food hygiene standard – a holiday market has grown by 32 per cent since caution clients that their claim is likely to be and destinations. SuperClubs, one of the biggest tactic that has often been used to attempt to deny 2004. According to travel industry analyst GfK turned down if it results from over-consumption names in the Caribbean with brands including compensation claims. Ascent, all-inclusive packages now account for of alcohol or use of drugs. But for many, Breezes, Grand Lido and Hedonism, boasts “Salmonella food poisoning is not caused by 37 per cent of UK package holiday sales, and binge drinking and the opportunity to sample International Travel Insurance Journal FEATURE 29

experiences they wouldn’t try at home are major whole weeks.” standards. First quarter 2011 revenue was up by inclusive concept with properties such as Sandals, selling points of an all-inclusive package. Activities such as jet-skiing are not usually on the 9.5 per cent, the company reported, with 21,000 which opened in 1981, and Hedonism II, which all-inclusive menu. But most all-inclusive resorts additional customers compared with first quarter opened the following year. For adults only offer them as paid-for extra, provided on-site 2010 – and the bar is now open all day, with The key selling point, initially, was security. This Hedonism II, for example – an all-inclusive, by the resort’s favoured sub-contractor. Clients drinks included in the package. was Jamaica ‘lite’ – all the sun, fun, sea and adults-only pioneer since its launch almost who intend to use such facilities should read the sand with no need to step outside the discreetly 30 years ago – invites its clients to ‘shed your small print, say insurers, as most resorts decline No problem? camouflaged chain-link fence of the compound. inhibitions and join a party on the nude beach’ responsibility for such optional extras. The true all-inclusive resort product was born and Though most operators would deny it, staff at and cites its ‘non-judgmental attitude’ as a major The French-owned Club Méditerranée is often came of age in Jamaica and the Caribbean in the some more relaxed resorts would even discreetly part of its attraction. credited with pioneering the all-in concept as 1980s, at a time when safety and security were supply small quantities of Jamaica’s best-known Back when all-inclusive was still in its infancy, early as the 1950s. But Club Med™’s original major issues for the island’s tourism industry. herb – the only transaction which required cash I listened to the general manager of a Jamaican product – while innovative in its day – fell The slogan: ‘Jamaica: no problem’ had been to change hands. all-inclusive resort as he lamented the ability of short of being truly all-inclusive. All meals, and created for the Jamaica Tourist Board by a Hedonism II, which opened in 1982, outside his British guests to soak up the booze, day after Negril, on the island’s west coast, quickly became day … after day. “The Americans come down for a legend for an ‘anything goes’ attitude to 24- a long weekend, maybe three or four nights,” he First Choice is the first major British tour hour partying, allowing its middle-aged clients said. “The first night, they make the most of the to relive their permissive youth, if only for a few free bar, and they order their favourite drinks. days. Even the cigarettes were free – though that “The next morning, they wake up with a operator brand to commit itself completely to is apparently a thing of the past. hangover and for the rest of the time they mostly ‘Hed II’ was soon followed by a wave of order soft drinks, maybe a beer with lunch or a selling all-inclusive holidays emulators, which tapped into demand for a

glass of wine with dinner. During the day they a modicum of wine or beer with lunch and blue-chip Madison Avenue agency advertising less rowdy and more sophisticated all-inclusive use all the free activities and watersports. They dinner, were included in the package price, along to revive the destination’s flagging tourism. products. The all-inclusive sector rapidly don’t want to be so messed up that they can’t go with a range of sports and activities. But guests The reality, however, was that Jamaica did have diversified, with brands calculated to appeal waterskiing or windsurfing.” He added: “But who wanted more than their allotted ration of problems, and they would not be resolved by to singles, couples, families and child-free you Brits? You get off the transfer bus from the mealtime drinks had to pay extra – not with cash, mere slogans. Violent crime, often drug-related, adults. As the all-inclusive concept expands airport, you go straight to the bar, and you drink but with Club Med’s own plastic bead currency. spilled out from the ‘yards’ of ghetto areas to and diversifies into new markets and new everything in sight until you can’t drink any Club Med, however, has come a long way from impact on the artificial tourist idylls of resorts destinations, travel insurers will build on more. Next day, you wake up and do it all over the simple thatched huts of its first resorts. The such as Ocho Rios, Montego Bay and Negril. their knowledge of covering clients heading to again, starting with a Bloody Mary for breakfast company is increasingly focusing on its upscale Turning disaster into opportunity, Jamaican such resorts, and will look closely at the new and ending up with tequila slammers at four in resorts, while disposing of – or upgrading entrepreneurs such as Gordon ‘Butch’ Stewart and emerging risks associated with the all- the morning. And some of them do that for two – resorts that no longer match its upmarket and John Issa launched, then fine-tuned, the all- in market. n www.itij.co.uk 30 ASSISTANCE&HEALTHCAREWORLDMARKETS

Emerald Isle

lthough its Celtic Tiger economy has As a small country with a population of just Even the political and sectarian violence that Ireland attracts more than three million tourists fallen from grace, the Republic of 4.5 million people, an adequate transport cost more than 3,000 lives across the border in annually, with almost half of them coming Ireland is upgrading its accident and infrastructure, a temperate climate (temperatures Northern Ireland between the late 1960s and the from the UK and more than one million from emergency and medical evacuation rarely fall below freezing or rise above 22°C), few completion of a lengthy peace process in 2010 mainland Europe (mainly from France and services, with positive developments in both geographical extremes and no intractable endemic hardly affected the Republic – although the UK’s Germany), while the US is also an important Athe private and public sectors of its health diseases, the Republic of Ireland provides fewer Foreign and Commonwealth Office, erring on the market. However, tourism suffered severely in infrastructure. Robin Gauldie reports challenges for insurers and medical evacuation side of caution, still advises British travellers that 2010, with a 15-per-cent decrease in visitor providers than most travel destinations. there is an ‘underlying threat’ from terrorism. numbers and 500,000 fewer British visitors. International Travel Insurance Journal ASSISTANCE&HEALTHCAREWORLDMARKETS 31

Arrivals from the US and continental European dependence on acute hospitals, Ireland will need religious charities. The largest public hospitals, Embassy in Dublin, reporting to the US State markets also declined. 20,000 public hospital beds by 2020. Meeting with around 600 beds each, include Tallaght Department in Washington, cited overcrowded that need would call for a €4-billion investment Hospital in Dublin, University College Hospital hospitals and long waiting times for accident and Public provision and the opening of one new, 600-bed hospital in Galway and Cork University Hospital. emergency (A&E) treatment in Irish hospitals. Public health spending has increased dramatically each year until 2020. Given the country’s parlous The number of hospital beds actually declined In 2005, the then-US Ambassador James Kenny over the last four decades, partly as a result financial state, that is simply not an option. during Ireland’s boom years, from nine beds per reported to Washington that Ireland’s healthcare of regional funds being made available by the Creating an integrated health system – by 1,000 people in 1980 to five beds per 1,000 in system had not kept pace with the country’s European Union (EU) since Ireland’s accession doubling the number of day case beds, reducing 2005 – though this must be placed in the context economic rise and criticised the mixed private- in 1973, but critics say the money spent has not the time patients spend in hospital before and of quality versus quantity, with more beds in public healthcare structure. Kenny noted that necessarily translated into better care. after operations, expanding community services better and more up-to-date hospitals, fewer beds patients with private health insurance enjoyed In 2005, public health provision was restructured and increasing the number of critical care beds by in outmoded, smaller, local hospitals, and more quicker access to treatment and benefited from with the creation of the Heath Service Executive 25 per cent – would reduce demand for public modern medical techniques allowing shorter ‘subsidised public facilities’. “Public hospitals (HSE). Reorganisation of the national health inpatient care beds to fewer than 9,000 by 2020, patient stays and more efficient use of beds. often ring-fence up to 20 per cent of beds for service is ongoing, not without encountering say the review’s authors. Spending on hospital administration rose up to private use, even when uninsured patients some criticism. Currently, Ireland has 50 acute care public three-times faster than spending on beds, doctors on waiting lists have greater medical need,” A review by PA Consulting Group, commissioned hospitals across the country, 35 of which provide and nurses, according to some sources, and in Kenny said. by the HSE, has warned that Ireland can expect a accident and emergency services. Most public 2009 the HSE reported that there were 49,000 Inherent weaknesses in the system were 60-per-cent increase in demand for healthcare by hospitals are directly managed by the HSE, administrators within the public service for highlighted in January 2011, when an outbreak 2020 and says that the country is over-reliant on but a significant number are run by voluntary 62,000 front line staff. of the H1N1 swine flu virus swamped accident acute hospitals. organisations. In this overwhelmingly Roman In comments passed to the Wikileaks website and and emergency departments across the country. “To develop a world-class health system, we have Catholic country, most of these are linked to published in The Independent newspaper, the US At its peak, more than 560 patients were forced to replace outdated practices with modern ways of doing things that reflect the needs of patients,” said Prof. Brendan Drumm, the HSE’s chief executive officer. “The review tells us that more resources are not the only answer to improving access and reducing waiting times. Hospitals can reduce waiting times by simply modernising the way staff manage the passage of patients in and through their hospitals.” Without a new, integrated approach to reduce its

Ireland attracts more than three million tourists annually, with almost half of them coming from the UK and more than one million from mainland Europe

www.itij.co.uk 32 ASSISTANCE&HEALTHCAREWORLDMARKETS

Ireland has 50 acute care public hospitals across the country, 35 of which provide accident and emergency services

Dublin to wait on trolleys in hospital corridors and satisfied with the care received. waiting rooms before they could be treated. Costs for care and treatment compare favourably In June, the Irish government announced the with many developed nations such as the US. creation of a new Special Delivery Unit (SDU), Irish residents who are unemployed or earning to be established during the second half of 2011. lower incomes – around 30 per cent of the Tasked with cutting population – are eligible waiting lists, the SDU’s for the state medical card, priority will be to which entitles them to tackle accident and free hospital care, but emergency waiting In 2005, public those on higher incomes, times, according to and visitors, must pay fees Health Minister James health provision for some services. There is Reilly. Waiting times a flat €100 fee for patients in many A&E units was restructured attending accident and are ‘unacceptably emergency departments, high’, Reilly said, and with the creation of and a flat fee of €100 per frequently exceed day (up to a maximum the current six-hour the Heath Service €1,000) for inpatient waiting time target. care. However, there will be Executive All EU nationals carrying no new government a European Health funding for the SDU, Insurance Card (EHIC) which will instead be are entitled to same level financed from the budget of the existing National of healthcare as Irish citizens, as are visitors from Treatment Purchase Fund. Switzerland and other European Economic Area Meanwhile, the HSE has cut back accident states and – since 1998 – Australia. and emergency services in mid-western and northeastern regions and is similarly Private options reconfiguring A&E departments in Cork and Three major companies – Hibernian Aviva, Kerry. It has recently denied that it will curtail Quinn Healthcare and the state-owned VHI A&E services at St Columcille’s (Loughlinstown) Healthcare – offer private health insurance. Hospital, one of Dublin’s main hospitals, by the Private health insurance premiums are subsidised, end of the year, but health service employees’ attracting tax relief at source at the standard representatives have warned of impending chaos tax rate of 20 per cent, and encouraging some in the public hospital system, citing a shortage of 47 per cent of Irish people to take out private junior doctors and increasing demand. health cover. Despite gripes about long waiting lists from Irish While the public sector appears somewhat residents awaiting treatment within the public embattled as it attempts to come to terms with healthcare system, satisfaction with treatment, future trends, recent years have seen considerable professional staff and facilities is generally high, growth in private healthcare provision in with a survey conducted by the HSE in 2007 Ireland. Three of the country’s private hospitals showing up to 90 per cent of patients were are classified as ‘high-tech’ establishments, International Travel Insurance Journal ASSISTANCE&HEALTHCAREWORLDMARKETS 33

Waiting times in many A&E units are ‘unacceptably high’ … and frequently exceed the current six-hour waiting time target

search and rescue (SAR) services for the Irish well as Belfast and Derry, in Northern Ireland. Coast Guard, starting from 2012 and operating The company is headed by Keith Trower, from bases at Dublin, Waterford, Shannon and former director of managed care at AXA PPP Sligo. CHC already operates SAR missions from Healthcare, where he was responsible for travel these bases, but will provide enhanced services insurance and emergency medevac services. from next year, said CHC Ireland managing AMI is an approved air ambulance provider director Mark Kelly. for several leading travel insurers, including “Over the next decade, this contract will offer a MAPFRE Assistance, International SOS, Europ number of service improvements, including the Assistance, and the international assistance ability to deliver a paramedic to any SAR incident organisation Eurocross Assistance. within an hour anywhere on our coastline,” Kelly One reason for the apparent shortfall in private said. CHC’s Sikorksy S61-N helicopters will be sector air ambulance provision has been Ireland’s replaced by Sikorsky S92-As, custom-configured close proximity to the UK. With most of the for SAR work, from next year. Since February Republic coming well within the operational 2011, Coast Guard helicopter crews have been envelope of fixed-wing aircraft and helicopters upgraded to full air ambulance/paramedic status, operating from England, Wales or Scotland, UK- ensuring that all SAR flights have at least one based operators are able to meet the evacuation trained paramedic onboard. needs of British holidaymakers in Ireland, who Until recently, Ireland had no privately can of course also be transferred by road across operated air ambulance providers, a lack that the border into Northern Ireland (part of the was remedied in June 2010 with the launch UK) for treatment under the British National of Dublin-based AeroMedevac Ireland (AMI). Health Service. AMI operates a Cessna 500 Citation II aircraft Despite the financial vicissitudes of the last two configured around the PLUS modular advanced years – and despite grumbles about waiting life support system and AeroSled trauma lists from Irish residents and the Irish media sled platform and based at Weston Airport, – Ireland’s health and emergency medical 13 km from the city centre. It serves nine infrastructure is, in short, well fit for purpose as airports in the Republic – including Dublin, far as the international travel insurance industry Galway, Shannon, Sligo, Cork, Farranfore is concerned, and looks set to make further real (Kerry), Donegal, Waterford and Knock, as progress in the near future. n

including Beacon Hospital, which was opened to Jon Billings, HIQA’s director of healthcare, by the Pittsburgh-based global health enterprise quality and safety. According to the HSE, UPMC in 2006. The following year, it opened however, innovations such as the introduction the first emergency department attached to of an ‘Advanced Paramedic’ training programme an independent hospital in the eastern region, and a system of upskilling for the service’s and currently has 183 acute care beds and 14 1,200 paramedics have produced ‘significant dedicated critical care beds. improvements’ in patient care. Dublin’s Blackrock Clinic will complete a In the Dublin area, the NAS is complemented by five-year, €100-million investment in 2012, ambulance services provided by the Dublin Fire expanding to have more than 160 beds, to Brigade, and several private ambulance services become the first major acute hospital in Ireland also operate in tandem with the NAS. The longest to accommodate all patients in single rooms. established of these (founded in 1993) is Medicall, Mater Misericordia, with locations in Dublin and based in Dublin and providing nationwide Limerick, claims to be the only private hospital coverage with regional stations in Cork, Galway in Ireland to offer integrated, 24-hour 365-day and Monaghan. Through an agreement with intensive care and anaesthetic service. the recently launched air ambulance operator Ireland’s National Ambulance Service (NAS) AeroMedevac Ireland, Medicall also claims to was created in 2005, taking over from a offer a seamless transfer for air ambulance patients patchwork of services operated by regional to hospitals throughout the Republic and in health authorities, and since then the NAS Northern Ireland. has been criticised for its failure to match up to international rapid response standards. The Medevac matters HSE’s own statistics show that only around Currently, most emergency helicopter services one in four calls are responded to within eight are provided by the Irish Air Corps, with six minutes. Counter-intuitively, the problem is AgustaWestland AW139s and two Eurocopter at its worst not in remote rural areas but in EC135s. Operating out of Casement Air Corps Dublin, Ireland’s capital city. In January this base at Baldonnel, southwest of Dublin, and year (2011), Ireland’s Health and Quality with ranges of around 1,000 km and 745 km Information Authority (HIQA) announced an respectively, these helicopters can perform initiative aimed at ensuring that emergency evacuations from all parts of the country, including services should respond to ‘immediately life- remote areas and offshore islands. The Air Corps threatening calls’ within eight minutes. also has CASA CN235 and Learjet aircraft, which “The absence of such a system in Ireland has been can be used for air ambulance duties. a major gap in what is needed for a safe, good- Meanwhile, CHC Helicopter has won a renewed, quality emergency response service,” according 10-year contract worth €500 million to provide www.itij.co.uk 34 PROFILE Worldwide medical guide

ITIJ spoke to Pascaline Wolfermann, director How did this go, and what did you learn hospitals and air ambulance companies medical risk rating for 236 countries and territories; of resource development, Emergency from this process? abroad. How do you make sure these partners I spearheaded this project in partnership with Response Center, FrontierMEDEX, about The evacuations we conducted out of Egypt went continue to provide the standard of care Harvard Medical International and some other key her global travels and how it brought her to very well. We ultimately transported over 600 FrontierMEDEX requires year after year? consultants. It’s been a lot of fun. the assistance industry individuals out of the country during the situation. Focusing on the medical side (as this is the area I I am happy to work with our staff on complex These large-scale evacuations are always very oversee), our credentialing process has evolved medical evacuation – I am the globe/Google Earth Where were you born, where did you study, interesting events since this is when we really see the quite a bit over the last decade; from asking simple dictator as I keep emphasising how that tool is and where do you live now? benefit of our in-house departments collaborating to questions, we have defined very specific tools to key to what we do! I love working with our case I was born in Alsace, France, at the border of develop the most effective plan based on the fluidity not only gather documentation, but also to perform managers and team leaders: they are the ones Germany and Switzerland; I am half-Swiss, half- of the situation. If there was a particular challenge, audits for all kinds of providers, such as hospitals and doing the real work, making it all happen (very often French. I started studying English in Strasbourg, it was obtaining accurate information from clients outpatient clinics, hyperbaric centres, air ambulances under an incredible amount of stress due to the France, then graduated with a BA in history on a on the number of individuals they had in Egypt as and medical escorts or physicians. Unlike most delicate situation); they are an amazingly efficient and full scholarship from McPherson College in Kansas well as their passenger manifest requirements. This accreditation programmes out there, our audits passionate group of people always striving to provide and went on to complete a master’s degree in information is critical when developing plans. As include the technical/medical criteria, but they also the best solutions. Hats off to them. international relations at the Sorbonne, Paris. I am you can imagine, accurate information such as the value other components: language and cultural issues now based in Baltimore, MD, USA. number of individuals will impact the number and/ that our members could face, logistics (how far is the If you could work in any other profession, hospital from the airport? Is it is a safe area what would you be and why? What made you decide to of town?). These non-medical elements Apart from being an Olympic swimmer … which move to the US? can also impact the healthcare delivery to seems not to be happening! This is a long story … since I our members ... you can have a very well- As a student, I considered diplomacy or becoming was a kid, I have always been trained medical team available to treat you, an art curator. Later on, with my passion for the interested in working abroad but if you cannot communicate effectively international and medical assistance fields, I could – and that is why I studied and you feel at a complete loss in this new imagine going back to the humanitarian development international relations and was environment, you may not do well. world, once my daughter is grown. When I worked considering working in the French We do take into consideration some for an NGO, I felt a lot of the volunteers were not diplomatic corps. A three- external accreditation programmes such necessarily qualified to perform their job. They month internship at the French as EURAMI, CAMTS, JCI, and QHA were escaping from problems back home. With the Embassy in Washington, D.C. experience I will have by then, I’ll be able to make a quickly deterred me from this … real difference. too much politics – what was I expecting? Do you have any hobbies? In fact, I have not lived in France I love travelling and will explore independently for almost two decades (i.e. I I am the type of anywhere. Last year, I visited the UNESCO World moved when I turned five years Heritage ancient villages of Southern Anhui – Xidi old!). Before moving to the traveller that I do and Hongcun – in China with my daughter. I am the US 11 years ago, I had lived in type of traveller that I do not want to have as a client South America ­– in the Peruvian not want to have as I’m always going to remote places, not paying and Brazilian Amazon for seven attention to risks and just assuming everything will years – in really remote cities as a client end up fine! and villages on the river. Since I love art museums and always take advantage to visit I had loved my experience in museums near or far. the US as a student, when I My boss Susan Torroella introduced me to triathlons decided to leave South America, I two years ago and I have since competed in a few decided to pursue my passion for Trent, etc., but we do not rely solely on races and train consistently; I love swimming, but international medical assistance in these accreditations. After all, almost all the bike and run parts are more challenging and it a country I had always enjoyed; I hospitals in Saudi Arabia are JCI accredited, goes downhill after the swim! Aside from triathlons, moved to the US. while the care provided is not always I will do a three-mile (4.8-km) open-water swim in what we expect. Business practices and September to support cancer research. How did you come to ethics are also key in our credentialing work in the assistance process and we will not use air ambulance What are you reading at the moment? industry, and how did providers who broker – even if they are A few guidebooks as I am leaving for a site survey you come to your role at EURAMI or CAMTS accredited. Outside trip to Colombia, Ecuador and Peru at the end FrontierMEDEX? of regular site survey visits, we reassess the of the week. I will also pick up short stories from I was introduced to this field by a colleague during or size of aircraft we need to send in. It became a quality of the air ambulance or hospital after each Gabriel Garcia Marquez (Los Funerales de la Mama my master’s in international relations: I applied for a good opportunity to remind customers of our Travel case we have with them. Grande/The Funerals of the Big Mother) to get into summer assistance co-ordinator position at Europ Security Manager (TSM) tool, a real-time GDS I have seen that some air ambulance providers have the Colombian mood; his Spanish is so dense and Assistance in Paris and loved it, but at that time, I felt tracking tool. started sending our format to their clients to show accurate that it is always a nice challenge for me. I’ve it was only a ‘student job’. I never realised I could do their credentials, so I assume our questionnaire is also been reading a few books by Amelie Nothomb, this for real. When I finished my master’s, I went to What are your feelings about working with quite comprehensive! a Belgian writer; they are fun, witty and sarcastic and Peru to co-ordinate several medical projects for the other (rival) international assistance companies Our security department has the same process for it helps me keep up with French. One of my sisters NGO Doctors of the World. When I moved back to in disaster or mass evacuation situations, such vetting security providers. is a real literature expert and she would pull her hair the US, I realised that international medical assistance as Egypt and Haiti? Can this work? out at this last one! was the perfect mix for me: foreign languages, At this point, I do not think the issue is so much What are you most proud of – both assisting people in need, knowledge of geopolitics working with a ‘rival’; most assistance companies personally and professionally? Do you have any vacation plans? Where and logistics, geography, cultures, and experience in have friendly competition – we all know who will or It is awfully cliché, but I am obviously very proud would you like to visit next? the inconsistencies of medical care worldwide. After will not co-operate. The challenge is that during a of my 12-year-old daughter who was born in I think it’d be easier to ask where I would not want a couple of years with a medical assistance company crisis, it is difficult to work together when the bridges the Brazilian rainforest … in a hospital I would to go next … the list would be shorter. There are in Atlanta, I moved to FrontierMEDEX, assuming have not been built beforehand. During the crisis recommend anyone to be evacuated from! She has still so many countries I’d like to discover or re- responsibilities for the international medical network. itself, we all work so intensely and quickly that it is already travelled and lived in many countries; she is discover. The only places where you will not find My role quickly grew to also overseeing all aspects of challenging to co-ordinate with colleagues at that well grounded and incredibly flexible ... which she me are all-inclusive resorts as I enjoy exploring on international medical logistics while also focusing on time. The structure, protocols and channels should has to be in order to put up with me! my own and experiencing real life. Mixing culture mentoring staff as they co-ordinate complex medical be established before a crisis; some people in the Professionally, I feel very blessed I have had so (language, art, crafts, food) and nature is always evacuations. industry are trying to achieve this. many rich experiences, in many different countries appealing to me, so I am interested in countries like and I have always been able to adapt well. At Japan and Greece … I also want to explore further FrontierMEDEX was involved in evacuating FrontierMEDEX has a credentialing process FrontierMEDEX, I am very proud of MEDEX all the countries I consider home – the US, France, clients from Egypt during the recent unrest. for assessing the quality and suitability of 360m, our Global Medical Monitor that includes a Switzerland, Peru and Brazil. 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 36 SERVICEDIRECTORY To have your company listed in the Service Directory email: [email protected]

AMREF Flying Doctor Service Augsburg Air Ambulance Dr Bettina Vadera – Medical Director Roland Schoberth – Director Wilson Airport, LangataRoad, PO Box 18617, Nairobi, KENYA Roseggerstr 17, D-86368, Gersthofen, GERMANY

tel: +254 20 6000 090 email: [email protected] tel: +49 821 299 1020 email: [email protected] (AFRICA)

fax: +254 20 344 170 website: www.amref.org (EUROPE) tel: +49 821 299 2030 website: www.ambulanzflugdienst.de

Netcare 911 International Capital Air Charter Jacques Pienaar – Fixed Wing Operations Manager Lisa Humphries – Sales Director AIR AMBULANCE AIR AMBULANCE Riverview Park, Janadel Avenue, Midrand, SOUTH AFRICA Hangar 68, Exeter International Airport, EX5 2BA, UK

tel: +27 10 209 8392 email: [email protected] tel: +44 845 055 2828 email: [email protected] fax: +27 10 209 8405 website: www.netcare911.co.za fax: +44 1392 350 039 website: www.capitalaircharter.co.uk

West African Rescue Association DRK Assistance Florian Zagel – Managing Director Andreas Speich – Managing Director Klotey Cresent 6, North Labone, Accra, GHANA Aufm Hennekamp 71, 40225 Düsseldorf, GERMANY

24hr tel: +233 243 666 111 email: [email protected] tel: +49 211 301805-0 email: [email protected] tel: +233 302 781 258 website: www.westafrican-rescue.com fax: +49 211 301805-21 website: www.drkassistance.com ) AeroMed Asia Inc. European Air Ambulance Cindy Wong / Lorraine Paul – International Account Management Patrick Schomaker – Director Sales & Marketing SINGAPORE BANGKOK THAILAND 175A, rue de Cessange, L-1321, LUXEMBOURG

tel: +603 7965 3883 email: [email protected] 24hr tel: +49 711 7007 7007 email: [email protected] fax: +603 7629 8810 website: www.aeromed-asia.com fax: +49 711 7007 7009 website: www.air-ambulance.com AUSTRALASIA ( AirMed International LLC FAI – rent-a-jet AG Jeffrey T Tolbert – President Volker Lemke – Director Sales & Marketing Airport World Trade Center, 1 Sky Plaza Road, Flughafenstrasse 100, D-90268 Nuremberg, GERMANY Hong Kong International Airport, HONG KONG tel: +852 3756 3680 email: [email protected] tel: +49 911 36009 31 email: [email protected] fax: +852 3756 3681 website: www.airmedasia.com fax: +49 911 36009 59 website: www.rent-a-jet.de

CareFlight Group Greek Flying Doctors Medical and Tasking Centre Dimitris Kanellis – Manager PO Box 5078, Robina Town Centre, Queensland, 4230, AUSTRALIA 3 Doukisis Plakentias Str, 152 34 Halandri, Athens, GREECE

24hr tel: +61 7 5553 5955 email: [email protected] tel: +30 210 674 0600 email: [email protected] fax: +61 7 5553 5914 website: www.cmsairambulance.com fax: +30 210 674 0634 website: www.greekflyingdoctors.gr

CareFlight International IFRA Paul Smith – National Manager Dr Christian Steindl – Director Westmead Hospital Campus, PO Box 159, Westmead, NSW 2145, AUSTRALIA Bahnhofplatz 13/5, POB 160, 3500 Krems, AUSTRIA

tel: (+61) 2 9893 7683 email: [email protected] tel: +43 2732 825 610 email: [email protected] fax: +61 2 9689 2744 website: www.careflight.org fax: +43 2732 851 01 website: www.ifra.at

Flying Doctors Asia Jet Executive International Charter Prithpal Singh – CEO , Director Irena Dimitrijevic – Marketing & Sales 313 Old Bird Cage Walk, #01-15/02-16, Seletar Airport, Mündelheimer Weg 50, D-40472, Düsseldorf, GERMANY SINGAPORE “Homebase FRA & MUC” 24hr tel: +65 9297 7757 email: [email protected] tel: +49 211 602 7775 email: [email protected] fax: +65 6483 5407 website: www.flyingdoctorsasia.com fax: +49 211 602 77766 website: www.jetexecutive.com

Hope Medflight Asia Pte Ltd Mayoral Executive Jet Dr Charles Johnson – Medical Director Juan Carlos García Caparrós – Commercial Director 2 Loyang Lane 03-01, Singapore 508913, SINGAPORE Dominguez Toledo S.A., 118 La Orotava, Malaga 29006, SPAIN

24hr tel: +65 6100 1911 email: [email protected] tel: +34 952 048 609 email: [email protected] fax: +65 6400 5254 website: www.hope-flight.com fax: +34 924 048 612 website: www.mayoralaviation.com

Medic’Air International 每递安国际 Medic’Air International Dr Huaqun Gao – Medical Director Dr Herve Raffin – General Manager 885 Renmin Road, Huaihai China Building, Room 808, 200010 Shanghai, CHINA 35 rue Jules Ferry, 93170 Bagnolet, Paris, FRANCE

tel: +86 2163 558289 email: [email protected] tel: +33 141 72 1414 email: [email protected] fax: +86 2163 558285 website: www.medic-air.com fax: +33 148 57 1010 website: www.medic-air.com

ADAC-Ambulance Service North Flying a/s Robert Glueck – Marketing & Sales Director Jesper Kragelund – Sales Manager Am Westpark 8, 81373 Munich, GERMANY North Flying Terminal, Aalborg Airport, DK-9400, Nørresundby, DENMARK

tel: +49 89 76 76 52 85 email: [email protected] tel: +45 9632 2900 email: [email protected] (EUROPE) 24h Alarm: +49 89 76 76 50 05 website: www.adac.de/ambulance fax: +45 9632 2909 website: www.northflying.com

Air Medical Ltd Redstar Aviation Glenn Salt – Flight Operations Manager Mustafa Atac – CEO Oxford Airport, Kidlington, Oxfordshire OX5 1QX, UK Sabiha Gokcen International Airport, J Blok Kurtkoy, 34912 Istanbul, TURKEY

tel: +44 1865 842 887 email: [email protected] tel: +90 216 588 0216 email: [email protected] tel: +44 1865 370 642 website: www.airmed.co.uk fax: +90 216 588 0225 website: www.redstar-aviation.com

International Travel Insurance Journal call +44 (0) 117 925 5151 To make an alteration to a listing email: [email protected] SERVICEDIRECTORY 37

) Swiss Air Ambulance / Rega AIMS Peter Meierhans – Director of Sales Bernadette Breton – Managing Director PO Box 1414, Zurich Airport, CH-8058, SWITZERLAND Private Bag X5, Benmore Gardens 2010, Johannesburg, SOUTH AFRICA

tel: +41 333 333 333 email: [email protected] (AFRICA) tel: +00 27 11 783 0135 email: [email protected] EUROPE

( fax: +41 44 654 3590 website: www.rega.ch fax: +00 27 11 783 2950 website: www.aims.org.za

Tyrol Air Ambulance AMREF Flying Doctor Service Jakob Ringler – Managing Director Dr Bettina Vadera – Medical Director AIR AMBULANCE PO Box 81, A-6026, Innsbruck Airport, AUSTRIA Wilson Airport, Langata Road, PO Box 18617, Nairobi, KENYA

tel: +43 512 224 220 email: [email protected] tel: +254 20 6000 090 email: [email protected] fax: +43 512 288 888 website: www.taa.at fax: +254 20 344 170 website: www.amref.org ASSISTANCE COMPANIES ASSISTANCE

Aero Jet International Interhealth Technologies Stuart Hayman – President Kevin Thomas – Director - International 4631 NW 31st Avenue, #220 Ft Lauderdale, FL 33309, USA P O Box 3058, Bedfordview 2008, SOUTH AFRICA

tel: +1 954 730 9300 email: [email protected] tel: +27 11 622 8010 email: [email protected] fax: +1 954 485 6564 website: www.aero-jet.com fax: +27 11 622 8264 website: www.interhealth.net

Air Ambulance Professionals, Inc. Medical Services Organisation (MSO) Brian L. Weisz – President Vernon Pillay – Operations Director - International Division (NORTH AMERICA) Ft. Lauderdale Executive Airport, 1535 South Perimeter Rd, PO Box 1578, Gallo Manor, 2052, SOUTH AFRICA Hangar 36B Ft. Lauderdale, Florida 33309, USA tel: +1 954 491 0555 email: [email protected] tel: +27 (0)11 259 5403 24hr email: [email protected] fax: +1 954 491 6114 website: www.airambulanceprof.com fax: +27 (0)11 259 5001 website: www.mso.co.za

Air Ambulance Specialists Netcare 911 International Tom Cox – Director of Business Development Louis Mabele – International Assistance Operations Manager 345 Inverness Drive South, Suite A110, Englewood, Colorado, 80112, USA Riverview Park, Janadel Avenue, Midrand, SOUTH AFRICA

tel: +1 720 875 9182 email: [email protected] tel: +27 (0)10 209 8387 24hr email: [email protected] fax: +1 720 875 9183 website: www.airaasi.com fax: +27 (0)10 209 8405 website: www.netcare911.co.za

AirMed International LLC West African Rescue Association Jeffrey T Tolbert – President Florian Zagel – Managing Director 1000 Urban Center Drive, Suite 470, Birmingham, AL 35242, USA Klotey Cresent 6, North Labone, Accra, GHANA

tel: +1 205 443 4840 email: [email protected] tel: +233 244 312 496/7 email: [email protected] fax: +1 205 443 4841 website: www.airmed.com fax: +233 21 781 259 website: www.westafrican-rescue.com

Global Jetcare, Inc. On Call International

Bart Gray – President Michael J. Kelly – President & CEO 16479 Runway Drive, Brooksville, FL 34604, USA One Delaware Drive, Salem, NH 03079, USA NEW tel: +1 352 799 7771 email: [email protected] tel: + 888 289 0567 email: [email protected] fax: +1 352 799 7776 website: www.globaljetcare.com fax: +1 603 328 1770 website: www.oncallinternational.com (AMERICAS) JET ICU GORAL ASSISTANCE CANADA INC. Mike Honeycutt – President David Ohayon – Local Manager 2561 Rescue Way, Brooksville, FL 34604, USA 2335 Stevens St, VSL, Montreal, QC H4M 1H1, CANADA

tel: +1 352 796 2540 email: [email protected] tel: +1 514 4481343 email: [email protected] fax: +1 352 796 2549 website: www.jeticu.com fax: +1 514 4481835 website: www.goralassist.com

Latitude Air Ambulance SelectCare Worldwide Jeff McIntosh Magdi Riad – President CANADA #1201, 438 University Avenue, Toronto M5G 2K8, CANADA USA tel: +1 289 426 1133 email: [email protected] tel: +1 416 340 7265 email: [email protected] fax: + 1 289 426 1134 website: www.latitude2009.com toll free: +1 866 261 6718 website: www.selectcareworldwide.com

LIFESUPPORT Patient Transport World Travel Protection Graham Williamson – CEO David McLean – Vice President, Sales & Marketing #9-1009 Allsbrook Road, Parksville, British Columbia, V9P 2A9, CANADA 400 University Avenue, 15th Floor, Toronto, ON, M5G 1S7, CANADA

tel: +1 250 947 9641 email: [email protected] tel: +1 416 205 4646 email: [email protected] fax: +1 877 288 2908 website: www.LifeSupportTransport.com fax: +1 416 205 4676 website: www.wtp.ca

Skyservice Air Ambulance Assistance Online David Ewing – VP International Business Development Bertrand Guichoux – CEO Montreal/PE Trudeau Int Airport, 9785 Avenue Ryan, Montreal (Quebec), Zendai Cube Edifice 6/F, 58, Changliu Road, Pudong, 200135 Shanghai, CHINA H9P 1A2, CANADA tel: +1 514 497 7000 email: [email protected] tel: +86 21 6104 9500 email: [email protected] fax: +1 514 636 0096 website: www.skyservice.com/airambulance fax: +86 21 6104 9484 website: www.assistanceonline-china.com

To have your company listed in our service directory (AUSTRALASIA) Dynamiq Janine Benson – Director of Emergency Assistance contact the sales department now: Level 5/33 York St, Sydney 2000, NSW, AUSTRALIA [email protected] or telephone: +44 (0)117 922 66 00 tel: +61 (0) 2 9978 6600 email: [email protected] fax: +61 (0) 2 9888 3609 website: www.dynamiq.com.au/assist

www.itij.co.uk 38 SERVICEDIRECTORY To have your company listed in the Service Directory email: [email protected]

First Assistance Marm Assistance Mary-Jo McDonald – CEO Jill Atac – CEO PO Box 17-310, Greenlane, Auckland, NEW ZEALAND Sabiha Gokcen International Airport, J Blok Kurtkoy, 34912 Istanbul, TURKEY

tel: +64 9 356 1650 email: [email protected] tel: +90 216 588 0588 email: [email protected]

fax: +64 9 525 1278 website: www.firstassistance.co.nz (EUROPE) fax: +90 216 588 0602 website: www.marmassistance.com

Global Assistance & Healthcare med con team GmbH

(AUSTRALASIA) Mario Babin – Chief Executive Officer Michael Weinlich – Managing Director Cilandak Commercial Estate - # 111 GC, Jl. Raya Cilandak KKO, Gerhard-Kindler-Str.6, 72770 Reutlingen, GERMANY Jakarta 12560, INDONESIA tel: +62 21 299 78 999 email: [email protected] tel: +49 7121 433 660 email: [email protected] fax: +62 21 299 78 9555/66 website: www.global-assistance.net fax: +49 7121 433 619 website: www.medconteam.com ASSISTANCE COMPANIES ASSISTANCE ASSISTANCE COMPANIES ASSISTANCE ADAC-Ambulance Service ONE Assist Robert Glueck – Marketing & Sales Director Linda Norman – Group Client Relationship Manager C/Cardenal Rossell No.1, Esc. A 2˚. Desp 8-9, Palma de Mallorca 07007, Baleares, Am Westpark 8, 81373 Munich, GERMANY SPAIN tel: +49 89 76 76 52 85 email: [email protected] tel: +44 (0) 1992 708 700 email: [email protected]

(EUROPE) 24h Alarm: +49 89 76 76 50 05 website: www.adac.de/ambulance 24 tel: +44 (0) 1992 405 718 website: www.oneassist.com

Altas Assistance Save Assistance France Arvydas Bebravi˘cius – Managing Director Franck Molinier – Director of Business Development Lentvario Str. 7, Lt-02300 Vilnius, LITHUANIA 19 rue de Provence, 78310 Maurepas, FRANCE

tel: +370 5 264 4020 email: [email protected] tel: +33 13062 6752 email: [email protected] fax: +370 5 264 4021 website: www.altas-assistance.lt 24 tel: +33 13062 1122 website: www.saveassistance.com

AP Companies Savitar Natalya Butakova – Business Development Manager Lydia Semchenkova – Business Development Manager 17 Varshavskoye Shosse, Moscow 117105, RUSSIA 25/1, 7th Floor, Trubnaya Str., Moscow, 127051, RUSSIA

tel: +7 495 989 1120 email: [email protected] tel: +7 495 987 1775 email: [email protected] fax: +7 495 989 1130 website: www.ap-companies.ru fax: +7 495 987 1776 website: www.savitar-gr.com

ARC Europe SA SOS International Hans Biekmann – Network Director Helle Drager Sandahl – Communications & Marketing Manager Avenue des Olympiades 2, 1140 Brussels, BELGIUM Nitivej 6, DK-2000 Frederiksberg, Copenhagen, DENMARK

tel: +32 2 706 6660 email: [email protected] tel: +45 7010 5055 email: [email protected] fax: +32 2 706 6601 website: www.arceuropemedical.com fax: +45 7010 5056 website: www.sos.eu

CNAS TBS Team 24 d.o.o Carole Luisy – Managing Director Edvard Hojnik – General Manger 80 rue des alliés, 38100, Grenoble, FRANCE CROATIA, SLOVENIA, SERBIA, MNE, BH, KOS, MAC

tel: +33 438 49 83 49 email: [email protected] tel: +386 2616 5819 email: [email protected] fax: +33 438 49 83 40 website: www.cnas-assistance.com fax: +386 2618 5800 website: www. tbs-team24.com

DRK Assistance CONNEX Assistance Middle East Andreas Speich – Managing Director Lara Helmi – International Network Director Aufm Hennekamp 71, 40225 Düsseldorf, GERMANY Office 703, Block B, Belrasheed Towers, Qusais, Dubai, UAE

tel: +49 211 301805-0 email: [email protected] tel: +97 14 257 82 84 email: [email protected] fax: +49 211 301805-21 website: www.drkassistance.com fax: +97 14 257 82 85 website: www.connexassistance.com (MID. EAST)

Global Assistance a.s. GORAL ASSISTANCE LTD Petr Bold – General Manager Marcel Kadoche – International Network and Development Manager Dopraváku˚ 749/3,184 00 Prague 8, CZECH REPUBLIC Maskit 27 str. Herzeliya Industrial Park 46733, ISRAEL NEW tel: +420 266 799 770 email: [email protected] tel: +972 9 9579930 email: [email protected] fax: +420 266 799 797 website: www.1220.cz fax: +972 9 9579931 website: www.goralassist.com

Global Voyager Assistance - Russia IES Medical Costas Danilenko – CEO Eitan Kariv – CEO PO Box II, 125124 Moscow, RUSSIA 2 Yagea Kapaim Street, Tel Aviv, ISRAEL

tel: +7 495 775 0999 email: [email protected] tel: +972 3 639 9990 email: [email protected] fax: +7 495 775 0998 website: www.gvassistance.com fax: +972 3 687 2950 website: www.iesmedical.co.il

Global Voyager Assistance - Black Sea Dr Colin Plotkin & Sons Consulting INC. Olga Turubarova – General Manager Dr Colin Plotkin – Managing Director 77-79 Nezhinskaya Str., 65023, Odessa, UKRAINE 27-3088 Francis Road, Richmond, British Columbia V7C 5V9, CANADA

tel: +38 048 7373 441 email: [email protected] tel: +1 604 241 9677 email: [email protected] fax: +38 048 7373 442 website: www.gvassistance.com fax: +1 604 241 0733 website: www.plotkinconsulting.com

Greek Flying Doctors To have your company listed in our service directory

Dimitris Kanellis – Manager CATASTROPHIC 3 Doukisis Plakentias Str, 152 34 Halandri, Athens, GREECE contact the sales department now:

tel: +30 210 674 0600 email: [email protected] CLAIMS SPECIALISTS [email protected] or telephone: +44 (0)117 922 66 00 fax: +30 210 674 0634 website: www.greekflyingdoctors.gr

International Travel Insurance Journal call +44 (0) 117 925 5151 To make an alteration to a listing email: [email protected] SERVICEDIRECTORY 39

AIMS UnitedHealth International Bernadette Breton – Managing Director Philip Brun – Vice President of Sales & Service Private Bag X5, Benmore Gardens, 2010 Johannesburg, SOUTH AFRICA 3100 SW 145 Avenue, Miramar, FL 33027, USA

tel: +00 27 11 783 0135 email: [email protected] tel: +1 954 378 0694 email: [email protected] (AFRICA) fax: +00 27 11 783 2950 website: www.aims.org.za fax: +1 954 378 0771 website: www.uhgi.com (AMERICA) COST CONT. Interhealth Technologies Global Assistance & Healthcare Kevin Thomas – Director - International Mario Babin – Chief Executive Officer Cilandak Commercial Estate - # 111 GC, Jl. Raya Cilandak KKO, P O Box 3058, Bedfordview 2008, SOUTH AFRICA Jakarta 12560, INDONESIA COST CONTAINMENT tel: +27 11 622 8010 email: [email protected] tel: +62 21 299 78 999 email: [email protected] fax: +27 11 622 8264 website: www.interhealth.net fax: +62 21 299 78 9555/66 website: www.global-assistance.net

Medical Services Organisation (MSO) Global Excel Management Vernon Pillay – Operations Director - International Division Michael Drew – Vice President of Sales 73 Queen St, Sherbrooke, QC J1M 0C9, CANADA PO Box 1578, Gallo Manor, 2052, SOUTH AFRICA 17548 Deer Isle Circle, Winter Gdn, FL 34787, USA tel: +27 (0)11 259 5403 24hr email: [email protected] tel: +1 866 566 1130 email: [email protected] fax: +27 (0)11 259 5001 website: www.mso.co.za fax: +1 819 566 8335 website: www.globalexcel.ca CLAIMS MANAGEMENT

ChargeCare International Interhealth Technologies Christiane Burniston – Managing Director Kevin Thomas – Director - International Monument Business Park, 1D Park Offices, Warpsgrove Lane, Chalgrove, Oxford, UK P O Box 3058, Bedfordview 2008, SOUTH AFRICA

(EUROPE) tel: +44 1865 400 007 email: [email protected] tel: +27 11 622 8010 email: [email protected] fax: +44 845 003 9923 website: www.chargecareinternational.co.uk fax: +27 11 622 8264 website: www.interhealth.net

Marm Assistance ONE Claims Jill Atac – CEO Linda Norman – Group Client Relationship Manager Sabiha Gokcen International Airport, J Blok Kurtkoy, 34912 Istanbul, TURKEY 1-4 Limes Court, Conduit Lane, Hoddesdon, Hertfordshire EN11 8EP, UK

tel: +90 216 588 0588 email: [email protected] tel: +44 (0) 1992 708 700 email: [email protected] fax: +90 216 588 0602 website: www.marmassistance.com 24 tel: +44 (0) 1992 405 718 website: www.oneassist.com

Medical Claims International Spain SelectCare Worldwide Fatima Guillen Grande – Managing Director Magdi Riad – President C/Ciudad de Aguilas No.2, Local 2A, Madrid 28030, SPAIN #1201, 438 University Avenue, Toronto M5G 2K8, CANADA

tel: 00 34 913 016 145 email: [email protected] tel: +1 416 340 7265 email: [email protected] fax: 00 34 913 016 160 website: www.mcimanager.com toll free: +1 866 261 6718 website: www.selectcareworldwide.com

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

Global Medical Management LIFESUPPORT Patient Transport Raija Itzchaki – COO Graham Williamson – CEO (NORTH AMERICA) 1300 Concord Terrace, Suite 300, Sunrise, Florida 33323, USA #9-1009 Allsbrook Road, Parksville, British Columbia, V9P 2A9, CANADA

tel: +1 954 370 6404 email: [email protected] tel: +1 250 947 9641 email: [email protected] fax: +1 954 370 8613 website: www.gmmusa.com fax: +1 877 288 2908 website: www.LifeSupportTransport.com

Olympus Managed Healthcare SPECIALISTS 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 COMM. REPATRIATION fax: +44 (0)117 925 5940 website: www.voyageur24.com

OneWorld Assist ADAC Taka Katsube – Director Assistance & Cost Managment Christoph Ullrich – Director of Purchase / International Network 10th Floor, 6081 No.3 Road, Richmond, BC V6Y 2B2, CANADA Am West Park 8, 81373 Munich, GERMANY

tel: +1 604 303 2113 email: [email protected] tel: +49 89 7676 2912 email: [email protected] fax: +1 604 276 4593 website: www.oneworldassist.com 24hr Alm: +49 89 7676 5005 website: www.adac.de/ambulance TRANSPORT SelectCare Worldwide Lufthansa Medical Services Magdi Riad – President Doris Ehring – Manager Sales & Marketing Lufthansa German Airlines, Lufthansa Base, FRA SX/M, D-60546, #1201, 438 University Avenue, Toronto M5G 2K8, CANADA Frankfurt/Main, GERMANY tel: +1 416 340 7265 email: [email protected] tel: +49 (0)69690-20904 email: [email protected] toll free: +1 866 261 6718 website: www.selectcareworldwide.com fax: +49 (0)69690-58147 website: www.dlh.de CRITICAL CARE PATIENT CRITICAL CARE PATIENT

Star Healthcare Albin Repatriation Ltd Gigi Galen – President Emerson De Luca – General Manager 850 7th Avenue, Suite 803, New York, 10019, USA 83 Westbourne Grove, Bayswater, London W2 4UL, UK

tel: + 1 212 581 8228 email: [email protected] tel: +44 20 7313 6920 email: [email protected] FUNERAL fax: + 1 212 581 8272 website: www.starhealthcarenet.com DIRECTOR fax: +44 20 7313 6999 website: www.albininternational.com

www.itij.co.uk 40 SERVICEDIRECTORY To have your company listed in the Service Directory email: [email protected]

Funeral Home AURIGA Ltd. Vejthani Hospital Helen Pradova – Chief of International Department Lauranee Sirikasem – Assistant Marketing Director 1 Ladprao Road 111, Klong-Chan Bangkapi, Bangkok 10240, B. Nmcové Street 1052/1, 412 01 Litomerice, CZECH REPUBLIC (ASIA) THAILAND tel: +420 724 257 899 email: [email protected] tel: (+66)-2-734-0000 email: [email protected] fax: +420 416 735 800 website: www.funeral-assistance.cz fax: (+66)-2-370-1596 website: www.vejthani.com HOSPITALS HOSPITALS

Funeralcare International CareFlight Group Louisa Killen – Repatriation Specialist Medical and Tasking Centre Murray House, 50 Whitta Road, Manor Park, London, Essex E12 5DA, UK PO Box 5078, Robina Town Centre, Queensland, 4230, AUSTRALIA

FUNERAL DIRECTORS tel: +44 20 8788 5303 email: [email protected] 24hr tel: +61 7 5553 5955 email: [email protected] fax: +44 20 8788 2525 website: www.co-operativefuneralcare.co.uk fax: +61 7 5553 5914 website: www.cmsairambulance.com

John Allison Monkhouse Co., Ltd (Thailand) CareFlight International

Pim Karnasuta – General Manager (AUSTRALASIA) Sue Robshaw – Co-ordinator Westmead Hospital Campus, PO Box 159, Westmead, NSW 2145, 89/7 MOO 19, Soi Yingcharoen, Bangplee, Samutprakarn 10540, THAILAND AUSTRALIA tel: +66 2382 5345-7 email: [email protected] tel: +61 1300 655 855 email: [email protected] fax: +66 2261 7939 website: www.monkhouse.com.au fax: +61 2 9689 2744 website: www.careflight.org

Lutece International Medic’Air International 每递安国际 Zouhaier Hertelli – Repatriation Specialist Dr Huaqun Gao – Medical Director 56 rue Olivier de Serres, 75015 Paris, FRANCE 885 Renmin Road, Huaihai China Building, Room 808, 200010 Shanghai, CHINA

tel: +33 1 56 08 00 23 email: [email protected] tel: +86 2163 558289 email: [email protected] fax: +33 1 56 08 00 43 website: www.pflutece.com fax: +86 2163 558285 website: www.medic-air.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 Greek Flying Doctors Melanie Walkling – Partner Dimitris Kanellis – Manager 299-305 Whitehorse Road, West Croydon, Surrey CR0 2HR, UK 3 Doukisis Plakentias Str, 152 34 Halandri, Athens, GREECE

tel: +44 20 8684 2324 email: [email protected] tel: +30 210 674 0600 email: [email protected] fax: +44 20 8684 8000 website: www.rowlandbrothersinternational.co.uk (EUROPE) fax: +30 210 674 0634 website: www.greekflyingdoctors.gr

Servilusa Redstar Aviation Vanda Castro – Manager International Department Mustafa Atac – CEO Agencias Funerarias SA, International Dept. Rua do Sabiha Gokcen International Airport, J Blok Kurtkoy, 34912 Istanbul, TURKEY Entreposto Industrial, 8-2 Esq, 2610-135 Amadora, PORTUGAL tel: +35 121 470 6300 email: [email protected] tel: +90 216 588 0216 email: [email protected] fax: +35 121 470 6499 website: www.servilusa.pt fax: +90 216 588 0225 website: www.redstar-aviation.com

USP Hospitales S.L Voyageur Aeromedical Travel Francisco Rico – International Relations Manager Marc Lucas – General Manager C/Miguel Angel, 23 3˚, 28010 Madrid, SPAIN Voyageur Buildings, 43 Colston Street, 43 Colston Street, Bristol BS1 5AX, UK

tel: + 34 951 91 30 30 email: [email protected] tel: +44 (0)117 927 3554 email: [email protected]

(EUROPE) fax: + 34 951 91 30 40 website: www.usphospitales.com fax: +44 (0)117 925 5940 website: www.voyageur24.com HOSPITALS HOSPITALS Baptist Health South Florida International Services AMREF Flying Doctor Service Yohandra Fuentes – Assist V-P/Int. Insurance Dev. & Revenue Mangement Dr Bettina Vadera – Medical Director 8940 North Kendall Drive, Suite 601-E, Miami, Fl 33176, USA Wilson Airport, Langata Road, PO Box 18617, Nairobi, KENYA

tel: +1 786 596 2373 email: [email protected] tel: +254 20 6000 090 email: [email protected] fax: +1 786 596 5979 website: www.baptisthealth.net/international fax: +254 20 344 170 website: www.amref.org (N AMERICA) Integrated Healthcare Services StandbyMD Brenda Escobar - International Program Coordinator Alex Sánchez – Managing Director 450 E. Las Olas Blvd., Ft. Lauderdale, FL 33301, USA 777 Brickell Avenue, Suite 1370, Miami, Florida 33131, USA MEDICAL PROVIDER tel: + 1 305 222 6750 email: [email protected] tel: +1 305 459 4882 email: [email protected] tel: + 1 305 222 6751 website: www.hcaeastflorida.com fax: +1 305 421 5575 website: www.standbymd.com

Jackson Memorial Hospital International Voyageur Aeromedical Travel Luis Felipe Arango – Vice President of International Business Marc Lucas – General Manager Jackson Medical Towers, East Tower, Suite 829, Voyageur Buildings, 43 Colston Street, Bristol BS1 5AX, UK 1500 NW 12th Avenue, Miami, FL 33136 - 9998, USA TRAVEL TRAVEL

24hr tel: + 1 305 355 1212 email: [email protected] AGENTS tel: +44 (0)117 927 3554 email: [email protected] tel: + 1 305 355 5544 website: www.jmhi.org fax: +44 (0)117 925 5940 website: www.voyageur24.com

University of Miami Health System V Creative Design Jose Quesada M.D., M.B.A. – Director Finance & Operations Steve Annette – New Media Director 1099 N.W. 14th Street, Miami, Florida 33136, USA Voyageur Buildings, 43 Colston Street, Bristol BS1 5AX, UK

tel: +1 305 243 9100 email: [email protected] tel: +44 (0)117 929 4636 email: [email protected] fax: +1 305 243 9101 website: www.uhealthinternational.com fax: +44 (0)117 925 2040 website: www.vcreativedesign.co.uk WEB & MEDIA ADVERTISING

International Travel Insurance Journal call +44 (0) 117 925 5151 To make an alteration to a listing email: [email protected] SERVICEDIRECTORY 41

www.itij.co.uk 42 REGULARS

• GRAPEVINE • GRAPEVINE • GRAPEVINE • GRAPEVINE • GRAPEVINE • GRAPEVINE • GRAPEVINE • GRAPEVINE • GRAPEVINE• GRAPEVINE • GRAPEVINE • GRAPEVINE • GRAPEVINE GRAPEVINE • GRA PEVINE VINE GRAPE - - Grapevine say in Tunisia that some people receive heavy- Sanderson, spokesman for the ambulance station handed treatment.” where the paramedic is based, said: “Ambulance The revolution, which occurred at the beginning crews have to make quick decisions and think on of the year, resulted in a significant drop in their feet. They have access to a language line and tourist bookings for the summer period, with carry multilingual phrasebooks, but Nicola used coastal areas hit particularly hard and hotels her initiative with the iPhone app.” closing, worsening the country’s unemployment figures. Tourism is a key source of revenue for Tunisia, accounting for around 6.5 per cent of its gross domestic product and accounting for the employment of one in five Tunisian people, both directly and indirectly.

Turtle power for laying eggs – it is a naturally provided maternity Beware sat ward. When your airport is virtually surrounded by water, your neighbours can sometimes come nav help! We all know that the Teenage Mutant Ninja in the hard shell variety!” Turtles had the power to save people from the An American tourist in the UK was recently evil Shredder, but some turtles from New York looking forward to her trip to the famed Windsor showed their own power recently, as their Tunisian tourist Castle (also scene of a recent ITIC), and, not migration to a beach to lay their eggs shut down knowing the way, she typed Windsor Castle into one of the runways at John F. Kennedy Airport. board laughs off Life-saving her sat nav. A couple of hours later, she arrived The turtles were making their way towards a at her destination – only it wasn’t quite what she beach from the bay that surrounds the airport, revolution language app expected. Instead of delivering her to the regal and crossed the runways with no regard for In an attempt to show tourists that Tunisia is once abode, the faithful sat nav had taken her to the passing aircraft. Reports of obstacles on the again open for business, the tourist board in the A paramedic in the UK had to think quickly Windsor Castle Pub in Western Super Mare on runway came in from pilots just as the airport was country is poking fun at the recent violent uprising, recently when she was asked to treat a Polish the other side of the country. Andrew Cassidy, reaching its busiest time of day. One pilot said: “Be partnering pictures of the country’s most popular patient who did not speak any English. Nicola assistant manager of the pub, said: “I have been advised 30 feet into the take-off roll, left side of areas with ironic statements about the perception Draper, though, is most definitely part of the working here for six years and have always the centreline, there’s another turtle.” of what it is like on the ground currently. As an 21st-Century generation, and reached straight wanted someone to come in and say that and it Jet Blue reported the turtle issue on Twitter, example, one picture of some well-preserved for her iPhone, downloading an online medical has finally happened. It was funny because she had saying: “Running over turtles is not healthy for ancient Roman ruins is run atop the slogan: Polish translator tool. She said: “It’s a great tool. her sat nav, iPod and phone and even with all that them and nor is it good for our tyres.” The New “They say Tunisia is nothing but ruins.” Another It allowed me to communicate with the patient technology, she ended up here.” Perhaps instead York Port Authority said of the incident: “The advertisement for the country shows a woman without the need for an interpreter or the cost of watching the changing of the guard, she got to VCD-121-qtrstrip-p39.pdf 1 24/01/2011 16:08 sandy spot on the other side of Runway 4L is ideal receiving a massage, with the message: “They to the service of using the language line.” Gary see the changing of the barrels! (Ahem).

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International Travel Insurance Journal ONTHEMOVE 43

Swiss Re completes InterGlobal shake-up appoints Connett

Swiss Re has said that the appointment of Christian International private medical insurer InterGlobal Mumenthaler as chief executive of the company’s has appointed Linda Connett as business reinsurance subsidiary, Swiss Reinsurance Company development manager, with responsibility for Ltd, marks the culmination of its leadership revamp. building distribution and sales of individual and It described the re-shaping, which began with a share group PMI in the UK through the intermediary exchange offer – first announced in mid-February channel. Connett brings over 20 years’ and declared successful in May – as ‘enhancing client experience in health insurance and employee focus, to increase capital efficiency and transparency, benefits to InterGlobal, having previously worked and to create long-term value for shareholders’. for international health insurance providers Mumenthaler was named as chief marketing officer Goodhealth Worldwide (now Aetna International), for Swiss Re in January, with responsibility for leading Medicare and PPP Healthcare (now AXA PPP). and growing the firm’s core reinsurance business. She has also gained significant experience in the From 1 October, he will become chief executive of international employee benefits sector with Lorica Swiss Reinsurance Company Ltd, taking on additional and joins InterGlobal from Sword Health, a health responsibility for the reinsurance subsidiary’s entire insurance software provider, where she was business performance, including responsible for Mary-Jo McDonald financial results, capital and asset sales and client Luca Marighetti allocation. Stefan Lippe remains chief support. McDonald executive of the parent group, Swiss Paul Weigall, Re Ltd, in charge of implementing group head Marighetti joins promoted to CEO group strategy, overseeing and taking of sales and ultimate responsibility for all businesses. marketing for Zurich First Assistance in New Zealand has announced the InterGlobal, appointment of Mary-Jo McDonald as its new chief said of the Zurich Financial Services Group has announced executive officer (CEO). McDonald’s appointment appointment: the appointment of Luca Marighetti to the position comes after five years as the company’s general “With many of group head of strategy – the appointment was manager (GM) and 10 years in the insurance companies in effective from 1 July. Marighetti replaces Christian and assistance industry. Over her tenure as GM, the UK seeking Carl, who is to focus fully on his other function as McDonald helped to expand the company’s global IRM appoints growth from group head of mergers and acquisitions. In his new operations, with several major contracts signed overseas markets role, Marighetti will be responsible for leading the with insurers in the UK, Europe and Australia in new head of and seconding process of defining Zurich’s group strategy. He will recent years. partnership staff overseas, ensure a strong link to the planning process and First Assistance executive chairman Murray Berkett the IPMI sector support the chief executive officer in reviewing acknowledged McDonald’s strategic direction continues to existing strategies and monitoring execution. He will and profile in the industry as key factors in this The Institute of Risk Management grow. InterGlobal report directly to chief executive officer Martin Senn appointment: “Mary-Jo brings substantial experience (IRM) has announced the Linda Connett already has a and be based in Zurich. and business acumen to the role as CEO and appointment of Murray Barber as its good penetration Marighetti brings nearly 30 years of professional has been instrumental in steering the company new head of partnerships. He was previously the of the UK group and individual PMI market, but experience to Zurich. He held a number of senior throughout much of its recent growth. [Her] publisher of CIR magazine at Perspective Publishing. with Linda’s appointment, we will be able to roles at Procter & Gamble, SC Johnson, McKinsey & expertise and industry knowledge is a real asset to Steve Fowler, IRM’s chief executive, commented on capitalise further on growth in the market.” Company, Deutsche Bank and Allianz Group. First Assistance and we welcome her strategic vision the appointment: “The Institute continues to grow in for the future of the organisation.” both numbers and influence in the UK and overseas and we need to build strong relationships with others operating in the risk management field. IRM is firmly committed to the value of education, training CII chooses corporate development director and professional development in risk management Boyle joins ARS and Murray’s appointment will help us connect The UK’s Chartered Insurance Institute (CII) by peers and public alike. I am looking forward with other organisations who seek to demonstrate has appointed Graeme Sutton, ACII, as director to making a significant contribution to the CII’s David Boyle has joined Aon Risk Solutions’ (ARS) commitment to the same goals.” of corporate development. Sutton joins the extensive work in further raising standards of aviation team as head of the Asia Pacific region. Based The IRM claims to be the ‘world’s leading enterprise- organisation from M4 Underwriting Limited, professionalism within the market.” in London, Boyle reports directly to Simon Knechtli, wide risk education institute’ owned by practising risk having had previous roles at companies including Director of financial services and insurance markets global head of airlines and head of ARS’ aviation professionals. It provides qualifications, short courses Fusion, Zurich and Independent Insurance. Steve Jenkins added: “I am delighted that Graeme is team. Boyle joins Aon from Willis, where he was and events at a range of levels from introductory to Sutton said of his new role: “The Aldermanbury joining the CII at this exciting time when the market regional director for the Asia Pacific (APAC) region. expert, supporting risk professionals by ‘providing the Declaration and Chartered status are very topical is increasingly looking to invest in the professional He started his career as claims broker in 1993 at skills and tools needed to put theory into practice in at the moment; they play a crucial role in the development of its people. Graeme’s expertise will Marsh, rising to vice-president of the firm in 2000, order to deal with the demands of a sophisticated increased desire within our sector for standards help us ensure we are responsive and relevant to the before joining Willis in 2002. and challenging business environment’. of professionalism that can be clearly recognised needs of the market.”

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