ESSENTIAL READING FOR TRAVEL INSURANCE INDUSTRY PROFESSIONALS WWW.ITIJ.CO.UK DECEMBER 2010 • ISSUE 119 Travel CUE call to arms

French insurer Groupama has called on its fellow travel insurers operating in the UK to collaborate on the launch of the latest initiative that is aimed at reducing the level of fraud seen in the UK’s travel insurance industry. Sarah Watson has the story

The Travel Claims Underwriting Exchange (CUE) initiative is led by the Insurance Fraud Bureau (IFB) and IDSL/Polaris, and is being created in a bid to allow insurers to share data on suspect claims. As we explain in our feature on this topic on page 28, the CUE is not the only avenue insurers can take to share data with each other, as rivals appear on the market. Groupama counter fraud manager Andy Pagett said: “Individual databases could be damaging to the various industry initiatives we are currently pursuing. It means we cannot guarantee the necessary compliance and governance around the sharing arrangements and this dents our credibility with the Information Commissioner at a time when we are engaging them on this matter.” He continued: “What we need to recognise is that a travel insurance claim is often the fi rst attempt at fraud by the opportunistic fraudster. If they Licensing milestone reached in US continued on p4

The US Travel Insurance Association (UStiA) has travel insurance, while at the same time improving states to adopt one common licensing approach, achieved a milestone in the quest for adoption of the protection given to customers. replacing the old fragmented system. In the states a uniform licensing standard for travel agents and Jim Grace, president of the UStiA, said: “By that adopt the amendment, travel retailers that sell other sellers of travel insurance in the US. Mandy amending the current licensing standards, we have insurance will be allowed to offer and disseminate Aitchison reports on the new guidelines made major progress toward reducing licensing their products without a licence, as long as specifi ed burdens for retailers offering travel insurance. At the consumer protection requirements are met. Under Acting on recommendations from the UStiA, and same time, the new standard will, once implemented the new NAIC Standards and Guidelines, allowable with the assistance of the American Society of in all states, offer greater transparency and consistent non-licensed activities would include offering general Travel Agents (ASTA), on 21 October the National consumer protection.” information such as descriptions of coverage and Association of Insurance Commissioners (NAIC) Previously, each travel agency, travel agent and others pricing, as well as processing applications and adopted language for a new Uniform Licensing selling travel insurance cover had to be licensed collecting premiums, so long as the insurance Standard and Implementation Guideline that would in the states in which they conduct their business. provider (managing general agent and nationally signifi cantly streamline the licensing process for selling The new NAIC guidelines lay the groundwork for licensed producer) whose continued on p4 2 NEWS

IN THIS ISSUE ITIJ CONTRIBUTORS

REGULARS Tatum Anderson is a freelance international health and technology business writer with a decade of experience. Her News continued 4 specialist subjects include emerging markets, business, health and public health policy. She has written for a variety of publications, Editorial blog 6 including The Economist, Guardian Weekly, BBC News Online, the Company brief 8 Wall Street Journal Europe and the Financial Times. Insurance matters 9 Gerry Bolger MHM, RN, is a freelance in-flight nurse Health matters 13 and policy advisory on pressure ulcers at the Department of Travel matters 14 Health, England. He is also the programme director for the Quality in Caring work within the Chief Nursing Officer’s (CNO) IPMI news 16 Directorate at the Department of Health. As well as being a Cross-border care 18 registered nurse, Gerry also holds a Masters’ degree in health management. He formerly led the Royal College of Nursing Air ambulance news 22 In-flight Nurses Association as their chair for eight years and has Service directory 39 been involved in clarifying issues on medicines administration in that role. Grapevine 46 On the move 47 David Craik has been working as a freelance journalist for the past six years and writes for national newspapers and magazines. This includes shifts on the Daily Express City and Business desk where he covers market reports including the insurance sector. He has experience writing news and features on a wide range of subjects including insurance, aviation, transport, recruitment, IT, personal finance and small business. FEATURES

Feature: Is there strength in numbers? 24 ITIJ asks if insurers working together actually works

Feature: Digital marketing – part 1 28 Are travel insurers using all the tools available to them?

Assistance & Healthcare World Markets: Uruguay 32 A small South American country with mixed healthcare facilities

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.

Helen Watts fax: +44 (0)117 929 2023 Printed by Pensord Press, South Wales, United Kingdom Advertising sales: David Fitzpatrick email: [email protected] James Miller Copyright © Voyageur Publishing 2010. Materials in this publication may not be reproduced in any web: www.itij.co.uk form without permission Finance: Elspeth Reid INTERNATIONAL TRAVEL INSURANCE JOURNAL ISSN 1743-1522 Louise Goddard Would you like to make a comment? Design: V Creative Design WOULD YOU LIKE TO SUBSCRIBE? Please get in touch with Ian Cameron, vcreativedesign.co.uk VISIT www.itij.co.uk Editor-in-Chief of ITIJ on +44 (0)117 922 6600 ext205

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4 NEWS

Delays highlight the importance of cover

US-based Travel Insured International has said that economy, includes $16.7 billion in extra costs paid two recent government reports serve as a cautionary by passengers. The Associated Press noted that reminder to travellers about the value of travel ‘researchers looked more broadly at costs associated insurance. A new economic study released by the US with flight delays, including passengers’ lost time Federal Aviation Administration (FAA) has documented waiting for flights and then scrambling to make other the hefty cost to passengers of flight delays. In addition, arrangements when flights are cancelled’. US Department of Transportation statistics showed The Department of Transportation (DOT) a sharp rise in September 2010 flight cancellations as separately reported a marked September 2010 airlines complied with the three-hour tarmac delay increase in flight cancellations as airlines complied penalty rule. The numbers support the need for travel with the May 2010 Tarmac Delay rule that fines insurance, said the company, to protect travellers from carriers $27,000 per passenger if they hold unexpected costs. passengers on a plane on the ground for three The FAA study takes a detailed look at 2007 flight hours or more. The DOT reported that airlines delay costs, the last year for which full statistics cancelled 0.9 per cent of their September 2010 Air Passenger Duty comes into force are available. The report states that trip delay- flights, compared to 0.6 per cent cancelled in related costs, a $33-billion yearly hit to the overall September 2009. The first of November marked the first day of the from the airline as it is only payable if the traveller new, increased Air Passenger Duty (APD) paid by departs. Unfortunately, many airlines, particularly UK travellers. The APD is divided into four bands budget ones, charge an administration fee, which (A, B, C, and D), and each one has seen a rise, can be more than the APD itself.” He continued: InsureandGo in a tangle with HMRC although long-haul travellers in band D will see the “The cancellation section of a travel insurance It has been reported in Post Magazine that UK- and penalties, the group will be required to raise biggest increase. The shorter the flight, the smaller policy typically provides cover for travel costs that based travel insurance intermediary InsureandGo additional capital to maintain a solvency balance sheet the increase – for example, a passenger travelling to are ‘irrecoverable’ or ‘not recoverable elsewhere’. warned that it would have to raise millions of pounds and continue to meet regulatory capital requirements Egypt, which is a band-B destination, will pay an extra Also, some policies are very explicit and make in capital if it were to lose an appeal against Her and, therefore, to continue trading as a regulated £15 in APD, while a passenger flying to Singapore or airport departure duty a specific exclusion. At the Majesty’s Revenue and Customs (HMRC), just weeks entity.” It has been estimated the firm’s liability will be Australia will face a £30-hike in APD charges. claims stage the attitude of insurers varies – some before it was bought by Spanish insurer MAPFRE. In less than £6.73 million. Industry expert Phil Salcedo from Travelzoo UK will adopt a pragmatic approach with the customer September, InsureandGo submitted its 31 December The HMRC said it would not comment on individual said: “Those most affected by the changes will be being able to recover the fee charged by the airline 2009 year-end financial statement to Companies cases, while a spokesperson for the tribunal service families, as they will be travelling in larger groups and to obtain the APD refund, whereas others will not.” House, which said: “The company has been subject would only confirm that the case was ‘in the system’ all children over the age of two are subject to the full Hayman called for a consistent approach by the to an investigation by HMRC relating to certain value and ‘had been stayed’. The reason for the stay APD price hikes.” travel insurance industry to deal with genuine cases added tax (VAT) matters. The directors [who all was not given. Gregorio Santos, chief executive of Peter Hayman, director of PJ Hayman Travel where customers have incurred costs that are not resigned last month following the take-over] strongly MAPFRE Assistance in the UK, would not comment Insurance Specialists, believes that the increase could recoverable. He also said that the increase in APD disagree with the findings of the HMRC in this matter on the HMRC issue. result in more uninsured travellers: “The increase could mean that fewer travellers will invest in travel and an appeal has been lodged with the first tier tax in APD on 1 November highlights a problem that insurance, as the increased flight costs could mean tribunal. Should the tribunal find that the group is many travellers may not be aware of until they that already stretched family budgets won’t go as far liable for the full amount of estimated VAT, interests have to make a claim. APD should be recoverable as covering the cost of insurance. Travel CUE call to arms continued from p.1

achieve success here, there is potential for them to move on to make fraudulent claims under household and motor cover.” Pagett believes that if the industry works together and takes a collaborative Licensing milestone approach to stamping out fraud once and for all, it reached in US would also have an impact further down the line continued from p.1 for other classes of insurance. “Just as importantly,” he added, “it will demonstrate that we have the product is being sold holds a business entity licence. wherewithal the apply CUE to other classes of The UStiA has described the new amendment business such as commercial insurance. We really as a win-win situation for both travel agents and need cross-industry collaboration to achieve success consumers, with Grace saying: “Once states have [and] sharing information is the key to stamping out adopted the NAIC standards, travel agents offering fraud, and that’s got to be in the best interests of our and disseminating travel insurance can do so under policyholders and the industry as a whole.” the provider’s licence and will not need to be licensed Glen Marr, director of the Insurance Fraud Bureau themselves. This move will help provide travel (IFB), commented: “Travel insurance is typically agencies with a value-added source of revenue.” viewed as high-risk business, and the absence of For consumers, the new standard provides greater controlled data sharing leaves the sector exposed to protection as it requires the insurance provider to claims fraud and undermines the industry’s ability to meet a number of criteria, including clearly identifying properly understand the scale and financial impact of itself in all sales and fulfilment materials, registering the this risk. The current industry efforts, fully supported travel retailer by state, conducting background checks, by the IFB, to add travel data to the existing CUE training non-insurance travel retailers, and more. model in order to match travel to travel data, and “The recommended change has major implications also cross match existing household, motor and for consumers,” said Grace. “By providing one set of personal injury records for fraud prevention and licensing standards across all 50 states, the travelling detection purposes, are long overdue.” Marr is also public can be assured that there will be more consistent of the opinion that the industry must work together control over those who sell travel insurance.” to form one, cohesive approach, rather than multiple Finally, Grace warned that the adoption of the new data pools: “Leveraging CUE as an industry hub guidelines is still in its infancy, with much more work and adopting this model also means travel data to come: “The UStiA has worked hard on the issue will form another part of the existing consolidated of uniform licensing. We have come a long way, and industry data pool accessed daily by the IFB utilising couldn’t have accomplished this without the help of its powerful analytical software to identify and track our members and the support of ASTA. However, organised and cross-insurer fraud. Any move to try while NAIC’s adoption of the new language and address travel fraud outside the CUE model represents a major accomplishment, this is not the would be counterproductive, and the travel sector end of the road. We still have a lot of work ahead would not benefit from or form part of the industry’s to ensure that each state’s insurance commission collaborative efforts to reduce fraud.” implements these guidelines.”

International Travel Insurance Journal NEWS 5

Southern Cross tops value list

New Zealand-based Southern Cross that in order to achieve the best possible value Travel Insurance (SCTI) has topped a for its product, the company has focused solely survey of Australia’s best value travel on maximising operational efficiencies by making insurance products, thanks to a new significant investments in technology over the past 12 direct-to-consumer online business model. months. He said: “The saving gained by going direct The insurer’s international travel insurance to the consumer online allows us to offer customers product, TravelCare, was rated by research a high quality, low-priced product in what is an house Canstar Cannex as offering ‘five- extremely competitive market.” star value’ in a survey that considered 42 According to Morrison, approximately 92 per insurance brands and 221 policies. SCTI cent of the insurer’s policy sales are now made was one of five brands awarded the ‘five- through the website, with more than 70 per cent star’ rating for outstanding value by Canstar of customers having their insurance documents Cannex, although Southern Cross stood emailed to them rather than paper mailed, while 45 out due to its pricing and high item limits in per cent of customers receive a post-purchase text its policies. message confirmation of their policy number and an SCTI chief executive Craig Morrison said emergency assistance phone number. Travel company refuses hotel bills

UK holiday firm Thomas Cook is facing legal pressure to reconsider a unilateral decision it took to subtract five per cent off its payments to hotel operators in Spain, Portugal and Greece. The company said it was forced into the move as a result of the multiple challenges to have hit British tour operators this year, including ‘the volcanic ash impact, the general election and the emergency budget’, but Hotrec, the European umbrella trade body for hotels, has said the action by Thomas Cook is ‘unfair, unwarranted and amounting to a breach of contracts’. It has accused the travel provider of using threats of the withdrawal of further business in order to force hoteliers to accept the lower payments. Hotrec, though, has responded by looking into possible legal action at either a national or European level, claiming that Thomas Cook is abusing its dominant position in the market. Cehat, the Spanish Confederation of Hotels and Tourism, is also said to be considering legal action against the British company. The organisation said in a statement: “[Thomas Cook’s actions] unilaterally break contract terms and represents a dangerous precedent for the Spanish hotel industry. We will provide legal advice for all the affected hoteliers with the aim of recovering the owed and unpaid amounts.”

Online company stops trading

Irish firm Chase Travel International, which sold trips exclusively through the travel trade, has ceased trading just three months after it opened an office in Australia. A message on the company’s website states: “Dear Travel Agent, it is with great sadness that as of the 1st of November Chase Travel has ceased trading. The company is seeking professional advice on the next steps and a further update will be provided accordingly.”

Boys in Blue

Irish firm Blue Insurances has been named Best Travel Insurance Company at the Northern Ireland Travel Awards, taking the prize home for the third year in a row. Blue Insurances beat off fierce competition from leading insurers for the award, with other finalists including AXA, Whitehorse, and Mondial Assistance. Ciaran Mulligan, joint managing director of the company, said: “We are delighted to receive this prestigious award again and make it a hat trick. Our team at Blue Insurances look forward to providing continued excellent standards of customer satisfaction.”

www.itij.co.uk 6 NEWS

Pre-existing confusion continues

Travel insurance specialist World First Travel Insurance has warned the UK public of confusion over the disclosure of pre-existing medical conditions o Insure and Go just refuse to stay out when buying travel insurance policies, as it seems of the news ... not content with a take- that the situation is not improving. Consumers Sover by MAPFRE, they’ve also taken on of travel insurance have been told that they are the dreaded HMRC (Her Majesty’s Revenue legally required to disclose any pre-existing medical and Customs) or the ‘Tax Man’ as the rest conditions to ensure that they are provided with of us know them. Once they’ve got you in the right level of cover. They were then warned: their sights, HMRC are renowned for being “Every insurer has different standard terms for this, like a dog with a bone. We can only wish with some asking for any medical history in the past them luck there. fi ve years and others, like World First, asking only In the US the actions of the UStiA and ASTA for the past 12 months. All insurers will ask different would appear at long last to be bringing the questions, with the answers that are provided being possibility of a uniform licensing standard used to determine the level of risk the travellers for the issuance and sale of travel insurance may pose and the premium they will need to pay.” across America. The impact of this should not Common problems seen by the insurer when it be under-estimated. The possibility that the comes to disclosing existing conditions include people same policy could be sold in each and every only thinking that their medical history over the past state has the potential to give an enormous 12 months is relevant. boost to the sales of travel insurance. Now Domestic trippers The next word of caution from World First concerns all the insurers have to do is educate the 10 Premium hikes the ‘tick box’ system used by many insurers. “A per cent of the population who actually do shun travel cover number of online insurers rely on tick boxes to say have a passport to let them know exactly begin in earnest that the person taking out the policy has read the what travel insurance is... iknow-uk, an online travel company for UK holiday terms and conditions. World First warns that often, I guess that still means that McDonalds won’t accommodation and leisure attractions, has carried Peter Hayman, director of UK-based P J Hayman when it comes to buying anything online, human be clamouring to give away a free policy with out a revealing poll showing that 81 per cent of Travel Insurance Specialists, has given his reaction to nature is to simply tick the box without reading what every Big Mac sold. people have never even considered taking out AXA’s announcement of insurance premium increases. it is being linked to – but when it comes to travel insurance for a domestic holiday. Even more, 93 per He commented that the moves refl ected his recent insurance, people could be agreeing that they do not … and a Merry Christmas to you too! cent, have never actually gone ahead and bought prediction that the travel insurance market would have any pre-existing conditions and that they don’t travel insurance for their UK holiday, which would start to see sharp rises in the premiums, exacerbated need to declare anything.” protect them from unexpected bills resulting from by the impending rise in Insurance Premium Tax. Martin Rothwell, managing partner of World First, Ian Cameron cancellations and luggage loss or theft. Hayman said: “This week, the UK’s largest travel commented on his own company’s approach: “If Editor-in-Chief Marcus Simmons, managing director of iknow-uk, insurer, AXA, went public announcing ‘double-digit’ you want to be covered for a pre-existing medical [email protected] said: “The amount of people heading off for a UK rises to be expected on their book of travel insurance. condition, then you’ll need to tell us about anything break who have never even considered insuring Many of these changes are being implemented prior that has been suffered or which medication, advice their holiday is really shocking. From our research, to the Christmas holiday season. The premium or treatment has been received in the past 12 it’s clear that people associate travel insurance mainly increases are being driven by ever-increasing medical months. This applies to all members of your party with medical bills, and as they know that those don’t claims costs, particularly in the US, and historically and includes investigations or reviews (routine or apply within the UK, they don’t think of insurance as low premiums, which are now being addressed.” He otherwise), longstanding conditions, surgery, as China and Russia a necessity.” He added: “Many people simply assume also gave his prediction that some scheme holders well as injuries which may be exacerbated by the that their possessions are covered on their home will have diffi culty renewing on competitive terms, activity/trip you propose to undertake.” He added: sign agreement insurance, but it’s worth checking before you set off particularly at the cheaper end of the market – “It’s crucial to look at what insurers consider to be a to make sure. Even if they are, if you have to make a consisting mainly of Internet and aggregator products. pre-existing medical condition and ensure you fully China Life Insurance Company and Russia’s claim it’s always better to be able to make the claim However, he also stated that even allowing for likely declare everything, for all members of the party, Rosstrakh Insurance Company, together with on your travel insurance to avoid hefty increases on premium increases, travel insurance still represents for the time period required. It’s also essential to travel association World Without Borders, have your home insurance premium.” ‘excellent value for money’ and is still an essential make sure you read all the terms and conditions signed a deal in Moscow recently that enables the purchase for any trip, and price should not be the only before you buy, or as soon as you receive your beginning of a co-operative agreement on travel factor in the decision-making process. documentation to make sure you are fully covered.” insurance between Chinese and Russian citizens. The ITIJ spoke to Fiona Macrae, operations director of agreement allows the insurers from both countries travel insurance specialist Insurancewith.com, who to provide services abroad for customers who buy believes that the move could force some travellers the cover domestically. According to people close to Post Offi ce issues to rely on their bank and the ‘free’ insurance, which the deal, it is hoped that the agreement will provide is added as a ‘sweetener’ to their current account. a platform for both governments on which they can insurance warning Whilst for some this may be okay, others are warned lower the costs of co-ordinating the safe travel of to think about this potential false economy. She says: their citizens. In light of a recent statement by IMRG Capgemini “We would encourage anyone who has a pre-existing Sun Tao, general manager of China Life’s international e-Retail Sales Index announcing that the online the medical condition to check the wording of the ‘free’ department, told the Xinhua News agency that it is travel sector has grown by 18 per cent year-on-year, travel insurance policy they receive with a bank the fi rst time his fi rm has co-operated with its Russian the biggest increase for over two years in 2010, account or credit card very carefully. You need to counterparts on behalf of the Chinese government. the Post Offi ce has reminded all holidaymakers make sure you are actually covered for pre-existing He added that the signing of the agreement was a of the importance of purchasing adequate travel medical conditions. Some of these policies may offer key link in the entire co-operative project of travel insurance for their trip. Internet fl ight comparison to extend cover for pre-existing medical conditions safety insurance between the two countries. Sun said site Skyscanner reported that European destinations provided you declare them, but the majority will not that in the future, all Russian tourists heading to China have proved popular for UK travellers this summer, cover pre-existing medical conditions at all, especially will be able to buy insurance from their domestic but many UK holidaymakers heading to the continent more serious conditions like cancer.” companies, and enjoy peace of mind knowing that may wrongly assume that any required medical the coverage is suffi cient for travelling in China. As treatments will be covered by the European Health part of this drive, an emergency centre has been set Insurance Card (EHIC), and believe that they they do up by China Life, which provides 24-hour aid and not require a separate travel insurance policy. Insurers could escape global risk list medical services to cater to travellers in need, while Head of travel insurance for the Post Offi ce Rachel a similar centre has been set up in Russia for Chinese Croft said: “It is also important to remember that Lord Turner, chairman of the Financial Stability as the failure of an insurance company was unlikely tourists. an EHIC does not act as a replacement for travel Board (FSB) in the UK, has indicated that individual to have the same knock-on effect that the failure of a Other moves by the two countries to promote travel insurance as it only provides the same level of care as insurance groups are likely to escape inclusion on the bank would have. to its citizens is an agreement on a mutual visa-free a local citizen and does not cover private treatment global list of large fi nancial institutions that look set to Lord Turner commented: “We know that whereas regime for tourist groups with at least fi ve people, or repatriation. So if you’re not properly insured with come under tougher regulatory scrutiny. Speaking there is the specifi c problem of 30 to 50 individual and it is hoped that the integration of Chinese and travel insurance cover and have a serious accident to international insurance regulators in Dubai, Lord banks in the world where we have to focus on Russian insurance companies will cement travel fi rmly then you or your family could be left to pick up a Turner said that he believed that the FSB did not see resolution … there can be very large insurance in the minds of people from both countries. colossal bill.” individual insurers posing risks in the way banks did, institutions that are not relevant in this way.”

International Travel Insurance Journal NEWS 7

Take-up concerns Insurers: emphasise Post Office

A major online survey of over 5,000 people by kidnap avoidance named leading destination finder and value travel blogging website Whichbudget.com and TheTravelMagazine. Risk and security adviser Pasco Risk Management Ltd favourite net has found that the majority of people still travel has urged insurers and corporate firms to emphasise without insurance when they go abroad. A record measures that business travellers can take to reduce The UK public has once again named number of users took part in the survey, and the the risk of kidnap while abroad. The company stated the Post Office as its favourite travel results showed that almost half of the UK responders that there are over 20,000 reported kidnaps per year insurance and foreign exchange (44 per cent) did not take out any form of travel worldwide, and although many of these are between provider at this year’s British Travel insurance at all when they travelled overseas. criminal gangs or short-term hostage situations Awards – the Post Office has now won Other results from the poll showed that 11 per cent involving couples, criminal and terrorist elements see the travel insurance award five years of UK travellers only take out cover when they are the kidnap for ransom of corporate travellers as an in a row, and the foreign exchange travelling outside the European Union and eight per extremely lucrative trade. award for four years in a row. Ahead cent choose to travel with just a European Health The recent attempted armed robbery/kidnap in of several major competitors, the Insurance Card rather than full travel insurance cover. Brazil of racing driver Jenson Button demonstrated organisation secured 15 per cent of The survey also showed that compared to their the huge increase in the global ‘kidnap for ransom’ votes for the travel insurance award, continental neighbours, the UK’s travelling public risk that major corporates now face, said the firm, and 27 per cent of all votes in the appears to be more concerned about insurance, with adding that neither companies nor insurers are doing foreign exchange category. 37 per cent saying that they always travelled with enough to help executives avoid kidnap situations in Sarah Munro, head of Post Office Travel insurance, compared to just 25 per cent of Spanish the first place. Simon Atkinson, TravelSafe director Services, said: “We’re very excited that people and only 10 per cent of Italians. of operations for Pasco Risk, said: “Insurers and their once again we have been recognised Martino Matijevic, chief executive of WhichBudget, clients might spend time teaching executives going by the travel industry and more importantly the UK Squaremouth warns said: “It is difficult to predict if an airline will collapse, to high-risk countries what to do when they are public for the great value travel services we offer or which tour operator might go under, so it is kidnapped. But rarely do they give the same attention through our branch network, which serves 23 million of policy differences increasingly important for travellers and holidaymakers to telling executives what can be done to avoid being customers a week, as well as our website and call to ensure that they are adequately covered for any kidnapped in the first place. There are a number of centre. This has been another tough year for both US travel insurance comparison website eventuality so they are not left out of pocket.” very simple but effective things that executives can the travel industry and holidaymakers themselves, Squaremouth has warned that having the wrong do to protect themselves, but if they have not been and it is encouraging that people continue to trust travel insurance for a cruise could mean significant shown how to recognise and avoid risk situations and and value the services offered by the Post Office.” financial loss at sea: travellers should not assume behaviours they will become an easy target – even in one policy is as good as the next, especially when it city centre locations, as Jenson Button discovered.” comes to cruises. Speaking about the Button incident, Atkinson Chris Harvey, Squaremouth chief executive, said: added: “Jenson Button was lucky to have had an “Medical evacuation coverage could be more experienced police driver who could get him out of Travellers choose important for cruises than any other type of vacation. a dangerous situation very rapidly – most executives A medical evacuation is the one thing that can will not be so fortunate so they need to reduce risk cheapest cover bankrupt you if you don’t have proper insurance.” as much as they can. For example, wearing highly The company added that a single incident might visible branded clothing, like McLaren’s eye-catching A new study by UK-based Insurefor.com has found require an airlift from the ship, transportation to silver and orange team shirts, is an obvious magnet that almost three quarters of travellers select the multiple medical facilities and even a flight home, and for unwanted attention. For business executives cheapest travel insurance option instead of the if a policy does not provide enough coverage, the in high-risk countries carrying branded laptop bags most appropriate policy. The research shows that balance becomes the responsibility of the traveller. and wearing clothing with company logos is the 72 per cent of travellers do not fully understand As a guide, Squaremouth recommends between corporate equivalent of Jenson’s shirt.” exactly what they are covered for when buying $100,000 and $500,000 of medical evacuation Pasco Risk suggested that putting executives through travel insurance online, revealing coverage. Harvey advised: “Some policies an intensive risk-avoidance coaching programme could a lack of understanding when offer several million dollars of evacuation have a major impact on the number of claims being people come to purchase coverage, however, it is rare for an made for ‘at risk’ employees. Atkinson added: “There insurance for their trips, evacuation to cost more than $100,000. are obvious risk markets like Iraq and Pakistan, but with many opting for Don’t spend more for a policy thinking multi- other more Westernised economies such as Mexico, the cheapest option million dollar coverage is necessary.” Venezuela, Brazil and the Philippines are often even rather than the insurance Travellers frequently ask if they can choose where more dangerous for the unaware executive – the policy best suited to their needs. they will be evacuated to, according to the firm, Philippines for example is now seen as the kidnap According to the company, many and although some policies offer medical centre of Asia. Having been established in South Africa, people are being left out of pocket evacuation to a ‘hospital of choice’, Ski cover warning Pasco are very aware of the risks in under-developed when they come to make a claim most will evacuate to the nearest parts of Africa, but increasingly the real risk to corporate due to the type of policy they adequate medical facility. However, Up to one million Britons will be playing financial executives is in those regions where drug cartels and purchase, and the situation is not Squaremouth advised travellers Russian roulette on the ski slopes this winter, organised crime see kidnapping as an easy option helped by comparison websites that this distinction might not be according to AXA Insurance, because they will take for topping up their operating funds. Even in the US that focus solely on price. as important as it sounds – since to the piste without having adequate insurance in organised crime now sees kidnap as easy money.” Antony Martin, Insurefor the Squaremouth Zero Complaint place. The firm’s data suggests that around 17 per Underlining the benefit of avoiding kidnap, the managing director, said: Guarantee was instituted in 2001, cent of the UK’s adult population will enjoy a skiing company mentioned that criminal gangs, particularly “The practice of purchasing there has never been a complaint or snowboarding holiday this year, yet 10 per cent of in Central and South America, may still kill their insurance policies solely about a traveller being stranded these holidaymakers will not take out travel cover. A hostage even when ransom demands have been based on price is one that in a foreign hospital or a traveller further 25 per cent will rely on an annual travel policy met, in an attempt to hide their identity and deny an we have seen increase over who was refused an appropriate they already have in place, without checking whether opportunity for future prosecution. the years. Many of the price evacuation service. or not they are covered for winter sports activities. comparison sites and search The company further suggested The insurer has pointed out that this approach could engines have revolutionised the that cruise purchasers pay attention leave people exposed to potential costs of tens or way that we shop for financial when booking the trip because a even hundreds of thousands of pounds should they Abduction risk in products. They have sped up cruise line will sometimes include its own be injured on the slope. the process and driven down costs for travel protection plan in the total cost unless According to AXA’s figures, around 30 per cent of Algeria consumers while increasing competition among the traveller opts out. Some of these plans, warned skiers and snowboarders are likely to make insurance providers, something which can only be good news Squaremouth, will only provide credit toward a claims at some point, and 25 per cent of them will Europ Assistance has recommended that travellers for the customer.” He added: “However, our survey future cruise if the trip is cancelled, instead of cash have suffered some kind of injury while on holiday to Southern Algeria and the Sahel area take extreme shows that increasingly people are not fully aware of reimbursement. in the past. However, it seems there is a worrying caution, due to the risk of abduction faced by tourists. the details of the cheaper products they are buying However, if all coverage is equal, the firm lack of understanding about what travel insurance will The company passed on a warning from the French and are dangerously unaware of the level of cover recommends finding the policy with the best benefits and will not cover among winter sports enthusiasts. Foreign Ministry advising visitors and foreign nationals offered by these policies. The very nature of cheaper for the price. Harvey commented: “Travel insurance Around 19 per cent of people questioned by AXA residing in the area, particularly in the far south, to insurance is that it does not offer as comprehensive premiums are typically five to ten per cent of the did not believe their injuries would be covered by travel only when necessary and to remain extremely cover as the most expensive options. Therefore total trip cost, whether a cruise company’s policy a travel insurance policy, while around 30 per cent vigilant. The threat extends to the popular tourist travellers need to be fully aware of the details of their or an independent policy. Compare the costs and thought that transport home would not be covered if destinations of Tamanrasset and Djanet, which attract policy and exactly what it covers them for before benefits closely to find which cruise insurance is the they had to be brought back to the UK. large numbers of holidaymakers. they purchase it.” best value.”

www.itij.co.uk 8 COMPANYBRIEF

Vayant teams with Saga updates cover Jamaica offers added

Travel Guard In response to the variety of travel woes witnessed protection this year, a new comprehensive travel insurance policy A strategic partnership between Travel Guard North has been launched by Saga, a UK firm that specialises The Metropolitan Benefit Group, International America and Vayant Travel Technologies has been in holidays and insurance products for the over-50s Warranty Administration Services and the Veratis announced. It is hoped the tie up will help travellers market. The company says its new travel cover will Group have welcomed their new strategic partner and travel businesses choose from a larger array of give travellers a ‘top-of-the-range’ insurance policy in the Caribbean – the Jamaica Tourist Board. The airline carrier combinations through split-ticketing without having to pay an extra premium. affiliated companies, which provide marketing and to receive better flight prices and more itinerary In direct response to April’s ash cloud, Saga administrative support for a variety of insurance options, plus travel insurance protection in the event reviewed its travel insurance offering with the programmes globally, have entered into an agreement of a missed connection. aim of providing customers with cover for every with the tourist board to offer travel-related benefits to Many travel sites today avoid handling split tickets for eventuality when abroad – clients of the insurer visitors to the island. The insurance benefits have been complex travel itineraries due to the complexity of will now be automatically covered if air space is this year by Eurostar passengers, where trains were underwritten by ‘highly rated international companies’, pricing, taxation and the hassle involved in navigating closed for 24 hours from when they were due to delayed and cancelled. The insurance will now offer according to the group. interline rules, as well as a lack of relevant technology. depart. The upgraded policy also covers people if customers up to £5,000 cancellation cover if their In support of the move, the affiliated companies will Vayant and Travel Guard are embracing the challenge they are unable to reach their destination or return train is cancelled and they are unable to continue be embarking on a year-long marketing campaign through a shared commitment to provide a seamless home for a variety of reasons, including delay due with their independently booked holiday, or they that will be driven through media such as the customer experience with increased choice and to airport closure and strike action. After the first 24 are denied boarding because there are too many Internet, radio and television, as well as traditional protection. hours of being stranded abroad, customers will be passengers for the seats available. outlets such as travel agents and tour operators. At By combining non-interline carriers on a single covered either up to £100 per person per day for Saga’s final upgrade to its cover includes the provision the launch, special offers will be made to enhance itinerary, Vayant’s split-ticketing capabilities (known as meal and accommodation costs, or up to £1,000 of a new service team to help customers who lose Jamaica’s appeal as a tourism destination, including Multiline+) greatly increase the number of options of cover for travel arrangements to reach their their passport while abroad. A team of specialists will a complimentary VIP pass, mobile phone insurance, available to travellers when booking flights, and can destination or return home. Under the terms of the be available via a helpline to guide people through identity theft, and pre-paid credit cards. substantially lower travel costs. Consumers flying on new cover, incidents such as hurricanes that make the process of obtaining a new passport, and will split-ticketed itineraries today miss out on some of accommodation uninhabitable will also be insured. even contact the relevant embassy to ensure that the the protections that co-operating airlines traditionally Saga has also responded to issues experienced earlier new passport is delivered to the right place. provide for missed connections. With Travel Guard, Vayant will provide new offerings to travellers EA innovates worldwide to make split-ticketed itineraries far more Following the 2009 launch of NetGlobers, Europ appealing and less risky than a standard interline/ Assistance’s community website dealing with the alliance itinerary. Inkerman joins with Mondial theme of travel risks, the company has now launched Dean Sivley, president and chief executive of Travel a new iPhone application called ‘Dos & Don’ts’, Guard North America, said: “To complement The Inkerman Group, international specialists in at any point in time. aimed at helping travellers to avoid cultural gaffes Vayant’s new offering, we will be developing a business risk and intelligence, has joined forces with Gerald Moore, chief executive of the Group, said: “We while abroad. Thanks to the application, which new product to provide additional protection Mondial Assistance UK – the partnership will provide are delighted to be working alongside Mondial Assistance includes video clips and language programmes, and services for travellers coping with economic business travellers with a combined solution for to provide solutions that address the requirements of the EA Group has provided its clients with an challenges and changes in the travel marketplace. their risk assessment, travel advice, insurance and our customers. Whether it be a number of VIPs or easy way to overcome the cultural barriers they Travel Guard’s products are a perfect addition to assistance requirements. Through its Travel Safe and an individual business traveller, our knowledge and may encounter during their trip. The application Vayant’s technology suite. Together, we’re offering Tracka solutions, the Inkerman Group identifies risks, experience in security and intelligence services, in is available in two versions: Europe, and Europe unprecedented flexibility in travel planning, creating threats and vulnerabilities facing businesses today, and conjunction with travel insurance and assistance expertise Premium, which includes information for several new affordable travel options and helping leisure and provides information, advice and tracking solutions from Mondial, will provide customers with extensive Asian nations – China, India, Japan, Korea, Thailand business travellers plan their trip with confidence.” that enable companies to know where their staff are protection when travelling to higher-risk areas.” and Vietnam. The company has plans to introduce apps for South America and the Middle East in the next few months. Chinese insurers RAK inks deal Barclays links with rewarded FirstAssist RAK Airways, the national carrier of Ras Al Khaimah in the Middle East, has signed a key co-operation Barclays Bank in the UK has announced that it has Shanghai-based China Continent Property and agreement with RAK Insurance to offer travel formed a three-year partnership with FirstAssist, Casualty Insurance Company Ltd, a subsidiary of the insurance to its passengers as part of the airline’s replacing its previous partnership with Aviva. As a largest Chinese reinsurer, China Re, has jointly won value-added service offering. RAK Airways chief result of the deal, Barclays customers taking out an account worth ¥200 million (US$30 million) for executive officer Omar Jahameh said: “Our co- travel cover from the bank will now have their the integrated national travel service liability insurance operation agreement with RAK Insurance will travel insurance and assistance services provided project in 2011, with five other domestic non-life enhance the range of value-added services we are by FirstAssist. Alastair Hardie, managing director insurers. The other insurance companies involved already able to provide passengers with. We advise of FirstAssist, expressed the firm’s delight at being include PICC Property and Casualty, China Pacific all our passengers to avail themselves of travel selected by Barclays, and stated that his company Property Insurance, Ping An Property and Casualty, insurance to protect themselves against accidental offers a travel insurance proposition that encompasses China Life Property and Casualty, and Taiping unforeseen circumstances; our new agreement all customers, regardless of age, illness or destination. General Insurance. In a statement made to the press, with RAK Insurance, which offers passengers travel China Continent P&C said: “The National Tourism insurance starting from as low as $5 per person, will Administration of China has estimated the premium enable our passengers to secure their journey for a of the project will reach ¥200 million in 2011.” minimal cost.” Kanetix provides tips The tourism regulator introduced the insurance Antoine Stephan, managing director of RAK system in 2001, with the aim of protecting Insurance, said: “As an RAK-headquartered Canadian firm Kanetix has explained to travellers travellers, but the increasing number of travellers company, we are pleased to partner with the when and why they might benefit from topping up is forcing the insurers to bolster their internal emirate’s very own airline, RAK Airways, and their existing travel insurance policy and has urged resources co-ordination and enhance the efficacy of support its endeavour to provide customers with a consumers to consider all the different types of CBG brings in new their joint services. valued product offering.” policy there are available on the market. The Kanetix service offers online top-up travel insurance quotes partner for a variety of coverage and deductible options. Through the website, travellers can get quotes for Insurance broker CBG Group is to spread its wings eAtlasAmerica launched for US visitors top-up travel insurance from up to six providers. in the travel insurance market after signing a new With Kanetix, travellers can complete a quote and deal with FirstAssist Insurance Services. Under the US-based health and travel insurance brokerage ability to have instant access to printable ID cards purchase travel insurance before embarking on their terms of the agreement, FirstAssist will act as a sole International Services, Inc., has announced the and other plan services. The insurance cover holiday from anywhere with Internet access, even underwriter for CBG’s ‘Cover All’ travel insurance launch of a new website, eAtlastAmericaInsurance. includes benefits for in-patient hospitalisation, on a smartphone. With the Kanetix mobile travel policy. The policy, which was launched in September com, for international travellers and visitors to surgery, diagnostic expenses and outpatient medical insurance service, travellers looking to purchase 2006, offers worldwide annual travel insurance for the US. The new site features the Atlas America services. Prescription drugs, intensive care, and insurance or just top up their existing cover can do so a family of two adults and up to five children. The Insurance plan, offering health cover for non-US accidental death and dismemberment are also in a taxi on the way to the airport, or while waiting policy had previously been underwritten by Union citizens who are visiting the US, with the extra included in these types of plans. for their flight, train or bus. Reiseversicherung AG of Germany.

International Travel Insurance Journal INSURANCEMATTERS 9

Malaysia’s regulator focuses on risk

Malaysia’s central bank, Bank Negara Malaysia, is management and oversight within insurers. the year, which will aid insurers to identify where considering the need for insurance companies to Dr Aziz noted that in the insurance and takaful more work is needed. appoint dedicated heads of risk management to industries, there have been continued improvements Dr Aziz added: “We will monitor closely the provide assurances to its board on the companies’ in corporate governance practices and a further implementation plans by insurers to meet and risk management quality, according to the bank’s strengthening of the capital positions of certain maintain internal capital targets that are above the governor, Dr Zeti Akhtar Aziz, in her keynote address individual institutions. However, these improvements regulatory minimum level. Given the increasingly at the Financial Industry Conference, which was held have been uneven between companies and she said complex and competitive environment going recently. She said that the move is to promote better that overall progress could be further accelerated. forward, smaller insurers, particularly in the general risk management systems and processes among Insurers were also told that a regulatory framework insurance industry, need to strengthen their ability to insurers and a more integrated approach to risk for takaful insurance would be issued by the end of comply with the higher prudential standards.”

PwC promotes Solvency II

Charles Garnsworthy, a partner of PricewaterhouseCoopers, provider of industry- focused assurance, tax and advisory services, has urged the insurance industry not to waste the competitive advantages of the forthcoming Solvency II directive. In a speech made at the recent Association of British Insurers’ (ABI) Solvency II conference, Garnsworthy espoused the benefits of the new directive, saying: “Solvency II is a great opportunity for insurers to transform how investors, analysts and policyholders perceive the security and value the sector adds. This opportunity may be wasted as many firms are so bogged down in what they need to do to comply.” He continued: “Many insurers will need to rethink where and how they want to compete, as there will inevitably be aspects of some businesses that no longer make sense. It is worrying that we are hearing about people being taken out of product design and innovation to work on compliance as Solvency II offers the chance to stand out from the pack.” Garnsworthy concluded by saying: “Solvency II will be a catalyst for managing risk and capital more efficiently and is a real chance for the industry to send a clear message to the markets that it can respond swiftly and decisively to opportunities.” Meanwhile, October 2010 saw the inaugural Solvency II event from Gain-Line, a partnership offering a comprehensive set of Solvency II services, with senior representatives from insurance firms gathering to hear how plans for the new directive were progressing. Kesh Sharma, managing director of Magellan Consultancy Services, said: “It was refreshing to see companies recognising that Solvency II leaves a lot to individual interpretation, which can have both negative and positive implications, but it is very positive to see these companies proactively embracing and introducing positive change in their organisations.” Meanwhile, Mark Fidler of Liberty focused on data requirements as well as the opportunities and options available, while Kali Bagary, managing director of JMR Consulting UK, commented: “With far-reaching implications across the company, people really need to start looking at the impact now, particularly in regard to the IT systems. The longer companies leave it, the more costly it could become and it is likely to deliver a lower return on investment with firms progressively being reactive rather than proactive.” Tariq Ghadie partner of CirclePeople added: “Having the right resources is key within this environment as there are a number of sources out there in the market who claim to be experts in Solvency II, when this can plainly not be the case when you consider where we are in the implementation of the life cycle and how the guidance and directives are still being produced.”

www.itij.co.uk 10 INSURANCEMATTERS

ICBC buys stake in Self-sustenance for AXA-Minmetals Islamic finance NEWSWIRE

The world’s largest bank by commercial market Regulators and standard setters in Malaysia have AIA Group is worth up to US$38.9 billion, value, the Industrial and Commercial Bank of China called for efforts to adopt a framework for self- according to Merrill Lynch, a unit of Bank of (ICBC), has announced that it is to buy a 60-per-cent sustaining and stable growth in Islamic finance, a America and an arranger of the group’s initial public stake in French group AXA’s China life insurance move that would include developing a cross-sectoral offering in Hong Kong. venture, AXA-Minmetals Assurance, at a price of prudential and supervisory framework across the around 1.2 billion yuan (US$180 million). President Islamic banking, takaful and capital market. Bank China’s insurance industry raked in a of ICBC Mr Yang Kaisheng confirmed that the Paris- Negara Malaysia governor Dr Zeti Akhtar Aziz combined ¥1.01 trillion in insurance premiums for based insurer would hold a 27.5 percentage share outlined recommendations on Islamic finance and the first eight months of this year, representing a of the company, while China Minmetals Corporation global finance stability at the Global Islamic Finance surge of 33 per cent year on year, according to data will own the remaining stock. Forum 2010 in Kuala Lumpur, noting that some from the CIRC. Peter Staddon In other related news, Swiss insurer Zurich Financial of the recommendations have already shown Services has announced that it is to buy shares in immediate results, such as the signing of the Articles Underwriters with Lloyd’s of London said BIBA adds to its New China Life Insurance (NCI) to the value of of Agreement to establish the International Islamic it refused to provide cover to ticket sellers, around $420 million in order to solidify its presence Liquidity Management Corporation, which serves the broadcasters or merchandise producers for Focus Group in the rapidly expanding Chinese insurance market. role of managing liquidity in the system and allowing cancellation or disruption of the Commonwealth Zurich chief executive Martin Senn commented: the effective management of the monetary policy. Games in New Delhi, India, due to a lack of The British Insurance Brokers’ Association (BIBA) has “Our decision to participate in NCI’s share issue information about infrastructure and security announced the strengthening of its Healthcare Focus reflects our belief that China’s fast-growing threats. Group through the appointments of Mike Izzard and insurance sector represents an attractive investment Wayne Pointin to its committee. Izzard is former opportunity.” Insurance agents in Malaysia have huge chairman of the Association of Medical Insurance Social media potential to expand the life insurance market, as Intermediaries, while Pointin joins the team from Jelf penetration currently only stands at 41 per cent, Employee Benefits. The appointments follow the guidance for brokers said Adnan Zain, president of the Life Insurance recent employment of John Miller from Towergate, Association of Malaysia. who joined as a representative of consolidators and The British Insurance Brokers’ follow the committee’s decision to broaden its remit Association (BIBA) At the annual Monte Carlo rendezvous, from private medical insurance to wider healthcare has produced Swiss Re said the outlook for the global reinsurance issues, such as income protection critical illness and a collection market is mixed, with increased merger activity, group life insurance. of legal low interest rates and regulatory changes all issues Speaking of the appointments, Peter Staddon, documents facing insurers and reinsurers. head of technical services for BIBA, said: “The designed to new members to the Focus Group will strengthen help brokers Non-life insurers in India have begun the expertise of the group, which will help us to understand and to raise the premiums they charge corporations to tackle a range of healthcare industry issues head manage the risks which they offer group health insurance after they on.” Glen Smith, managing director of Healthcare that surround the have been hit by high, commercially unviable claims Partners and chairman of the BIBA Healthcare Focus use of social media, of those insured under corporate health schemes. Group added: “The stronger focus group will help us after increased to engage with government, especially following the interest from China Life Insurance is to focus on insurance announcements around the National Health Service members about the products that provide death, old age and medical in the recent comprehensive spending review.” communication medium. protection, said Wan Feng, the company’s The documents include president. The company has started to shift its sales guidance on using social strategy towards bancassurance. media, a template social media AIG closes policy and a template disclaimer Zurich Financial Services Group has entered for use on Linked In groups. into a definitive agreement to sell back to Unnim its MetLife deal Leighann Burtrand, communications 50-per-cent stakes in the life and general insurance manager for BIBA, commented: “Many members bancassurance companies jointly owned with US-based American International Group (AIG) has have been talking to us about their plans to increase Unnim. The agreement follows a merger of several closed the deal to sell its foreign unit American Life their use of social media. We have, therefore, Spanish banks. Insurance Company (Alico) to MetLife for US$16.2 Outside expert highlighted the important issues and many risks billion in cash and shares. Together with the $20.5 that social media can present to members.” She The Dow Jones news agency, citing Robert billion already raised from its recent initial public popularity rises continued: “These include copyright issues, the Henrikson, chief executive of MetLife, has reported offering (IPO) of its Asian life insurance business speed of communication, defamation and reputation. that life insurers in the US will obtain one third AIA, AIG has managed to garner $36.7 billion to A new study has shown that the world’s largest We hope that members find the legal documents of their profits from emerging markets by 2020 repay the American government. According to insurance companies are placing greater value on helpful in identifying and managing these risks.” as the economies of countries such as China and information released by the companies, the MetLife outside expertise to oversee their investments in the Emma Bate, a partner at Beachcroft LLP, the law India expand. deal involves around $7.2 billion in cash and the wake of the global financial crisis, with third-party firm that produced the documents, added: “BIBA remainder in MetLife securities, which ‘will be sold general account assets under management topping members need to be aware of the legal and The board of directors of AXA has given over time, subject to certain lock-up provisions and the US$1-trillion mark for the first time, reports Asset commercial risks of using these sites, as do their its full backing for AMP’s AU$14 billion (US$13.7 market conditions, to provide additional funds to International. The 2010 Insurance Asset Manager employees. The speed and simplicity of social media billion) bid for AXA Asia Pacific, paving the way repay the government’. Annual Service has revealed a total of US$1.47 means it is all too easy for staff to post something for AMP to become Australia’s biggest wealth A week earlier, the gross proceeds from the IPO trillion in insurance company general account and inappropriate or unlawful.” She continued: “In management company. of AIA reached $17.8 billion, and the exercise sub-advised assets as of 31 December 2009, particular, as brokers are Financial Services Authority of the over-allotment option increased these representing an increase of 32 per cent compared regulated, they must take reasonable steps to ensure Reuters has reported that almost every proceeds to $20.5 billion. AIG has said it will with the previous year’s total of $1.1 trillion. that all communication, including tweets or posts on Taiwan insurer has passed a stress test by the use the cash proceeds from both transactions Adam Tosh, managing director social media island’s financial regulators, in a bid to meet global to repay the credit facility extended to it by the of investment solutions at websites, accounting standards. Those that passed the test Federal Reserve Bank of New York in 2008. Rogerscasey, explained how, are ‘clear, are not required to raise capital for now, according Robert Benmosche, president and chief executive enticed by cost savings and fair and not to people close to the companies. officer of AIG, said: “We promised the American greater expertise, firms of all misleading’ taxpayers we would repay them, and the IPO types are leaning toward outside and if The International Insurance Society has of AIA last week and the completion of the Alico help to assume responsibility of they are announced that Dr Yehuda Kahane of Tel Aviv transaction move us closer to delivering on our investment management. He said: a financial University in Israel is the 2011 winner of the promise. As we said on 30 September, AIG will “Many organisations of a certain promotion, prestigious John S. Bickley Founder’s Award. Also restructure itself around its core property casualty size don’t have enough expertise should be honoured is Frank Swedlove, president of the and life and retirement services businesses, which and resources to hire enough of signed off Canadian Life and Health Insurance Association, are performing well, and will provide our company their own staff, and they’re often in the usual who will receive the Commissioner General Award. with a strong foundation to build value for all looking to outsource their chief way.” stakeholders going forward.” investment officer function.”

International Travel Insurance Journal INSURANCEMATTERS 11

Insurance NEWSWIRE premiums on

AIG has reported a $2.4-billion loss for the the rise last quarter, which the company says is due to restructuring changes. The company still owes According to Australia’s Sydney Morning around $100 million from the bailout package it Herald, insurance costs are on the rise, with received two years ago at the peak of the 2008 car, home and contents premiums rising by economic crisis. as much as 10 per cent this year. But it is not all doom and gloom for the consumer, Reinsurance intermediary Aon Benfield as watchdogs state that households can has launched its Life Reinsurance hub for the save up to 40 per cent by shopping around. Asia Pacific region, offering clients a spectrum Insurers have blamed the increase in of solutions, from traditional proportional and premiums on bad weather, while evidence non-proportional to non-traditional transactions, shows that consumers are not good when covering the full range of life insurance products. it comes to shopping around for insurance products, with just four companies Thailand’s insurance industry is projected accounting for more than 77 per cent of to be worth 770 billion baht (US$26 million) in five Australia’s insurance business. years, expanding by 82 per cent from this year Financial services analyst David Lalich, part on the back of continuing market liberalisation of the consumer finance research group Mount Merapi in Indonesia Britannica and increased capital inflows, reports the Bangkok Infochoice, commented: “There is a perception that Post. paying less means compromising on quality, but in our survey lower-cost challengers scored on par Disaster insurance scheme for Indonesia The Singapore life insurance industry has with the big players for key customer satisfaction The Indonesian government has announced plans to set Indonesia Capital Market and Financial Institution reported a 17-per-cent increase in new business indicators.” Colin Brigstock, a principal of the actuarial up a disaster insurance scheme to cover financial losses Supervisory Agency chairman to conduct a study for the first nine months of the year compared to consulting firm Finity, added that consumers can find and provide for emergency needs in the face of natural on the establishment of disaster insurance.” He the same period last year, according to the Life differences in prices of as much as 20 per cent by disasters such as the three major catastrophes suffered continued: “In principle, we have reached an Insurance Association. shopping around, particularly in car insurance. Home by the country in recent times: an earthquake-triggered agreement on the need to establish disaster insurance, he continued, does not tend to show as tsunami off West Sumatra, the eruption of Mount insurance. We will carefully study an appropriate Qatar Insurance Services, owner of the much as a price difference. Merapi in Yogyakarta and massive flooding in Jarkata. insurance design to prevent any difficulties in its claim insurance and reinsurance trade fulfilment system Agus Martowardojo, the country’s finance minister, process. The proposed disaster insurance will be Qatarlyst has acquired RI3K, the London- said of the announcement: “I have asked the reinsured with world-class reinsurance companies.” based technology firm that supports paperless transactions for the commercial insurance and reinsurance industries.

Ageas UK has reported its third-quarter results, which show non-life gross written premiums are up by 14.1 per cent to £703 million from the same period last year, while new annual protection premiums rose by 60 per cent to £16.3 million.

India’s insurance regulator has asked insurers to restrict outsourcing of core activities such as claims, underwriting and policy servicing, to guard against major financial lapses and to protect policyholders. Singapore insurers

Rating agencies are likely to increase urged to cut costs their oversight of catastrophe risk in Asia and many reinsurers will have to make substantial Singapore’s insurance industry has been asked to investment to address this new emphasis, do more to keep insurance protection affordable according to Aon Benfield. by Goh Chok Tong, the country’s senior minister. Speaking recently at the 40th anniversary of AM Best has said that China’s life Singapore’s largest insurance group, NTUC insurers are expected to continue to benefit from Income, Goh Chok Tong urged insurers to place the country’s economic development, though more emphasis on protection plans, such as term uncertainties over changes in macroeconomic assurance, stating that the product was a more policies and the performance of the domestic cost-effective way of meeting customers’ needs, equity market present challenges for their asset especially those from lower-income homes. Goh management operations. Chok Tong also made reference to studies that have suggested that Singaporeans are underinsured, Total premiums collected by the life stressing the importance of having sufficient coverage insurance industry in India increased by 23 per to assist dependants in case of untimely death, cent in the first half of the current fiscal year due critical illness or disability. He said: “It could be due to higher new business premiums, according to the to complacency and a false sense of security that Life Insurance Council. misfortune would not befall the individual. Or it could also be a general lack of awareness of how Prudential has reported a 17-per-cent much coverage would be considered adequate.” He increase in third-quarter group sales to £809 added: “But the more likely reason is the perception million, boosted by growth in Asian markets. The that getting the recommended amount of insurance company also reported £1.3 billion in new business protection is costly and beyond their means. Hence, profit for the first nine months of the year. it is given lower priority amidst other more pressing financial commitments like housing, children’s RSA has issued its interim management education and other day-to-day needs.” statement, showing that the third quarter of Goh Chok Tong then commented that part of the 2010 continued the company’s good top line problem lies in the traditional practice of keeping savings momentum and strong financial position. Net and protection elements into wholelife plans and written premiums were up 10 per cent to £5.5 concluded by saying that the insurance premiums in such billion. plans are often three-to-five times that of assurance plans, despite offering the same level of protection.

www.itij.co.uk 12 INSURANCEMATTERS

Spotlight shines on enterprise risk management Global economies

The global financial crisis has placed enterprise risk management performance polarised over crisis management (ERM) under the spotlight, according during the recent financial to a recent ERM survey by consultancy firm Towers crisis was mixed; risk International legal practice Norton Rose has launched Watson. The 2010 survey revealed that most appetite is important to the results of its global survey of financial institutions, insurers recognise the need for improvement in the ERM success; the business which found that 73 per cent of respondents believe ERM programmes, especially with the approach of impact of ERM continues that responses to the global financial crisis are further Solvency II regulations in 2012 and ever-increasing to grow; a lack of polarising between countries that were forced to bail rating agency expectations. The 2010 survey, which resources is inhibiting ERM out their banks and those that did not. Consequently, questioned 465 chief executives, chief financial development, including the survey found, the appetite for global co- officers and chief actuaries in insurance companies a lack of skilled people; operation has broken down. Also revealed was the around the world, also found that many ERM convergence of economic fact that more respondents now believe it will be practitioners are making ERM part of their decision- capital methodology has over 12 months before a return to liquidity to match making process, while those less experienced slowed; and Solvency II is pre-financial crisis levels is seen – a 40-per-cent rise practitioners continue to strengthen their ERM proving to be challenging on respondents in 2009. framework. However, the survey’s main findings in Europe and its influence Of the 314 respondents, 87 per cent identified revealed six main points: insurance company risk is spreading. Asia, including China, as the main region offering the best prospects for businesses, followed by Australia (27 per cent) and South America (26 per cent). In addition, 66 per cent believe the appetite for global regulatory reform has diminished and 77 per cent expect a long and shallow or flat recovery for the foreseeable future. Looking at a UK-specific level, the survey found that nearly 70 per cent do not think that the Financial Services Authority’s (FSA) restructure will make the UK a less competitive financial centre and 77 per cent think that bank levies will not improve better risk management in the UK. In addition, the respondents were split nearly in half on whether dividing retail and investment banking will matter following the FSA restructure.

Chinese reforms offer opportunities

An article by McKinsey has shown that healthcare reforms announced by the Chinese central government, and the US$125 billion the government has already committed to the cause, will stimulate the country’s healthcare market, creating many opportunities for private payers, insurers, providers and IT vendors. The authors of the article, Claudia Sussmuth-Dyckerhoff and Jin Wang, demonstrate their belief that the reforms will make the country more attractive for private companies to enter the healthcare market, by clarifying the roles that public providers will pay, while identifying niches for private players and making the operating environment more transparent and fairer for them. In the article, the consultants state that the size of the market, which is currently estimated to be around $240 billion, could exceed $600 billion within the next decade. They believe that healthcare spending is likely to rise faster than gross domestic product, as a result of better insurance coverage, improved access to high-quality care, and rising demand. Private healthcare insurance could become more accessible to the Chinese, continued the report, generating premiums of $90 billion by 2020, compared to the $8.4 billion generated in 2008. For private entities, the best opportunities were identified as being in supplemental health coverage and programme management, because the depth of coverage provided by public insurers will continue to vary significantly, thus creating a market for additional products. The article also states that private companies have an opportunity to help local governments manage the public insurance programmes, as in some regions governments have already been working with private firms in a range of areas, including benefit design, enrolment and provider management. In addition, they conclude that private firms can show governments how to accelerate the adoption of standard treatment protocols, install performance- monitoring mechanisms, and minimise variations in treatment costs.

International Travel Insurance Journal HEALTHMATTERS 13

Dengue infection continues

Dengue fever is continuing its seemingly unstoppable march across the world this year, with several countries reporting heightened numbers of cases. In Vietnam, more than 250 cases of dengue fever have been diagnosed in Da Nang’s hospitals during the first two weeks of October, bringing the total number of cases seen this year to around 3,000 – a six-fold increase over the same period last year. A report from the Da Nang General Hospital has shown that the facility is receiving between 20 and 30 patients each day Africa seizes chance High alert in French authorities complaining of dengue fever symptoms, which has forced some people into sharing beds. The report against polio Hong Kong confirm dengue cases states that around 80 per cent of its patients have been young adults and children, and 150 of the patients are At the end of October, countries across the African Officials in Hong Kong have confirmed the first case in a serious condition. continent seized a chance to drive out polio when 15 of bird flu in the territory in seven years, sparking Two cases of dengue fever have been confirmed In South America, meanwhile, the virus is also counties launched a synchronised mass immunisation fears about the risk from imported poultry from in mainland France – both in the city of Nice. spreading. According to the 154th Epidemiological campaign to reach 72 million children, capitalising China. The case is a 59-year-old woman suffering The Provence-Alpes-Cote d’Azur regional health Alert issued by the Network of Venezuelan Scientific on gains made earlier in the year. A total of some from bird flu, who was hospitalised following a board reported: “Thirteen people are undergoing Medical Societies, cases of dengue continue to occur 290,000 vaccinators have been mobilised to go trip to the mainland. York Chow, health secretary monitoring. They live nearby and have been throughout the country. Unconfirmed reports have door-to-door to deliver two drops of oral polio for Hong Kong, has insisted that imported poultry offered the opportunity to undergo analyses and shown that there are 97,000 cases of dengue fever, vaccine to every child under five in areas considered from China poses no increased risk to public health, are in good health.” The risk of an epidemic on while more than 72 patients have died. The amount to be at ‘highest risk’ of polio transmission. despite raising the alert for bird flu to ‘serious’, mainland France is considered to be limited, but represents three times the number of cases reported Dr Gianfrano Rotigliano, UNICEF’s regional director meaning that there is a risk of contracting the nevertheless is possible due to the local presence in the same period in 2009, and is the highest in the for West and Central Africa, said: “We are on the cusp disease within the territory. of the tiger mosquito. country since health records began. of an exciting possibility this year. Political leaders across Africa answered the challenge posed by this dreadful disease and … it shows what can be done when there is leadership and dynamic partnership with donor support around such an important health issue.”

Haitian outbreak continues

An epidemic cholera strain has been confirmed in Haiti by the US Centres for Disease Control and Prevention (CDC). The organisation has warned volunteers heading to the area that although no cholera vaccine is available in the US, travellers are able to greatly reduce their risk of contracting the potentially fatal bacterial infection by following its safe food and water advice. Such advice tells travellers to obtain medicine for diarrhoea before arriving in Haiti; only drink water that has boiled for at least a minute; In Brazil, a bulletin released by the Golas Secretariat not to put ice in drinks; eat only foods that have been of Health in October stated that there have been thoroughly cooked and are still hot, or fruit that the 66 deaths due to dengue fever this year, which is traveller themselves have peeled. Finally, the CDC a 73-per-cent increase on the number of deaths said: “If you are travelling in Haiti and have severe registered in 2009. In total, the number of cases of watery diarrhoea, seek medical care right away. It is dengue fever has reached 99,494 – an increase of important to remember to drink fluids and use oral 215 per cent on the same period last year. In Sao dehydration salts to prevent dehydration.” Paolo, surveillance shows that in Campinas city, the dengue epidemic is the worst in the last three years, and the second highest in history. Dengue has also continued its track across India, where hundreds of cases are being reported each day. Delhi now has at least 5,000 people infected, while in Uttar Pradesh the total number of sufferers has reached 924, and Chennai has seen 296 people test positive for dengue since January. Nepal has recorded 350 confirmed cases of the disease, with three deaths; Pakistan has confirmed nearly 3,000 cases of infection and 15 deaths; Taiwan has reported the number of indigenous cases as 658, with a further 256 imported cases of the fever.

www.itij.co.uk 14 TRAVELMATTERS

Pensioner adventurers travel the world Brazilian hopes high Travel warning for

According to a number of travel providers, including arrange becomes less relevant for them. Bridge the Brazil has been identified by Caribbean tourism Northern Ireland Saga and STA Travel, a new breed of traveller is giving World is somewhere that an STA customer can experts as among emerging tourist destinations a much-needed boost to Britain’s travel industry – the migrate to.” The company plans to take 50,000 that are not yet being taken seriously by the travel The US bureau of consular affairs in Ireland has over-50s. UK-based travel company Saga, which passengers on ‘grey gap years’ in 2011. industry. Richard Sealy, tourism minister for Barbados, issued a warning to US citizens travelling in the North specialises in travel for the over-50s, has reported a Feedback from customers is also positive. One said at the recent Caribbean Tourism Organization of Ireland following a series of bombings over the strong growth in sales for the age range with sales up couple, Carol and Vincent Domingo, aged 63 and 70 Leadership Strategy conference: “We can think about summer. The statement reads: “US citizens travelling 300 to 400 per cent over the past few years. And, it respectively, are the type of customer that projects it today and say it will not work, but I am sure you will to Northern Ireland should remain alert to their would seem, other companies are getting in on the such as Bridge the World are aimed at – three years remember when the UK was not our major market. surroundings and should be aware that if they choose act. This summer, Shearings launched a collection of ago they took a three-month holiday to Australia Now it is, because of all the work we have done. to visit potential flash points or attend parades, worldwide tours aimed at the over-50s while STA and New Zealand, which included a driving trip So I tell you, it will be an absurdity for any minister sporadic violence remains a possibility.” The bureau Travel, which has provided round-the-world tickets for between Sydney and Brisbane, as well as a three-day or director of tourism to ignore the Brazilian market, also warned travellers that demonstrations intended students and young travellers for the past 30 years, has stopover in Singapore and Dubai. Carol commented: which is now recognised as one of the fastest-growing to be peaceful could become confrontational and launched a new project, Bridge the World, specifically “Stopovers are appreciated by the aged on long-haul in terms of development.” Barbados already offers a possibly escalate into violence. for the over-50s. flights ... what I yearn for is a company that provides weekly flight to Brazil, and although Sealy said the flight In response, a spokesman from the Northern Ireland John Constable, group managing director for STA, versatility, some independence, and option of a was not always filled to capacity, ‘it is paying margin’, Tourist Board said: “Over recent years, we have seen said: “Over-50s want to take long-haul trips. A third touch of adventure, and that visited the route less and he is confident for the future. a huge increase in the number of visitors to Northern of them will take a long-haul holiday next year. travelled while staying in adequate, but not four-star, Sealy also stressed to delegates the importance of Ireland, and our feedback shows that the vast majority When they were 20, the gap year did not exist. accommodation.” developing relationships with other emerging markets, of those visitors see Northern Ireland as a safe and That demand is there.” He added: “We found that Bridge the World will also sell cruises, although such as China, partly in order to compensate for the secure destination.” However, similar warnings from we were losing our customers because, as soon customers are expected to use them as students continuing fall in visitor numbers from the UK. He said: the Australian and New Zealand Governments have as people start to have a family, the type of trip we would use airlines – on a ‘hop-on’, ‘hop-off’ basis. “Our UK numbers continue to decline, 8.1 per cent, caused some concern. The Australian Government which is a big worry for us, because not only is it our has advised its tourists to avoid any protests and largest market, but it is also the market where most of demonstrations, while the New Zealand Ministry of out visitor spend comes from.” Foreign Affairs suggested that citizens avoid Northern Ireland between April and August due to the potentially violent demonstrations taking place. Confidence low, but appetite is high Gulf tourists head New research has revealed that 84 per cent of Britons for Germany are still planning breaks away over the next 12 months, and holidays remain at the top of the list of reasons Figures from the German National Tourist Board why people are saving, but 20 per cent of people are (GNTB) show that the number of tourists heading less confident about travelling than they were a year to the country from the Gulf Co-operation Council ago. The findings, which have come about as a result (GCC) countries has increased by 42 per cent year- of a survey undertaken by Post Office Travel Insurance, on-year, making the GCC Germany’s second-largest suggest that because holidays are so important to the tourism revenue stream. There are also plans afoot UK, travellers are becoming more informed about in Germany to increase this number further, said protecting themselves while abroad, as it was found that Antje Roeding, director of the Dubai-based German 55 per cent of holidaymakers said that having adequate National Tourist Office, who said: “Germany has travel insurance or ATOL protection would make them also drawn up a comprehensive tourism plan, under feel more confident about travelling. which it will focus on health and wellness tourism in Indonesia gains popularity According to the results of the survey, 40 per cent 2011.” German hospitals are said to be developing of holidaymakers are concerned about their travel specific offers for guests from the Arabian Peninsula, Indonesia’s tourism industry is enjoying a successful tour operators and travel companies have also firm going bust, while 35 per cent are worried about such as Arabic language support for patients and year so far, according to Sapta Nirwanda, director complained that increasing congestion on the airline or airport strikes, and 30 per cent worry most accompanying relatives, in preparation for the general of marketing at the Ministry of Culture and Balinese roads has resulted in incessant traffic jams. A about extreme events such as earthquakes, or a renewed tourism effort. Tourism, and hopes are high that visitor numbers problem for Bali, though could mean advantages for repeat of this spring, when volcanic ash caused travel Roeding went on to say that summer is the most will exceed the seven-million mark by the end of other destinations nearby that will pick up the people misery for thousands. When asked about the types important travel season – this July, there were the year. During a recent conference, he said: “We who don’t wish to travel to somewhere as crowded of holidays they are planning to book, respondents 66-per-cent more tourists from the Gulf visiting are very pleased with tourism achievement for this – Lombok, for example, is experiencing growth of varied – 39 per cent are planning breaks in the UK, when compared to July 2009. Between January year. Despite the fact that some long-haul markets over 25 per cent. 33 per cent would like to go on a city break, 31 per and July this year, there was a rise of over 40 per remain weak, we achieved growth in all of our Other hurdles to the continued development of cent want an all-inclusive deal and 21 per cent would cent in the number of Gulf travellers to Germany. major incoming markets until August 2010. We the tourism industry in Indonesia are visa problems, prefer an independently booked holiday. Roeding added: “With 620,510 overnight stays, this [have welcomed] so far over 4.6 million international which Nirwanda addressed during the conference: Rachel Croft, head of Post Office Travel Insurance, makes the Gulf region one of the strongest overseas visitors, a number up by almost 12.2 per cent.” “We recognise that Indonesian destinations in said: “We have experienced unprecedented disruption source markets for Germany, second only to the Nirwanda said he was particularly pleased with the border areas, such as Batam or Bintan Islands near this summer, but it’s positive to see that there is still an US.” Figures collated by the GNTB also show that growth seen from markets in Australia, the UAE, Singapore, are disadvantaged. We are discussing appetite for travel. While we cannot always control Germany is the second most popular European Saudi Arabia and China, all of which have seen [the issue] with immigration authorities to see if or predict events, we can take measures to protect destination for Gulf tourists. growth of over 20 per cent this year. While Australia we could not introduce a kind of ‘vignette’ system ourselves. It is encouraging to see that is 2010’s fastest-growing market to date, he noted allowing multiple entry to travellers residing in consumers have become aware of the risks that Japan remains a notable exception with arrival specific designated areas. We hope to come to associated with travelling and as a result, numbers dropping by 11 per cent since January. an agreement despite the fact that numerous are more likely to take the appropriate Arrivals from Europe in the first half of the year administrative hurdles remain.” precautions to minimise disruptions.” numbered 500,000, showing the resilience of European traveller numbers, despite the economic problems. Growth from January to August ranged from seven per cent to 10 per cent for most Earnings increase for Royal Caribbean European nations, except for France, whose numbers were only up by 2.6 per cent. Arrivals from US-based Royal Caribbean Cruises Ltd has recently “Profitability momentum moving into 2011 the US, meanwhile, are also up by over eight per announced an increase of 55 per cent in third is also quite strong with our newest vessels cent, despite the absence of direct flights from the quarter earnings year-on year, rising from $230.4 performing exceptionally well and our US to Indonesia. million in the third quarter of 2009, to $356.8 million management team controlling costs very Bali remains top of the list in terms of popularity, during the same period this year. Richard Fain, effectively.” capturing 36 per cent of all international arrivals. chairman and chief executive officer of the company, According to the company, revenues However, the impressive growth seen on the commented on the increase: “We continue to improved to $2.1 billion in the third small island has had its negative effects, with characterise demand for our brands as steady and quarter of 2010 compared to $1.8 billion accommodation during the high season becoming solid, and the strength of our third quarter results in the third quarter of 2009 due to capacity increasingly expensive and hard to find. Many is certainly a validation of that.” He continued: increases and yield improvements.

International Travel Insurance Journal

16 IPMI NEWS

Bupa partners with MediHelp

Expatriates in Romania, Bulgaria and Hungary are market especially, because our members can benefit being given access to private medical cover as a from medical services anywhere in Europe.” result of a new partnership between Bupa and Clients who choose to take out the health insurance MediHelp International. The two private medical package will be able to choose the clinic or hospital insurers have together launched a new product for they would like to be treated in, rather than be expatriates in the eastern European states, as well as restricted to a network chosen by the insurance natives of the countries, offering access to world- company. Furthermore, MediHelp International has class healthcare facilities. Zahal Levy, president of established partnerships with a number of private MediHelip International, said: “This partnership is a medical facilities in all three countries, meaning that first in central and eastern Europe. We are the only customers can go to a clinic and receive treatment company to offer Bupa health insurance in all three without having to pay for it themselves and then Aviva launches IPMI countries. Our plans our unique, in the Romanian await reimbursement. marketing push Morgan Price

Aviva UK Health has launched an intermediary website launched marketing campaign on the benefits of selling international private medical insurance (IPMI). The Morgan Price International Healthcare has provider has a new website, which offers brokers announced the launch of a new website, which a range of information, including brochures for the has the functionality to provide online quotes for its international products Aviva offers. The site also international health insurance policies. The company includes a map that shows relevant health-related has said that in order to promote sales through its information from a range of popular expatriate intermediary partners, it will provide its partners with countries, along with a translation tool, enabling their own URL link to enable their clients to visit the intermediaries to translate a block of text easily. Morgan Price site directly from their own. When the Teresa Rogers, international sales and marketing client saves a quote or buys a policy online, details manager at Aviva UK Health, said: “Whereas in the of the purchase will be automatically sent to the UK, private health insurance is an alternative to the brokerage firm and a commission duly allocated. state system or an employee perk, in many countries An important point for clients and intermediaries to international health insurance is mandatory for note is that although Morgan Price does ask a series those requiring a work visa. Worryingly, our recent of medical questions during the application process, research showed that over a third (34 per cent) of policies will continue to be issued with moratorium young workers considering moving abroad wouldn’t underwriting until the new full medical underwriting consider it important to take out international health option is available. insurance. We want to encourage intermediaries to Also soon to come online is the ability to offer learn more about the international market so that quotations for life insurance, personal accident they can confidently talk to their clients about their insurance and travel cover in certain territories international medical insurance needs.” around the world.

Compulsory PMI Aetna enhances for foreign workers programme

Malaysia’s Ministry of Home Affairs is considering Aetna has announced the launch of its enhanced global the enforcement of compulsory private medical emergency assistance programme, which will be able insurance for foreign workers, according to a report to provide its international members with emergency by the Bernama news agency. The report went and urgent medical evacuation, repatriation and on to state that the proposed regulation will mean medical assistance, as well as access to travel that worker’s compensation insurance paid for by assistance services. In combination with its existing employers will cover occupational-related diseases 24/7 customer service and clinic support capabilities, and accidents, but medical insurance for non- Aetna Global Benefits (AGB) will leverage the services occupational diseases and injuries will be paid for by of On Call International, which is the US affiliate of the foreign worker. the International Assistance Group, a collaborative At the moment, Malaysia’s compensation payouts network of 32 independent medical assistance for its three million foreign workers are significantly companies with response centres in 53 locations. lower than those paid by Thailand and Singapore, Donna Otten, head of AGB, commented on the tie which has caused a rise in foreign workers’ unpaid up: “The unique structure of our global emergency hospital bills and has increased the burden of assistance services with On Call allow us to provide a healthcare on the Malaysian people. Over the better customer experience as part of our integrated past five years, MYR64 million (US$20.7 million) service model. One call to Aetna by the member or of unpaid healthcare bills have been left by foreign physician triggers live co-ordination of the medical workers, of evacuation with On which 19 Call based on our per cent was prompt identification owed to public of the affected hospitals. The member, his or her government plan benefits and the estimates an emergency situation. additional cost The end result to employers for our members of MYR3 per and employer plan month per sponsors is a better foreign worker evacuation outcome but the private with enhanced health insurance communication and premium would reporting, real-time be borne fully data access and by foreign greater flexibility in workers. plan options.”

International Travel Insurance Journal IPMI NEWS 17

Costs ‘pushed up’ New appointments at InterGlobal for expatriates International private medical the same role for the Middle East. insurer InterGlobal has Stephen Hartigan, chief executive for InterGlobal, said A recent article published in UK newspaper The Telegraph announced the appointment of the new appointments: “The Middle East and Asia has stated that unnecessary treatments, prolonged stays of two new regional general Pacific are significant growth areas for InterGlobal. in hospital, excessive diagnostic testing and overcharging managers to target the Both have large expatriate populations and a growing can ultimately push up medical insurers’ premiums. Fraud company’s growth in the Asia demand for high-quality international private medical was also identified as an issue, adding around 10 per cent Pacific and Middle Eastern insurance.” He continued: “I am delighted that to the cost of premiums in the US. regions. The company has we have been able to appoint two such capable Another issue raised was pressure placed on appointed Steve Conway as individuals as our new regional general managers to patients by the hospitals themselves. Hazel Gregory, regional general manager for lead our development in these important regions. former head of the UK subsidiary of a Dutch health Asia, responsible for business Both Steve and Mike have an in-depth knowledge insurer and a current medical insurance adviser, was development and operations of the private medical insurance industry and a real placed under such pressure when her husband was across six offices in Asia, while understanding of the requirements of expats from Steve Conway & Mike Delamere admitted to a private hospital in Spain after falling ill Mike Delamere will take on their private medical insurance cover.” with suspected pericarditis. After the hospital had told the couple that discharging themselves would make their insurance null and void, despite the fact that the tests for a heart attack had proved negative, they were told that a third test costing k800 was essential. Hazel said: “I was fortunate to have had experience with the medical profession and was able to be assertive. If I hadn’t, it would have been wobbly – you are particularly vulnerable at times like that.” After contacting her insurer’s 24-hour helpdesk, further tests were declared ‘superfluous’ by the insurer’s duty doctor and the hospital stay consequently limited to just two-and-a-half days. Hazel had advice for other travellers: “If you feel the hospital is putting you under pressure you should get in touch with your insurers and get a new perspective on what is going on.”

IMG Europe wins industry award

IMG Europe, the European subsidiary of International Medical Group (IMG), has recently been awarded Best International PMI Provider at the Health Insurance Awards 2010 – the company was shortlisted for the award in 2009 where it was a highly commended finalist. The awards ceremony recognises top achievements within the intermediary and health insurance provider communities and was hosted by Health Insurance magazine. Carl Carter, managing director of IMG Europe said of the award: “We are delighted to have won such a prestigious and highly prized award. We know that brokers have a choice and we are proud that they choose to do business with IMG and IMG Europe.” He continued: “We pride ourselves on our products and personal service so it was a pleasure to accept the award on behalf of our team.”

Aetna chairman to retire

Aetna’s chairman and chief executive officer Ronald A. Williams is to retire in April 2011 after nearly 10 years with the company – as of November 2010, Williams will become executive chairman and Mark T. Bertolini, currently the company’s president and head of business operations, will be appointed chief executive. Commenting on his retirement, Williams said: “After nearly 10 years at Aetna and with the company performing well, it is time to step aside. The passage of major healthcare reform legislation has underscored the need for market-based solutions to address quality and affordability challenges in healthcare, and the next few years will present another opportunity for Aetna to lead.” Speaking of his new role, Bertolini added: “I am proud to be given the opportunity to lead Aetna, a company with extraordinary people … I am excited about the challenges and opportunities that lie ahead and believe Aetna has the right strategy to win in the marketplace.”

www.itij.co.uk 18 CROSS BORDER CARE

Mexico anticipates more medical tourists Abu Dhabi hospitals

According to Health Digital System (HDS), a Mexican However, one problem experienced by Mexico fail inspections company that provides technological solutions for is that only two per cent of its hospitals and clinics information systems in the country’s healthcare hold Joint Commission International accreditation, According to Health Authority-Abu Dhabi (HAAD), system, the number of but the federal health department two-thirds of hospitals and clinics in the emirate of medical tourists to Mexico is currently working on new Abu Dhabi failed initial inspections in 2009 mainly this year will easily exceed certifi cation for hospitals on the because of poor hygiene, with the most serious the 50,000 welcomed in northern border, as well as in the problems uncovered at small private clinics – one 2009. Between January centre of the country. inspector found a dirty syringe stored in a doctor’s and September 2010, HDS has estimated that around desk, which the doctor in question had been planning 44,512 foreigners checked 300,000 US citizens travel abroad on reusing. Offi cials, however, have attributed the into Mexican hospitals, for medical care, a drop in numbers lapses to the ‘widely differing backgrounds of health 25-per-cent more than did from fi ve years ago, which saw staff’ and see their challenge as being bringing them during the same period around 750,000 Americans seeking all up to the same standard. last year. The study also revealed that of the 50,000 medical care abroad. Another survey, this time by Inspectors made more than 1,300 visits to health or so patients that were treated in Mexico last year, Deloitte Center for Health Solutions, stated that there facilities in the emirate last year, with 315 existing each one spent an average of US$13,000 a week on were 540,000 medical travellers in 2008 with the MEPs vote on cross- facilities failing the test and only 156 passing fi rst time. medical care, creating a total of $650 million. predicted growth failing to surface. Paul Keckley of New facilities fared a little better, but only 55 out of the HDS expects growth within the sector to continue to Deloite commented that the economy ‘has beaten border healthcare 126 passed their initial inspection, with failing facilities rise and predicts a revenue of around $1.2 billion in down the anticipated 20 per cent growth’, a thought given 45 days to improve before re-inspection. two years’ time, due in part to the fact that treatment echoed by Patrick Marsek of MedRetreat, an Illinois- A vote by European Parliament MEPs on new EU Although the HAAD has reported a marked in Mexico costs around half as much as that in the US, based medical travel agency that reported a downturn rules on access and rights to cross-border healthcare improvement in facilities over the past three years, which encourages medical tourists to the country. in business of 30 per cent since 2008. has reportedly guaranteed patients’ rights to cross- fi ve key problems remain: poor hygiene and infection border care while safeguarding the provision of control; little maintenance of medical equipment; lack quality healthcare services at a national level. The of medical records; non-observance of clinical practice Medi-Clinic eyes Switzerland proposal allows patients to receive hospital treatment guidelines; and non-maintenance of facilities to fi re and in other member states and be reimbursed as they safety standards. Inspectors also found staff performing South African-based private hospital group Medi-Clinic as Hirslanden – a group operating in Switzerland that would if they had received the treatment at home, tasks for which they were not qualifi ed or licensed, is said to be looking into the possibility of acquisition is already owned by Medi-Clinic. Hirslanden hospitals but this is not to be at the expense or the viability of and regularly witnessed lab technicians working on in the Swiss healthcare market, as it expects the treat Swiss nationals as part of the state’s healthcare the national health systems. urine or blood samples without wearing protective government’s health reforms to drive consolidation in service in seven of the 10 cantons in which it has a MEPs managed to narrow the list of reasons for gloves, as well as toxic and chemical cleaning products the private hospital industry. The Swiss government presence, which could stand the company in good which a patient can be refused cross-border medical being stored alongside medical equipment, with is amending its Health Insurance Act to replace its stead when the reforms are enacted. According to treatment, while another proposal stipulates that dentists reusing ampules on different patients. current fee-for-service model with fi xed fees, and Medi-Clinic chairman Dr Edwin Hertzog, Hirslanden member states cannot refuse reimbursement after Dr Khalid Fulad, director of health and compliance at plans to give its 26 cantons the power to approve could also stand to benefi t from the change to fi xed proper authorisation has been granted. At the HAAD, commented that the problems were most their own lists of private hospitals that can treat state fees, as its average length of stay is shorter than state moment, patients wishing to receive treatment in common in small private clinics and health centres as patients. The changes, due to be implemented from hospitals. In the new system, he added, hospitals will another country do not know if they will be refunded larger hospitals tend to ‘have a big budget that allows 2012, are expected to prompt individual private be reimbursed for treating a condition, rather than or how that may happen – the new directive is, them to hire qualifi ed staff of a high calibre’. Speaking hospitals to seek mergers with the larger groups, such paid for each test or procedure given to a patient. therefore, designed to allow patient mobility as has at a three-day workshop already been witnessed with students and workers. Under the new directive, centres with national contracts to access information relating to healthcare in other countries will be set up, and if permission is given for a patient to receive care in another EU country, payment will be made directly by the country of the patient to the country where medical treatment is received. However, although most countries have accepted the outcome as being inevitable, Poland, Slovakia and Portugal all voted against the proposal, while Romania abstained. There were 227 amendments made to the plan on healthcare auditing, Dr Fulad explained the lapses and verbal agreements were made on three points: in cleanliness and following procedures: “Smaller patients can seek hospital care in another country clinics take procedures for big hospitals and try to without prior authorisation; cross-border care can implement them without amending them for their be refused by a country only in a limited number of specifi c conditions, or a lack of policy at the facility circumstances; and 25 million Europeans with rare or a lack of adherence to policy, and of course a diseases will be covered under the proposed law. stubborn mentality as well.” Research shows that the majority of people tend The HAAD has arranged a series of workshop for to stay near home when in need of medical care, healthcare directors and managers. “Our teams show or choose to travel only when in need of specialist the healthcare facilities what they are doing wrong, treatment or if better facilities are close, as is seen in and teach them the right way of going about things,” Luxembourg, which sees a number of its residents said Dr Fulad. cross the border to France, Belgium or Germany to receive treatment – in fact, around seven per cent of the country’s medical payments are cross-border, the highest fi gure in the European Union. IPMI PROVIDER

International warning for Indonesia Interglobal The Health Ministry of Indonesia has banned local hospitals from branding themselves as ‘international’ CONTACT: Peter Rousseau - Group Business Devlpmt. Director unless they are formally accredited as such by an Woolmead Hs East, The Woolmead, Farnham, international organisation. The move prompted Surrey, GU9 7TT UNITED KINGDOM 10 local hospitals to apply for approval from the tel: +44 (0)1252 745 900 Joint Commission International. Dr Supriyantoro fax: +44 (0)1252 745 920 email: [email protected] of the Health Ministry said: “The existence of such web: www.interglobalpmi.com international attributions did not guarantee the quality of a hospital’s service to the public.”

AIRAMBULANCENEWS 21

CareFlight in the spotlight Helijet awarded

CareFlight, which took over the provision of Darwin instead. Locke told the local paper that she eight-year contract aeromedical evacuation services to the Top End area was informed that no CareFlight aircraft were available of Australia on 1 July this year, has been criticised by at the time of the transport as they were out of action. Canadian firm Helijet International has secured a a local resident, who, after being told her daughter In a statement to the same local newspaper, The deal worth $94.7 million with the British Columbian needed an air evacuation to Darwin, then had to Katherine Times, CareFlight said that there were Ambulance Service; the original contract begins on drive her there herself. Jodie Locke told a local aircraft available at that time, adding: “In the case of a 1 April next year and runs for eight years, with a newspaper that her nine-year-old daughter broke her broken arm, where there are no additional injuries, possible four-year extension option. Under the terms arm in two places on 30 September, and had surgery the arm is immobilised and adequate pain relief and conditions of the contract, Helijet will provide that morning in Katherine. The family was then administered. This was considered a low acuity case three dedicated helicopters that will be available informed that they would have to be transferred to and suitable for transfer via other modes of transport 24/7, two of which are to be based at the company’s Darwin for further surgery and a plane would arrive apart from aeromedical services aircraft. In this case, headquarters at Vancouver International Airport, later on that day to perform the transfer. Some hours the patient was reassessed at the Katherine District and the third in Prince Rupert. The company has later, they were informed that the aircraft would not hospital and it was deemed appropriate for them to said it will buy three Sikorsky S76C+ helicopters to be able to transfer the girl until the following day. The travel by road to Darwin. Department of Health and fulfil its side of the contract, and will require a staff of girl was then made ready for transport, however, Families clinical staff considered this to be clinically around 45 people to manage, fly and maintain the no plane arrived, so Locke drove her daughter to appropriate for such a low acuity patient.” aircraft. A statement from Helijet International said: AirMed offers “The helicopters will be exclusive deal equipped with the latest operating and safety American air ambulance company AirMed Rega installs Propaq system advancements to International has partnered with the American Bar provide the highest level Insurance Plans Consultants (ABI) to offer exclusive MD Monitor of mission safety and discounts on its membership programme to members reliability.” of the American Bar Association, which has nearly For all those heading to Switzerland for skiing The contract between 400,000 members, making it the latest voluntary this winter, the good news is that Zoll Medical BC Ambulance Service professional association in the world. Dave Andrews, Corporation, a manufacturer of medical devices and Helijet is not the president of the ABI, said: “A low-cost AirMed and related software solutions, has announced that first between the two Traveler membership surpasses travel insurance by Swiss Air-Rescue – Rega – is the first international air organisations – Helijet bringing you to the hospital of your choice. Purchasing medical transport provider to install the new Propaq has provided two an AirMed membership through ABI is the simple MD Monitor/Defibrillator on its medical helicopters. dedicated helicopters for solution to unexpected travel emergencies.” Over the past year, Rega and Zoll have worked 12 years and one turbo- together to provide valuable clinical and human factor jet fixed-wing aircraft for input into the design of the life-saving device, which the past five years. CareFlight’s KingAir B200 Martin Eadie has been developed specifically to meet the special LifeTeam enters needs of air ambulance operators. The Propaq MD is an ultra-lightweight compact device with advanced service in Nebraska capabilities that combine the well-accepted and MedjetAssist highlights benefits proven features of Propaq monitors, but it is also LifeTeam Critical Care Transport has expanded 60-per-cent smaller and 40-per-cent lighter than MedjetAssist, a US-based medical evacuation and due to a motorcycle accident. After initial stabilisation, its service to a new base at the McCook Ben similar devices. It is two pounds lighter than the repatriation membership programme, has been the member was transferred to his home in Ontario Nelson Regional Airport, Nebraska, US, providing current air medical vital signs monitor, even with alerting its members and potential customers to for continued care and rehabilitation. 24/7 critical care air ambulance transportation in defibrillation and pacing added, said the company. the high costs of air ambulance services, in order a Beechcraft C90 aircraft. The service has been Roland Albrecht, medical director of Rega, said: to underline the benefits of coverage through Israel to the US welcomed by locals, who had previously had to “We are pleased to have been involved in the final membership schemes. Medjet arranged a transfer for a 65-year-old rely on distant air ambulance providers when it was development of a life-saving product that advances MedjetAssist said it provides medical evacuation and member from Richmond Hill, New York, US, who necessary to transport a critically ill patient. patient care and provides the ruggedness, durability repatriation services to hundreds of members every was hospitalised in Jerusalem, Israel, with bilateral Fire chief Marc Harpham said that in the past, fire and advanced functionality required for air medical year – members who were not expecting to be quadricep tendon ruptures that were sustained in a trip and emergency medical services (EMS) personnel operations. Working with Zoll resulted in an innovative injured or fall ill. An individual annual MedjetAssist and fall accident. After initial stabilisation, the member have had to rely on a fixed-wing aircraft based in solution that meets the challenging requirements membership starts at only $250 and can save was commercially repatriated to his home hospital in Goodland, or EMS helicopters based in Kearney of emergency air transport.” Meanwhile Jonathan members tens of thousands of dollars in medical New York for surgical repair and rehabilitation. and North Platte. He said: “Having LifeTeam here Rennert, president of Zoll, said: “The adoption of the transportation, said the firm. To underline the cost and staffed here 24/7 can change our response time Propaq MD is indicative of the [effort] to which this savings provided by membership coverage, the Aruba to the US to critical care emergencies from approximately well-respected civilian air ambulance operator goes provider gave examples of transports it has recently Medjet arranged a transfer for a 74-year-old 20 minutes to five minutes.” He added that it was through to provide top-level critical care to patients. arranged. All of the flights took place 3 October 2010. member from Oxford, Massachusetts, US, who was especially advantageous to have a fixed-wing aircraft Due to its advanced capabilities and compact size, the hospitalised in Oranjestad, Aruba, with generalised on hand, rather than a helicopter, as they can cope Propaq MD replaces the need for separate monitors Namibia to Canada weakness and aphasia, and was later diagnosed with better with adverse weather. The LifeTeam staff are and defibrillators, resulting in more cabin space and Medjet arranged a transfer for a 56-year-old member an ischaemic stroke. After initial stabilisation, the housed in a five-bedroom facility at the airport to reduced weight. With its small footprint, it’s also easy from Ontario, Canada, who was hospitalised in member was transferred to his home hospital in implement a rotation of three personnel stationed to mount inside the aircraft.” Namibia with multiple rib fractures and a haemothorax Oxford for continued care and rehabilitation. there on a full-time basis.

www.itij.co.uk 22 AIRAMBULANCENEWS

First anniversary for RFDS jet

Setting the standard The Royal Flying Doctor Service (RFDS) has reported the first double critical care transfer, where two that the first year of operation for its only aeromedical critically ill patients were transported at the same Gerry Bolger asks: are our healthcare clinical advanced practice training required for aeromedical jet was highly successful, transporting more than 200 time, each with their own critical care doctor and staff sufficiently trained, and who is setting the repatriations. As such, how do assistance companies people from the furthest reaches of Western Australia. nurse team. This is simply not possible using our standard for in-flight care? and more importantly how do insurers and The Rio Tinto Life Flight jet made a special visit to the regular fleet and would have required two aircraft underwriters ensure that clinical staff (doctors and Jandakot Airport for the birthday celebrations, which and many more flight hours without the support of Because health professionals are trained differently, nurses) are adequately trained and maintaining their included the cutting of a birthday cake. the jet.” He continued: “The Rio Tinto Life Flight jet there is a likelihood that there will be a variance competency skills set by their profession? Derby resident Sarah-Jane Anderson, who was has made a tremendous difference to our ability to in the standard of training to register initially, and To train as an in-flight nurse in the UK requires an transported to Perth last year after being involved in a respond to the needs of rural and regional Western then in the specialist skills required for aeromedical NMC registration, and in-flight nurses recommend vehicle accident on the morning of her 25th birthday, Australia and is a huge step forward for aeromedical care. Training of healthcare staff is the responsibility that a minimum of three years’ post-registration joined in the celebration to highlight the benefits the services in Australia. As we celebrate its first birthday, of each country and/or the regulator for the experience is gained in an acute setting (emergency, jet service is delivering to rural and remote areas of I would like to thank Rio Tinto for their vision and profession concerned. In England, the regulation intensive care etc) before then commencing a the state. Anderson was hit by a drunk driver while generosity in making the dream of an aeromedical jet of such services comes under the Care Quality recognised course that adequately trains one to standing outside the local shops during a shopping service a reality.” Commission (this will be different in the other practice as an in-flight nurse. trip for her birthday party that night. She was stuck The jet was made possible by a $5-million partnership devolved authorities) and currently the Financial This is where the issues commence, because under the vehicle and was dragged 10 metres. She with mining company Rio Tinto. The firm’s chief Services Authority regulates insurance and finance- the regulator does not stipulate what that training sustained significant injuries including six broken executive of Iron Ore and Australia, Sam Walsh, said related issues. Interestingly, all three rarely work is, but in the case of harm, or if a regulator was ribs, a broken shoulder and wrist, a collapsed lung, Rio Tinto was proud to be associated with such a together to support each other in ensuring high- investigating, it is not uncommon that the Bolam test bleeding on the brain, deep road burns, a broken left significant improvement in remote medical care: “As quality repatriations. The question that needs to – a test around negligence, skills and competency leg and pelvis, and a split liver and spleen. Anderson a business we operate in remote locations so we be asked is why not? And if not, who is setting the – where the practitioner states s/he as having more and a man who had also sustained injuries in the understand the significant challenges faced by people standard of care in the air? than average skills and abilities expected, which accident were rushed to Perth for treatment in the living and working in regional Western Australia when In the UK, the must be in Rio Tinto Life Flight jet and she remained in Royal it comes to medical care. When the partnership was Nursing and accordance with Perth Rehabilitation at Shenton Park for five months. developed, we wanted our contribution to really make Midwifery Council a responsible Anderson outlined the important contribution of the a difference to regional communities and seeing the jet (NMC) replaced professional body jet to local healthcare: “We were lucky to be able to one year on making such an impact is very rewarding the United of opinion, even fly in the jet as it took us only two and a half hours for everyone at Rio Tinto.” Kingdom Central if others differ in to get from Derby to Perth. It’s pretty critical for us The jet’s medical fit out and operations are also Clearing Council opinion. rural and remote people to be able to access medical supported by funding from the Flying 1000 fundraising for Nursing, In the UK, facilities as quickly as possible and a lot of people group, RFDS Victorian Section and Maroomba Midwifery and there are two wouldn’t make it without the RFDS.” Airlines. The State Government’s Royalties for Regions Health Visiting in recognised RFDS Western Operations chief executive Tim programme has also underwritten its operating costs 2002, and they courses for Shackleton said the jet, a Hawker 800XP2, had up to a value of AU$1 million per year for three years. regulate nurse nurses, which give transported about 200 people in its first year, greatly registration for the initial training improving the ability to respond to urgent needs in initial registration to practice – the rural and remote Australia. He added: “The Rio Tinto and the practice Royal College of Life Flight jet was the realisation of a long-held dream of educational Nursing’s In-Flight for the RFDS and its first year has proven just how standards. Nurses Course, important it is to rural and remote Western Australia. The NMC is which provides a We have experienced unprecedented demand for responsible for The issue that assistance course with both our services in the last year and the jet has helped the requirements academic credits us respond to urgent cases throughout the State and for education, companies need to consider over a three- Australia’s Indian Ocean territories.” which in the UK to-four month The jet has been particularly beneficial for residents is provided by is: are you an employer when period and an of the north of the state, with 112 of its 208 patients faculties for health intensive teaching coming from the Kimberley region and 52 patients at universities. engaging an in-flight doctor programme coming from the Pilbara. This means over two weeks. Shackleton said the jet’s ability to carry up to four that nurses or nurse? The second patients had allowed the regular RFDS fleet to remain and midwives is provided closer to bases throughout the state and had also currently qualify by the Royal resulted in the achievement of a significant milestone: with a degree in Air Force for “The capacity of the jet allowed the RFDS to conduct nursing or a diploma (the latter being phased out their staff and is done over a longer period of by 2013). Therefore, the regulator is responsible time. There are other courses, which it could be for the requirements to practice as a registered argued, would provide such training, for example nurse to qualify and to practice; currently few the CCAST course. However, the difference is Scottish service specialist qualifications are regulated by the NMC. that the two formerly mentioned courses are It has been historically seen that the advanced level specifically focussed on nursing practice needs. As extended of practice in nursing, while an issue for regulator, is such, it is the nurse who must satisfy the regulator actually deemed the responsibility of the employer. and their representative in supporting any claim The Emergency Medical Retrieval Service (EMRS), The recent Advanced Level of Practice1 statement that they demonstrated the adequate skills and which originally operated in the Hebrides Islands off from the Department of Health clarifies the competencies to practice. Interestingly, in other the coast of Scotland, has now extended its service Red Crescent prepared issue. While often confused with ‘role’, it is really countries outside Europe, the length of training for area to cover rural areas across the whole of the about the ‘level’ the practitioner is operating at. nurses is at least several weeks – if not months – and country. The number of medical teams available has Captain Abdulhamid Al-Jawfi, the director of the Traditionally, there have been different phrases to is more regulated, however, that is in line with those been increased from one to two, with the number of Saudi Red Crescent’s air ambulance operations, mean the same thing between professions. The countries’ systems. doctors rising from eight to 15, at a cost of £2 million has said that all landing spots have been tested and CHRE (the overarching regulator for the healthcare Given the somewhat murky situation, each insurer, a year. The team makes use of Scottish Ambulance are prepared to cope with the influx of hundreds professional regulators) has requested the need underwriter and assistance company should be Service aircraft as well as Royal Navy helicopters to of thousands of Muslim pilgrims who travel to the for clarification around this subject. The issue that checking and be assured that each practitioner, perform life-saving missions. region during the Haj season. Al-Jawfi said that Red assistance companies need to consider is: are you whether a doctor, nurse, paramedic or other, Dr Stephen Hearns, the lead consultant with the EMRS, Crescent has trained its pilots to fly at holy sites an employer when engaging an in-flight doctor or has the sufficient training to perform the duties told BBC Radio Scotland: “In terms of staffing resource, in Saudi Arabia, the Al-Laith area near the coastal nurse? expected of them. They should also ensure that this is the most highly equipped emergency medical road, the Al-Hemma area and the Al-Sumaisi area. Looking at the wider view, the European Union such training will be recognised, or is recognised retrieval service in the world. Each day we will have During testing before the Haj season, helicopters (EU) has stipulated the recognition of cross training by the organisation that provides indemnity cover, two consultants on duty and they’re consultants from were landed at various places as near as possible across the European Community, and the EU has as some may only recognise profession-specific emergency medicine, anaesthetics or intensive care to the holy sites where the largest crowds gather. set a directive to recognise initial training to practice training. Furthermore, assistance providers should who are trained and equipped to work in the aircraft Landing areas have been established for helicopters for qualification as a doctor, nurse or midwife; but as good practice check that their clinical staff are up and to carry out lifesaving critical care and interventions at the Jamrat Bridge, Arafat, the Al-Noor and Nira there is little guidance that is specific to the to date in their knowledge, meet their regulatory in any environment.” The Scottish government funding Hospitals, and King Fahd Hospital in Madinah. The requirements and can demonstrate competence in that was needed to set up the service means that health air ambulance service will be on offer 24 hours a day 1 Department of Health, Advanced Level of Practice, London, delivering high-quality, safe and efficient in-flight care. staff now undertake responsibilities with the EMRS as throughout this year’s Haj, which is the first time the November 2010 part of their job descriptions. emergency medical service has been introduced.

International Travel Insurance Journal

24 FEATURE

Is there strength in numbers?

ITIJ spoke to several travel insurers in the An ongoing battle claims and claimants before it ended over data supply three years of data to CRIS for it to run through UK to assess the ongoing development “We tried to get a CUE database going in 1995 but protection concerns. Then, four years ago CRIS, a trial database and come up with successful matches. of the travel claims sharing database, the industry wasn’t as developed then as it is now,” which runs part of the home and motor database, However, Remmington says, it took ‘a long time’ for asking whether or not there really is an says Remmington. “It was dismissed because travel came to the TICC eager to get an equivalent travel the insurers to provide the data as contracts had to appetite among the industry to work be signed protecting confidentiality. Also, one of the cohesively to fight fraud insurers then pulled out at the last minute because they were unhappy over how the data would be held. On Friday 19 November, Julie Remmington “Travel insurers collect data in a different “The trial wasn’t as successful as we hoped,” explains began assessing a series of tenders for a project Remmington. “Travel insurers collect data in a aimed at reducing travel insurance fraud in the different way. Because some refer to baggage claims UK. For Remmington, chairman of The Travel way. Because some refer to baggage claims as as personal possessions and others as belongings, the Insurance Claims Committee (TICC), the process matches we found weren’t strong.” marked the beginning of the end of a personal personal possessions and others as belongings, and an industry-wide 15-year long journey. The A new hope project – developing a database along the lines of However, last year a project team consisting of the household and motor Claims Underwriting the matches we found weren’t strong.” representatives from AXA, Chartis, Groupama, Exchange or CUE for the travel insurance sector Cunningham Lindsey, Insure & Go and the TICC, – would allow insurers to track peoples’ claims with the backing of the Insurance Fraud Bureau, histories with those of the rest of the sector and insurers thought it would be too complicated and too CUE started. “It wanted travel on board and they restoked the CUE dream. hopefully catch multiple claimants. It’s an idea that expensive because the margins in the sector are very were keen to talk with our members, but we just “The tenders are now out to find a database host,” has garnered precious little industry support over low. There was also debate about whether that cost couldn’t get the bigger insurers to support it,” states explains Remmington. “They will tell us what they the years, but Remmington is hopeful of getting should be borne by the insurer or the claims handler.” Remmington. “We sent emails to the decision can provide and how much it will cost.” the new system up and running in time for next For the next ten years, the TICC ran its own makers but we didn’t get a reply.” Remmington says a ballpark figure would be a 40p fee summer’s peak-holiday season. system, using faxes to inform insurers of ‘dodgy’ The TICC did have enough backers – four insurers – to paid by an insurer to check a claim against the database,

International Travel Insurance Journal FEATURE 25

down from the £1.50 a claim mooted 15 years ago. difficult as possible for fraudsters whilst delivering But perhaps not yet. Some significant caution about will be very effective in identifying serial claimants. “Hopefully all the underwriters of travel insurance valued benefits to the vast majority of our customers the industry being able to come together over this “As an industry we need some visibility as to the very will subscribe and the claims teams in all companies who have genuine claims.” issue and make it work still lingers. small number of people potentially claiming regularly will have an additional resource to combat fraud,” on a non-genuine basis,” he says. “They need to be she states. “There are still a few companies who are screened in the right way to protect the product and very protective and want to do their own thing and “I believe that a CUE database, which the genuine customer.” not share information. But we are a lot more open He is confident that the industry can be collaborative as an industry now.” While she would like the system every travel insurer commits to signing over this issue and that competitive concerns over in place before next summer, Remmington is not sharing data will not be a factor. However, he setting a strict deadline. “I’ve been doing this for so expresses concerns over both cost and whether the long, I just want it to happen,” she states. up to, is the best way to unite the industry can effectively manage and use the data in When ITIJ talked to insurers about the prospect of the correct way. “Can it be a cost-effective system? a CUE database arriving soon, it was hard to detect industry against fraud” You have relatively thin margins in the travel business the reasons behind Remmington’s nervousness so you have got to be comfortable with paying extra or why it has taken the industry so long to come money for data feed and employing more people together on this issue. The feedback seemed Perhaps Remmington is right. Perhaps the industry A note of concern to respond to what the data is telling you,” Davies overwhelmingly positive. is ready to come together and secure the positive AXA Insurance’s group fraud risk manager Richard says. “Those insurers who don’t operate the data Stuart Bensusan, head of sales at Essential Travel, benefits of a CUE database from collective action. Davies is supportive of the database and believes it in the way it is intended will increase the cost of the suggests that one in 10 travel insurance claims has a ‘fraudulent element’ and that the only way the industry is going to combat the problem is to work together. “If one insurer goes out with a hard line on fraud and doesn’t get the support of the industry, that company will run the risk of losing customers to the competition. I believe that a CUE database, which every travel insurer commits to signing up to, is the best way to unite the industry against fraud,” he states. “I wouldn’t say that there is a lot of resistance in the industry to the idea of a CUE system. Some insurers are concerned about exposing sensitive data and overcoming the issue of different companies using different systems, but as long as it’s done properly, I think it’s a very good idea.” Paul Everett, director of sales and marketing at Europ Assistance agrees: “The desire for the database has always existed but previous initiatives have foundered due to data protection act concerns or set-up and access costs. There is now a clear understanding that such a database would contravene no regulations and is an essential investment in a time of ever- increasing fraud.” One more from Chartis: “We have long advocated a similar industry-wide approach to travel insurance. It’s early days and a lot of work still has to be done before an efficient mechanism is in place,” says David Miller, head of UK claims. “However, I’m pleased that we are moving forward as an industry as ultimately it is only through joint and concerted effort that we will tackle the problem. Let’s not forget that the cost of insurance for all is increased by the actions of a minority, so our focus is on making it as

www.itij.co.uk 26 FEATURE

product for the honest customer. We need to deliver a system that works the way it was intended to work and not just deliver a system quickly because it looks like an easy thing to do.” What does he mean by that? “We all hear urban myths about serial claimants and it will be great to turn those myths into fact by analysing the data. But the biggest question the insurance industry has got is how to respond to that risk identifi cation process,” he says. “I want to be comfortable that we have the right governance of control over how individual insurers react to that information so that the interests of honest customers are visibly protected. My perception is that the travel industry has some way to go before it gets to the point of fraud control maturity that we see in other product lines, in particular home and motor.” Davies stresses that a match on a database is just that, a match, and not evidence of fraud. It is therefore vital to follow the information through and be investigated in a professional manner. “If that doesn’t happen – if fi rms haven’t got the correct levels of skill, then there is an inevitable risk that the interests of an honest customer are going to be compromised in some shape or form,” he adds. “That is the worst possible outcome and if that is a risk then I would rather not see a CUE database being set up.” There is also the hint of a potential split in the industry over the running of a database. It seems they are like London buses. You wait years for one and then suddenly two appear. Mike Webb, chief executive offi cer of Mondial Assistance in the UK, has been working with four other insurers, AXA, AIG, GTI and Travel Claims Services to create a shared database for claims independent of that being proposed by the Insurance Fraud Bureau and the TICC. These insurers equate to roughly between 25 and 30 per cent of the market. Its system creates a risk score and has helped the insurers improve their fraud detection rates and

“the travel industry has some way to go before it gets to the point of fraud control maturity that we see in other product lines, in particular home and motor.”

prevent multiple fi ctitious claims. someone else,” he says. “This has been rumbling on Webb says it was created because the development now for 15 years. I’d be amazed if it actually goes of CUE was simply taking too long. “We are ahead. People in the travel industry are stupid, they desperate for it to happen. As long as it is cost don’t want to listen to new ideas.” effective it is the ideal solution,” he states. “But at Wilson also fears CUE will fail to tackle the ‘real Mondial we are conscious that this has been talked cancer’ of fraud, which stems from overseas about for some time and sometimes the industry is medical clinics. “When you get a 27,000 bill from better talking about something than actually doing it.” a healthcare clinic in Turkey that doesn’t actually Webb would like more insurers involved in the exist, then that is the biggest problem,” he says. database, but stresses that it is not there to replace “CUE is good for catching the odd fraudulent CUE. “Ours is an interim solution. If CUE becomes a person but not that. We should be spending our reality we would defi nitely want to be involved with money where the big fraud is happening. But we’ve it but we can’t keep waiting,” he states. tried to get the industry behind us on this but again This will please Remmington. “For CUE to work nothing has happened.” we need Mondial to work with us,” she says. “Their Despite this, Remmington is hopeful of soon system will not work. No disrespect to them but it ‘celebrating’ the introduction of CUE. On previous only works if you use their computer system. The concerns she says: “Confi dentiality is no longer claims they are sourcing from are very small and the a problem as all the systems are compliant these matches are very small. What they are doing is better days. The synergies of terminology are more than nothing but they would be better off joining us.” diffi cult but we have agreed them in principle, but Webb stresses again that Mondial would join CUE until we choose a supplier for the database it will but says its system would be ‘retained for a while to not be fi nalised.” She is sure CUE is the answer for make sure we get the benefi ts that we want to get – the industry and that it is ready to work together it needs to be very low cost’. to reduce the cost of fi ghting fraud. “The motor Former Insure & Go chief Perry Wilson is ruling industry has highlighted serial claimants and seen out the industry ever getting together on this issue. costs come down through its CUE system,” she “The biggest problem is that everyone in the travel says. “We can do it as well. We can work pretty industry is so scared about giving their data to well together.” n

International Travel Insurance Journal

28 FEATURE

Digital Marketing DigitalDigital Marketing Marketing

In the fi rst of a two-part series on digital marketing, Catherine Stagg-Macey analyses current research on the use of established and new digital marketing methods by insurers, and gives some advice on how to best get started if you’re considering some of the latest digital marketing tools

part one

International Travel Insurance Journal FEATURE 29

unique to the UK but we expect other markets to follow this trend. These multiple ways of interacting The amount of noise and column inches – virtual and underlines the preference of the consumer – they want to choose when and where to discuss print – dedicated to the phenomenon of Twitter and insurance requirements. Increasingly, customers will rely heavily on the other social network sites has been overwhelming Internet to search for information to inform their purchase decision. Indeed, our research shows that insurers expect 60 per cent of their customers to use digital tools to search for information before making a purchase in three years’ time. Although many customers may choose not to make the purchase online, they will be heavily influenced by digital tools when being made aware of new products, comparing prices or making use of other services like claims notifications; and it is in this search for information where digital media plays a key role. Thus, there is certainly an offline impact of online marketing. Even if customers choose not to purchase online because of concerns over data security, it is reasonable to expect every other aspect of the purchase to be strongly influenced by digital media. It would be a mistake to measure success solely by an online purchase.

Here to stay Established digital media tools have proven themselves, and the industry has strong views on the comparative effectiveness of the various digital media options as shown in the figure below. With one exception, the allocation of digital marketing spending maps to the perceptions of where money he amount of noise and column inches their advantage. What is less clear is the interest ease of buying books, music, groceries and clothes can be spent effectively. For example, typically, 37 – virtual and print – dedicated to the and adoption rates in the emerging channels, and online. These are positive experiences in the most per cent of an insurer’s budget is spent on email Tphenomenon of Twitter and other social how priorities may have to shift from established to part, and it’s understandable that consumers transfer marketing (the highest allocation), and this is seen by network sites has been overwhelming. And this noise emerging in the coming years. this expectation of the shopping experience to their 68 per cent of respondents to be more efficient than is far in excess of the current value to financial services bank and insurer. traditional media. So, a further proof point of the companies. To the insurance professional who is The customer is changing In the United Kingdom, the consumer is offered adoption and success of traditional digital methods. focused on operational challenges today, these new It’s commonly accepted that customer behaviour is a myriad of choices in how they buy insurance But the interesting exception to this is social tools seem to raise more questions than answers. changing. We call it the Amazon or Google effect. including online, agent, broker, grocery store, post networking. Currently, only 13 per cent of the digital But many industry observers believe these new Customers have experience of the immediacy and office or aggregator. This complexity is currently marketing budget is allocated to social networks technologies bring with them new opportunities. Digital marketing encompasses established methods of digital advertising with the customer, such as emails, display ads and video ads, as well the chief barrier to as emerging methods such as blogs and social networks. Insurers have all embraced established adoption of tools such methods to their advantage where it makes sense as social networks was for the brand and the line of business. Many forms of digital marketing have been around for more insufficient metrics to than a decade, and this, along with the perceived effectiveness of certain methods, is reflected in measure impact of the how insurers allocate their marketing budgets. Celent research shows that emails typically make up tools and insufficient almost 40 per cent of insurer’s marketing budgets. This is closely followed by paid keyword searches capabilities to handle and display ads, with both categories roughly a third of the budget. This is a clear proof point that this internally insurers have leveraged traditional digital media to

What percentage of your customers do you expect to use digital tools in three years’ time to do the following activities?

Fig; 1 Source: Celent

www.itij.co.uk 30 FEATURE

only 13 per cent of the Compared with traditional media, how efficient are the Digital marketing channels following tools in achieving your company’s marketing goals? digital marketing budget Although some travel insurers are lagging behind when it comes to capitalising on the is allocated to social power of the Internet, others have recognised the web as a means of communicating more networks … however, closely with their customers, as well as being a way to add value to their brands. The social networks appear to increasing power of digital marketing cannot be underestimated, and travel insurers should be third in the list of tools be aware of the ways and means of web marketing – whether it is through search that are more efficient engine optimisation, pay per click, brand than traditional media bidding, viral marketing or social networks. • When it comes to search engine optimisation (SEO), this can take place (sixth in order of priority); however, social networks either on a web page through the use of appear to be third in the list of tools that are more meta data; through a website using keyword efficient than traditional media. Other emerging strategies, or offsite – i.e. inbound links media tools such as wikis, podcasts, and blogs have to a company’s website from Facebook. mixed reviews. This could reflect one of two things: More advanced SEO measures include these tools are not particularly effective for insurance the use of videos and images on websites, marketing, or that insurers have yet to determine as well as sales channels; all of which can how to leverage these tools. contribute to appearing higher up on the This interest in social networks is noteworthy. As Fig; 2 Source: Celent Google rankings after a customer enters a a fairly new tool, insurers appear to recognise the general search. At the International Travel value that can be obtained from this channel, even Insurance Conference that was held in if current marketing budgets are not mapped to Established digital media tools such as email have more apparent in the coming years. Ultimately, it will Brighton in May this year, the power of this opportunity. In conversations with insurers, proven themselves. But in considering emerging be through engagement of customers through these Google was highlighted: in order to take the chief barrier to adoption of tools such as social digital media, insurers should consider the following: media that real value will be garnered. advantage of such power, travel insurance networks was insufficient metrics to measure impact Experiment in digital media, including emerging This article as based on a Celent report published companies must put as much information of the tools and insufficient capabilities to handle this tools. The measurement tools have not yet caught up in April 2010 titled Digital Marketing in Insurance: A as possible on their preliminary web pages internally. This dilemma of wanting to adopt and with the digital tools, but there is a good case to be Partnership with Potential. n before a customer is asked to log in, as the invest in new digital media channels will continue for made for trying small experiments with new media. some time. Capture the feedback. The web is nothing if more accessible the website is, the more It is also worth noting that the web is more than an not a noisy room of chatter. Customers will already likely people are to continue to use it. additional marketing channel. Applying the traditional be talking about their experience of products and • Pay per click (PPC) advertising – mass marketing methods to the digital world will services, and the organisation should at the very In our next issue adverts placed at the top of Google’s web not bring full rewards. Buying ads on Facebook or minimum have a process of capturing this. ITIJ gets down to the finer details pages after a search – has been shown to having a Twitter account misses the point of the Feedback loop. An experiment was conducted, of how to build a successful digital have a quicker effect on a company’s sales communication opportunities with the customer. the customers have spoken, and the next step is to profile for your marketing needs, volume. It does take some confidence on But we cannot get away from having specific, learn from the experience. and asks: how can travel insurers behalf of the insurer that the investment traditional measurable goals for the use of the new Digital media is here to stay, and for some time will make better use of the digital media will be worth it, but various studies have tools. At the end of the day, being ‘cool’ doesn’t co-exist with traditional media channels. New tools available today, and what is the shown that PPC, while it can be expensive, matter, not even to the cool insurance brands. are changing customer and broker behaviour and best way to harness the power of can be worth its weight in gold. It’s about revenue, efficiency, and loyalty. The should be recognised as having such an impact. Celent emerging digital marketing trends? measurement of the impact of these emerging digital believes that the real value to insurers of emerging • Brand bidding describes the use of tools remains a significant hurdle for most insurers. digital tools will become measurable, and therefore brands as keywords in PPC campaigns by affiliates, competitors, online retailers, auction platforms and price comparison insurers expect 60 per cent of their customers to use digital tools to sites. This is a murky world that companies should be extremely wary of entering, as search for information before making a purchase in three years time the international laws governing trademark infringement are varied and inconsistent. For example, Google will only investigate trademark infringement complaints in Catherine Stagg-Macey is a senior advertising text seen in the US, UK and a analyst in Celent’s insurance practice and few other countries. is based in the firm’s London office. Her research focuses on IT strategy issues • Viral refers to anything that consumers for the UK and European life and general will pass from one to another. Viral insurance industries, with recent research marketing can come in the form of videos or focusing on the core insurance games, but while videos are popular and get vendor landscape, IT spending, hundreds of thousands of views, viral games and bancassurance. Prior to – such as the ‘Bus Racer’ game recently joining Celent, Ms Stagg-Macey created by Churchill Insurance – can catch was a senior consultant at millions of consumers in their net. Insurers ATOS KPMG Consulting in should consider what viral marketing London and South Africa, can be used for, including raising mass and prior to that she was brand awareness, data collection, voucher an internal strategy distribution, and audience acquisition. consultant for Marsh in London. • Social networking is also becoming a more important communication channel on which insurers can engage their customers in a friendly environment. By using Twitter, Facebook and other sites such as LinkedIn, many travel insurers have made their brands more accessible to their users and are able to interact with them more easily to determine the needs of their customers.

International Travel Insurance Journal

32 ASSISTANCE&HEALTHCAREWORLDMARKETS Riviera Americana

Touted as South America’s answer to St Tropez or the Hamptons, resorts on the east coast of Uruguay, the continent’s smallest country, are fast gaining a reputation as exclusive retreats for the super-rich. Tatum Anderson shows how the healthcare facilities match up

medical care in Uruguay is considered to be, at the very least, adequate by the US State Department

International Travel Insurance Journal ASSISTANCE&HEALTHCAREWORLDMARKETS 33 Riviera Americana

nce a fishing village, José Ignacio’s beaches medical director of Unidad de Negocios Asistencia Most of the best healthcare services are in and Montevideo are Hospital Británico de Montevideo are today more likely to feature the – AXA Assistance Argentina, says: “We give around the capital city of Montevideo, less than (Montevideo British Hospital), Asociación Española Obikini-clad jet set. Summer residencies assistance to a lot of foreign visitors in tourist areas 200 km from Punte Del Este. This concentration (Spanish Association), and La Asistencial, says of the wealthy and up-market seafood restaurants such as Punta Del Este, Piriápolis and Colonia Del of resources is perhaps understandable given that Dr Nigel Dowdall, chief medical officer for AXA are patronised by the likes of Naomi Campbell Sacramento, as well as in Montevideo itself.” Montevideo is the only large city in Uruguay, and has Assistance’s Travel Business Unit. He believes there and Shakira, and down the road from José Ignacio Surprisingly, however, there are not many good- a population of 1.3 million inhabitants (the population is a very good standard of medical care throughout is Punta Del Este, which has attracted the rich and quality health facilities used by assistance companies of the country is only three million). In fact, 92 per the country, adding that medical care in Uruguay famous for a century. Nestled between two giants, in this part of the country, nicknamed the South cent of the population is highly concentrated around is considered to be, at the very least, adequate by Brazil and Argentina, on the South Atlantic Ocean, American Riviera. Montevideo, its suburbs and 20 or so smaller towns. the US State Department. Asociación Española, the coast is just a short plane ride from Buenos Aires In Punta Del Este, there are just two sanatoria The geography of the country means a transfer for example, is one of the best private hospitals and so attracts well-to-do Argentine holidaymakers or private clinics: Cantegrill and Mautone, which from the coast and other areas to the capital is in Montevideo with facilities and services on offer as well as the international jet set from further afield. can provide only limited medical assistance, relatively fast and easy, says Uruguay Asistencia, a including cardiovascular surgery, neurosurgery, MRI, says Romanelli. “No cardiac surgery or major subsidiary of MAPFRE Asistencia, which operates CT scan and ICU. Health matters neurosurgery is available there. Complex cases must in 40 countries worldwide. For medical specialities Indeed, Uruguay has traditionally suffered from Unsurprisingly, there is a great call for health facilities be transferred to Montevideo or Buenos Aires for including trauma, paediatrics, gynaecology, neurology an oversupply of physicians. This middle-income in tourist areas of Uruguay. Dr Jorge Romanelli, final admission, via ground or air ambulance.” and cardiology, the three recommended hospitals in country has a higher number of physicians per

medical care in Uruguay is considered to be, at the very least, adequate by the US State Department

www.itij.co.uk 34 ASSISTANCE&HEALTHCAREWORLDMARKETS

10,000 population than the US, UK and Sweden. According to World Health Statistics 2010, Uruguay had 12,348 physicians (37 per 10,000 population). In contrast, there were 2,880 licensed nurses, which is about eight per 10,000 head of population, considerably less.

Most of the best services are in and around the capital city of Montevideo, less than 200 km from Punte Del Este

Private provision Like AXA Assistance, MAPFRE prefers to use the private clinics of Uruguay for its clients, says Virginia Villanueva de Pedro, medical director at MAPFRE Asistencia, who added: “In private clinics you can find quality care and the best technology available. It is possible to manage critical patients.” These services also appeal to expatriates too, and the clinics are able, for the most part, to deal with assistance companies and foreign clients. “People speak fluent English in Montevideo and the main resorts,” she says. “There are no administrative problems for foreign people. In general, Uruguayans are kindly to tourists.” However, services provided to tourists can be expensive. While a consultation at the clinic costs about US$50, a home visit can be as much as $400 and an outpatient emergency outside Montevideo up to $370. Most institutions will accept credit cards, but some GPs will take cash only, regardless of whether or not the person standing in front of them has travel insurance cover. Uruguay’s private sector is made up of a complex array of companies and health insurance plans. First, there are a number of private sanatoria (clinics) and hospitals, which offer private medical care to the high-income groups in Uruguay. It is possible to buy membership to one, or a network, of these facilities via a monthly subscription – a number of local and international companies buy such memberships for their employees. Monthly rates at Hospital Británico, for example, can cost upwards of $1,977 per month for a private room, although this depends on age and whether the patient is a dependant. Applicants for such schemes are interviewed by a medical examiner and issued with an ID card to carry with them at all times. One of the most well known hospitals in Montevideo, Sanatorio Americano, has a large membership and is associated with medical centres in other parts of the country. The network, called FEMI, provides assistance including house calls, appointments with GPs and specialists in Uruguay as well as other countries in Latin America, offering coverage to half a million members and employing 2,800 physicians. AXA Assistance says that in its experience, neither age nor past medical history are considered to be problems when obtaining this kind

International Travel Insurance Journal ASSISTANCE&HEALTHCAREWORLDMARKETS 35

Uruguay’s private sector is made up of a complex array of companies and health insurance plans

of coverage. and can provide diagnostic procedures, non-complex Sanatorio Americano itself is just over half an hour medical and surgical admissions and dentistry from the capital’s airport and boasts five operating services. rooms, two delivery rooms, 25 ICU beds for adults The most well known of these mobile emergency and children, 10-bed intermediate cardiac treatment groups are Suat, which has been operating since and more than 100 conventional beds. the nineties, Systema de Emergencia Medico Movil Beyond private hospital schemes, Uruguayans and (SEMM) and Unidad Coronaria Móvil (UCM), which expatriates can also buy a type of private healthcare has operated in Uruguay for over 30 years. that provides partial coverage only. For example, Most subscribers to these emergency plans will also some healthcare companies offer coverage only for have a separate concurrent comprehensive insurance emergency care. These so-called mobile emergency plan too. Some hospitals even arrange emergency systems have their own emergency telephone coverage with these companies when admitting numbers, clinics, call centres, ground ambulances applicants to their own private insurance plans. For

www.itij.co.uk 36 ASSISTANCE&HEALTHCAREWORLDMARKETS

It is not uncommon for patients to be airlifted to Buenos Aires in Argentina or Sao Paulo in Brazil

instance, Hospital Británico says that its hospital State of wellbeing scheme can be combined with mobile emergency Uruguayans are generally healthy and cover, and under that scheme, an ambulance with benefi t from a well-established and SEMM costs $325, Suat $310 and UCM $318. professional public healthcare system, These private mobile emergency companies link according to the UK’s Foreign and with the public emergency system too; if Uruguay’s Commonwealth Offi ce, and life expectancy emergency telephone number 911 is called, for at birth was 76.4 years last year. Many people example, often emergency call centre operators will put that down to Uruguay’s well-educated send the nearest ambulance to the scene, regardless population – the country is well known for of whether it is a public or private vehicle. its high literacy rates, arguably the highest in Private healthcare is not seen just as the preserve South America – a large urban middle class, and of the very wealthy; indeed, Uruguay’s health relatively even income distribution. Indeed, the system is so dominated by private providers that average Uruguayan standard of living compares it is seen as unique, because it runs a mandatory well with that of most other Latin Americans. private insurance system that covers over 60 per The country is also famous for having the fi rst cent of the population. The mandatory private welfare system in South America. services are managed by so-called Institutions for However, other groups, such as the Pan-American Collective Medical Attention (IAMCs), which are Health Organisation, say the public health service private, non-profi t organisations that provide prepaid provided in Uruguay is fragmented and inequitable. comprehensive health insurance and facilities for The public health service is managed by the State patrons to use. This mandatory insurance system has Health Service Administration (ASSE), although been run by IAMC for decades and caters mostly there are other parallel health services dedicated to to the formal workforce. In 2007, the IAMC system the armed forces, police force and other institutions consisted of 41 medical centres (estimates put them too. The Armed Forces Health Services has its own at 48 today) and included 12 based in Montevideo hospital infrastructure, with 450 beds in Montevideo itself. The rest were located in the interior of the and nursing services at military units in the rest of country, although many IAMC clinics also lease the country. It provides coverage to approximately services from private sanatoria too. AXA Assistance’s 165,000 people, including those on active service, Romanelli says visitors are able to use IAMC clinics retirees, and their dependants. for assistance if they have travel health insurance ASSE operates a network of hospitals, health centres, associated with these providers. polyclinics, and family physicians throughout the

International Travel Insurance Journal ASSISTANCE&HEALTHCAREWORLDMARKETS 37

One of the most well known hospitals in Montevideo, Sanatorio Americano, has a large membership and is associated with medical centres in other parts of the country

country and is estimated to cover around 40 per The hospital is also home to two so-called Highly cent of the total population and provide 8,000 beds. Specialized Medical Institutes (HSMI), facilities that (Together ASSE and IAMC cover about 90 percent of specialise in high-technology services including chronic the Uruguayan population.) dialysis, kidney transplants, prosthesis, hip and knee It is not necessary to be a member of ASSE to obtain surgery. The HSMI facilities at Hospital Maciel are care, and public hospitals run by the administration dedicated to dialysis and marrow transplantation, are largely free and used predominantly by although these services are provided privately, and unemployed people and those on low salaries; even here, services are limited. Some transplants must that includes informal workers, and dependants of still be done in Argentina, says MAPFRE. formal employees whose parent or guardians are not Within the public health system, first aid assistance, financing their healthcare through IAMC. including the ambulance service, is provided free of The poorest people in Uruguay receive a Carné charge. Any medication required in the first instance Gratuito, a special card that entitles them to free is also free to patients, including visitors. If it is healthcare. They are not required to contribute a co- necessary to remain hospitalised as a consequence payment for any services or medications, but those of surgery or for any other reason, fees are charged who earn more are allocated a Carné Bonificado and according to the service provided. are required to contribute a minimum co-payment. (Several private institutions have emergency centres The public sector, unsurprisingly, has far less to too. Hospital Británico de Montevideo and Sanatorio spend per beneficiary than the private sector (the Americano both offer round-the-clock emergency public sector spent approximately $12 per person services and ambulances.) per month, while the private sector spends $32 per Patient transfers to other countries, on the other hand, person per month in 2007). As a result, the ASSE can be very expensive, say experts. Serious medical suffers from old and inadequate infrastructure, and problems that require hospitalisation and medical its users may not always receive prompt service, evacuation to the US can cost tens of thousands of according to the World Bank. There is also a shortage dollars, explains the US State Department, and it is not of staff and long waiting times, especially in emergency uncommon for patients to be airlifted to Buenos Aires departments. “There are often critical delays to major in Argentina or Sao Paulo in Brazil. As a result of this surgeries, as is also common in the public hospitals of situation, there are a number of private air ambulance Argentina,” agrees AXA Assistance’s Romanelli. companies operating in Uruguay. Aeromás, for Things are getting better, however, says Mapfre’s instance, is a Montevideo-based firm that transports Villanueva de Pedro. “Waiting lists are improving but critical patients 24 hours a day and says it has a team some specialties like ophthalmology, urology and capable of stabilising and transporting critical patients, anesthesia have less human resources. But it is common while mobile emergency company SEMM provides air for hospital rooms to have 16 to 20 beds together.” ambulance services too. There are good-quality ASSE hospitals, including In conclusion, it is fair to say that the standard of Hospital Maciel and Hospital Español, both of healthcare facilities in Uruguay are good if a little which are recommended by assistance companies. patchy, and for a tourist in need, there are plenty Hospital Maciel is a tertiary level acute care facility of physicians and specialists on hand to offer their offering vascular surgery, neurosurgery, haematology, expertise. If the healthcare is deemed not sufficient diabetology, thoracic surgery, diseases of the for your client, then air ambulances are just a phone respiratory tract, and nephrology. call away! n

www.itij.co.uk 38 PROFILE Lily of the Valley

ITIJ spoke to Lily Chen, general manager of the brand name assistance companies that have operated Essential Healthcare Network, about her history for over a decade here and there are also local in the industry, as well as what the future holds for assistance companies that have local relationships Chinese healthcare reform with clients and healthcare providers. It is very diffi cult to start any kind of business in China without Where were you born, where did you go an existing relationship and it would take years to to school/university, and where do you build, and then probably end up with none of the live now? expected returns. It is vital that companies hire local I was born in Guangzhou, China. I was only 15 years talent as key staff members and try to understand the old when I fi rst went to the US, where I completed way of doing business here themselves. my high school, graduate and undergraduate education. I got my BS degree in Hospitality What should international payors and Management from California State Polytechnic assistance partners bear in mind when University of Pomona; and my MBA (with an choosing a local assistance partner in emphasis in marketing and technology) from the China? What are some of the unique University of California, Irvine. features of handling medical assistance I have been living in Shanghai in China since 2001, cases in China? but to be honest I never planned to return to live International payors and assistance partners and work in China; Los Angeles is now my home, should ask: Can they do the job? If so, what is the and my family – parents and brother – and my best demographic coverage of the company in question? friends are all in LA as well. A stumbling block to offering assistance services in China is the size of the country. What was your fi rst job after leaving Also, given the current healthcare model in which university, and how did you come to public hospitals control most of the resources but work in the travel health insurance/ they normally don’t care about the standard of assistance industry? service, it may be wise to choose a few partners that My fi rst job was working as a hotel manager at specialise in their own regions; and put together, an a Holiday Inn. I learnt a lot from all my jobs, but assistance company or insurer may cover the whole after working for a medical provider in Shanghai for of China without a problem. Most importantly, you several years, I started to have a taste for the travel must always have a backup plan! Another anomaly health insurance/assistance industry. At the time, I about China is that the assistance company must was the director of marketing and account services send its staff to public hospitals to pay for any services at World Link Medical and Dental Centers, which is rendered instead of sending a guarantee of payment now known as Parkway Health, the leading provider (GOP), as most of the public hospitals won’t sign of healthcare services to expatriates in China. I was EHN provides insurance and assistance positive evolution for the company and I see this role GOP agreements that cover its emergency and in charge of the direct billing department when services. How have travel insurance developing further as time goes on. local services. This rule applies to both public and the company started to build its insurance direct products for outbound travellers private facilities, although some of the VIP wards or billing department. In that role, I was in touch with developed in recent years, and have sales Cost containment is an ongoing concern international wards of the public hospitals in fi rst-tier insurance companies and therefore assistance grown steadily? for international payors. How do you cities, and some of the international private hospital companies as well. Before founding the Essential Essential Healthcare Network doesn’t have its own guarantee fair costs for insurers and and clinics accept GOPs. Some of our network Healthcare Network (EHN), I was the general insurance product at the moment, although we do prompt payment for hospitals? providers accept GOPs and some even accept manager of a start-up hospitality chain. have plans for the provision of insurance. We are, It is diffi cult to provide any real form of cost advance payments. Our network includes public and at the moment, acting as a broker to sell existing containment in China. If asked, we would outsource private hospitals, although private providers account How did you come to your current role? travel insurance products for Chinese people to our network to an insurance company that needs it, for the majority of facilities. I founded EHN with the help of investment from a go overseas. Currently, we provide non-urgent along with a hospital price list. US-based consulting company. assistance services to our members who need It is important for foreign insurance and assistance If you could do any other job in the What gave me the confi dence to start the fi rm was them – for example, giving them health advice over companies to use a local network in China, especially world other than the one you do now, that I believed I had learnt a lot from my last role as the phone. If there is a need for assistance, we will the insurance and/or assistance companies that what would it be? the general manager of a start-up company, but I still co-ordinate the providers needed for the service don’t have much client volume here. For many Found my own healthy dessert and drink chain wanted to go back and work in the healthcare sector. to offer a solution to our members. Normally, the insurers, it is too costly to build and to know your stores, like Starbucks. It was a very diffi cult decision to take, especially own network. Some of the public hospitals track considering that the start-up had begun to break the number of referrals they are given, but if the What motivates you? even fi nancially. number of referrals over a certain period doesn’t Being able to help people is what matters to me, and It is very diffi cult meet the expectation of the hospital, the direct billing it motivates me to go further with what I am doing When did Essential Healthcare Network agreement will expire and they won’t consider doing now. begin operations? How has it grown to start any kind of business with that company again next year. since its inception? What is your favourite holiday Essential Healthcare Network started operations in business in China Are you seeing an increased presence destination? Where would you like to May 2008. The US-based investor of the company of international assistance companies visit next? and I shared the same view on the future of Chinese without an existing operating in China? Do you think there The Maldives are my favourite destination, and I healthcare market developments. We all thought is room in the market for additional would like to visit Australia next. that there would be more quality private medical assistance operators? providers entering the market due to the Chinese relationship Yes, I do see a steady increased presence of What are you currently reading? healthcare reform, and in addition to this, local international assistance companies operating in Currency War Chinese people are now more concerned with their China and I am sure there is room for additional health and growing wealth. member pays us directly for the service provided. assistance operators who charge a fair price in China. If you were having a ‘dream’ dinner Since 2008, we have modifi ed our business model We have seen our sales growing steadily over the However, doing business in China, especially in party, who would be there – and what in order to enable us to scale up our business. EHN past few years as more Chinese travel for pleasure. assistance, may be quite challenging. would you eat? has gained a good reputation among our clients and We have also helped international insurance First of all, like running operations in any part of the It would be having a nice dinner with the US healthcare providers, and we have obtained new clients companies and assistance companies to search world, operating in China requires local knowledge president, Barack Obama, in a nice French restaurant from word of mouth, which enables us to grow steadily. for suitable providers for their clients, which is a and a strong governmental relationship. There are to talk about the healthcare reforms in the US.

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 40 SERVICEDIRECTORY To have your company listed in the Service Directory email: [email protected]

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

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

Air Ambulance Network CareFlight International AUSTRALASIA

Kirk Pacheco – President ( Paul Smith – National Manager AIR AMBULANCE AIR AMBULANCE 905 Martin Luther King Jr Drive, Suite 330, Tarpon Springs, Florida 34689, USA Westmead Hospital Campus, PO Box 159, Westmead, NSW 2145, AUSTRALIA

24hr tel: + 1 727 934 3999 email: [email protected] tel: (+61) 2 9893 7683 email: [email protected] fax: + 1 727 937 0276 website: www.airambulancenetwork.com fax: +61 2 9689 2744 website: www.careflight.org

AMREF Flying Doctor Service European Air Ambulance Dr Bettina Vadera – Medical Director Patrick Schomaker – Director Sales & Marketing Wilson Airport, LangataRoad, PO Box 18617, Nairobi, KENYA 175A, rue de Cessange, L-1321, LUXEMBOURG

tel: +254 20 6000 090 email: [email protected] 24hr tel: +49 711 7007 7007 email: [email protected] fax: +254 20 344 170 website: www.amref.org fax: +49 711 7007 7009 website: www.air-ambulance.com

European Air Ambulance Flying Doctors Asia Patrick Schomaker – Director Sales & Marketing Prithpal Singh – CEO , Director 313 Old Bird Cage Walk, #01-15/02-16, Seletar Airport, 175A, rue de Cessange, L-1321, LUXEMBOURG SINGAPORE 24hr tel: +49 711 7007 7007 email: [email protected] 24hr tel: +65 9297 7757 email: [email protected] fax: +49 711 7007 7009 website: www.air-ambulance.com fax: +65 6483 5407 website: www.flyingdoctorsasia.com

Netcare 911 International Hope Medflight Asia Pte Ltd Jacques Pienaar – Fixed Wing Operations Manager Dr Charles Johnson – Medical Director Riverview Park, Janadel Avenue, Midrand, SOUTH AFRICA 2 Loyang Lane 03-01, Singapore 508913, SINGAPORE

tel: +27 10 209 8392 email: [email protected] 24hr tel: +65 6100 1911 email: [email protected] fax: +27 10 209 8405 website: www.netcare911.co.za fax: +65 6400 5254 website: www.hope-flight.com

Skyservice Air Ambulance Medical Wings David Ewing – VP International Market Development Dr Sommart Somsiri – Medical Director YUL/Trudeau Int Airport, 9785 Avenue Ryan, Montreal (Quebec), H9P 1A2, 222 Room 3259, Donmuang Int Airport Moo 10, Viphavadee-Rangsit Rd, Sikan, CANADA Don Muang, Bangkok 10210, THAILAND tel: +1 514 497 7000 email: [email protected] tel: +662 247 3392 email: [email protected] fax: +1 514 636 0096 website: www.skyservicebas.com/airambulance fax: +662 535 4355 website: www.medicalwings.com

West African Rescue Association Skyservice Air Ambulance Florian Zagel – Managing Director David Ewing – VP International Market Development YUL/Trudeau Int Airport, 9785 Avenue Ryan, Montreal (Quebec), H9P 1A2, Klotey Cresent 6, North Labone, Accra, GHANA CANADA 24hr tel: +233 243 666 111 email: [email protected] tel: +1 514 497 7000 email: [email protected] tel: +233 302 781 258 website: www.westafrican-rescue.com fax: +1 514 636 0096 website: www.skyservicebas.com/airambulance ) AeroMed Asia Inc. South Pacific Air Ambulance Cindy Wong / Lorraine Paul – International Account Management Scotty Watson – Managing Director SINGAPORE BANGKOK THAILAND NEW ZEALAND AUSTRALIA SINGAPORE

tel: +603 7965 3883 email: [email protected] tel: +64 9256 9000 email: [email protected] fax: +603 7629 8810 website: www.aeromed-asia.com fax: +64 9256 9111 website: www.spaa.co.nz AUSTRALASIA ( Air Ambulance International ADAC-Ambulance Service Mr Peter Veazey – CEO Robert Glueck – Marketing & Sales Director P.O. Box 1044, Magnolia. Texas 77353, USA Am Westpark 8, 81373 Munich, GERMANY

tel: +1 832 934 2390 email: [email protected] (EUROPE) tel: +49 89 76 76 52 85 email: [email protected] fax: +1 832 934 2395 website: www.airambulanceinternational.com 24h Alarm: +49 89 76 76 50 05 website: www.adac.de/ambulance

Air Ambulance Network Air Ambulance International Kirk Pacheco – President Mr Peter Veazey – CEO 905 Martin Luther King Jr Drive, Suite 330, Tarpon Springs, Florida 34689, USA P.O. Box 1044, Magnolia. Texas 77353, USA

24hr tel: + 1 727 934 3999 email: [email protected] tel: +1 832 934 2390 email: [email protected] fax: + 1 727 937 0276 website: www.airambulancenetwork.com fax: +1 832 934 2395 website: www.airambulanceinternational.com

AirMed International LLC Air Ambulance Network Jeffrey T Tolbert – President Kirk Pacheco – President Airport World Trade Center, 1 Sky Plaza Road, 905 Martin Luther King Jr Drive, Suite 330, Tarpon Springs, Florida 34689, USA Hong Kong International Airport, HONG KONG tel: +852 3756 3680 email: [email protected] 24hr tel: + 1 727 934 3999 email: [email protected] fax: +852 3756 3681 website: www.airmedasia.com fax: + 1 727 937 0276 website: www.airambulancenetwork.com

CATEGORY KEY CLAIMS MANAGEMENT INSURERS Air Medical Ltd AIR AMBULANCE CLAIMS SUBROGATION MEDICAL ESCORT ON COMM. AIRLINE AIR AMBULANCE INTERIOR COMMERCIAL REPAT SPECIALISTS MEDICAL PROVIDER Glenn Salt – Flight Operations Manager AIRCRAFT PERFORMANCE SOLUTIONS CRITICAL CARE PATIENT TRANSPORT MEDICAL SCREENING Oxford Airport, Kidlington, Oxfordshire OX5 1QX, UK ASSISTANCE COMPANIES FUNERAL DIRECTORS RE-INSURANCE CATASTROPHIC CLAIMS SPECIALIST HEALTHCARE CLINICS TRAVEL AGENTS tel: +44 1865 842 887 email: [email protected] COST CONTAINMENT HOSPITALS WEB & DESIGN SERVICES tel: +44 1865 370 642 website: www.airmed.co.uk call +44 (0) 117 925 5151 To make an alteration to a listing email: [email protected] SERVICEDIRECTORY 41 ) AirMed International LLC ) Medic’Air International Jeffrey T Tolbert – President Dr Herve Raffin – General Manager 1000 Urban Center Drive, Suite 470, Birmingham, AL 35242, USA 35 rue Jules Ferry, 93170 Bagnolet, Paris, FRANCE

tel: +1 205 443 4840 email: [email protected] tel: +33 141 72 1414 email: [email protected] EUROPE EUROPE ( fax: +1 205 443 4841 website: www.airmed.com ( fax: +33 148 57 1010 website: www.medic-air.com

Augsburg Air Ambulance Medilink International Air Ambulance Roland Schoberth – Director Martin Farrugia – Business Development Manager AIR AMBULANCE AIR AMBULANCE Roseggerstr 17, D-86368, Gersthofen, GERMANY 99 Mill Street, Qormi, QRM 3100, MALTA

tel: +49 821 299 1020 email: [email protected] tel: +356 2278 5400 email: [email protected] tel: +49 821 299 2030 website: www.ambulanzflugdienst.de fax: +356 2278 5700 website: www.mi-aa.com

Capital Air Charter North Flying a/s Lisa Humphries – Sales Director Jesper Kragelund – Sales Manager Exeter International Airport, EX5 2BD, UK North Flying Terminal, Aalborg Airport, DK-9400, Nørresundby, DENMARK

tel: +44 845 055 2828 email: [email protected] tel: +45 9632 2900 email: [email protected] fax: +44 1392 350 039 website: www.capitalaircharter.co.uk fax: +45 9632 2909 website: www.northflying.com

European Air Ambulance Redstar Aviation Patrick Schomaker – Director Sales & Marketing Mustafa Atac – CEO 175A, rue de Cessange, L-1321, LUXEMBOURG Sabiha Gokcen International Airport, J Blok Kurtkoy, 34912 Istanbul, TURKEY

24hr tel: +49 711 7007 7007 email: [email protected] tel: +90 216 588 0216 email: [email protected] fax: +49 711 7007 7009 website: www.air-ambulance.com fax: +90 216 588 0225 website: www.redstar-aviation.com

Euro Link Air Ambulance Skyservice Air Ambulance Dr. Friedrich Renner – Medical Director David Ewing – VP International Market Development YUL/Trudeau Int Airport, 9785 Avenue Ryan, Montreal (Quebec), H9P 1A2, Putzbrunner Str. 114, 81739, München, GERMANY CANADA 24hr tel: +49 89 613 72103 email: [email protected] tel: +1 514 497 7000 email: [email protected] fax: +49 89 613 72106 website: www.FlyEuroLink.de fax: +1 514 636 0096 website: www.skyservicebas.com/airambulance

FAI – rent-a-jet AG Swiss Air Ambulance / Rega Volker Lemke – Director Sales & Marketing Peter Meierhans – Director of Sales Flughafenstrasse 100, D-90268 Nuremberg, GERMANY PO Box 1414, Zurich Airport, CH-8058, SWITZERLAND

tel: +49 911 36009 31 email: [email protected] tel: +41 333 333 333 email: [email protected] fax: +49 911 36009 59 website: www.rent-a-jet.de fax: +41 44 654 3590 website: www.rega.ch

German Red Cross Air Ambulance Service Tyrol Air Ambulance Andreas Speich – Managing Director Jakob Ringler – Managing Director Aufm Hennekamp 71, 40225 Düsseldorf, GERMANY PO Box 81, A-6026, Innsbruck Airport, AUSTRIA

tel: +49 228 2300 23 email: [email protected] tel: +43 512 224 220 email: [email protected] fax: +49 228 2300 27 website: www.grcairambulance.de fax: +43 512 288 888 website: www.taa.at

Greek Flying Doctors Aero Jet International Dimitris Kanellis – Manager Stuart Hayman – President 3 Doukisis Plakentias Str, 152 34 Halandri, Athens, GREECE 4631 NW 31st Avenue, #220 Ft Lauderdale, FL 33309, USA

tel: +30 210 674 0600 email: [email protected] tel: +1 954 730 9300 email: [email protected] fax: +30 210 674 0634 website: www.greekflyingdoctors.gr fax: +1 954 485 6564 website: www.aero-jet.com

IAS Medical Air Ambulance International George Ditchburn – Operations Manager Mr Peter Veazey – CEO (NORTH AMERICA) 145-157 St John Street, London, EC1V 4PY, UK P.O. Box 1044, Magnolia. Texas 77353, USA

tel: +44 870 042 1465 email: [email protected] tel: +1 832 934 2390 email: [email protected] fax: +44 870 042 1480 website: www.iasmedical.com fax: +1 832 934 2395 website: www.airambulanceinternational.com

IFRA Air Ambulance Network Dr Christian Steindl – Director Kirk Pacheco – President Bahnhofplatz 13/5, POB 160, 3500 Krems, AUSTRIA 905 Martin Luther King Jr Drive, Suite 330, Tarpon Springs, Florida 34689, USA

tel: +43 2732 825 610 email: [email protected] 24hr tel: + 1 727 934 3999 email: [email protected] fax: +43 2732 851 01 website: www.ifra.at fax: + 1 727 937 0276 website: www.airambulancenetwork.com

Jet Executive International Charter Air Ambulance Professionals, Inc. Irena Dimitrijevic – Marketing & Sales Brian L. Weisz – President Mündelheimer Weg 50, D-40472, Düsseldorf, GERMANY Ft. Lauderdale Executive Airport, 1535 South Perimeter Rd, “Homebase FRA & MUC” Hangar 36B Ft. Lauderdale, Florida 33309, USA tel: +49 211 602 7775 email: [email protected] tel: +1 954 491 0555 email: [email protected] fax: +49 211 602 77766 website: www.jetexecutive.com fax: +1 954 491 6114 website: www.airambulanceprof.com

Mayoral Executive Jet Air Ambulance Specialists Juan Carlos García Caparrós – Commercial Director Tom Cox – Director of Business Development Dominguez Toledo S.A., 118 La Orotava, Malaga 29006, SPAIN 345 Inverness Drive South, Suite A110, Englewood, Colorado, 80112, USA

tel: +34 952 048 609 email: [email protected] tel: +1 720 875 9182 email: [email protected] fax: +34 924 048 612 website: www.mayoralaviation.com fax: +1 720 875 9183 website: www.airaasi.com 42 SERVICEDIRECTORY To have your company listed in the Service Directory email: [email protected]

AirMed International LLC On Call International Jeffrey T Tolbert – President Michael J. Kelly – President & CEO 1000 Urban Center Drive, Suite 470, Birmingham, AL 35242, USA One Delaware Drive, Salem, NH 03079, USA

tel: +1 205 443 4840 email: [email protected] tel: + 888 289 0567 email: [email protected] fax: +1 205 443 4841 website: www.airmed.com fax: +1 603 328 1770 website: www.oncallinternational.com (AMERICAS) European Air Ambulance SelectCare Worldwide Patrick Schomaker – Director Sales & Marketing Magdi Riad – President AIR AMBULANCE

(NORTH AMERICA) 175A, rue de Cessange, L-1321, LUXEMBOURG #1201, 438 University Avenue, Toronto M5G 2K8, CANADA

24hr tel: +49 711 7007 7007 email: [email protected] tel: +1 416 340 7265 email: [email protected] fax: +49 711 7007 7009 website: www.air-ambulance.com toll free: +1 866 261 6718 website: www.selectcareworldwide.com ASSISTANCE COMPANIES ASSISTANCE Global Jetcare, Inc. Asia Assistance Partners Bart Gray – President Siriporn Wongurai – International Operations Director 184/235 Forum Tower, 36 Flr Ratchadapisek Rd Huaykwang, Bangkok 10320, 16479 Runway Drive, Brooksville, FL 34604, USA THAILAND tel: +1 352 799 7771 email: [email protected] tel: +662 645 3733-5 email: [email protected] fax: +1 352 799 7776 website: www.globaljetcare.com fax: +662 645 3732 website: www.aapartners.net

JET ICU Assistance Online Mike Honeycutt – President (AUSTRALASIA) Bertrand Guichoux – CEO 2561 Rescue Way, Brooksville, FL 34604, USA Zendai Cube Edifice 6/F, 58, Changliu Road, Pudong, 200135 Shanghai, CHINA

tel: +1 352 796 2540 email: [email protected] tel: +86 21 6104 9500 email: [email protected] fax: +1 352 796 2549 website: www.jeticu.com fax: +86 21 6104 9484 website: www.assistanceonline-china.com

LIFESUPPORT Patient Transport Customer Care Pty Ltd Graham Williamson – CEO Louise Heywood – Business Development & Marketing Manager #9-1009 Allsbrook Road, Parksville, British Columbia, V9P 2A9, CANADA Level 3, 60 Miller Street, North Sydney 2060, NSW, AUSTRALIA

tel: +1 250 947 9641 email: [email protected] tel: +612 9202 8222 email: [email protected] fax: +1 877 288 2908 website: www.LifeSupportTransport.com fax: +612 9202 8220 website: www.customercare.com.au

Skyservice Air Ambulance To have your company listed in our service directory David Ewing – VP International Market Development YUL/Trudeau Int Airport, 9785 Avenue Ryan, Montreal (Quebec), contact the sales department now: H9P 1A2, CANADA tel: +1 514 497 7000 email: [email protected] [email protected] or telephone: +44 (0)117 922 66 00 fax: +1 514 636 0096 website: www.skyservicebas.com/airambulance

AIMS Dynamiq Bernadette Breton – Managing Director Janine Benson – Director of Emergency Assistance Private Bag X5, Benmore Gardens 2010, Johannesburg, SOUTH AFRICA Level 5/33 York St, Sydney 2000, NSW, AUSTRALIA

(AFRICA) tel: +00 27 11 783 0135 email: [email protected] tel: +61 (0) 2 9978 6600 email: [email protected] fax: +00 27 11 783 2950 website: www.aims.org.za fax: +61 (0) 2 9888 3609 website: www.dynamiq.com.au/assist

AMREF Flying Doctor Service First Assistance Dr Bettina Vadera – Medical Director Mary-Jo McDonald – General Manager Wilson Airport, Langata Road, PO Box 18617, Nairobi, KENYA PO Box 17-310, Greenlane, Auckland, NEW ZEALAND

tel: +254 20 6000 090 email: [email protected] tel: +64 9 356 1650 email: [email protected] fax: +254 20 344 170 website: www.amref.org fax: +64 9 525 1278 website: www.firstassistance.co.nz ASSISTANCE COMPANIES ASSISTANCE

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 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

Netcare 911 International South Pacific Air Ambulance Louis Mabele – International Assistance Operations Manager Scotty Watson – Managing Director Riverview Park, Janadel Avenue, Midrand, SOUTH AFRICA NEW ZEALAND AUSTRALIA SINGAPORE

tel: +27 (0)10 209 8387 24hr email: [email protected] tel: +64 9256 9000 email: [email protected] fax: +27 (0)10 209 8405 website: www.netcare911.co.za fax: +64 9256 9111 website: www.spaa.co.nz

West African Rescue Association ADAC-Ambulance Service Florian Zagel – Managing Director Robert Glueck – Marketing & Sales Director Klotey Cresent 6, North Labone, Accra, GHANA Am Westpark 8, 81373 Munich, GERMANY

tel: +233 244 312 496/7 email: [email protected] (EUROPE) tel: +49 89 76 76 52 85 email: [email protected] fax: +233 21 781 259 website: www.westafrican-rescue.com 24h Alarm: +49 89 76 76 50 05 website: www.adac.de/ambulance

CATEGORY KEY CLAIMS MANAGEMENT LEGAL SERVICES Altas Assistance AIR AMBULANCE CLAIMS SUBROGATION MEDICAL ESCORT ON COMM. AIRLINE AIR AMBULANCE INTERIOR COMMERCIAL REPAT SPECIALISTS MEDICAL PROVIDER Arvydas Bebravi˘cius – Managing Director AIRCRAFT PERFORMANCE SOLUTIONS CRITICAL CARE PATIENT TRANSPORT MEDICAL SCREENING Lentvario Str. 7, Lt-02300 Vilnius, LITHUANIA ASSISTANCE COMPANIES FUNERAL DIRECTORS RE-INSURANCE CATASTROPHIC CLAIMS SPECIALIST HEALTHCARE CLINICS TRAVEL AGENTS tel: +370 5 264 4020 email: [email protected] COST CONTAINMENT HOSPITALS WEB & DESIGN SERVICES fax: +370 5 264 4021 website: www.altas-assistance.lt call +44 (0) 117 925 5151 To make an alteration to a listing email: [email protected] SERVICEDIRECTORY 43

AP Companies SOS International Natalya Butakova – Business Development Manager Helle Drager Sandahl – Communications & Marketing Manager str. 9, dom 5/7, ul. Nizhnyaya Syromyatnicheskaya, Moscow 105120, RUSSIA Nitivej 6, DK-2000 Frederiksberg, Copenhagen, DENMARK

tel: +7 495 989 1120 email: [email protected] tel: +45 7010 5055 email: [email protected] (EUROPE) (EUROPE) fax: +7 495 989 1130 website: www.ap-companies.ru fax: +45 7010 5056 website: www.sos.eu

ARC Europe SA TBS Team 24 d.o.o Hans Biekmann – Network Director Edvard Hojnik – General Manger Avenue des Olympiades 2, 1140 Brussels, BELGIUM Ljubljanska Ulica 42, 2000 Maribor, SLOVENIA

tel: +32 2 706 6660 email: [email protected] tel: +386 2618 2301 email: [email protected] fax: +32 2 706 6601 website: www.arceurope.com fax: +386 2618 5800 website: www. tbs-team24.com ASSISTANCE COMPANIES ASSISTANCE ASSISTANCE COMPANIES ASSISTANCE CNAS CONNEX Assistance Middle East Carole Luisy – Managing Director Lara Helmi – International Network Director 80 rue des alliés, 38100, Grenoble, FRANCE Office 703, Block B, Belrasheed Towers, Qusais, Dubai, UAE

tel: +33 438 49 83 49 email: [email protected] tel: +97 14 257 82 84 email: [email protected] fax: +33 438 49 83 40 website: www.cnas-assistance.com fax: +97 14 257 82 85 website: www.connexassistance.com (MID. EAST) (MID. DRK Assistance IES Medical Andreas Speich – Managing Director Eitan Kariv – CEO Aufm Hennekamp 71, 40225 Düsseldorf, GERMANY 2 Yagea Kapaim Street, Tel Aviv, ISRAEL

tel: +49 211 2711 2020 email: [email protected] tel: +972 3 639 9990 email: [email protected] fax: +49 211 3018 0527 website: www.drkassistance.com fax: +972 3 687 2950 website: www.iesmedical.co.il

Global Assistance a.s. Dr Colin Plotkin & Sons Consulting INC. Petr Bold – General Manager Dr Colin Plotkin – Managing Director Dopraváku˚ 749/3,184 00 Prague 8, CZECH REPUBLIC 27-3088 Francis Road, Richmond, British Columbia V7C 5V9, CANADA

tel: +420 266 799 770 email: [email protected] tel: +1 604 241 9677 email: [email protected] fax: +420 266 799 797 website: www.1220.cz fax: +1 604 241 0733 website: www.plotkinconsulting.com

Global Voyager Assistance - Russia To have your company listed in our service directory Costas Danilenko – CEO CATASTROPHIC PO Box II, 125124 Moscow, RUSSIA contact the sales department now:

tel: +7 495 775 0999 email: [email protected] CLAIMS SPECIALISTS [email protected] or telephone: +44 (0)117 922 66 00 fax: +7 495 775 0998 website: www.gvassistance.com

Global Voyager Assistance - Black Sea AIMS Olga Turubarova – General Manager Bernadette Breton – Managing Director 77-79 Nezhinskaya Str., 65023, Odessa, UKRAINE Private Bag X5, Benmore Gardens, 2010 Johannesburg, SOUTH AFRICA

tel: +38 048 7373 441 email: [email protected] tel: +00 27 11 783 0135 email: [email protected] (AFRICA) fax: +38 048 7373 442 website: www.gvassistance.com fax: +00 27 11 783 2950 website: www.aims.org.za

Greek Flying Doctors Interhealth Technologies Dimitris Kanellis – Manager Kevin Thomas – Director - International 3 Doukisis Plakentias Str, 152 34 Halandri, Athens, GREECE P O Box 3058, Bedfordview 2008, SOUTH AFRICA COST CONTAINMENT tel: +30 210 674 0600 email: [email protected] tel: +27 11 622 8010 email: [email protected] fax: +30 210 674 0634 website: www.greekflyingdoctors.gr fax: +27 11 622 8264 website: www.interhealth.net

Marm Assistance ChargeCare International Jill Atac – CEO Christiane Burniston – Managing Director Sabiha Gokcen International Airport, J Blok Kurtkoy, 34912 Istanbul, TURKEY Monument Business Park, 1D Park Offices, Warpsgrove Lane, Chalgrove, Oxford, UK

tel: +90 216 588 0588 email: [email protected] (EUROPE) tel: +44 1865 400 007 email: [email protected] fax: +90 216 588 0602 website: www.marmassistance.com fax: +44 845 003 9923 website: www.chargecareinternational.co.uk

med con team GmbH Marm Assistance Michael Weinlich – Managing Director Jill Atac – CEO Gerhard-Kindler-Str.8, 72770 Reutlingen, GERMANY Sabiha Gokcen International Airport, J Blok Kurtkoy, 34912 Istanbul, TURKEY

tel: +49 7121 433 660 email: [email protected] tel: +90 216 588 0588 email: [email protected] fax: +49 7121 433 619 website: www.medconteam.com fax: +90 216 588 0602 website: www.marmassistance.com

Save Assistance France Medical Claims International Spain Franck Molinier – Director of Business Development Fatima Guillen Grande – Managing Director 19 rue de Provence, 78310 Maurepas, FRANCE C/Ciudad de Aguilas No.2, Local 2A, Madrid 28030, SPAIN

tel: +33 13062 6752 email: [email protected] tel: 00 34 913 016 145 email: [email protected] 24 tel: +33 13062 1122 website: www.saveassistance.com fax: 00 34 913 016 160 website: www.mcimanager.com

Savitar CATEGORY KEY CLAIMS MANAGEMENT LEGAL SERVICES Lydia Semchenkova – Business Development Manager AIR AMBULANCE CLAIMS SUBROGATION MEDICAL ESCORT ON COMM. AIRLINE AIR AMBULANCE INTERIOR COMMERCIAL REPAT SPECIALISTS MEDICAL PROVIDER 25/1, 7th Floor, Trubnaya Str., Moscow, 127051, RUSSIA AIRCRAFT PERFORMANCE SOLUTIONS CRITICAL CARE PATIENT TRANSPORT MEDICAL SCREENING ASSISTANCE COMPANIES FUNERAL DIRECTORS RE-INSURANCE tel: +7 495 987 1775 email: [email protected] CATASTROPHIC CLAIMS SPECIALIST HEALTHCARE CLINICS TRAVEL AGENTS fax: +7 495 987 1776 website: www.savitar-gr.com COST CONTAINMENT HOSPITALS WEB & DESIGN SERVICES 44 SERVICEDIRECTORY To have your company listed in the Service Directory email: [email protected]

Global Excel Management SelectCare Worldwide Michael Drew – Vice-President Sales Magdi Riad – President 73 Queen St, Sherbrooke, QC J1M 0C9, CANADA #1201, 438 University Avenue, Toronto M5G 2K8, CANADA 17548 Deer Isle Circle, Winter Gdn, FL 34787 USA tel: +1 866 566 1130 email: [email protected] tel: +1 416 340 7265 email: [email protected] fax: +1 819 566 8335 website: www.globalexcel.ca toll free: +1 866 261 6718 website: www.selectcareworldwide.com

Global Medical Management Star Healthcare Raija Itzchaki – COO Gigi Galen – President

(NORTH AMERICA) 1300 Concord Terrace, Suite 300, Sunrise, Florida 33323, USA 850 7th Avenue, Suite 803, New York, 10019, USA

tel: +1 954 370 6404 email: [email protected] tel: + 1 212 581 8228 email: [email protected] COST CONTAINMENT

fax: +1 954 370 8613 website: www.gmmusa.com CLAIMS MANAGEMENT fax: + 1 212 581 8272 website: www.starhealthcarenet.com

Olympus Managed Healthcare To have your company listed in our service directory Steven Jacobson – CEO 777 Brickell Avenue, Suite PH70, Miami, Florida 33131, USA contact the sales department now: tel: +1 305 530 8600 email: [email protected] [email protected] or telephone: +44 (0)117 922 66 00 fax: +1 305 530 0766 website: www.omhc.com

OneWorld Assist LIFESUPPORT Patient Transport Taka Katsube – Director Assistance & Cost Managment Graham Williamson – CEO 10th Floor, 6081 No.3 Road, Richmond, BC V6Y 2B2, CANADA #9-1009 Allsbrook Road, Parksville, British Columbia, V9P 2A9, CANADA

tel: +1 604 303 2113 email: [email protected] tel: +1 250 947 9641 email: [email protected] fax: +1 604 276 4593 website: www.oneworldassist.com fax: +1 877 288 2908 website: www.LifeSupportTransport.com SPECIALISTS SelectCare Worldwide Voyageur Aeromedical Travel Magdi Riad – President Marc Lucas – General Manager #1201, 438 University Avenue, Toronto M5G 2K8, CANADA Voyageur Buildings, 43 Colston Street, Bristol BS1 5AX, UK

tel: +1 416 340 7265 email: [email protected] tel: +44 (0)117 927 3554 email: [email protected]

toll free: +1 866 261 6718 website: www.selectcareworldwide.com COMM. REPATRIATION fax: +44 (0)117 925 5940 website: www.voyageur24.com

Star Healthcare ADAC Gigi Galen – President Christoph Ullrich – Director of Purchase / International Network 850 7th Avenue, Suite 803, New York, 10019, USA Am West Park 8, 81373 Munich, GERMANY

tel: + 1 212 581 8228 email: [email protected] tel: +49 89 7676 2912 email: [email protected] fax: + 1 212 581 8272 website: www.starhealthcarenet.com 24hr Alm: +49 89 7676 5005 website: www.adac.de/ambulance TRANSPORT UnitedHealth International Lufthansa Medical Services Philip Brun – Vice President of Sales & Service Doris Ehring – Manager Sales & Marketing Lufthansa German Airlines, Lufthansa Base, FRA SX/M, D-60546, 3100 SW 145 Avenue, Miramar, FL 33027, USA Frankfurt/Main, GERMANY tel: +1 954 378 0694 email: [email protected] tel: +49 (0)69690-20904 email: [email protected] fax: +49 (0)69690-58147 website: www.dlh.de

fax: +1 954 378 0771 website: www.uhgi.com PATIENT CARE CRITICAL

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

Global Excel Management ANUBIS International Repatriation Michael Drew – Vice President of Sales Fabrice Kana – Development & Quality Manager 73 Queen St, Sherbrooke, QC J1M 0C9, CANADA Tour Pleyel, 93200 Paris, Saint Denise, FRANCE 17548 Deer Isle Circle, Winter Gdn, FL 34787, USA

tel: +1 866 566 1130 email: [email protected] FUNERAL DIRECTORS tel: +33 149 195 960 email: [email protected] fax: +33 149 471 901 website: www.anubisgroup.org CLAIMS MANAGEMENT fax: +1 819 566 8335 website: www.globalexcel.ca

Interhealth Technologies Funeral Home AURIGA Ltd. Kevin Thomas – Director - International Helen Pradova – Chief of International Department P O Box 3058, Bedfordview 2008, SOUTH AFRICA B. Nmcové Street 1052/1, 412 01 Litomerice, CZECH REPUBLIC

tel: +27 11 622 8010 email: [email protected] tel: +420 724 257 899 email: [email protected] fax: +27 11 622 8264 website: www.interhealth.net fax: +420 416 735 800 website: www.funeral-assistance.cz

Funeralcare International CATEGORY KEY CLAIMS MANAGEMENT INSURERS Louisa Killen – Repatriation Specialist MEDICAL ESCORT ON AIR AMBULANCE CLAIMS SUBROGATION COMMERCIAL AIRLINE Murray House, 50 Whitta Road, Manor Park, London, Essex E12 5DA, UK AIR AMBULANCE COMMERCIAL REPAT MEDICAL PROVIDER tel: +44 20 8788 5303 email: [email protected] INTERIOR SPECIALISTS fax: +44 20 8788 2525 website: www.co-operativefuneralcare.co.uk AIRCRAFT PERFORMANCE CRITICAL CARE MEDICAL SCREENING SOLUTION PATIENT TRANSPORT John Allison Monkhouse Co., Ltd (Thailand) ASSISTANCE COMPANIES FUNERAL DIRECTORS RE-INSURANCE Apple Kaewprasert – General Manager CATASTROPHIC CLAIMS President Park View Tower, 99/243 (30B) Pine Tower, Sukhumvit soi 24, Klongton SPECIALISTS HEALTHCARE CLINICS TRAVEL AGENTS Klongtoey, Bangkok, THAILAND WEB & DESIGN tel: +66 2382 5345-7 email: [email protected] COST CONTAINMENT HOSPITALS SERVICES fax: +66 81 584 5942 website: www.monkhouse.com.au call +44 (0) 117 925 5151 To make an alteration to a listing email: [email protected] SERVICEDIRECTORY 45

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 (ASIA) 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 Doctor Service Greta Plas – Repatriations Manager Dr Bettina Vadera – Medical Director Ringlaan 49, 1930 Zaventem, BELGIUM 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] FUNERAL DIRECTORS fax: +32 2 720 88 22 website: www.repatriations.com fax: +254 20 344 170 website: www.amref.org

Rowland Brothers International To have your company listed in our service directory Melanie Walkling – Partner 299-305 Whitehorse Road, West Croydon, Surrey CR0 2HR, UK contact the sales department now: tel: +44 20 8684 2324 email: [email protected] [email protected] or telephone: +44 (0)117 922 66 00 fax: +44 20 8684 8000 website: www.rowlandbrothersinternational.co.uk

Servilusa Greek Flying Doctors Vanda Castro – Manager International Department Dimitris Kanellis – Manager Agencias Funerarias SA, International Dept. Rua do

MEDICAL ESCORT ON COMMERCIAL AIRLINES COMMERCIAL ON ESCORT MEDICAL 3 Doukisis Plakentias Str, 152 34 Halandri, Athens, GREECE Entreposto Industrial, 8-2 Esq, 2610-135 Amadora, PORTUGAL tel: +35 121 470 6300 email: [email protected] tel: +30 210 674 0600 email: [email protected] (EUROPE) fax: +35 121 470 6499 website: www.servilusa.pt fax: +30 210 674 0634 website: www.greekflyingdoctors.gr

BUPA Cromwell Hospital Redstar Aviation Shams Maladwala – Commercial Director Mustafa Atac – CEO Cromwell Road, London SW5 0TU, UK Sabiha Gokcen International Airport, J Blok Kurtkoy, 34912 Istanbul, TURKEY

tel: +20 7460 2000 email: [email protected] tel: +90 216 588 0216 email: [email protected]

(EUROPE) fax: +20 7835 2444 website: www.cromwellhospital.com fax: +90 216 588 0225 website: www.redstar-aviation.com HOSPITALS HOSPITALS Baptist Health Int. Center of Miami Voyageur Aeromedical Travel Yohandra Fuentes – Finance Manager Marc Lucas – General Manager 8940 North Kendall Drive, Suite 601-E, Miami, Fl 33176, USA Voyageur Buildings, 43 Colston Street, 43 Colston Street, Bristol BS1 5AX, UK

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

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

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

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

Jackson Memorial Hospital International AMREF Flying Doctor Service Luis Felipe Arango – Vice President of International Business Dr Bettina Vadera – Medical Director Jackson Medical Towers, East Tower, Suite 829, Wilson Airport, Langata Road, PO Box 18617, Nairobi, KENYA 1500 NW 12th Avenue, Miami, FL 33136 - 9998, USA 24hr tel: + 1 305 355 1212 email: [email protected] tel: +254 20 6000 090 email: [email protected] tel: + 1 305 355 5544 website: www.jmhi.org fax: +254 20 344 170 website: www.amref.org

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

tel: +1 305 243 9100 email: [email protected] tel: +1 305 459 4882 email: [email protected] fax: +1 305 243 9101 website: www.uhealthinternational.com fax: +1 305 421 5575 website: www.standbymd.com

CareFlight Group Voyageur Aeromedical Travel Medical and Tasking Centre Marc Lucas – General Manager PO Box 5078, Robina Town Centre, Queensland, 4230, AUSTRALIA Voyageur Buildings, 43 Colston Street, Bristol BS1 5AX, UK

24hr tel: +61 7 5553 5955 email: [email protected] tel: +44 (0)117 927 3554 email: [email protected] fax: +61 7 5553 5914 website: www.cmsairambulance.com fax: +44 (0)117 925 5940 website: www.voyageur24.com

CareFlight International To have your company listed in our service directory

Sue Robshaw – Co-ordinator AGENTS TRAVEL Westmead Hospital Campus, PO Box 159, Westmead, NSW 2145, contact the sales department now: AUSTRALIA MEDICAL ESCORT ON ON ESCORT MEDICAL tel: +61 1300 655 855 email: [email protected] [email protected] or telephone: +44 (0)117 922 66 00 fax: +61 2 9689 2744 website: www.careflight.org COMMERCIAL AIRLINES COMMERCIAL

Medical Wings V Creative Design Dr Sommart Somsiri – Medical Director Steve Annette – New Media Director 222 Room 3259, Bangkok Int Airport, Viphavadee-Rangsit Rd, Sikan, Don Muang, Voyageur Buildings, 43 Colston Street, Bristol BS1 5AX, UK Bangkok 10210, THAILAND tel: +662 247 3392 email: [email protected] tel: +44 (0)117 929 4636 email: [email protected] fax: +662 535 4355 website: www.medicalwings.com fax: +44 (0)117 925 2040 website: www.vcreativedesign.co.uk WEB & MEDIA MEDIA & WEB ADVERTISING 46 REGULARS GRAPEVINE • GRA PEVINE VINE G RAPEVINE GRAP EVINE

GRAPEVINE • GRAPEVINE • GRAPEVINE GRAPEVINE • GRAPEVINE • GRAPEVINE • GRAPEVINE • GRAPEVINE • GRAPEVINE • GRAPEVINE • GRAPEVINE • GRAPEVINE • GRAPEVINE • GRAPEVINE • GRAPEVINE • GRAPEVINE • GRAPEVINE • GRAPEVINE • GRAPEVINE • Grapevine Miniskirt ban location in Italy to make use of new powers they have been given to crack down on anti-social planned behaviour. People who ignore or flout the new law would face fines of between €25 and €500. In a move sure to alienate the tourists who fall foul Mayor of Castellammare Luigi Bobbio wants of it, a seaside city in Italy is planning to instigate a people to wear clothes that are not revealing, ban on miniskirts and other revealing clothing, in meaning a tough new dress code that could a bid to improve what the mayor of the town has outlaw everything from miniskirts to low-cut called ‘standards of public decency’. The town, jeans. There will also be a ban on sunbathing, Castellammare di Stabia, is trying to be the latest playing football in public places, and blasphemy.

• GRAPEVINE • GRAPEVINE • GRAPEVINE • GRAPEVINE • GRAPEVINE • GRAPEVINE • GRAPEVINE • GRAPEVINE • GRAPEVINE • GRAPEVINE GRAPEVINE • GRA PEVINE VINE G RAPEVINE • Language barrier to wedded bliss A British couple who went to renew their wedding vows in the dream destination of the Maldives got a little more than they bargained for from the cleric taking the service – instead of the usual gentle wedding patter, they were subjected to a torrent of abuse … not that they knew, as the cleric was speaking the local language. A video of the ceremony that has appeared online shows the couple being called ‘swine’ and ‘infidels’, saying: “Your marriage is not a valid one. You are not the kind of people who can have a valid marriage … you fornicate and make a lot of children.” He also makes reference to bestiality, sexual diseases and ‘frequent fornication by homosexuals’ – an odd thing to say as a heterosexual couple renew their vows. Tourism officials in the Maldives are said to be very concerned about the incident and have requested a formal enquiry into the matter. The president of the Maldives telephoned the couple in question to give his personal apologies and to invite them back to the islands as his guests.

A bitter taste … A town in China has tried a new and innovative way to attract tourists – by staging a vinegar drinking contest. Organisers of the competition in Zhenggiang, eastern China’s Jiangsu Province, said it was also aimed at promoting the health benefits of drinking vinegar – such as curing hiccups. Contestants were lined up and had to drink three 375 ml bottles of local vinegar, one after the other – the winner downed his three bottles in just 28 seconds.

• GRAPEVINE • GRAPEVINE • GRAPEVINE • International Travel Insurance Journal ONTHEMOVE 47

Norton Rose adds Aetna promotes Groupama creates dedicated team to London office executives Groupama Insurances has created a dedicated of development underwriter for its growing personal International legal practice Norton Rose has Aetna has announced that its chief financial officer, business underwriting team in the UK, which will lines motor account. Reporting to the company’s head announced that Stuart Brown has joined the firm’s Joseph Zubretsky, has been named senior vice- serve London and the South. Three underwriters of motor, Andrew Fletcher, Julian joins Groupama London, UK, practice as a consultant. Prior to joining president and chief financial officer, and given the have joined the company – Therese Crowhurst, following 10 years with AXA, where he was most the firm, Brown was the senior transaction counsel at additional responsibility of leading the company’s Steve Scrimgeour and Darren Carter, all of whom recently assistant product manager. Bringing over Swiss Re’s UK Admin Re business, advising the group diversification initiatives. In addition, the company will report to Dawn Dillaway, the group’s head of 16 years of insurance industry experience across on closed life fund and longevity transactions – his said that Margaret McCarthy, chief information commercial underwriting. Therese Crowhurst and a range of disciplines, Julian will be responsible for specialist area. officer and leader of Aetna’s innovation, technology Steve Scimgeour will focus on non-motor, small-to- developing profitable motor business for Groupama Brown takes and services operations, is being promoted to the medium enterprise (SME) commercial business, having through its panel of intermediaries. He will be working a wealth of position of executive vice-president. Both Zubretsky worked for Groupama for three years and acquired closely with existing broker partners, developing and knowledge and and McCarthy will report to Mark Bertolini, currently substantial knowledge of the scheme’s business. strengthening key relationships and will be based in experience with president and head of business operations, who was Darren Carter has joined the firm from AIG, bringing Groupama’s headquarters in the City of London. him to Norton recently appointed as chief executive officer. From with him a reputation as a skilled underwriter. Andrew Fletcher commented on the appointment: Rose, having the end of November, Ronald Williams, who plans to Dawn Dillaway commented on the appointments: “Julian’s extensive experience in personal lines, alongside practised in the retire next year, became executive chairman of the “Our team has the skills and authority to really help his management skills, will help us to further enhance insurance sector company, while Bertolini takes his place as CEO. our supporting brokers take maximum advantage of our underwriting and development capabilities in for 14 years, Bertolini said of the appointments: “The recognition the valuable new SME business opportunities that private motor. This in turn will allow us to continue the but he also has for these outstanding individuals demonstrates the they produce.” swift and responsive service that we offer brokers in broad experience strength and depth of Aetna’s leadership team and Groupama has also appointed Julian Abson in the role managing and developing business for Groupama.” across life our strong success planning process.”

Stuart Brown assurance matters and advises on mergers and acquisitions, reinsurance, regulatory Benmosche succession planned Williams joins issues and Solvency II. He trained and qualified as a solicitor at Clifford Chance before joining GE as AIG, taken by surprise by the in 2012. Coversure managing counsel to the GEIS European Life and news that its chief executive A statement from AIG read: “Bob Former chief executive of the British Insurance Brokers’ Health Reinsurance business. Robert Benmosche has cancer, feels fine, continues to work a Association (BIBA) Mike Williams has opened a new Brown said: “I am delighted to join the insurance has said that chairman of the firm normal schedule and the board branch for franchise-based insurance broker Coversure. practice at Norton Rose, having known and worked Steve Miller would step in as the continues to assume that Bob will Williams, who left his role with BIBA in 2003, took up with them for many years. I was attracted to their strong insurer’s interim chief if it becomes remain CEO on this timetable. In the role with Coversure on 1 December and is now track record in the insurance sector in general and the necessary. Benmosche’s revelation the event that Bob would become running the franchise in the Chelmsford area of the life insurance sector in particular. Their involvement that he was undergoing ‘aggressive unwilling or unable to continue to UK. Previously, Williams held the position of managing in the recent AXA UK/Resolution acquisitions and the chemotherapy’ sent AIG’s board effectively serve in his current role, director of UKGI before he left the company in June BMW longevity reinsurance demonstrates the team’s members scrabbling for a succession our chairman, Steve Miller, would this year. Williams’s branch will initially handle a small outstanding experience and capacity to advise on plan that could be implemented if he step in as interim CEO of AIG for as book of business that has been handed to it by another complex life insurance and longevity matters.” needs to leave his position before long as it takes to identify and select a broker, Insurance Risk Solutions, whose chairman his stated end goal of stepping down Robert Benmosche long-term replacement for Bob.” Robert Beckett was also involved in UKGI as a director between July 2005 and October 2006.

RSA chooses Scandinavian head Brits announces Prudential moves UK-based insurer RSA has announced the handover from Rockard board departure Prudential has announced that Mike Wells has been appointment of Mike Holliday-Williams as Gustafson, who is leaving to appointed as president and chief executive officer of chief executive officer of RSA Scandinavia. become chief executive officer of Brit Insurance has announced that Matthew Scales Jackson National Life Insurance Company and will In the new role, he will be responsible for SAS Scandinavian Airlines. will step down as a board member on 20 December join the board of Prudential as executive director, the Scandinavian business of RSA, which Simon Lee, international chief following the Extraordinary General Meeting on 17 succeeding Clark Manning. Wells, who has been with includes operations in Denmark, Sweden, executive of RSA, welcomed the December. This news follows the announcement the company for 15 years, is currently vice-chairman Norway and Finland, as well as the Codan appointment: “I am delighted made in February this year of his intention to step and chief operating officer. Manning will leave the and Trygg Hansa brands. Holliday-Williams that Mike is going to lead our down as group finance director after over 15 years board of the company from 1 January next year, but was previously the managing director for Scandinavian business. He has the with the group. In August, it was announced that will continue in the role of chairman of Jackson until RSA’s UK personal lines operation, which right combination of experience Scott Egan would be joining Brit Insurance as group April to ensure a smooth transition. includes the More Than brand. Prior to and vision to drive our business finance director on 7 January next year. In addition, the Prudential board has announced the joining RSA, Holliday-Williams worked in Mike Holliday-Williams forward. Over the last four years, Dane Douetil, chief executive of Brit Insurance, appointments of Howard Davies and Paul Manduca the energy, telecoms and retail sectors, he has overseen the growth in the commented: “The entire board and I would like to as non-executive directors, with immediate effect. beginning his career with WH Smith before moving UK personal lines market in challenging conditions, thank Matthew for his considerable contribution to From 1 January 2011, Paul will replace James Ross as on to British Gas and Onetel. establishing RSA and More Than as a major force in the development of Brit Insurance and I am grateful the board’s senior independent director, with James Holliday-Williams will officially begin his role on 1 the online market as well as re-establishing RSA in the that he has agreed to be available to Scott Egan when remaining as a non-executive director until next May, February next year in order to ensure an orderly personal broker market.” he joins to ensure a smooth transition.” at which point he will retire.

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