Consumers in the UK are being made more aware of the hazards of drinking while on holiday, after Atlas Travel refused to pay out on a claim made by a young British tourist. Sarah Watson examines the case

Charlotte Robinson, 19, fell from the back of a moped while on holiday in Malia, Crete, a hotspot for young British tourists seeking sun, clubbing and fun in the summertime. Robinson was riding pillion

As consumers scrabble to save any extra cash in these increasingly hard times, insurers have been warned to be on the lookout for fraudsters trying to claim back the cost of a holiday they can no longer afford. Mandy Aitchison reports

A recent study that showed a 13-per-cent rise in suspicious motor claims in the past three months has served as a warning to travel insurers to be on the lookout for more fraudulent claims as consumers try to claw back some of their hard-earned cash in an effort to beat the credit crunch. Absolute Fraud Management (AFM), who conducted the survey, said it expects similar figures to arise from the inspection

Crunch prompts fraud concern

Milan Korcok investigates the use of personal credit reports by US hospitals

In a move that clearly erodes the value of foreign or domestic health insurance and PPO contracts, American hospitals are toughening their collections procedures and tapping into individual credit records

to determine patient ability, or willingness, to pay up when the bill comes due. By going directly after patients to pay all or even portions of their bills, hospital contracts with insurers become increasingly marginalised, as clients then shift the blame for non payment of benefits to their insurers. By dealing direct, they and their insurers also lose the benefit of

any discounts the insurers may have negotiated.The practice, reported by credit industry professionals to be common in at least 20 per cent of America’s almost 5,000 acute care hospitals, is growing rapidly and will soon become virtually universal as hospitals are increasingly burdened by uncompensated care and uncollected

ESSENTIAL READING FOR TRAVEL INSURANCE INDUSTRY PROFESSIONALS SEPTEMBER 2008 • ISSUE 92

NOW INSIDE: privatehealthcarenews GLOBAL HEALTHCARE • IPMI • CORPORATE BENEFITS

continued on page 4

continued on page 7continued on page 6

How’s your credit?

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Drinking small print under fire

As ITIJ went to press, the sad news came through of Spanair flight JK 5022 bound from Madrid to Gran Canaria, which crashed shortly after take off from Barajas Airport. Mandy Aitchison relates the details of the accident

Three days of official mourning were declared in Madrid after the flight crashed, killing 153 people and leaving just nineteen survivors, though some remain in a critical condition at the time of writing. Initial reports suggested that a fire had broken out in one of the MD-82’s engines during or shortly

after take-off from Terminal Four, and the plane ended up in a nearby field.Spanish Transport Minister Magdalena Alvarez said the plane had earlier begun taxiing to the runway before turning back due to a technical problem, which had caused an

Crash leaves 153 dead

continued on page 4

International Travel Insurance Journal

IN THIS ISSUE

REGULARSNews continued 4Company brief 8Insurance matters 9Health matters 12Editorial comment 12Air ambulance news 14Travel matters 16Profile 38Private Healthcare News 33Service directory 40Grapevine 46Diary dates 46On the move 47

FEATURES

News analysis: Policy exclusions 18David Craik investigates which exclusions in travel insurance policies are unrealistic and outdated

Feature: One last weekend of freedom 20Peter Corbett asks whether travel insurers are brave enough to take on the stag and hen parties that are becoming ever more international in their search for thrills

Assistance and healthcare world markets: Caribbean Basin 26Petra Kendall-Raynor has the details of the provision of healthcare and assistance services in the popular tourist region

PHN feature: The value of employer-offered health plans 38Carrie Dunn asks what a health plan can do for a company

Pete Corbett has been a newspaper journalist, an in-house industry press offi cer, a part time government and local authority press offi cer, a copy writer, a senior public relations executive, manager of a government publicity unit, translator of ‘offi cialese’ into plain English and corporate, business and trade magazine editor.

David Craik been working as a freelance journalist for the past six years and write for national newspapers and magazines. This includes shifts on the Daily Express City and Business desk where I cover market reports including the insurance sector. I have experience writing news and features on a wide range of subjects including insurance, aviation, transport, recruitment, IT, personal fi nance and small business.

Carrie Dunn is a freelance writer and has written about human resources and careers issues for publications includ-ing the Independent and Pay magazine.

David Ing is a freelance journalist covering mainly travel and tourism issues in Spain. He writes on air transport for a leading international news agency, as well as contributing special features to Newsweek and writing in-fl ight magazine articles and guidebooks.

Petra Kendall-Raynor is a freelancer with experience writing for daily, weekly and monthly national publica-tions. She covers news, news analysis and features on many subjects and has written extensively about the healthcare system, with work published in Care and Health, Nursing Standard, Health Insurance and Planned Savings magazines.

Milan Korcok is an award-winning freelance health poli-cy and economics writer who covers travel insurance, public health, and medical education issues in Canada and the US. He has been writing about health fi nancing and policy issues in these countries since the 1960s and is a frequent contribu-tor to leading North American professional journals and consumer media. He lives in Fort Lauderdale, Florida.

ITIJ CONTRIBUTORS

2

International Travel Insurance Journal

Published on behalf of Voyageur Publishing & Events Ltd, Voyageur Buildings, 43 Colston Street, Bristol BS1 5AX, UK

The information contained in this publication has been published in good faith and every effort has been made to ensure its accuracy. Neither the publisher nor Voyageur Ltd can accept any responsibility for any error or misinterpretation. All liability for loss, disappointment, negligence or other damage caused by reliance on the information contained in this publication, or in the event of bankruptcy or liquidation or cessation of the trade of any company, individual or fi rm mentioned is hereby excluded.

Printed by Pensord Press, South Wales, United Kingdom

Copyright © Voyageur Publishing 2008. Materials in this publication may not be reproduced in any form without permission INTERNATIONAL TRAVEL INSURANCE JOURNAL ISSN 1743-1522

Editor-in-chief: Ian CameronEditor: Sarah Watson (née. Lee)Assistant editor: Mandy AitchisonCopy editor: James WallisDesigners: Eli Butler Steve Annette Julie Wiles US correspondent: Milan KorcokConference manager: Denise ClementsProduction: Helen Watts

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International Travel Insurance Journal

4 NEWS

Do you trust credit card insurance?A recent poll by The Calgary Herald asked the question: ‘Do you trust credit card companies’ travel insurance or do you purchase supplementary insurance when you travel?’, with some interesting results. The value of supplementary insurance is often debated in the pages of ITIJ and at the International Travel Insurance Conference, with most providers agreeing that the majority of credit card-based insurance policies offer only limited benefits and have more exclusions than a normal policy. Now it seems the Canadian public at least is catching on.According to the results of the poll, 55 per cent of respondents didn’t believe the insurance offered by their credit card company was enough, and bought a separate travel insurance policy as well. However, slightly worse news was forthcoming when it was revealed that nearly 30 per cent of those who took part in the poll didn’t know what the coverage offered by their credit card was. Meanwhile, nine per cent said they knew they were only covered for the basics if they used their card insurance, while a further nine per cent admitted to ‘never’ buying travel insurance.

Ombudsman shows dispute figuresStatistics from the UK Financial Ombudsman Service (FOS) have shown that the majority of complaints regarding travel insurance referred to the service are related to unpaid claims for holiday cancellations. Many of such claims arose out of the ill health of someone who was planning to travel, or one of their close relatives.One particular case that was highlighted by the FOS was that of Miss J, who booked a holiday to Greece and took out travel insurance at the same time. Five months before the holiday, Miss J’s father was diagnosed with a heart condition. He responded well to treatment and soon appeared to be back to normal. However, just a few weeks before she was due to leave on holiday, her father’s condition deteriorated and Miss J was forced to cancel her holiday.Her claim was turned down by her insurer, who said that she should have cancelled her holiday the moment she became aware of her father’s condition. However, the FOS sided with the consumer on this issue, saying: “Her father had responded well to treatment in January and there had been no reason at that time for her to think she would need to cancel her holiday. We upheld the complaint and required the insurer to reimburse her

for the cost of the holiday.”In addition to complaints about the cancellation and curtailment small print in travel policies, the FOS also said it continued to see claims regarding medical expenses, loss of baggage and items left unattended. One such incident involved a Mr N, who was sitting on a bench in a New York subway station when the person sitting next to him engaged him in conversation for a couple of minutes. When he looked down, Mr N realised his rucksack, containing more than £2,000 worth of personal possessions,

had been stolen. He made a claim, but his insurer took the view that he had left the bag unattended – the FOS did not agree and ordered the insurer to pay up.A spokesperson for the FOS noted: “Although

the FOS continues to receive a wide range of travel insurance cases, it is reassuring to know that for the second year running the number of disputes referred to it about travel insurance has fallen. We hope that this reflects both improved claims and complaints handling by insurers, and also growing consumer understanding to what is – and isn’t – likely to be covered by travel insurance.”

Car theft clauses catch consumers

A recent travel insurance dispute has served to underline to both insurers and consumers the importance of asking the right questions when buying or selling a travel insurance policy.A British couple planned a long motoring trip in Europe, and because they were touring and only wanted to stay one or two nights in each place, they knew that there would be times when their luggage would be left in the boot of the vehicle. And, being savvy consumers, they were aware that some insurance policies wouldn’t cover unattended luggage in cars – even if the car is locked and the luggage out of sight – so they talked through their needs with the insurer before they left the UK, who assured them they would be covered for their trip.Unfortunately, the worst happened and despite leaving their car locked, alarmed and parked in a residential street, it was broken into in Sicily, leaving a window smashed and some of their personal belongings taken. Again, the couple did everything right, and went to the nearest police station to obtain a crime reference number so they could make the claim when they returned to the UK.However, what should have been a simple claim and payout did not turn out that way. The insurer rejected the claim on two counts: the first because their vehicle was UK-registered and therefore ‘a target for thieves’, and secondly because Sicily is (according to the insurer anyway) one of the poorest places in the world, thus making cars particularly vulnerable to theft. The couple stated that nobody from the insurer had pointed out these exclusions to them at the point of sale and told the insurer they would pursue the claim through the small claims court, at which point the insurer agreed to pay up.Since this issue was brought to the forefront of people’s minds, consumers have been warned that they should ask their insurer whether or not there are any factors that may disqualify them for cover in the specific countries they are planning to visit. In addition, customers should note down the name of the person they have spoken to at the insuranc ecompany and what they have advised.

of travel insurance claims. AFM has predicted that one of the biggest rises in claims will be from the ‘cancellation clause’ as householders realise that the two-week holiday they booked back in January is actually too expensive now. It also said that it expects a higher number of claims to be received regarding smaller claims, which in more prosperous times would simply have been ‘written off’ by the owner.Steve Manton of M Consulting agreed insurers should be aware of people’s tendency to try and get some cash back: “There will be an increase in fraudulent claims as the recession hits.” Meanwhile, Rob Upton, development director at CEGA Group added: “With the economy going the way it its, people might claim for smaller losses when, otherwise, they may not have bothered.” Insurers

are saying they are prepared, though, with trained staff on hand to recognise a nervous, and potentially fraudulent claimant, as well as to demand receipts for cameras, phones and other goods.Allan Clare, head of financial crime at Direct Line Insurance, warned consumers: “Fraudsters need to realise they are far more likely to get caught now than they have ever been. We have not noticed any significant increase in claims over recent months, but have a highly trained team and the latest technology ready to meet any increase in fraudulent activity.”Chris Price, head of travel for the insurer, added: “It is generally said that during an economic downturn insurers see an increase of fraudulent claims on their books.” He also pointed out, however, that it is difficult to attribute any fluctuation to fraud alone.

Crunch prompts fraud concerncontinued from page 1

Summer bombingsOn 29 July, a small bomb exploded in the popular holiday resort of Torremolinos, Spain, but did not cause any injuries or damage, according to government officials. The bomb went off just after midnight on the beach below the busy promenade, which is an area lined with bars, restaurants and hotels.The mayor of Toremolinos, Pedro Fernandez Montes, played down the attack and urged tourists not to panic: “Obviously people are frightened … above all the British tourists.” He went on to blame the British media for making the bomb sounds worse than it was, as the only damage was a hole in the beach.The explosion on the Costa del Sol follows on from four small explosions at holiday resorts in Spain’s northern coast on 20 July, which local authorities blamed on ETA, the Spanish separatist group. Elsewhere, at least 17 people were killed and 150 hurt after two bombs were detonated in the Turkish capital Istanbul. The first bomb was planted in a rubbish bin in the Gungoren area, causing crowds to gather to help the injured, at which point a second, larger bomb was set off. Although no group has yet claimed responsibility for the attacks, security services in Turkey said it bore all the hallmarks of Kurdish rebels.In the same month, a local Senegalese man was killed and dozens of people, including 15 Spanish tourists, were robbed when armed men help up several vehicles in Senegal’s troubled Casamance region. A spokesman for the army said: “On Tuesday [22 July] dozens of vehicles were held up by armed men in civilian clothes. One of the cars was carrying Spanish tourists. They killed one passenger because they thought he was a soldier, but he was a civilian wearing a camouflage cap.” The attack took place around 20 kilometres north of Ziguinchor, Casamance’s main town.

In addition, on 26 July, a series of bombs exploded in Ahmedabad, Gujarat and the surrounding area in India. Local reports state that up to 38 people were killed and more than 100 injured, with no reports of foreign casualties. British nationals have been advised by the Foreign and Commonwealth Office to exercise caution and to check with local authorities for the latest security advice. Police in India have also confirmed that up to five bombs went off in the centre of Bangalore on 25 July, with the press reporting three deaths and several injured; again, there were no reports of foreign casualities.

hour’s delay to the take-off time. Spanish media has reported a fault with a temperature gauge, but it was thought to have been fixed before the plane was sent out for a second attempt. Spanish ministers were quick to confirm their belief that there had been no foul play involved in the crash, it was a tragic accident.Although the majority of passengers on board the flight were Spanish nationals off on their holidays, it has been reported that there were some German, Swedish, Chilean and Colombian nationals onboard as well.The 15-year-old MD-82 passed a safety inspection

this January, according to Sergio Allard, a spokesman for Spanair, itself owned by Scandinavian firm SAS.Emergency services chief Ervigio Corral said that rescue workers had been faced with ‘a desolate scene’: “You couldn’t distinguish that there was an aircraft there apart from the remains of the tail. There was nothing of the fuselage.”Another rescue worker told the Associated Press news agency: “The fuselage is destroyed. The plane burned. I have seen a kilometre of charred land and few whole pieces of the fuselage.”

Crash leaves 153 deadcontinued from page 1

International Travel Insurance Journal

6 NEWS

debt. According to the American Hospital Association, community hospitals provided more than $31.2 billion worth of uncompensated care in 2006.This leveraging of patients is part of the shift away from comprehensive employer-based health coverage, which leaves employees with higher deductibles and co-payments, and the growth of individual Health Savings Accounts under which patients pay for all but catastrophic health costs. Foreign patients too are feeling the sting as hospitals, particularly in areas of tourist density, are increasingly dumping all or most foreign accounts into the hands of international bill collectors. (See ITIJ 91, Here come the collectors)In their defense, hospitals say the use of credit data helps them differentiate between those accounts that are recoverable and those that are dead losses. They say also that such data helps them determine which of their patients are eligible for ‘charity’ or assisted care, which most publicly-funded institutions that account for at least 80 per cent of acute care hospitals are required to provide according to locally established ‘poverty’ or family income levels. By federal law, private hospitals too are required to provide emergency care to any who need it, but once these patients are stabilized, are free to send them elsewhere.Consumer advocates say use of credit records encourages hospitals to cut back care for patients they know can’t pay, something hospitals assiduously deny. Consumerists also argue that such financial information threatens patients’ privacy. And they say that many hospitals mine the data and encourage or pressure patients to load their unpaid hospital bills onto unused credit card lines of credit – some of which carry horrendously high interest rates.“This has the potential to put people at risk financially,” Mark Rukavina, executive director of the Access Project, a research group focusing on medical debt, is reported as saying in The Wall Street Journal.

Despite such concerns, the credit screening of hospital clients is a booming industry in the United States, with a plethora of firms – among them major credit reporting agencies such as Equifax – developing software data hospitals can integrate into their own systems to help them predict which patients can pay, which cannot, and which are just likely to walk away.Minnesota-based SearchAmerica, which produces automated credit-screening software, reports selling its products to more than 1,000 hospitals in just the past three years. Search America says that for every $1 a hospital spends on its software, it can expect $5 back in improved collections.Consumer advocates have raised the concern about patient privacy, but the Health Insurance Portability and Accountability Act (HIPAA) does not prevent hospitals from providing patient payment histories to credit reporting agencies. And the Fair Credit Reporting Act (FCRA) allows hospitals to obtain patients’ credit reports if they get their permission. Sometimes this permission is obtained overtly, other times, however, it is buried in some of the fine print patients or their families unwittingly sign as part of the admissions procedure. The FCRA also states that after a patient owes money, the hospital becomes a creditor and has grounds for checking a credit report even without such permission.According to The Wall Street Journal, Equifax and other credit industry professionals assert that a hospital typically becomes a creditor as soon as the patient walks through the door and requests services. Whatever the legal niceties of credit authorizations may be, case managers and third party representatives for foreign insurers say that when a loved one is being wheeled into the emergency room in a foreign country, it takes considerable courage or bravado to deny the admissions official running beside them the credit card information or admitting paper signatures they are demanding.

How’s your credit? continued from page 1

Amex urges annual coverFollowing the release of figures that show more than 85 per cent of British travellers are buying insurance in preparation for their holiday and 69 per cent are intending to buy an annual policy in the next 12 months, American Express Insurance Services is encouraging more Britons to consider the cost-saving benefits of an annual policy rather than single trip cover.Chris Rolland, head of American Express Insurance Services, said: “With so many cheap flights and last-minute holiday deals available to Britons, taking a mini-break is all the more appealing. However, if people are planning to go away more than once this year, it is far more cost effective to buy an annual insurance policy than numerous single trip products, giving them peace of mind all year round.”

NEWSWIREMarks & Spencer Money came top at the Your Money Direct Awards 2008, winning the title of best online travel insurance provider. The judges commented on ‘a comprehensive explanation of the products available and its straightforward application process’.

AM Best’s Consumer Centre has made available on its website a new multimedia feature that gives travellers helpful tips about travel insurance.

North Korea has said it will eject South Korean tourists from a resort inside its territory after a S. Korean tourist was shot by N. Korean soldier, prompting strong protests.

The Caribbean is a hotspot for tourism, an industry that many islands in the region rely on for continued growth. However, numbers of British people travelling to the region could drop following the brutal killing of two British doctors, who were there on honeymoon in July. Catherine Mullany died on the island, while her husband was flown by Skyservice Air Ambulance back to the UK, where he subsequently was declared brain dead and had his life support machine turned off.The alarm was raised in the early hours of the morning, when other guests at the Cocos Hotel in Antigua were woken by the sound of gunshots. When the police arrived, nearly 20 minutes later, hotel security staff directed them to one of the luxury resort’s 19 hilltop cottages, where they found Dr Catherine Mullany with a fatal gunshot wound to the head. Her husband of just two weeks, Ben, was lying nearby having been shot once in the neck. The couple were on the last day of their honeymoon.It is thought the couple were asleep when at least one gunman broken into their apartment in what detectives believe was an attempted robbery. According to the police, the person responsible had circumnavigated the resort’s security system, which includes a perimeter fence, security lighting, CCTV and motion sensors, as well as moving around the three security guards who were on duty. As a result of the incident, 10 other guests were relocated to different parts of the same resort.Antigua’s tourism minister Harold Lovell told reporters that the authorities were doing everything they could to catch the killers: “Soldiers will be patrolling with police,

and patrolling the island as a whole. This is something we want to do as a government to make sure that people feel safe. Generally we are in a heightened state of awareness and we have to make sure that there is no repeat of this incident.” Tourism bosses on the island have even offered a reward of more than £65,000 for information relating to the incident, while an anonymous businessman has added to the reward fund.Following the incident, the UK Foreign and

Commonwealth Office added the following information to its website with regards to Antigua: “There has been an overall increase in crime in Antigua over recent months, including gun crime. Two British nationals were shot near Valley Church in the southwest on 27 July 2008. You should take sensible

precautions and be vigilant at all times. Avoid isolated areas, including beaches after dark. Do not carry large amounts of cash or jewellery. Valuables and travel documents should be left, where possible, in safety deposit boxes and hotel safes.” The couple had followed all of this advice, yet tragedy still befell them.On 15 August, two women appeared in court in Antigua charged in connection with the murders. The pair are reportedly facing charges in relation to goods stolen from the couple, although exact details have yet to be released.On 18 August, a 20-year-old man and a 17-year-old boy were charged with the murders of Ben and Catherine Mullany. The two men appeared in court and were also charged with robbery and receiving stolen goods. The families of the deceased couple said they were pleased with the progress of the investigation.

Honeymoon dream cut short

John Cox, chairman of the UK’s Air Travel Insolvency Protection Advisory Committee, has claimed that customers of scheduled carriers are being left under-insured as many airlines continue to struggle for survival in the wake of huge fuel costs and serious competition. Cox accused certain airlines of not offering passengers the Scheduled Airline Failure Insurance (Safi), and also of purposefully blocking proposals to adopt a £1 levy that would also serve as protection to consumers. In Cox’s opinion, Safi could be an alternative to the £1 levy that the Civil Aviation Authority collects under new ATOL (Air Travel Operator’s Licence) procedures. In an editorial for TTG magazine, Cox said he was ‘profoundly worried’ that cover was not widespread as fuel prices and slowing demand were raising questions for many carriers over whether or not they have a viable future. He continued: “There are a lot of airlines that are not offering Safi at all. Most offer it only as part of a general travel insurance, which may or may not include airline insolvency cover.” He was also worried, he said, that Safi would become even more difficult to obtain from next January, because as a result of the regulation of travel agents selling CTI, many would stop offering Safi as well as travel insurance.In response to Cox’s concerns, Paul McClean, director of International Passenger Protection, an insurance underwriter, said that many airlines were offering customers the choice of taking out travel insurance at the point of purchasing the tickets, citing British Airways, easyJet and Ryanair as examples. Alan Bowen of the Association of ATOL Companies, added that although there is a risk that some travel agents will stop selling Safi next year, insurers were also setting up systems that allowed agents to escape FSA (Financial Services Authority) regulation by offering Safi without technically selling insurance.

Scheduled passengers at risk

www.itij.co.uk

NEWS 7

Drinking small print under fire continued from page 1

on the moped, not driving it, when she fell off, suffering a fractured skull and pelvis and ending up in hospital connected to a life support machine, where, at the time of writing, she remained.Atlas refused the claim to fly her back to the UK at a cost of £20,000, because, the company claims, she had been drinking before the accident occurred. A spokesman for

the firm pointed out: “Under the general exclusions applying to all sections of the policy, it states ‘no section of this policy shall apply in respect of … your drug addition or solvent abuse, excessive alcohol intake, or you being under the influence of alcohol or drugs’. We would further point out that no section of the policy shall apply in respect of any claims arising from needless self-exposure to peril, except in an endeavour to save a human life.” He continued: “The information in our possession indicates that the serious injuries were sustained as a result of the above exclusions and Ms Robinson’s claim has been subsequently denied.”

It has been reported that the Robinson family are still demanding some sort of proof from the treating doctors that she was under the influence of alcohol at the time of the accident. They are also currently masterminding fundraising efforts to bring her home themselves. At the heart of the issue, as highlighted by her mother, is that Charlotte was riding pillion, she was not in charge of the vehicle when it crashed, making her a victim of an accident, not the perpetrator.For more information about how the small print in travel insurance policies is causing havoc among consumers, please see our News Analysis on page 18.

It has been estimated that half a million British teenagers will be off on their first parent-free holiday this year, and in light of this, online insurer SwiftCover has warned such holidaymakers to ensure they have adequate travel insurance.“Your first parent-free holiday can be a great experience,” said Tina Shortle, marketing director for the firm, “but because of their age and new-found freedom, fledgling holidaymakers can be one of the most at-risk groups. We are encouraging teens to be prepared and stay safe so their holiday can be one to remember for all the right reasons.”Advice given to the youngsters includes not drinking too much, making sure which dangerous sports are covered under the terms of their policy, being aware of overexposure to the sun and making themselves aware of their surroundings so they don’t get lost. The insurer also highlighted that of all cases of Britons detained overseas, 40 per cent are for drug-related offences, and that ‘as drugs are always unpredictable and different strengths and purities exist abroad, experimenting on holiday is a massive gamble’.

Teenagers jet off without parents

EHIC confusion leaves tourist strandedA British holidaymaker has spent over a month in a serious condition in a hospital in Dublin as his family scramble to try and pool together the €10,000 needed to fly him home to Manchester. Peter Carter (66) and his son had only been in Ireland for a matter of hours when he fell down a flight of stairs and as a result of the fall, suffered a broken neck, head injuries and extensive bruising. He has since lost sensation and movement down one half of his body.Mr Carter had not taken out travel insurance for his trip because he thought the European Health Insurance Card (EHIC) would cover the cost of any treatment he needed. And he was right – the EHIC has covered the cost of the hospital treatment, but he and his family found out too late that it will not cover the cost of repatriation.His son Richard said: “I spoke to the British Embassy and to the Foreign Office and they are going by the book. They’re saying if there’s no travel insurance, then there’s no repatriation.”The case, which has been reported in the Irish media, yet again serves to highlight the fact that the government must do more to educate the public about the anomalies contained within the EHIC. There is significant confusion over what it will and will not pay for. The fact that the rules differ in different European nations is hardly helpful either, meaning there are thousands of holidaymakers abroad right now who think they are covered in the event of an accident, which may be far from the truth.

International Travel Insurance Journal

8 COMPANYBRIEF

Voyager Insurance Services has launched its newest online offering, responsibletravelinsurance.co.uk, which gives travellers the opportunity to buy a travel insurance policy that will financially benefit projects run by the Tourism Industry Carbon Offset Service (TICOS). The policy is underwritten by Elvia Travel Insurance International and supported by claims handling and international medical assistance from Mondial Assistance.TICOS develops projects that both offset carbon emissions and have wide socio-economic and environmental benefits. It matches these projects to service users, such as Voyager and other travel and tourism companies, all of whom are committed to offsetting and improving both the quality of the environment and life for local communities at tourism destinations. Jonathan Buttery, director of Voyager Insurance Services, said: “Air travel in particular is under the spotlight in relation to global climate change, but so too is the rapid growth of the tourist industry, which has placed social and ecological pressures on many regions around the world. The answer for eco-friendly holidaymakers is not to stop travelling altogether, the key is to travel responsibly.”

Access America, a US-based travel insurance and assistance provider, has introduced Cancel Anytime, a new plan that provides travel agents with a cash-back alternative for their cruise and tour clients who would like cancellation flexibility. The Cancel Anytime policy offers 80 per cent cash-back to customers for virtually any reason, anytime a policyholder cancels their holiday for an unforeseen cause. On average, says the company, this plan will cost around 10 per cent of the client’s total trip cost. The policy

is underwritten by BCS Insurance Company and administered by World Access Service, a company of Mondial Assistance.Mark Cipolletti, vice-president for marketing communications at Access America, said: “Cancel Anytime is the result of months of development that included consumer and travel agent research. The research revealed that consumers want cash back, not credits, and they even recommended the percentage of cash back they thought was fair.”

AIG Travel Guard has recently launched its latest new plan, which has been designed specifically for adventure travellers and provides cover for many activities that are commonly excluded from travel insurance policies including bungee jumping, mountain climbing, sky diving and motor sports.John Noel, CEO of AIG Travel Guard, said: “Adventure travel continues to be a high growth area for American tourism. Adventure travellers need coverage that the typical traveller does not, that’s why we created this special niche plan. Not only does it include insurance coverage, it also has a special hotline that’s a great resource for adventuresome travellers.”The plan, Adventure Travel Protection, offers a range of cover, including insurance for athletic events, aircraft flying and even hot air ballooning. The hotline provided as part of the plan offers weather reports and travel advisories, assistance locating trails and rafting locations, information on access issues, construction and detour information and locations of nearby outdoor gear shops.AIG has also introduced a series of enhancements to its ‘active suite’ of plans – Adventure Travel Protection, Sportsman’s Travel Protection and Tee, Tour and Travel plans. The improvements offer higher coverage limits and new features designed to provide increased coverage to travellers who continue to pursue their favourite activities while on holiday.

HSBC Insurance is launching an industry first, with its green travel insurance programme in partnership with the Hong Kong Polytechnic University (PolyU), which includes working with customers to reduce pollutants resulting from air, land and sea travel. The ‘Let’s Travel Green’ scheme is the result of recent research conducted by HSBC about the perceptions of people in Hong Kong, their attitudes and preferences relating to ‘green travel’.The survey showed that 60 per cent of respondents are aware that their travel activities result in carbon dioxide emissions, and 32 per cent are willing to do something to offset the adverse effects of travelling. So, from now until June 2010, customers who buy or renew HSBC TravelSurance policies will be promoting green travel, as one per cent of their

insurance premium will automatically be donated to the Let’s Travel Green programme.David Fried, group general manager and regional director of insurance for HSBC Asia-Pacific, said: “HSBC is the first major international bank to

achieve carbon neutrality. We are pleased to work with the Hong Kong Polytechnic University, riding on the university’s eco-block innovation.”Made from recycled glass and ash with a coating of titanium dioxide, the eco-block has pollutant-busting properties that break down certain harmful chemicals in the air. The material is used as a paving and partitioning material for buildings, streets and pavements and contributes to improved air quality by removing pollutants emitted by cars, trains, aeroplanes and other vehicles.

The Canadian Life and Health Insurance Association (CLHIA) has released a new information brochure on its website, called A guide to travel health insurance, which has been compiled in the hope of assisting Canadian consumers when they purchase travel insurance.Irene Klatt, CLHIA’s vice-president of health insurance, said: “Millions of Canadians travel every year either across the country or abroad for business or pleasure and, as we hear reported time and time again, unexpected illness and accidents do happen. The best way for the travelling public to protect themselves from unanticipated expenses is to make sure they obtain travel insurance before they leave.”The brochure contains advice and tips on how to determine what supplementary health cover is needed and what the available options are, questions consumers should ask before buying and an explanation of how the claims process works. It forms part of a series of publications on CLHIA’s website that offer advice and information to consumers buying insurance.

Responsible travel for the future

Access America introduces policy

AIG develops adventure plan

HSBC offers green scheme Information brochure released

TFG Global Insurance Solutions Ltd has launched a new travel insurance website: TravelInsuranceAgent.com, which offers travel insurance plans to people around the world. The plans include travel medical and evacuation insurance, trip cancellation and interruption insurance, group travel and international health insurance. The website also provides customers with useful articles on travel insurance and related issues.David Tompkins, president of the company, said: “This new travel insurance portal offers a user-friendly Web platform for travellers in need of travel insurance protection from reputable and secure travel insurance suppliers at a very competitive price point.”TFG has also recently launched a very specific travel insurance website that specialises in providing information and quote requests for companies and individuals working in Afghanistan. The firm already supplies insurance for high-risk regions such as Iraq and Africa to many private

firms, NGOs, reporters and security companies. All the plans TFG quotes for include coverage for passive war, riot and terrorism risk, including asset and personal protection.Tompkins noted: “Passive war risk is a must for any person who travels to Afghanistan because of the continued risk from the Taliban. We have helped several companies and organisations in their efforts to rebuild Afghanistan after many years of war. Passive war risk coverage means you are covered if injured or killed in Afghanistan as long as you are not an active participant.”

TFG launches travel website

Canadian travel insurance consumers have access to a new website, the truthabouttravelinsurance, which aims to give the average person helpful hints and guidelines regarding common exclusions, explanation of terms and other information.Nathan Lafayette, director of operations for AIG Travel Guard Canada, said: “The Truth About Travel Insurance public awareness campaign was created to help Canadians make informed decisions when choosing a travel insurance policy. Too many people find out the hard way that their provincial health insurance or travel insurance doesn’t cover them for what they need.”Developed by AIG Travel Guard as a public service site, the website features real life stories from travellers who either had the right insurance, or found out at the wrong moment they didn’t, to try and highlight pitfalls for ordinary consumers.

The truth is out there

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INSURANCEMATTERS 9

Italian insurer Generali has reported an 18-per-cent drop in first half net profits, which the company has attributed to a €905-million writedown in its bond and equity portfolio due to market crisis.Antoine Bernheim, chairman of the group, said the negative environment of the first half, coupled with ‘the evermore uncertain outlook for the balance of the year makes it difficult to give a reliable prediction for the end of 2008’. In the six months to 30 June this year, Generali had a net profit of €1.46 billion, down from €1.77 billion in the same period last year, although the figure is in line with analysts’ forecasts.Berheim did report a ‘healthy level’ of new business, however, with total premiums up by nearly seven per cent to €36.79 billion. Chief executive Giovanni Perissinotto said that the group still aims to achieve the target of doubling its 2006 dividend of €0.75 in 2009.

The latest US property/casualty insurance market survey has been released by the US Council of Insurance Agents & Brokers (CIAB) and shows that the commercial market remained in soft market conditions during the second quarter of this year. Respondents to the survey said they saw little change in the market for account renewals between the first and second quarters of the year and although insurers were still willing to accept lower deductibles and looser terms and conditions, the market was essentially the same.Council president Ken Crerar noted: “We think the survey generally reflects what is going on in the marketplace. There is still plenty of capacity, but as industry analysts have noted recently, the economic woes, coupled with the soft market are beginning to hit insurers’ bottom lines.” He added that a lack of hurricane activity over the past two years had helped insurers return to profitability, but that could all be due to change this summer – at the time of writing, Hurricane Dolly was on its way to the US coast.The results shown by the CIAB survey are supported by an analysis of the data by Lehman Brothers, which showed an average decline in premiums rate for all accounts of 12.9 per cent, compared to a 13.5 per cent drop in the first quarter of the year. For small accounts, average premiums were down by 9.7 per cent in the second quarter, with medium account premiums decreasing by over 14 per cent, and large accounts showing a drop of nearly 16 per cent.

At a recent public hearing convened by the New York State Department of Insurance and New York Attorney General, Aon Risk Services’ chairman and chief executive Steve McGill urged the Insurance Department to put in place comprehensive transparency and consent standards that apply to all insurance producers who conduct business in the state.Said McGill: “We believe in the fundamental principle that a client deserves to know whether its producer is working for the client or as an agent of an insurer, what insurers the producer approaches, how much the client will pay and how the producer will be compensated. This is essential to enable the client to make informed choices, to avoid an actual or potential conflict of interest by the producer and to produce the best and most competitive outcomes for clients.” He added that the Deparment should use its authority to create a ‘mandatory, clear and consistent disclosure of producer compensation and to apply the same rules to all producers’.

Soft conditions continue in US

Transparent standards urged in New York

Most of the big names in European insurance are being tipped as possible buyers of Spanish bank Santander’s insurance interests, a sale that is expected to yield up to €4 billion. David Ing reports

AXA, Allianz, Generali and Aviva are top of the market analysts’ lists. A deal with any of these could threaten the current dominance of Mapfre in Spain, which had almost 14 per cent of the market in the first quarter of 2008.Unlike recent sell-offs by other Spanish banks, which have kept a half share in their insurance interests, Santander is looking for a deal that will see it left solely as a distribution channel working

on commissions. That would enable Spain’s biggest bank to sell products not only in its home market but other countries where it has a major network of branches, such as in Portugal, the UK, Brazil, Mexico, Chile and Argentina. It has more than 13,000 such branches in all. The hoped-for deal would bolster its own cash reserves while freeing up money for any further investments that might appear in a jittery financial market, such as happened with the recent purchase of the British bank Alliance & Leicester.Santander Insurance only came into being two years ago with the merger of its own interests and those of subsidiary bank Banesto. The new entity briefly surpassed second-place AXA in Spain before settling

back into third position in 2007 with a 5.6-per-cent share. However, it is reported to have overtaken AXA yet again in what has proved to be a difficult first quarter of 2008 for the sector.While major rivals mull over offers expected to be between y3.5 billion and €4 billion, some analysts suggest that Santander may be tempted to split its insurance business by geographical areas. AXA is the opening favourite as buyer. But Santander could also be interested by a deal that involves the acquisition of Allianz’s subsidiary bank Dresdner.

Buyers eye Santander

Mapfre has opened its assistance subsidiary in Dubai, from which the company will co-ordinate and enhance its current business throughout the UAE and Oman. The office in Dubai joins a list of other recently opened offices in Jordan, Algeria, Egypt and India, Tunisia and Bahrain. In the expat haven of Dubai, Mapfre Asistencia offers assistance services to the insurance, finance and motor sectors that fall within its area of influence. It is also hoped that the new office will enable the company to enhance its customer services for the local corporate market and serve as the base from which new programmes and services will be launched.In related news, Mapfre has also reported its results for the first half of 2008: consolidated revenues increased by 17.9 per cent to almost €8.9 billion, with premiums exceeding €7.3 billion, a rise of 15.1 per cent on last year. The firm has credited the strength of the business to ‘organic growth and the increase in international activity that integrates the latest acquisitions’. Of the total volume of premiums recorded in the first half of the year, almost €5.7 billion came from the non-life business, which has increased by nearly 14 per cent due, in part, to the positive performance of Latin American business and the company’s reinsurance activity there. The life business recorded premium income of €1.6 billion, a 19.5-per-cent increase, thanks, says the company, to the success of specific campaigns, new products launched in Spain, and the rise in Brazilian business. Mapfre Re amounted written and accepted premiums of €860.5 million, representing a 10.3-per-cent increase over the same period in 2007, while Mapfre Asistencia increased its premium volume by over 10 per cent to over €860 million.

Mapfre opens assistance subsidiary

Generali suffers

International Travel Insurance Journal

10 INSURANCEMATTERS

Lloyd’s of London has now withdrawn its only permanent full-time representative in India, blaming a lack of further liberalisation in the country’s insurance sector.Lloyd’s, which only opened the office last year, has been asking since then for a branch licence to underwrite business locally. However, under current laws, a foreign reinsurer or insurer is only allowed to operated through a representative office, unless it makes the decision to set up a local company that must have at least 74 per cent Indian holdings – the foreign partner can still only hold a 26-per-cent share in the business.If the Indian Insurance Regulatory and Development Authority (IRDA) were to grant a branch licence to Lloyd’s, however, it would require a change in law. More specifically, a change to the Insurance Act of 1938 – a move that has been stalled repeatedly by left-wing politicians in the country for the past four years. The communist representatives are against a government proposal to increase the allowable foreign stake in a company from 26 to 49 per cent.Lloyd’s insiders have said the company will continue to operate its Indian business on an offshore basis and will also continue to lobby the Indian authorities with its case.

The insurance industry’s bill for losses due to natural disasters has already reached $13 billion in the first half of the year, a figure that is above average when compared to the last decade. Overall loss reached $50 billion and includes around $20 billion due to the Sichuan earthquake in China, but insured losses only came to around $13 billion, according to figures released by Swiss Re.Last year, natural catastrophes generated overall losses of $82 billion, says Munich Re, with the insurance industry paying out around $30 billion of the total. In giving estimates for overall economic losses and insurance industry losses, Munich Re declined to give any details or an update on its own share of natural catastrophe claims so far this year. It did, however, tell Reuters that it expected its share of the Chinese earthquake costs to be in the low to middle tens of millions of Euros. The firm also said that it has analysed around 400 natural disasters this year, of which 300 were attributable to extreme weather. Board member Torsten Jeworrek noted: “The year is following the long-term trend towards more weather catastrophes, which is influenced by climate change.”Extreme weather across the US has also meant large payouts for the reinsurer this year. “The overall loss caused by the floods on the Mississippi and elsewhere is likely to be around $10 billion, with an insured loss in the upper three-digit million dollar range,” said the company in a statement.Jeworrek also said that the figures from this year demonstrate the importance of proper risk assessment: “Risk awareness and measures designed to afford protection against such catastrophes in highly exposed regions must be given high priority.”

Following on from our report last month about Mike Wilkins’ appointment as chief executive of Insurance Australia Group (IAG), news has now surfaced that he is planning to withdraw most of the company’s underperforming UK operations, just two years after entering the market. Although he said IAG would be retaining Equity Red Star, its profitable UK specialist motor underwriter, Wilkins added that he would be seeking to sell Hastings Insurance, Advantage Insurance and the broking arm of Equity Insurance. The move will cost an estimated AU$350 million in charges, forcing the insurer to report yet another year of losses.In the announcement, Wilkins said that some

segments of the UK market have retained their attractiveness, in particular the specialist sector, where Equity Red Star operates.“With 37 years of unbroken underwriting profitability Equity Red Star is well positioned as a speciality business,” said Wilkins. “However, our other UK businesses were

caught in that

middle private motor market, which is highly competitive.”In his estimate, Wilkins told reporters that he would be able to deliver a AU$130-million saving annually

by withdrawing from the UK and by making the Australian business more efficient.

Lloyd’s pulls out of India

Disaster losses total $13 billion

IAG set to exit UK market

Insurers that deal in annuities could face potential capital shortfalls under the proposed Solvency II regulations that will soon come into action, according to industry experts. The legislation, which aims to match the capital that an insurer holds much more closely to the risks it faces, is due in 2012, but a recent test of the impact of the new rules showed that companies writing annuities would have to back these contracts with significantly more capital.Hitesh Patel, finance director at UK company Lucida, an insurer of pension liabilities, said of the issue: “The capital requirement increases

quite dramatically, which is out of step with the [country’s] Financial Services Authority’s current rules.”It was estimated by another insurer that its capital would have to more than double in order to be compliant with the Solvency II rulings.“The numbers are certainly very, very big,” agreed Paul Barrett, assistant director of financial regulation and taxation at the Association of British Insurers, who added that the matter was being discussed ‘at senior levels’ within life assurers.The concerns about Solvency II come at a difficult time for the life industry, as it is already concerned about the impact on writers of annuities with regards to changes to the reporting rules under so-called embedded value, which reflects the worth of long-term policies on insurers’ books. At the same time, the impact of falling equity markets on balance sheets is being nervously evaluated.

New rule could hit annuity firms

The National Insurance Brokers Association of Australia (NIBA) has stated that although in general, insurance premiums in the country are rising, such rises are both gradual and uneven, following figures from the June renewals period. The results of the renewals demonstrate that the sharpest premium increases have been in the personal lines market – home and contents and private motor insurance. In contrast, the increasingly competitive commercial lines market has seen significantly lower rate rises.Noel Pettersen, NIBA chief executive, said that this year’s results reveal that overall, 50 per cent of brokers reported ‘no change’ in premiums negotiated with insurers, while 23 per cent reported decreases. NIBA figures are representative of nearly the whole marketplace, with a 90-per-cent share of the commercial lines market. Pettersen added: “Some leading insurers have said over the past

six months that premiums will have to rise in the face of higher claims and falling investment earnings, but the intense level of competition in the commercial insurance market is keeping premiums lower than would otherwise be the case.”With regards to commercial lines, 26 per cent of brokers had premium rises, but 23 per cent said they experienced decreases. Whereas in the personal lines sector, figures showed that premium increases of up to 30 per cent were reported by 70 per cent of NIBA members, 27 per cent registered no change and the rest reported increased premiums.Pettersen’s prediction for the future of the industry was: “We expect rises will continue to be introduced over the next couple of years at least, but it’s obvious the insurers are being cautious in their approach.”

Uneven premium rises in Oz

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INSURANCEMATTERS 11

The Capita Group plc and Marsh Ltd have signed a deal to deliver and transform Marsh’s UK operations. The contract, which has now been finalised, is worth £187 million over 10 years and aims to enhance service delivery as well as generate cost savings.Under the terms of the agreement, Capita will provide support and processing services to improve Marsh’s broking activities to clients across its business. In addition, approximately 600 Marsh employees will transfer under TUPE to Capita, and Marsh’s outsourced work will be taken on by Capita’s new offshore facility in India.The deal states that Capita will undertake a ‘comprehensive transformation’ of Marsh that will enhance service provision to Marsh and its clients,

while also aiming to deliver reductions to operational transaction costs. Capita will also create a ‘centre of excellence’ for outsourcing services, based in Marsh’s

existing UK premises.Paul Pindar, chief executive of the Capita Group, said of the deal: “This partnership will draw upon Capita’s technical expertise across the insurance market and service re-engineering capabilities across the wider financial services industry. An integrated operations infrastructure will deliver cost and quality benefits alongside enhanced customer service and provide a flexible platform for Marsh’s current and new business.”Meanwhile, CEO of Marsh UK Martin South said: “We are very pleased to have

established this partnership with Capita and are confident it will be beneficial to both businesses.”

Capita and Marsh complete dealNEWSWIREING has received approval from the relevant authorities to start life insurance operations in the Ukraine. This will allow the firm to enter the fast-growing life insurance market in a country with over 46 million inhabitants and a growing middle class.

Zurich Financial Services Group has signed an agreement to acquire a 50-per-cent stake in the life insurance, pensions and general insurance operations of Banco Sabadell SA, while also establishing a long-term strategic distribution partnership with the bank, which is the fourth largest in Spain.

ACR ReTakaful SEA and ACR ReTakaful MEA, subsidiaries of Dubai-based ACR ReTakaful Holdings, have been granted licences by the central banks of Malaysia and Bahrain respectively.

Groupama has become the fifth largest non-life insurer in the Turkish market and has consolidated its number two position in the life insurance market, following its acquisition of two local insurers.

Marsh has been authorised by the Qatar Financial Centre Regulatory Authority to provide a broad range of insurance broking and risk advisory services in the country.

AXA Insurance Gulf has received regulatory approval to operate as a co-operative insurance company in Saudi Arabia.

Zurich’s Emerging Markets Solutions group has opened additional offices in Asia, Continental Europe and the Americas, in order to better serve the needs of brokers and customers involved in emerging marketplaces. The new offices are in Beijing, Frankfurt, Miami and Zurich.

Bharti AXA General Insurance has received IRDA’s permission to start operations in India, increasing the number of general insurers in the country to 20.

Swiss Re has now admitted it has a $9.6-billion exposure to the debt of mortgage financiers, renewing fears over its vulnerability to the credit crunch and sending its share prices spiralling down.

International law firm Norton Rose won Best Takaful Law firm at the International Takaful Summit Awards in July.

The Chinese insurance sector reported that premium income rose 51 per cent to ¥561.8 billion (US$81.8 billion) in the first six months of the year, according to figures released by CIRC.

So far, Chinese insurers have paid a combined total of ¥386 million in claims in the months since the Sichuan earthquake.

ING Group has received all final regulatory approvals and completed the sale of part of its Mexican business, Seguros ING SA de CV, to AXA.

Disaster modelling firm RMS said the total bill from Hurricane Dolly is likely to be less than $750 million. AIR Worldwide agreed, with a forecast loss of between $350 and $700 million of damage.

German subsidiary of Zurich Financial Services Group, Zurich Beteiligungs, has agreed to acquire 100 per cent of private accident insurers Baden-Badener Versicherung AG; the transaction is expected to close in the third quarter.

International Travel Insurance Journal

12 HEALTHMATTERS

Pains in Spain

We’re firmly in the grip of the credit crunch, and news abounds about the effect this is having on our travel habits, so the last thing we really need right now is a natural disaster to top it all off. But as we go to print, the US’s Gulf coast is feeling the effects of the hurricane season, with Hurricane Dolly, and now Fay causing damage and mayhem in Texas, Florida, and beyond. The big question is: how will insurers, especially those in the ‘Sunshine State’, weather the storm? We’ll be keeping a close eye on events, and will bring you all the latest from a state where hurricane insurance is already a cause of controversy for homeowners, and where trip cancellation is a must for visitors, particularly at this time of the year.In this issue of ITIJ, we have a feature on cover for stag and hen parties, and an analysis of travel insurance small print and how consumers are fighting for fairer policy wording and policy documentation – and winning. Elsewhere, we focus on the Caribbean, and explore its healthcare facilities and assistance market, whilst also bringing you a PHN analysis of employer-offered health plans.I hope you enjoy this issue!

JCI offers tips to travellers

Travellers not taking drugs

Joint Commission International (JCI), the hospital accreditation organisation, has offered American travellers heading to China for the Olympic Games some tips on how to best avoid becoming poorly while there.Karen Timmons, CEO of JCI, noted: “The adage that one ounce of prevention is worth a pound of cure is a good one to remember anytime you’re travelling abroad. By thinking ahead about potential healthcare needs and treatment options overseas, Americans can stay healthy and enjoy the Games.”Advice to travellers includes the suggestion that patients speak to their doctor about their plans and about any specific medical risks related to their medical history. Those heading east should

also review their vaccination history to make sure they are up-to-date on routine shots such as measles, mumps, rubella, tetanus, polio and meningitis. It also states that although there are no formal requirements for vaccinations to China, the US Centres for Disease Control and Prevention recommends vaccinations against hepatitis A and B, typhoid and rabies. Further tips for patients include: ordering double the normal amount of prescription medication – one for hand luggage and the other for checked-in luggage; a wariness of where food has been prepared and cooked; taking important medical documents with them on holiday and making sure travellers take copies of their travel insurance policy with them.

Spain is one of the most popular tourist destinations in the world, but new findings from Halifax Travel Insurance have shown that the country is also the place where British tourists are most likely to suffer from a stomach upset. Nationwide research among 2,000 Britons found that around 23 per cent had suffered some form of food poisoning while in Spain, whereas in Greece only 13 per cent had become ill, and in Egypt and Turkey the figure was even lower, with 11 per cent of respondents saying they were ill whilst there. The survey also showed that 28 per cent of UK tourists have suffered, at one time or another, the dreaded ‘Delhi belly ’ while travelling abroad, and of the unfortunate ones, 38 per cent were ill for two or more days, losing around £42 per person a day off the cost of their holiday.The research, however, demonstrated that a

certain level of care is being taken by British tourists – nearly half refuse to trust local tap water, while one in five take packaged or tinned food from home to try to prevent food poisoning.

The number of tourists returning to British shores with a potentially lethal form of malaria has risen sharply in recent times because travellers are not taking anti-malarial drugs, according to health authorities. The Health Protection Agency (HPA) has found that cases of falciparum malaria now account for three-quarters of all UK malaria cases, up from a third of cases 20 years ago. The HPA has attributed the rise to the increasing number of tourists heading to west Africa, where the disease is endemic.Peter Chiodini, director of the HPA’s malaria reference laboratory, noted: “Even though the total number of malaria cases has stayed roughly the same over the years, the proportion that are potentially fatal falciparum has risen steadily.”The study by the HPA found that cases of malaria were concentrated in communities where people frequently travelled to west Africa – some 96 per cent of falciparum malaria infections followed quickly on from visits to the region, with more than half of the infected travellers returning from Ghana and Nigeria.The latest findings show the widespread failure of health services to alert travellers to the dangers of marlaria while they are abroad, and the problem is exacerbated by the common misconception among migrants that they are resistant to the disease because they have lived in a country where the disease is rife. Scientists have reassured people that it is ‘extremely unlikely’ that mosquitoes in the UK could spread malaria by biting an infected person, although the risk is higher in Italy, Spain and Greece.Christopher Whitty, co-author of the HPA study, said: “The key thing is getting through to the people from

the African diaspora living in London and elsewhere, who go back to visit friends and relatives. Many believe malaria is not a big problem for them, but it is. No one can assume they are immune to malaria.”

The agency is now working with migrant communities to raise awareness of the dangers of visiting Africa and other high-risk countries without taking any form of anti-malarial drug with them.In related news, researchers in Melbourne, Australia, think they have identified a potential treatment that combats malaria. The malaria parasite produces a glue-like substance, which makes the cells it infects sticky, so they cannot be flushed through the body. The scientists have shown that removing the protein responsible for the glue can destroy its stickiness, and thereby undermine the parasite’s defences.Professor Alan Cowman, a member of the research team, said targeting the protein with drugs, or possibly a vaccine, could be a key aid in the fight against malaria: “If we block the stickiness we essentially block the virulence or the capacity of the parasite to cause disease.”

Sarah WatsonEditor

sarah@itij.co.uk

NEWSWIRESanofi Pasteur has notified the US CDC that the existing inventory of Japanese encephalitis vaccine will last through the first quarter of 2009. In order to prolong availability, the drugmaker will continue to restrict purchase of the vaccine to current customers and limit orders to nine does per month.

Provincial Health departments in Ho Chi Minh City and the Mekong Delta in Vietnam have reported a dengue fever outbreak, with many hospitals overloaded with cases. Soc Trang Province has been worst affected, with more than 1,900 cases reported in the first half of the year. Health authorities in Thailand have also reported a dengue fever outbreak, with numbers there significantly higher than last year. So far, there have been 31,226 cases in 2008. All 76 Thai provinces have been warned to be on the alert for the emergence of leptospirosis, of which there have been 580 cases, resulting in 15 deaths this year.

Canadian scientists have found that some anti-malaria drugs may have the unwanted side effect of decreasing the power of some antibiotics. Remote South American villagers were found to carry bacteria resistant to antibiotics that had never been used there.

At the end of July, 45 confirmed cases of yellow fever had been reported in Brazil, including 25 deaths. Among the most recent cases, two human cases of the disease were reported in the state of Sao Paulo.

Editorial comment

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HEALTHMATTERS 13

International Travel Insurance Journal

14 AIRAMBULANCENEWS

NEWSWIRESpotlight on Cessna 208 Caravan

With impressive worldwide sales fi gures, the Cessna Caravan 208B has demonstrated its popularity as a

utility workhorse across the globe. Design work for the aircraft dates back to the early eighties, and the fi rst prototype fl ew on December 1982; certifi cation followed in 1984. When production began the following year, it became the fi rst new single-engined turboprop powered aircraft to achieve production status.The 208B Grand Caravan fi rst fl ew in 1990 and is a stretched version of the basic caravan, powered by a 505kW PT6A-114, and is able to take 14 passengers when not fi tted out as an air ambulance. At the 1997 NBAA convention, the 208-675 replaced the basic 208 by combining the standard length airframe of the 208 with a more powerful engine.

Specifi cations

Capacity: Flight crew 1

Stretchers 4

Max cruising speed: 337 km/

hour

Max initial rate of climb: 975 ft/min

Range: 1,667 km

Max take-off weight: 3,970 kg

Wing span: 15.88 m

Length: 12.76 metres

D-COKE joins FAIOn 30 June, D-COKE, a refi tted Learjet 35, was commissioned by the German aviation authorities for use by air ambulance provider FAI. Following three months of overhauling and modifi cations, the Lear 35A has now entered operations from FAI’s home base in Nuremburg, replacing the former jet, D-CFAI. The new Learjet, thanks to its modifi cations by Raisbeck and AVCOM, has a signifi cantly improved fl ying range of 4,100 km, rather than the current 3,500 km, meaning that destinations such as the Canary Islands can be reached from Nuremburg without a fuel stop.In addition to putting D-COKE in service, there have been several other moves made to further the development of FAI’s fl eet in the past few months – at the end of February, a Learjet 60 was brought into operation, under a management contract for a mixed air ambulance and charter fl ights model, and another Lear 60 was added at the end of April, dedicated exclusively to the executive charter business. Then, in June, FAI acquired a third Lear 60 that will complete the fl eet at Nuremburg.The fi rm has had a busy start to the year, with 265 air ambulance repatriations in the fi rst half of 2008, four more than the same period last year – this is despite the recent stationing of a third jet in Africa and the resulting reduction in fl eet size in Nuremburg.

Raisbeck off ers incentiveRaisbeck Engineering is offering a US$15,000 Platinum Conversion Certifi cate to King Air owners who purchase the fi rm’s Epic Gold Performance System, which includes ram air recovery, enhanced performance leading edges, dual aft body strakes and a high fl otation gear door, now available for the Beechcraft B200GT aircraft. Raisbeck said the Epic Gold System is perfect for B200GT owners who currently have factory-installed Hartzell or Beechcraft propellers.Sam Jantzen Jr, chief operating offi cer of Raisbeck,

offi cially announced the deal at a recent company authorised dealer seminar, saying: “We are extremely pleased with the customer response to our Epic Gold package for the B200GT. We are delighted to demonstrate our sincere gratitude by providing these loyal customers a $15,000 Platinum Conversion Certifi cate to be used when they upgrade their aircraft to Epic Platinum.” The company says that to date, 40 per cent of new Beechcraft B200GTs have requested its Performance System prior to factory delivery.

Shared dispatch aims to improve responseTallahassee’s EMS helicopter, Life Net, based at Capital Regional Medical Centre, will soon be under the same dispatch centre in Jacksonville as two other North Florida medical helicopters – the aim of the move being to improve response times for all helicopters.Kelli Hadden, a Life Net nurse, commented: “That will make the closest helicopter go to the patient, it’s defi nitely going to be a positive thing. We’re looking forward to it.”The change will also reduce the likelihood of two EMS helicopters crashing, according to pilot Warren Willis, who was making reference to the tragic accident that occurred in Arizona recently, when two EMS helicopters crashed outside the hospital they were transporting their patients to. He continued: “Sometimes, you’ll have several aircraft inbound at the same hospital at basically the same time. We need to be alerted to that. I need to be looking for that other

aircraft on approach … (the dispatch) advises me of a situation that could be potentially hazardous.”The helicopters that will be affected under the move are all owned by Air Methods Corp., which operates 350 helicopters across the US. The cost of dispatching the Tallahassee helicopter out of Jacksonville instead is negligible, but the benefi ts are many, according to Toby Witt, business manager for the company. He explained: “This change will put them all in the same facility, which means we can dispatch the one closest to the patient, and it will save time.”

Air Ambulance Worldwide Inc has decided to discontinue the conformity and adding of a Lear Jet N53G to its operating certifi cate. The company is currently in search for another Lear 35A to add to its certifi cate and expects this to be complete within the next few months.

Florida-based Air Ambulance Professionals has acquired a fourth Learjet 35A to its fl eet, thus increasing the fi rm’s ability to meet the ever increasing demand for aeromedical transport in the Caribbean region.

Air Life of Oregon has announced that it has offi cially changed its name to AirLink Critical Care Transport, which it says represents connections across all aspects of emergency medical services.

MedAire Inc. has updated its Manual of In-Flight Medical Care, which is the only full-colour guide available to the aviation industry with step-by-step instructions on managing in-fl ight illness and injury.

Wales Air Ambulance can now land on a newhospital helipad on the country’s largest hospital; until now, the air ambulance had to land in a park before casualties could be transported to University Hospital in Cardiff.

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AIRAMBULANCENEWS 15

In an intriguing turnabout, the US international air ambulance fleet is now being mobilised by some of the nation’s hospitals to fly illegal immigrants, whose care they can no longer afford to provide, back home – all at hospital expense. Milan Korcok reports

The rationale from the point of view of the US hospitals is simple: pay $30,000 to deport an illegal back to Guatemala, Mexico or Jamaica, and cut your losses before the bill, which will surely go unpaid, climbing to hundreds of thousands of dollars or more, and do it before the costs go even higher.Tom Cox, director of business development for Colorado-based Air Ambulance Specialists, says his firm now does some two or three ‘repats of illegals’ a month, mostly to Mexico or Central or South America, and it recently has flown similar missions to the Middle East and India.Brian Weisz, president of Florida-based Air Ambulance Professionals, confirms that his firm too has repatriated immigrant patients to Jamaica and Mexico for South Florida hospitals, an element of business that didn’t exist a couple of years ago, but which is becoming more commonplace as hospitals become inundated with non-paying, uninsured, illegal immigrants.Federal law requires all hospitals, public or private, for-profit or non-profit, to treat anyone with a medical emergency who asks for help, regardless of their immigration status or ability to pay. Some states provide limited Medicaid emergency coverage for illegal immigrants, but none provides funding for long-term or nursing home care, thus limiting hospitals’ ability to place them after their emergency is over.

Media coverageThe deportation issue was recently featured in a New York Times report chronicling the story of Luis Alberto Jimenez, a Guatemalan national who in 2003 was ‘forcibly returned to his home country’ by Martin Memorial Medical Center in Stuart, Florida. The hospital paid an air ambulance firm $30,000 for the transfer, a small fraction of the $1.5 million of services it had so far expended on the brain-injured patient.Initially, Martin Memorial won a court order to deport Jimenez against the wishes of his court appointed guardian, but this order was then countermanded by a higher court. By then,

Jimenez was gone. But the legal aftershock remains.Carol Plato Nicosia, director of corporate business services at the hospital says that so far Martin Memorial has spent more than a quarter of a million dollars in legal fees fighting the after affects of the Jimenez case, and it has other ‘illegals’ running up fees into the millions, but neither their national consulates nor the

American government are prepared to help them facilitate the transfers even though they are willing to pay the air ambulance costs. Meanwhile in Arizona, Ground Zero for US illegal immigration wars, Mexican patient deportations by hospitals in Phoenix and Tucson have become routine despite court challenges. Reports about the numbers deported are mostly anecdotal, as the federal government will have nothing to do with the matter. But in the southern Arizona area, St Joseph’s hospital in Phoenix is reported to have repatriated at least 96 illegal immigrants over the last year; Maricopa Medical Center, five; Good Samaritan Medical Center, seven; while Broward General Medical Center in Fort Lauderdale, Florida has reportedly sent up to eight patients a year back home to Mexico or Caribbean countries, while Hollywood Memorial has also repatriated illegal immigrants. Chicago hospitals have reported returning at least 10 Hondurans in the last year, and the numbers from southern California and San Diego range into the hundreds.

Increasing numbersAir Ambulance Professional’s Weisz says that though such repatriations account for only a fraction of his business, they are increasing. And though his staff has encountered no major problems in conducting the transfers, as the hospitals involved have made all the appropriate arrangements, it is not a simple process and ‘everything has to be pre-planned’.Cox, of Air Ambulance Specialists, says that the logistical issues in handling the repatriation of an illegal immigrant patient are ‘time consuming’: “[These missions take] much longer than a routine transport, as we have to work with the local consulate in the destination country. Getting [undocumented patients] through customs and immigration, and locating a bed that will accept them can drag on for weeks.“There is no question that these kinds of transports are more difficult than the norm, but we understand the obstacles and we just go about the process. Our costs to the payer source is no higher than a routine trip.”

Air ambulances deport illegal immigrants

NZ ministers welcome report

Air Evac receives accreditation

New Zealand’s minster of health David Cunliffe, along with minister for ACC (Accident Compensation Corporation) Maryan Street, are said to be in favour of a set of recommendations from the Air Ambulance Reference Group (AARG), although they made it clear that more work is required before any changes will be made to the provision of emergency air ambulances in the country. The AARG recently released its report into the state of air ambulance services in New Zealand, and included proposals that would pave the way towards maintaining and improving current services.Speaking to a local news station, David Cunliffe said: “The Ministry of Health and ACC have already started work in developing an overreaching strategic direction for the ambulance sector. Many of the Reference Group’s proposals will be considered as part of the development of a wide ambulance strategy.”One of the AARG’s recommendations is the development of a lead Crown Funder for air ambulance services, with the possibility of then expanding the funding to road ambulances and inter-hospital transfers. Cunliffe continued: “The Ministry

of Health and ACC have already commissioned and considered independent advice on the formation of a single funder for all emergency ambulances. Again, this will need to be looked at in light of a wider strategy, which is expected to be released shortly.”Maryan Street added that ACC officials have already started work on implementing some of the report’s recommendations: “The review of the ambulance standard has been completed already – The Ambulance and Paramedical Services Standard NZS8156:2008 was published in May 2008. A large amount of work is now needed to investigate the feasibility of the rest of the report’s recommendations.”The AARG was created in February 2006 to provide advice to the minister for ACC and the minister of health on an appropriate framework for the development of air ambulance services for New Zealand. The group is comprised of representatives from the air and health sectors, other emergency services, local government, road ambulances, the Civil Aviation Authority and Ambulance New Zealand.

US helicopter air ambulance provider Air Evac Lifeteam, operated by Air Evac EMS Inc, has now received accreditation from the Commission on Accreditation of Medical Transport Services (CAMTS).The accreditation was given after Air Evac undertook the largest scale inspection process in CAMTS’ history and is now the largest medical transport company under one name to achieve the recognition. All 69 bases opened prior to May 2008 are now accredited, with three recently opened bases scheduled for review in the near future.Seth Myers, president of the firm, said he was ‘very pleased’ with the outcome of the inspection:

“This accreditation is a validation of the high quality standards in which we operate and serve our communities. The focus of the accreditation process is on patient care and aviation safety and was a very positive and constructive process for our company.”The voluntary accreditation process included on-site surveys at Air Evac Lifeteam’s corporate headquarters and cases by nine surveyors, along with a comprehensive review of the firm’s operations. Air Evac was evaluated on patient care, safety standards, quality improvement activities, education, equipment, staffing, communications, maintenance and administration.

International Travel Insurance Journal

16 TRAVELMATTERS

Airline industry feels the crunch

Olympics can damage tourism

Dubai continues growth

Crunch changes holiday plans

Temple dispute heightensRyanair’s plans for expansion appear to have fallen victim to the turndown in the aviation industry, following the announcement that the low-cost carrier would ground 12 of its planes at Stanstead airport this winter, as well as closing seven European bases. Services are being cut on even the airline’s busiest routes from the airport in the UK, while withdrawal from seven other airports, including Budapest and Valencia, will take place for six weeks from 4 November.Michael O’Leary, chief executive of the airline, denied accusations that it was struggling to fill its fleet of planes, which is expanding at a rate of more than 30 a year. Instead, O’Leary blamed high landing fees imposed by ‘twats’ at BAA, the airport operator, which he said was the main reason for grounding the planes.Elsewhere, US-based Continental Airlines reported a second-quarter net loss of $3 million on net income due to high fuel costs, and has since cut domestic capacity by around 10 per cent. United Airlines parent UAL Corp., US Airways Group Inc. and JetBlue Airways Corp. also posted second-quarter losses as their latest plans to cope with record fuel prices pushed industry job cuts to 26,000.

The myth that the country hosting the Olympic Games will see years of tourism benefits following the sporting event has been dispelled by research carried out by the European Tour Operators Association (ETOA), which represents travel agents. It is common for cities, when bidding to host the Games, to claim that lasting tourism benefits are worth the massive investment required. However, evidence from the most recent Games held suggest the exact opposite. Tom Jenkins, executive director of the ETOA, said: “The principal problem is the impression that everything will be over-crowded and overpriced and this blights a region.”Having looked at figures from Greece, where the 2004 Olympics were held, the ETOA found that the country had been falling behind the growth rates of regional competitors such as Croatia and Turkey since

the event was held. The research demonstrates that Greece’s growth rate of visitor arrivals is more than 20 per cent behind Turkey’s since 2004. Supporting this trend are figures from Australia, whose growth rate has failed to keep pace with New Zealand’s since the Olympics were held in Sydney in 2000.The ETOA also used evidence from some tour operators trying to sell China as a destination, who are suggesting that Beijing is unlikely to reap a tourism benefit from staging the Games this month. In May, a report was released showing just 77 per cent occupancy rates for five-star hotels in Beijing during the Games, while four-star hotels had an occupancy rate of just 44 per cent. Mr Jenkins added that the effect of staging a large sporting event was to scare regular visitors away from host cities, not just during the events themselves, but also in the months leading up to them.

Dubai International Airport handled a record 18.46 million passengers in the first half of the year, registering a growth of 13.8 per cent over the same period a year earlier. On average, the airport handled three million passengers a month in the first six months of 2008, making it the busiest period in the airport’s history. Predictions for use of the airport have now risen to 40 million this year.

Dubai International was also the world’s fastest growing airport last year in terms of international passengers, with a growth of over 19 per cent, or 34.3 million passengers. So far this year, March saw the most visitors, but February recorded the most significant growth at over 18 per cent. The average passenger movement per day at the airport has now increased to nearly 100,000.

Figures released by the UK’s Chartered Management Institute have shown that redundancy fears, tighter finances and pressure at work are combining to put holiday plans on hold across the insurance sector. The data also reveals that, even if they are going on holiday, insurance executives are unable to completely switch off from work life, spending holiday time on conference calls or checking emails.Having surveyed 1,484 insurance employees, key findings include the revelation that one in three executives is failing to use their full holiday entitlement; belts are being tightened in general as a response to the credit crunch – instead of paying for a holiday, one in four respondents said they would prefer to exchange holiday time for flexible working options. However, just 11 per cent of organisations say that they are willing to look at this as an option. Twenty-four per cent of those who participated in the survey blamed their lack of holiday on their workload, while 25 per cent say they have to use holiday allowance to care for dependents.

Tensions are rising steadily in Thailand and Cambodia, where there is a dispute over the Preah Vihear temple, with troops from both countries now patrolling the area around the site. The issue is due to go before a special Thailand/Cambodia General Border Committee, where the new World Heritage Site will be discussed. The Thai army commander

in the region, Lt-Gen Sujit Sithiprapa has now closed Khao Phra Viharn national park and sealed access to the border in the area, banning tourists from seeing the temple ruins from the Thai side of the border.The problem arose after Thailand demanded the return of the temple to the country, even though it lost a legal battle with Cambodia over the site in the International Court of Justice in 1962. It has also been reported that Thai soldiers are occupying a second

temple on the border between the two countries. Major Sim Sokha of Cambodia said that around 70 Thai soldiers are now occupying the 13th-Century Ta Moan Thom temple. Sim Sokha claimed that the Thai soldiers said they would only pull back when the initial dispute of the Preah Vihear temple was resolved.

Hawaiian hotel slumpReports from the Associated Press are saying that the hotel industry in Hawaii expects occupancy rates to continue their downward spiral as the island’s tourism slump continues to affect retailers who cater to visitors. Figures show that the state’s hotels were 69-per-cent full this June, which is a drop of seven per cent on the same month last year. A report into the state of the island’s hospitality industry was released recently by Hospitality Advisors, an industry consulting group, and was seen just days after island authorities reported a 14-per-cent decrease in visitor numbers.Keith Vieira, senior vice-president for Starwood Hotels and Resorts in Hawaii, noted ‘every indication says it’s going to get worse’, adding that many hotels were trying to come up with interesting incentives to try and attract some visitors back. Possibilities, he said, included asking for a federal waiver on landing fees at the airport, or asking the state’s authorities to temporarily eliminate the hotel room tax or general excise tax.

International Travel Insurance Journal

18 NEWSANALYSIS

Unrealistic expectationsDavid Craik examines some recent cases where travel insurance small print has come under fire from consumers

It was not only teenager James Pinnington’s body that hurt after crashing his scooter during his recent gap-year trip in Vietnam. His physical

ailments, including two broken legs, a fractured vertebra and internal bleeding will heal, but he is still unsure whether he will ever receive payment from his insurance company to cover the £25,000 cost of his medical care and his flight home to the UK.Pinnington’s father had purchased a comprehensive policy from high street retailer Boots, which offered up to £10 million for medical claims and repatriation expenses. However, Boots refused to cover his son James’s costs because it stated that although he was wearing a helmet at the time of the crash he did not have a full, valid UK motorcycle licence. This exclusion was contained in the policy document but according to the Pinningtons, this was in very small print on page 14 of a 50-page booklet.A spokesperson for Boots told ITIJ in a statement: “Boots have investigated Mr Pinnington’s claim. Our Gap Year Insurance policy wording clearly states that a claim will not be paid arising from using a two-wheeled motor vehicle as a driver or passenger if you are not wearing a crash helmet and the driver is not a holder of a full UK category motorcycle licence.”The insurance underwriters of the policy, AIG UK,

did not wish to add to this statement. It is continuing to liaise with the Pinningtons about their complaint.Also seriously injured in a moped crash this summer was British teenager Charlotte Robinson (See page 1). She fell from the back of a vehicle in Malia, Crete and her injuries left her connected to a life support machine. Her insurance company Atlas Direct has refused to cover the £20,000 cost needed to bring her back home to the UK. It said that as Robinson had been drinking alcohol, even though she wasn’t driving, her policy had been invalidated. Her family is fighting this stand and demanding proof from the hospital that their daughter had been drinking.Two different cases, but both highlight unhappy customers perceiving an unfairness in certain exclusions of travel insurance policies and the way they are communicated to policyholders.

Reality checkHow many holidaymakers when travelling round the Caribbean and Bali have hired and driven a moped without owning a UK motorcycle licence? And while no one should condone irresponsible drinking, are holidaymakers expected to remain teetotal for their whole trip for worry of not being covered? Are certain exclusions both unfair and unrealistic?

Boots is not the only insurer to have a clause relating to mopeds and the need for a UK licence. Barclaycard Travel Insurance and Swiftcover are amongst those that also have one. And there are other examples of contestable exclusions in travel insurance policies from around the world. The most common relate to extreme sports, complications or sickness arising from pregnancy, exclusions for certain illnesses and personal accident cover for people over a certain age. Cover is also restricted to having been resident in the country of purchase for a certain amount of time in a year. One policyholder with a US travel insurer did not get cover for a claim after he cancelled a holiday upon discovering that his mother had been diagnosed with cancer. The insurer did not pay because his mother was not a US citizen and lived abroad.

The UK’s Financial Ombudsman Service (FOS) has dealt with a number of exclusion complaints, with the majority of disputes based around clauses for pre-existing health conditions and cancellations.One example involved a man who had collapsed and had been told by a doctor that the reason for this was a migraine. However, he was advised that a brain scan should be booked as a precaution. In the meantime, the man bought a holiday and a travel insurance policy. He then had the scan and was told that he had suffered a minor stroke and should not travel. He cancelled his holiday, but the insurer rejected his claim for cover because of an exclusion which stated ‘any condition of which the policyholder was aware at commencement of the policy’. The FOS judged the insurer’s decision as neither fair nor reasonable.Another example was a woman who had to curtail her holiday after learning that her father had been admitted to hospital suffering

from liver disease after years of alcohol abuse. There was no cover because of a clause stating the insurer would not pay for ‘claims arising from the influence of intoxicating liquor’. The FOS decided that it was unfair to apply this clause in this circumstance. So are insurance companies going too far? Marc Gander of the British customer watchdog the Consumer Action Group says that insurance companies are ‘totally entitled to impose any conditions they want’. He says it is up to customers whether to accept them or not. Specifically on the Pinnington case he adds: “Lots of people use mopeds when they go abroad. They are vulnerable when they do so, especially in a country such as Vietnam where the road conditions are probably much poorer, as is the general driving behaviour. It does not surprise

me in the slightest that insurance companies want UK driver training as a minimum standard. It is a higher risk for them if people are not licensed. It is reasonable for holidaymakers to get training or to get some local insurance at their destination which won’t insist on UK driving standards.”However, he backs the Pinnington’s claims that the exclusion was not adequately communicated to them.

the majority of disputes are based around clauses for pre-existing health conditions and cancellations

the insurance was clearly targeted at young people, so the insurance company should have recognised

that when they go abroad they will use mopeds

www.itij.co.uk

NEWSANALYSIS 19

“I’ve talked to the father and seen the document,” he explains. “The insurance policy is in two parts. There is the Terms and Conditions (T&Cs) and a Key Facts document. In the T&Cs, the exclusion is there, but despite the Key Facts part listing certain extreme activities which are not covered, there is no mention of mopeds or the need to have a UK licence. The insurers were wrong not to have it there.”Gander reasons that as the insurance was clearly targeted at young people, the insurance company should have recognised that when they go abroad they will use mopeds. “It was not brought to James’s attention properly. It should have been more prominent. Young people do not always go through all the Terms and Conditions. They read the key facts and think that sums up everything they

should know and they are reasonable to believe that. They were out of order not to have it in the key facts,” says Gander.

Lessons to be learnedGander adds that there is a lesson for all travel insurers from this case: “Insurers are entitled to put whatever conditions they want [in the policy], but they are

obliged to call them to the attention of the customer in a way that addresses the target market. There has also been a criticism of insurance policies for many years that the language that is often used is not accessible. Insurers have a duty to make it accessible and tailor it to whoever they are addressing.”Malcolm Tarling, spokesman for the Association of British Insurers, did not want to comment on the Pinnington case, but stresses the importance of insurers making relevant terms and conditions clear to potential customers at the point of sale. “This is a requirement of the Insurance Conduct of Business Rules overseen by the Financial Services Authority,” he says. “It is important for customers to understand what they are covered for. It is not just about reading the policy, but understanding and comparing the

cover available under travel policies provided by different insurers.”Lorraine Moberley, underwriting director at UK and pan-European travel insurer the Professional Travel Insurance Company, also puts the onus on the policyholder. “They should be a little more responsible in their actions. If they are illegally driving a moped in a foreign country they should not expect to be covered

under a travel policy as they are exposing the insurer to an additional risk,” she says. However, she stresses the importance of insurers making their policies understood. “We highlight the main exclusions in our Key Facts document, which is a policy summary with the main cover, exclusions and limitations. There is always only so much you can define, but we aim to make our policies as clear as possible.” She adds that complaints from customers are generally not made about the unfairness of exclusions but about the evidence needed to support their claims.

Tarling says: “All travel policies contain restrictions, conditions and exclusions. This is why travel insurance remains very competitively priced. It is designed to cover events outside of your control. It is not designed to cover the consequences of your reckless actions. So travel insurance may not pay

out for any claim resulting from the customer getting drunk. Travel insurance is mainly sold off the shelf with no individual underwriting. These standard policies are suitable for most, but people should check that the cover they are being offered reflects their needs and circumstances.”

travel insurance is not designed to cover the consequences of your reckless actions

it is reasonable for holidaymakers to get training or to get some local insurance at their destination which won’t insist on UK driving standards

International Travel Insurance Journal

20 FEATURE

LOne ast weekend of freedomPeter Corbett investigates the insurance on offer in the global marketplace for the increasing numbers of stag and hen parties jetting off abroad for a weekend of debauchery

www.itij.co.uk

FEATURE 21

It’s 36 years since my own stag party and that was just a few mates together in a quiet corner of a pub in the village in Surrey where I was

getting married the next day. I haven’t dared ask my son in law about his!Anyway, here goes and as is my wont, I’ll start with a few stats, this time from the UK’s Foreign and Commonwealth Office (FCO). The figures actually date from a specific survey carried out in 2005, but an FCO spokesman told me that there was no indication that things had changed much since:• A quarter of those who go overseas on stag and hen weekends and who have their celebrations interrupted by ‘holiday horror’, lose their travel documents, their money, credit cards or tickets, for instance, or end up becoming sick or getting hurt• A quarter of those who had their trip spoilt in this way end up by getting arrested• But most significantly, almost half of those who travel overseas on these weekends go uninsuredThe following year, a survey of 3,000 partygoers by

UK travel insurance specialists InsureandGo, revealed that a staggering 70 per cent of hen and stag parties now take place overseas, and found that nothing had changed. If only these revellers knew, for instance, how much it would cost if they had to charter an air ambulance to bring them home!Anyway, the whole thing breaks down broadly into two separate but linked parts, the professionally organised trip and the one that’s put together by the bride and groom themselves – not together of course!

Get organisedI researched a couple of companies that specialise in organising hen and stag weekends, both in the UK and in Europe. They were chosen at random off the Internet – interestingly, none of the travel agencies I dropped into in my home town to pick up the odd brochure or two offered that kind of break. That’s even though they were well stocked with information about ‘normal’ weekend breaks in those

cities which attract those who are about to die, sorry those who are about to get married.Mike Wood, a director of Freedom Limited, told me that insurance wasn’t a condition of booking. “We have our own insurances in place, of course, public liability, professional indemnity, employers’ liability and so on, and in addition all of our activity suppliers have insurance that’s appropriate to where they are in the world. We do, however, advise our clients to make sure they have proper personal cover and many of them already have this, perhaps through their credit card or bank,” he said. I asked him about the type of people who went on hen and stag weekends. Freedom’s clients were, he said, generally in their late twenties or early thirties, perhaps in middle management, who knew how to conduct themselves.The result was that though alcohol could well play a major role in their enjoyment of their trip, they tended to undertake the various physical activities which might be part of their itinerary in the afternoon, leaving the evenings free for, well whatever else they might get up to.Nevertheless, he continued, if anyone turns up to go zorbing or go-karting or whatever and they’re not entirely fit (for fit read sober), activity organisers will refuse to let them take part. “We take our responsibilities very seriously,” he said, “this is a half-billion pound industry. It isn’t 100 per cent regulated but there is a code of conduct and we always try to do a step further than most.”At Redseven Leisure, which, like Freedom, also organises weekends for other companies, however,

insurance is a condition, though it can either be provided by the clients themselves or by the company. According to the company’s website, clients who arrange their own policy should ensure that it covers personal accident, medical and emergency evacuation, loss of money and, importantly, participation in whichever activity or dangerous sport they have chosen. If clients decide not to take out suitable travel insurance themselves, the company’s attitude is very clear – in accepting its terms and conditions, uninsured clients agree to indemnify Redseven

against any claim for loss or injury, with those in the group taking part in any activity which is part of their itinerary entirely at their own risk. However, Redseven goes on to warn its clients that if they don’t effect insurance cover, Redseven may actually decide to cancel participation in those activities with no refund being made.

“If we decide not to cancel your reservation, it is on the agreed basis that we shall not be liable for your participation in the itinerary and you participate entirely at your own risk,” the company points out. It goes on to add that that even if it arranges insurance cover for its clients, should activity providers insist that participants sign an insurance indemnity and waiver form, then that cover goes out of the window with those in the party taking part entirely at their own risk. And it adds that cover does not extend to activities that are not booked as part of the itinerary or have been booked independently of the reservation,

At Redseven Leisure … insurance is a condition, though it either can be provided by the clients

themselves or by the company

stag or hen parties could be eligible for a group discount,

which reduces the premium for parties of up to 10 people

International Travel Insurance Journal

22 FEATURE

and Redseven won’t be liable for any loss or injury. Finally just so there’s no confusion the ‘small print’ on its website is admirably large and clear.And just in case its clients are in any doubt about the kind of coverage they need, Brilliant Weekends carries this very clear message on its website: “You must ensure that you have adequate travel insurance with high medical cover (including repatriation by air ambulance) and cover for cancellation and curtailment.”

The insurance is out thereSo, where does the bride or groom (or should that be best man and chief bridesmaid?) go to arrange their own insurance?Interestingly, if you ‘Google’ hen and stag party insurance, a whole atlas of websites pops up but none of them, at least as far I had the patience to check them, actually offers any kind of insurance, except for two or three companies that do include ‘travel insurance’ in their package. And these packages were, how can I put this kindly, not as exotic as many, being based in places like Newquay and Edinburgh in the UK.The fact that the itinerary is properly planned and managed will be an advantage if the hen or the stag wants to organise her/his own cover but what would be the attitude of the insurance companies to someone who came to them with a request for cover for a DIY trip? And with no specialist insurers, at least as far as I could see, where would they start to look anyway?I contacted three companies who advertise heavily and could therefore be high on the list of insurers party planners might contact. First, I challenged

a staggering 70 per cent of hen and stag parties now take place overseas

www.itij.co.uk

FEATURE 23

Churchill (had to get that in), then asked Tesco and Esure for their thoughts.Chris Price, head of travel insurance for Churchill, told me that his company wanted travellers on stag or hens parties to enjoy their time away and he acknowledged that part of that time will be spent enjoying a few drinks with family and friends. However, he pointed out, travellers should be made aware that drinking so much that their judgement is seriously affected may impact on their ability to make a claim and he had some advice for people going on stag and hen parties who might be travelling abroad and planning to take part in sporting and leisure activities. They won’t, he said, be covered for any activity mentioned in the exclusion section of the policy booklet nor would they be covered if, for instance, they tried to climb from one hotel balcony to another unless their life was in danger (sic), drove a motor vehicle when disqualified or not licensed to do so, or used a motor bike or scooter unless the driver had the appropriate licence to do so and the driver and, if he/she had one, the passenger was wearing a helmet. As far as personal possessions were concerned, he said that Churchill always urged policyholders to make sure that valuable possessions (such as engagement rings) were listed on their home insurance policies, as the personal possessions limit imposed by many travel insurance policies

would be too low to replace these items if they get lost or stolen. “Travellers should always check their policy details before their trip and contact their insurer to discuss any particular sporting activities they have planned to make sure they are covered. At Churchill, we are more than happy to discuss people’s needs before they go away. And,” he added, “stag or hen parties could be eligible for a group discount, which reduces the premium for parties of up to 10 people. It is also important to remember to check if any of the travelling party have any pre-existing medical conditions.”A spokeswoman for Tesco Personal Finance said anybody planning a hen or stag weekend would be best advised to buy their travel insurance over the phone so they could check on activities which were covered – and perhaps more importantly those which were specifically excluded. Typically, activities such as paintballing or go karting would be covered, but not the more extreme activities such as hang gliding or zorbing and, the spokeswoman stressed, whatever cover is provided it’s negated if an accident happens when people are under the influence of alcohol.Esure takes exactly the same line. They would, Emma Lloyd told me, offer either an individual or a group policy but it would be a standard one, with the usual exclusions and exceptions. And, she added, it would also be made very clear to the proposer that if alcohol played any part in an accident, Esure would not be liable.

Can we cover it?More than forty years ago, when I started work for Royal Insurance, my father, who had also spent his life in the business, wondered how long it would before I confirmed cover on a marquee on a mountain top in February. I never did (sorry Dad) but his comment made me very cautious. I reckon that if I was setting out on that first job today, Dad would be warning me about hen and, particularly, stag parties.There’s obviously a gap that needs to be filled but is anyone brave enough to fill it? Yes, cover could be provided but when you look at the stats I started with, I wonder what the premiums – and the exclusions – would be. Anyone want to offer a 22-year-old a thousand miles away from home and setting out to get out of his skull cover for any injury he might incur while he’s racing a quad bike? Hands up! Thought not!

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MJSlightonhoriz76.indd 1 24/4/07 16:01:04

There’s obviously a gap that needs to be filled but is anyone brave enough to fill it?

anybody planning a hen or stag weekend would be best advised to buy their travel insurance

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International Travel Insurance Journal Awards Evening

After yet another successful year of the ITIJ Awards, we are proud to announce that this year’s ceremony will even better last year’s event to once again provide the industry with an outstanding occasion that celebrates excellence and achievement in the global Travel Insurance and Private Healthcare industries.

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

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

The fi nalists’ presentations will be screened at the ITIC Gala Dinner awards evening in Budapest on Friday 14th Nov.

The categories:• Air Ambulance provider of the year• Assistance/Claims Handler of the year• Cost Containment company and provider of the year (to include PPOs and general services)

• Insurer/Underwriter of the year• Intermediary of the year (to include all retailers of travel insurance)

• ITIJ marketing campaign of the year (judged independently)

• Best International Healthcare Insurer

ITIJ AWARDS 2008

The rules:

• One vote per category per subscriber to ITIJ

• Votes/nominations must be received by 28th August 2008 to: www.itij.co.uk/awards

• Only registered company domain names will be accepted. Hotmail, Yahoo and other Web-based emails will not be accepted

• The fi nalists within each catergory will be contacted on Monday 1st September and provided with the criteria and deadline for submitting their presentation

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sponsors of the Insurer of the Year Award

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sponsors of the Assistance Company of the Year Award

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International Healthcare Insurer

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International Travel Insurance Journal

26 ASSISTANCE&HEALTHCAREWORLDMARKETS

The Caribbean Basin region can be defined as a large area from the coast of Florida in the United States stretching to the northern

coast of South America and taking in Mexico, Central America and the West Indies along the way. The area is home to around 37.5 million people and,

according to the Caribbean Tourism Performance scale, in 2005, 22.5 million people visited the region, which is host to stunning scenery. As a consequence, the Caribbean Basin has become a giant playground for millions of tourists who return year on year to take time out of the rat race, soak up the sun and

indulge in the activities on offer.A decade ago the Caribbean Tourism, Health, Safety and Resource Project cited the area as the most tourist dependent region in the world. Tourism was expected to generate $32 billion of economic activity in 1998 and contribute to a quarter of the GDP. Total

economic activity by the tourism industry should reach $40.3 billion, predicted to grow to $81.9 billion over the next decade.

Illness and injuryBut the dream of an idyllic getaway can inevitably

Island lifeThe Caribbean Basin boasts many seemingly idyllic resorts with sun-kissed beaches and crystal clear seas, but when things

go wrong, local healthcare facilities can be less attractive. In the first of our features to bridge the gap between ITIJ and PHN,

Petra Kendall-Raynor has the details

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ASSISTANCE&HEALTHCAREWORLDMARKETS 27

turn into a nightmare when illness or accident strikes. Last year, British tourists were struck down with a stomach bug outbreak in the Dominican Republic and were so ill with vomiting and diarrhoea they had to be treated at a local hospital.One guest told a national newspaper: “It’s been hell on earth. Every day we see a child run to the toilet to be sick – often not making it. Hotel bosses seem unwilling to co-operate and won’t answer questions.”Lawyers at award-winning travel law specialists Irwin Mitchell have dealt with dozens of cases of cruise ship passengers who have contracted various illnesses including E-coli and the Norovirus. Robert Ladle, a 60-year-old from Leeds, suffered severe poisoning in January 2007 while on a Caribbean cruise. The holiday was a 60th birthday celebration for him and his wife. His lawyer, Jenny Brooks from Irwin Mitchell, said: “This outbreak of dysentery, which ruined what should have been a special holiday for Mr Ladle, could easily have been avoided if stricter hygiene and sanitation measures had been put in place. We have repeatedly called for more to be done to improve safety standards on cruise ships. Tighter regulation and independent inspection of cruise liners is needed to avoid further illness outbreaks, which cause significant suffering to passengers.”In terms of tourism, Shai Gold, former vice-president of international medical services at Jackson Memorial, explains: “There are millions of tourists on vacation in the Caribbean and quite a few of them engage in sporting activities.” He says that the range of seemingly harmless pastimes can often end up with tourists suffering serious injuries: “I know people who have been driving a golf cart while intoxicated and it has overturned, riding a jet ski where people are swimming, and not obeying warning signs when scuba diving. Even looking at a girl in a bar the wrong way could lead to problems, with tourists being attacked. If you go to a destination which is an exotic island, you can contract an exotic bug.” He says that anyone coming into the hospital would be screened and financial clearing would be pre-requested. Mr Gold reveals that British tourists usually have wall-to-wall coverage, whereas other European tourists may not.In 2006, a 14-year-old American teenager was killed in a jet ski collision in the Bahamas. He was visiting from New Jersey and collided with a boat. In 2002, the two-year-old son of a British couple died in hospital after being hit by a speedboat. On top of unexpected illness and accidents, tourists may also be the victims of natural disasters. In 2007 hurricane Dean struck through the Caribbean sea, causing millions of pounds worth of damage and claiming 42 lives. The eastern region of the Caribbean is prone to hurricanes from June to November. In 2004, Grenada was severely damaged after Hurricane Ivan swept through the island, resulting in a total breakdown of transportation and communication. In November last year, an earthquake measuring 7.3 on the Richter scale hit Martinique and St Lucia, with both tourists and residents experiencing injuries following structural damage to buildings.If a holiday does not go according to plan and a medical emergency occurs, it could cost thousands of pounds for tourists to be returned to their country of origin. The UK Foreign Office website warns that if a tourist needs to be returned to the UK it could cost £30-35,000 for an air ambulance from the east coast of the US. It is careful to caution that the British Embassy or High Commission will not pay for this and tourists should have adequate travel insurance, with medical or health cover for an injury or sudden illness abroad. Users of the website are told that

cheaper policies will usually have less cover and they should shop around to find the right product rather than travel with no cover at all.

HealthcareBupa has invested millions in the Latin American and Caribbean market and works with local insurance companies in Mexico, Ecuador, Dominican Republic and in South America. But it is not just tourist coverage, there is a huge expatriate market seeking adequate healthcare. The company bought two health companies, Amedex and IHI Denmark in 2005, increasing their access to the expatriate market. Earlier this year, Bupa International launched five health insurance plans to meet the healthcare needs of people living in the region who want treatment at home or overseas.Following the launch of the health cover, David Maltby, managing director of Bupa Latin America said: “Many Latin Americans often travel overseas for medical treatment which is why we have designed our new products to fit with peoples’ different lifestyles and health requirements. It also makes things simpler for customers. So whether you are looking for cover for diagnosis and everyday treatment or a fully comprehensive plan with no monetary limits, there is a policy to meet your needs and those of your family.” The Bupa Essential Care Hospital Network offers members access to 50 hospitals and clinics in the US, as well as a wide range of hospitals in the Caribbean basin region. Other insurers in the region include the Government of Bermuda, Caribbean Insurers (Health) Limited, BF&M and The Argus Group.The perceived and actual lack of high quality medical services in the area has led to several Caribbean-based insurers offering health insurance products for residents and ex-pats. Ray Parry of Strategic Claims Network (SCN) said that on cases that his company has been involved with, all policies provide for treatment in North America. For these there seem to be two main areas of choice, The North Eastern US (centred around

Boston) and Southern Florida (centred around Miami). In his experience, insureds have been able to choose the facility that they want to be treated at with little or no interference from the insurer. This is probably because premiums are very high and insurers tend towards keeping the client happy no matter what. He added: “Although on relatively rare occasions the policy will be approaching its lifetime limit and insureds are forced to pay for treatment themselves. In these cases we can usually get the facility to lower their treatment costs.” The result, continued Ray, is that choices are often made on the recommendation of family and friends or perhaps a local medical professional. Inevitably, this leads to a reduction in the levels of discount that could be obtained had the insurer directed the client. Recently, SCN’s sister company Assured Medical Associates has seen insureds seeking treatment in Canada, particularly for diagnostics such as colonoscopies and some neo-natal treatments (this

is a juxtaposition as AMA is also seeing an increasing number of Canadians who want treatment in the United States).David Angelone, chief executive of cross border solutions, United Health International said that in many areas of the Caribbean, primary care is quite good, but complex cases often need to be transferred to the US for treatment: “South Florida offers some of the most advanced treatments and

facilities in the world,” said David, “and with our proximity to the Caribbean, it is easy to transport patients here when required.” UnitedHealth has a network of over 200 hospitals and 25,000 physicians in Florida alone, handling the medical needs of 2.5 million people. In addition to the advantages of geographic proximity and unit cost discounts, David also believes that the sophistication of United’s care management processes help ensure that patients are

Bupa has invested millions in the

Latin American and Caribbean market

in the Cayman Islands there is still not much of a medical

infrastructure

International Travel Insurance Journal

28 ASSISTANCE&HEALTHCAREWORLDMARKETS

receiving the most effective care in the most effective setting. “Our patients are tracked from admission to discharge in the case of hospital care, our providers follow evidence-based best practice guidelines, and our post-discharge follow-up procedures provide

patients with the assurance that they are receiving top-notch care. We do not see the US system supplanting the Caribbean systems so much as supplementing them,” he added.Baptist Health South Florida’s hospitals, including

Baptist Hospital of Miami and South Miami Hospital, have a long history of treating expatriate employees stationed in Latin America and the Caribbean. “We have had the pleasure of working with many countries, governments and other official agencies, in treating their expatriate employees stationed in the region. Our bilingual staff of over 50 representatives is trained to cater to the special and urgent needs of international patients and their family members. In addition to co-ordinating all their medical and local lodging needs, they also deliver unbeatable personalised care”, said Allen J. Brenteson, corporate vice-president of Baptist Health International Center of Miami.Tourists who do encounter difficulties

finding the right care in the Caribbean may be flown to the US for essential treatment and Jackson Memorial Hospital, along with Baptist Hospital and South Miami Hospital in Miami, Florida act as nerve centres for tourists coming from the Caribbean. Gold says the staff at the

hospital have expertise in handling tourists who suffer from complex and acute cases. The Florida Hospital Gamma Knife Center is also a key referral centre for physicians and patients from the Caribbean, Latin America, and South America. The hospital is an acute care health system and specialises in surgery where they use finely focused beams of gamma radiation with minimal effect on surrounding normal tissue and without the usual risks of surgery or an incision. The Miami Medical Alliance, meanwhile, is made up of several hospitals including, Aventura Hospital and Medical Center, Baptist Hospital, Cedars Medical Center, Mercy Hospital, Miami Children’s Hospital, Miami Heart Institute and Medical Center, Mount Sinai Medical Center, South Miami Hospital, and Jackson Memorial. They all treat patients in their international departments and the indgenous population of the Caribbean and Latin America can sometimes even be referred for treatment by a doctor in their home country to take advantage of the advanced medical treatment. Other popular choices on the Eastern Seaboard are Mass General, Lahey Clinic, Johns Hopkins and Dana Farber Cancer Center. All of these facilities derive millions of dollars annually from Caribbean insurers. While the situation in Canada can be difficult, Parry says SCN is seeing an increase in the number of Caribbean insureds going there.Some islands do not have specialist medics like cardiologists as they are often difficult to recruit because they would lose their skills if they were covering a very small community. But, admits Gold, Panama and Colombia offer excellent healthcare and there is a brand new hospital in Antigua. He adds that Guadalupe and Trinidad also have more than adequate medical facilities, but Barbados and Cayman Islands vary in the level of complex cases they can treat: “It is fair to say that elsewhere in the region there are hardworking health professionals who do their very best for patients – but the best

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ASSISTANCE&HEALTHCAREWORLDMARKETS 29

doctors and nurses in the world cannot work without the correct infrastructure.”Tourists coming into Jackson Memorial may require an even smoother entrance than other patients because they are coming back to reality with a health crisis during a fantasy holiday, says Gold. A medical concierge will meet the tourists at upon their arrival at the hospital and provide ‘lifestyle support’ similar to a hotel or cruise ship. Mr Gold says the concierge acts as a bridge between the lifestyle and medical needs of the patient and will pay attention to little details such as a bathrobe and slippers and may even act as an advocate on behalf of the patient as an ‘extension of the family.’In terms of insurance, he says that some tourists will have insurance that does not recommend certain hospitals: “The insurer then becomes the villain in the eyes of the patient.”His hospital, however, offers a Direct Access membership service where customers receive a gold card and are pre-registered on the hospital database. It will also act on the patient’s behalf and hire a licensed air ambulance company to transport them to the hospital as quickly as possible. However, members must sign an agreement form authorising the hospital to use their credit card information to pay the air ambulance company for air and ground service as needed.

Air ambulancesAir ambulance costs range from $6,500-$25,000 from the Caribbean islands, £18,000-$25,000 from Central America and over $30,000 from South America. Mr Gold estimates that a simple case of someone with broken bones would cost around $2,500, but a more complex case of someone involved in a car accident with multiple fractures and lung problems could stay in the hospital for three to four weeks at a cost of $500,000-$700,000: “We work with insurance companies to ensure we decrease the cost of stay by trying to get a discharge plan as soon as possible. I can’t emphasise enough how important it is for people to buy insurance.”Some air ambulance companies offer competitive deals and low-cost membership in a bid to ‘protect’ tourists from costly air evacuations. If you are a member of MedjetAssist, for example, and in a hospital more than 150 miles away from home, the company will send a medically equipped and staffed aircraft to pick you up and fly you to the hospital of your choice at no additional charge. Regular membership ranges from $225 a year for an individual up to $1,450 for a five-year family membership.Air ambulance company AirMed medical department

manager and chief flight nurse Michael Key has been on more than 550 medical missions to over 70 countries and regularly travels onboard flights from the Caribbean. He admits that sometimes there is a lot of red tape surrounding the evacuation of tourists: “By the time we get the call, we need to know that the person will be able to pay upfront or have coverage. These are $8 to $9-million dollar airplanes

and it is a business.”Key says that he has seen some people without coverage pay for the bill on five or six credit cards, but admits it can be ‘heartbreaking’ when they can’t help someone despite having the facilities. He says over 10 years, he has transported around 650 patients with various problems: “We deal with a lot of trauma; it sometimes can be as simple as

some hospitals will try to take advantage of tourist patients if they know they will only be there for a

one-off visit

International Travel Insurance Journal

30 ASSISTANCE&HEALTHCAREWORLDMARKETS

someone looking the wrong way crossing the road and getting hit by a vehicle. We also deal with a lot of high-risk obstetric cases.”For those who cannot be initially transported out of the country, some healthcare facilities in the region can present a range of problems for assistance companies. Medex Assist offers international travel, medical, security evacuation and assistance services to around 13 million people per year. They also offer pre-trip medical and security intelligence. Pascaline Wolferman, director of the emergency response centre and resource development at the company, says a lot of tourists from Canada and the US travel to the Caribbean basin from November to April. She says the main destinations are Mexico and the Dominican Republic: “When people travel they always think of exotic illnesses, but in reality a lot of the main issues we have are traumas and cardiac conditions.”Wolferman says the company tries to reach the

travellers before they go abroad, offering them information about the area and online support. She reveals that some hospitals will try to take advantage

of tourist patients if they know they will only be there for a one-off visit: “In Mexico we’ve had cases where someone from the ER will drive the patient to a cash machine before seeing them in a treatment room.”Some hospitals might even be in collusion with private air ambulance companies and tell a patient

they need to be evacuated by air immediately at a cost of $4,000, when in fact it is unnecessary. “If that is the way they function, they have some very serious ethical issues and are trying to live from the tourist population,” Ms Wolferman adds. However, she says, Medex Assist has local providers they trust: “If a hospital does not perform as it should, we are not going to refer anyone to their facility. In areas where there has been trouble, we will visit them and have to deal with it.”The International Center’s Patient Services Offices, which are located at South Miami Hospital and Baptist Hospital, are routinely called upon to co-ordinate air ambulance transfers from leading cruiselines such as Royal Caribbean and Carnival Cruiselines navigating in the Caribbean, as well as other island destinations, including the Yucatan.

PitfallsSome hotels can also be unscrupulous with their all-inclusive packages, including medical care on-site. In certain situations, Ms Wolferman says she would advise tourists to get a taxi, get out out of the hotel, and the company will tell them where to go: “These are very big issues for us.” She says in the Dominican Republic there are not many options in terms of local hospitals and clinics for the company to work with: “For a minor injury you may still have to put up with their charges, but it is still in the patient’s best interests to be there. We would review cases and bills because that way we can look at over charging. There are definitely some areas of the Caribbean where overcharging tourists is a big problem.” Wolferman reveals two examples are the Dominican Republic and the Riviera Maya in Mexico and says some other islands have customary prices especially the islands linked to a European country like the Netherlands Antilles, Guadeloupe and the British Virgin Islands: “I see overcharges occurring whenever the main clientele for the medical provider comes from tourism and when the provider has pretty much a monopoly. For example, Punta Cana and Puerto Plata in the Dominican Republic are areas where there are more tourists than locals and medical providers overcharge frequently – an aspirin can cost US$10 – not only do they overcharge, but they often ‘over-diagnose’, meaning they pretend the patient is sicker than he is and will do unnecessary tests and treatment.”Parry of SCN agreed: “Our experience as cost-containers (not an assistance company) and therefore usually dealing with bills after they have been issued, is that with Caribbean medical providers overcharging, it seems to be prevalent in some areas while others, like the Bahamas and Bermuda, have not been a huge problem. Mexico on the other hand is a huge problem with inflated bills and often unnecessary treatments. Pro-active case management is, in my opinion, a necessity in these areas. When case management is not available, we have found that using an experienced medical negotiator (In our case we use Dr Colin Plotkin) can usually save considerable

in the Dominican Republic there are not many options in terms of local

hospitals

www.itij.co.uk

ASSISTANCE&HEALTHCAREWORLDMARKETS 31

time, money and aggravation.”Dr Jose Quesada, director of finance and operations for the International Medicine Institute of the University of Miami Health System, is also aware of the problem, telling ITIJ: “We understand this is a sensitive issue in healthcare worldwide. Transparency and competitiveness are our main goal when setting prices.”There are some local assistance companies who pretend to be able to negotiate excessive bills, according to Ms Wolferman, but she admits she has not seen anything solid in relation to that yet: “I think we are better off being vigilant and talking to the providers directly.” Better prices tend to be where there is a large local population who will not accept inflated prices, she says.The company has dealt with many unusual and frustrating cases: “We had a US nurse in Jamaica with appendicitis. She went to the hospital in Kingston which was appropriate for this type of procedure. Once there, she called us up to let us know she had a latex allergy and the hospital, a tertiary care facility, did not have any non-latex gloves. They could not touch her.”Medex had to do an emergency air ambulance evacuation to Miami simply because of latex and the air ambulance company dispatched also had to make sure they had their latex allergy protocol in place: “We do offer a wide range of assistance, from the most simple situation, to the most critical.”She says as a general rule the company needs to look at the healthcare facilities offered, uncover financial medical traps and make sure the quality of service offered is good enough for their members’ needs.An assessment report from the Intergovernmental Panel on Climate Change shows the Caribbean region is in danger and that by around 2050, climate change is expected to reduce water resources on small islands – to the point where they become insufficient to meet demand during low rainfall periods. Sea levels are expected to rise and storm

surges will affect vital local infrastructure and facilities. A leading paper in the Dominican Republic recently estimated that global warming could eliminate tourism as we know it by the middle of this century.In 2002, in recognition of the need to mitigate the effects of natural hazards and disasters, the Caribbean Development Bank (CDB) established a Disaster Mitigation Facility for the Caribbean (DMFC), with financial assistance from the United States Agency for International Development. In April this year, the bank requested the financial experts should meet in Trinidad to discuss the possible global credit crisis and CDB reported that the Caribbean region was already experiencing a downturn in tourism.So, aside from issues with healthcare facilities in the Caribbean basin, insurers will now also need to make sure they are aware of wider problems in terms of the global economy and climate change.

ITIJ AHWM rATIngHeALTHcARe cosT HHH

Access To emeRgency cARe HHHH

oveRALL qUALiTy of cARe HHH

ems (AiR AmbULAnces) HHH

Please note: These ratings are an overview of what ITIJ believes to be a fair reflection of the general standards in the country, and do not represent any one hospital or service. ITIJ recognises that some individual facilities and services would receive different ratings than others, and to those shown in our chart, should ratings of each be done separately.

There are some local assistance companies

who pretend to be able to negotiate excessive bills

International Travel Insurance Journal

32 PROFILE

Do you have a favourite holiday destination?I love South East Asia and visit Thailand as much as I can: I like the country, the kind and generous people and the atmosphere. My favourite hotel is the Shangri-La in Bangkok – the service there is top-notch.Have you ever had to use your travel insurance?No – I have private medical insurance in Germany, which also includes overseas care, so I don’t have to buy separate travel insurance. I did have a bad bout of gastroenteritis once, though – after eating ice cream in Thailand (should have known better!). Also, when I was 18, I broke my leg and flew home with it in a cast, but I had to organise everything myself – travel insurance and assistance didn’t really happen back then! Travel insurance at that time was thought of more like life insurance – to be used if you are seriously injured or killed abroad.So assistance is now the name of the game?It’s the name of the game, the game being to provide a product and service to the client, and to make that product valuable to the client. But at the same time, containing costs is probably one of the biggest buzz words of the last two years, simply because some of the hospitals and healthcare providers that provide the care are milking the system to a point where it has become a major issue. At the AXA Assistance Group, we are always looking for a win-win situation for all parties – the healthcare provider and us – that makes financial sense and is fair. There are some

countries, however, which I like to call ‘rogue states’, countries like Bulgaria, where you have major financial issues (see PHN, p34). To make it worse, the medical bandwidth isn’t there. As soon as we get a case from over there, AXA tries to get the client out of the country. Fortunately, Bulgaria isn’t that far from the rest of Western Europe, so you can have them back on home turf in a few hours. Bulgarian

medical facilities can provide basic services, but if your client is seriously ill, they need to be taken out of the country. So, cost containment is our major issue at the moment; it is a battle that we are trying to win, but are probably losing. Anyone that says they are winning the cost containment battle is lying. I am a doctor, and I know what services are available and what they cost. I don’t understand what doctors in Turkey and Bulgaria are doing charging the same amounts or more than a doctor in Germany or the US. The average cost of treating gastroenteritis in US is between $400 and $500. For the same treatment in Turkey or Bulgaria, the cost could reach well over €1,000 – a completely unjustified sum due to their lower operating costs. Staying with the example of gastroenteritis, they see these patients as having ‘major bacterial infections’ and so give them expensive antibiotics instead of simple re-hydration. They can also charge over €90 for one litre of saline. And what of doing business in the US, where cost containment is imperative?Indeed it is. We have to use PPO

networks – you have companies such as United Health and Global, but isn’t this a scam? Have you ever received a 35-per-cent discount at your local Mercedes-Benz dealer? I do not think so! I can appreciate why Hygeia, for example, are in the business – to protect Canadian snowbirds from exorbitant costs. The problem is that the cost of

healthcare in the US and many other countries simply out

of control. There has to be a radical restructure of US healthcare, and there has to be somebody very strong to do it. Who knows what will happen in 2009 after the US elections.Do you have a favourite book?The New England Journal of Medicine is my usual reading matter, along with healthcare portals on the Internet. I like to keep as up-to-date as possible with what’s happening in the industry, so I also keep my hand in with HEMS involvement.Do you have a favourite film?I liked Dancing with Wolves a lot. I thought the music integration in the movie was fantastic. John Berry is a fantastic composer of soundtrack music. I do listen to chillout music, but when I’m in the car, when I like a moment of peace of quiet to myself. What do you do to relax?I like motorbikes, and have two of them. I have one BMW K1200R, which is one of the fastest bikes made today. I also have a Ducati (my Italian lady!) – it’s the one thing I do where I can turn my brain off from daily work and concentrate on driving. I drive from Munich to my parents-in-law’s house in Lagano, and I drive through the German, Swiss and Austrian Alps, which is absolutely fantastic. In September last year, I was in southern Tyrol, going through the Dolomites, which was brilliant. The Italians have fantastic roads – they are built for motorbikes! I do like taking the bike on the autobahns in Germany, but it ruins the tyres. Having worked on an air ambulance helicopter, it makes you watch your speed – you don’t want to end up like one of your patients.What are you proudest of in your life?Passing medical school with honours was one of the proudest moments of my life. I did my doctoral thesis on Immunology and I always say ‘do what you’re most scared of ’, so I started with cardiology, and then went into gastroenterology. Then I wanted to do intensive care medicine because it has so many different areas, and I have remained in this field of medicine.How did you start in the industry?I started in assistance after working in a cardiac care unit with the guy who is now the chief medical officer for Mondial Germany. At the time he was working for a small French assistance company, SFA. SFA then got American Express as a client and grew very quickly, so he had a problem in that he had too much work to do – both for Mondial and for SFA. So he asked me for help and I said ‘what the heck’, and we built the company up. That has been an achievement! That was almost 10 years ago now.What does the immediate future hold for you and AXA?We are getting ready to launch AXA Travel Insurance, which will compete with products from the other top European insurers. The wheels are turning, but these things take time. Rolling out a new product is not as easy as one thinks. Today, process costs and efficiency are two essential components in the creation of travel insurance. Profit margins remain low, and efficiency does not always go hand in hand with good service, plus there are KPIs that must be adhered to.If you could do any other job in the world, what would it be?There is only one answer to this question: I would have loved to become a pilot. At least my son is able to fulfil this dream – he started his pilot training this year.

Motorbikes and medicineITIJ recently spoke to Dr Michael Braida, chief medical officer with AXA Assistance Group, for Germany and the UK, about his work, training, and love of the open road

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GLOBAL HEALTHCARE • IPMI • CORPORATE BENEFITS 33

privatehealthcarenewsGLOBAL HEALTHCARE • IPMI • CORPORATE BENEFITS

Minister justifies bid to cap tariffsSouth African health minister Manto Tshabalala-Msimang has said that her plan to cap the tariff increases charged by local private hospitals will save the private healthcare industry from ‘overall destruction’. Sarah Watson reports

When questioned in parliament about her motives for regulating private hospitals, the minister said that increased private hospital tariffs had directly contributed to fewer people being able to afford a medical scheme and said that if charges continued to rise at a rate above inflation, medical scheme membership would continue to fall.“The decline in the size of the medical scheme risk poll, together with an ageing population, would serve to increase premiums even further, creating a vicious cycle that would result in the overall destruction of the private sector.” She continued: “The public sector hospitals that are currently under severe strain would be placed under further pressure by a collapsing private sector. Given these challenges, we have proposed amendments to the National Health Act; these proposals are intended to rein in these high costs in the private sector for the long-term viability of the sector.”Elsewhere, in her opening address at the recent BHF conference, Msimang made reference to a wide range of initiatives that aim to improve the governance of private medical schemes. At the same time, she agreed with Linza van Aswegen, chairperson of the executive committee of the Financial Intermediaries Association (FIA) of South Africa, that broker fees are not one of the problems driving up costs in the sector. Aswegen said that financial intermediaries will continue to play a critical role in terms of facilitating this healthcare reform, with ‘organisations such as the FIA acting as a crucial sounding board for both the industry and government decision makers’. She added: “Because intermediaries interface directly with the consumers they provide vital insights into what consumers require from their medical schemes, and how products and services can be made to meet their needs even better.” The health minister cited increased costs in the sector as a ‘source of concern’, despite the fact that recent research published by the Council of Medical Schemes confirmed that fees charged by brokers have not increased costs significantly. Aswegen continued: “Independent brokers add enormous value to the private healthcare industry, enhancing products and

Irish insurer Vhi is to be investigated by the European Commission following a complaint lodged by two private hospital backers in the country. Mandy Aitchison has the details

The complaint alleges that the state insurer has abused its dominant position in the Irish healthcare market. If the Commission rules against Vhi, the insurer could face fines of many multiples of its turnover, as well as having repercussions for the wider private healthcare market.The complaint was lodged by Jimmy Sheehan, a consultant orthopaedic surgeon and property developer John Flynn, both of whom have sizeable stakes in a

number of private hospitals around the country.Irish newspaper The Post reported: “It is understood that the complaint includes the allegation that the Vhi is achieving a double reduction in supply to its own benefit, as it is a dominant purchaser and also exercises dominance on the selling market. It is also believed to include an allegation in relation to the Vhi’s policy on the introduction of new technologies.”Sheehan has made repeated claims over the years that Vhi is abusing its position in the marketplace by offering inadequate reimbursement rates to private hospitals, making attempts to place a cap on fees and in places failing to even cover the basic cost of care to

a policyholder. He also claims that as a result of such practices, Vhi has stymied development of the private hospital industry in Ireland. Both Sheehan and Flynn have taken on the case as private citizens, not as representatives of the industry, nor on behalf of any of the private hospitals they are associated with.The European Competition Directorate has confirmed it has agreed to investigate a complaint against Vhi, has conducted a preliminary report into the alleged violations and has also written to the insurance company requesting a formal response to the complaint. Vhi has since issued a statement saying it does not believe there is any substance to the case.

Vhi to be investigated

continued on page 35

International Travel Insurance Journal

34 privatehealthcarenews

Lower rate increases indicatedThe latest survey carried out by Milliman, one of the world’s largest actuarial and consulting firms, has indicated that premium rate increases in health insurance continue to exceed the government’s official rate of inflation, but remain lower than premium increases of recent years. In the sixteenth survey of its kind, Milliman found that the estimated 2009 January renewal increases of 8.5 per cent for health maintenance organisations and 9.4 per cent for preferred provider organisations continue a trend towards lower price hikes. The survey is unique because it asks HMOs and PPOs to respond regarding a given set of benefits and demographics, thus removing three important factors that can affect the results of other health cost surveys:

differences in benefit design, cost sharing levels and member demographics.Speaking on the report’s findings, co-author Doug Proebsting said: “Possible contributing factors to the rise in healthcare costs beyond the average rate of inflation include increasing consumer demand due to direct-to-the-consumer marketing and the availability of medical information on the Internet. Rising rates of chronic conditions, new technology, speciality drugs, a move away from traditional managed care, cost shifting impact from government healthcare programmes and the uninsured, and the recent surge in building new hospitals may also contribute to the rise.”

Health insurance outstrips motorThe Economic Times of India has reported that health insurance is now the single largest business in the country’s non-life sector after car insurance, accounting for just below 18 per cent of total business for the fiscal year ended in March. Together, motor and health insurance helped the Indian general insurance sector to grow by 12 per cent in the 2007-08 fiscal year, now accounting for 63 per cent of all non-life premium as against 55 per cent previously.Third-party motor insurance increased by nearly 50 per cent to Rs46.2 billion (US$1.08 billion), while the health insurance business grew by 55 per cent to Rs49.7 billion. In 2007-08, non-life insurers in India wrote Rs281.3 billion of business, representing an increase of over Rs30 billion from the previous year. This increase was significant, especially when it is considered that several lines of insurance have endured lower premium collections this year – one such sector is aviation insurance, where figures fell by 28 per cent despite large-scale fleet expansions by airlines.

Insurers ‘should fund weight loss surgery’Bristish private hospital group Spire Healthcare has suggested that private medical insurers should offer gastric banding and gastric bypass operations to morbidly obese policyholders in an effort to combat the growing problem that is costing millions of pounds a year to tackle.The comments were voiced after the UK Department of Health (DoH) announced it would be calling for a ‘national movement’ to face the problem. Following the DoH announcement, Spire’s clinical services director Dr Jean-Jacques de Gorter wrote to health insurers asking them to cover weight loss surgery as part of their policies. He added: “This would have the double benefit of both extending the value of PMI to insured patients and helping manage the risk of excessive healthcare costs arising from the consequences of obesity.”

Cost explosion in Bulgaria

Dr Michael Braida discusses the latest news from Eastern Europe

Bulgaria has clearly established itself as a popular tourist destination. The first resorts in the Black Sea region were few and the medical infrastructure was in a similar underdeveloped state. With more tourists visiting Bulgaria so have the hotels and resorts increased in number. Numerous medical clinics have sprouted up like mushrooms all based on the same business model. These clinics provide rudimentary to questionable full-scale medical services for the tourists. The clinics are often located within the hotel complex with basic laboratory services, ECG, sometimes a defibrillator and other low-tech devices. The fact that the clinics are integrated into the hotel complex makes the referral system work very efficiently.

The pie chart fundamentally shows the principal medical problems being treated in Bulgaria. Gastroenteritis is still, as in many countries, an important cause for medical treatment. Cost to treat has varied between £40 to an extraordinary £2,500. The current average for gastroenteritis is

approximately £580 and our data clearly indicates that the price is on the rise.Why discuss a generally simple medical issue like gastroenteritis? The reason is that this ‘simple’ medical problem has led to some cases of incomprehensible medical practice and pricing. Some clinics have opted to charge astronomical rates for IV treatment. Infusions are extremely cheap in western Europe. Many healthcare providers are now charging prices which can easily make up 50 per cent of the invoice.

The assistance industry and underwriters are very concerned about this development and so far all attempts to mitigate the costs have been in vain. Eventually our clients, the tourist will have to carry this burden. We also have noticed a surprisingly high percentage of fractures, sprains and simple trauma when compared to other more mature holiday destinations. This could be attributed to the low cost of alcohol being offered in the resorts. The clinics have certainly opted not to perform any blood alcohol tests for the usual reasons. Upper respiratory tract infections are in-line with other typical tourist destinations. The statistics may not illustrate any real differences, however, as in other tourist regions, overzealous use of antibiotics is also evident and is a problem.Imaging technology is lagging behind Western standards but it is expected to improve rapidly. Bulgaria’s tourist healthcare providers are certainly benefiting from the growth of the tourist industry. Time will tell if these healthcare suppliers will evolve into true healthcare contributors or ‘business units’.

Principal medical problems treated in Bulgaria.

High claims increase in number

Insurers endure hard first halfGlobal investment bank Lehman Brothers has said that health insurers in the US need to show stronger signs of stability when they report second-quarter earnings if they are to tempt back investors to their suffering stocks. Overall, the managed healthcare sector is predicted to post a 4.2-per-cent drop in second-quarter earnings when compared to the same period last year. Of the larger companies, Lehman has forecast that only Aetna will post double-digit earnings per share growth, while Wellpoint will post flat earnings and UnitedHealth Group, it predicts, will report a 27-per-cent drop. Since March this year, five of the seven largest US health insurers have revised their earning forecasts, some even more than once, sparking fears from already nervous investors. Pressure on the health insurers is not helped by a recent decision by Congress to override a veto by President George W. Bush and passed legislation that will cut payments to health insurers who deal with Medicare.So far, health insurers have blamed disappointing results on a variety of problems, including mistakes in pricing their health plans for employers; offering overly generous benefits on Medicare programmes and declining enrolment rates that stem from increased competition.

NEWSWIREFrench firm Icade has strengthened its involvement in the healthcare sector with the acquisition of three clinics and a convalescent home from the 3H Group for f76 million, taking the company’s healthcare portfolio to 1,760 beds.

Ramsay Health Care has said it will invest over £12 million in UK hospitals to increase theatre space, bed capacity and diagnostic imaging facilities. The projects follow the firm’s recent announcement that it is expanding into Ireland to develop a private hospital in Limerick.

The Bangkok Mediplex building, Thailand’s first all-inclusive wellness and lifestyle centre, is in the final stages of construction and is now forecast to open by the end of the year.

In the past year, Private Healthcare UK’s website has climbed from 50th position to 17th in the Hitwise league table of UK health and medical websites. Revenues from the firm’s numerous websites are growing at over 50 per cent per year.

The annual High Claims Survey carried out by the Australian Health Insurance Association (AHIA) has this year shown an increase of more than eight per cent in the number of high claims paid for people under the age of 30. Statistics show

that health funds paid out 4,739 claims of more than AU$10,000 for under-30s in 2007, signifying an 8.6-per-cent rise from figures on 2006. In total, benefits paid by health funds for claims worth over $10,000 was $88 million, with the highest claim cost being attributed to neurosurgery.

Dr Michael Armitage, AHIA’s chief executive officer, said that the survey provided further

evidence that young people in Australia did use their private health insurance and made claims for non-discretionary procedures.

In order to collate the figures, the AHIA used data from 35 nationally registered

health benefit organisations, representing 99.1 per cent of the private health insurance industry in the country.

www.itij.co.uk

GLOBAL HEALTHCARE • IPMI • CORPORATE BENEFITS 35

1,000s of expats underinsuredSpecialist insurer Hiscox has warned that thousands of British professionals abroad are dangerously underinsured. The firm voiced its concerns following research that identified a growing trend for underinsurance among professionals being sent overseas for work.At the moment, figures show there are 2.2 million British expatriates in professional employment abroad, and according to Hiscox, many of those assigned to such roles are being left to fend for themselves when it comes to health insurance, leaving many inadequately insured and relying upon the group insurance offered by their employer. This situation has created what Hiscox is calling a financial ‘expat gap’, which it believes employers have a responsibility to fill. It also pointed out that expats are particularly at risk because more often than not, employer-purchased group schemes have low limits – typically between £10,000 and £20,000 – whereas most personal home insurance policies will value a person’s contents at £70,000.Laurent Schonbach, expatriate underwriter at Hiscox, said: “The expat gap is a significant – and growing – problem. Large numbers of international assignees are potentially vulnerable to significant financial loss. We find that ‘gold collar’ workers in places like Saudi, Japan or Hong Kong often posses many items that are woefully underinsured by their employers’ policy.”

services thanks to the feedback they receive from consumers. In the same way, the FIA hopes to enhance government understanding of the private healthcare sector – one of the reasons we have already requested an audience with the minister of health as a matter or urgency.”Also weighing into the debate in South Africa is Di McIntyre, a health economist from the University of Cape Town, who believes that too much power concentrated within the country’s three largest hospital groups is pushing up the prices in the private healthcare sector. She said that through their control of the market, Netcare, Life Healthcare and Medi-Clinic were able to influence prices when negotiating tariffs with the medical aid schemes, and increase such tariffs without the risk of losing business. She added: “Except for a few large administrators, the majority of the schemes that are smaller have to accept the prices, because they are not in a powerful position.” In her opinion, the concentration of hospital providers is also pushing up costs.Melanie Da Costa, director of health policy at Netcare, said there was no causal link between the concentration of the market and the price hikes: “Hospital prices have been very well contained. From 1999 to 2008 increases were 7.9 per cent,

versus medical inflation of 9.5 per cent. Negotiations with funders are robust, with six administrators representing 71.6 per cent of medical schemes.” McIntyre agrees with the health minister that the private healthcare industry needs a ‘strong regulatory framework’, but made it clear this did not mean she was in favour of the National Health Amendment Bill tabled by the minister. “I am not sure that it [the bill] is framed properly and I don’t believe it would address these issues. I can’t go into details, but it needs work and more time,” she said. The bill, which is currently before parliament, would purportedly create a ‘transparent platform’ on which healthcare providers and funders could negotiate, but the hospitals are protesting that this was merely an effort by the government to dictate prices.

Adam Pyle, a member of the marketing team for Life Healthcare, contributed by saying that differences should be distinguished between increases in hospital spend as a result of price increases, and others as a result of utilisation drivers: “Consolidation has not impacted price increases, which since 1999 have averaged 1.7 per cent above CPIX [the consumer price index minus mortgage costs]. This increase indicates that hospitals are concerned about price increases and are not able to increase prices as they see fit.”

Minister justifies bid to cap tariffs continued from page 33

International Travel Insurance Journal

36 privatehealthcarenews

Berner chosen for Cerner

Hibernian appoints new chairman

InterGlobal recruits Dickman

Account managers join HSA

Cerner, an international supplier of healthcare information technology solutions, has announced that Rich Berner has been appointed vice-president and general manager for Cerner Middle East. In his new role, Rich is responsible for strategy, consulting, sales and operations for the firm in the Middle East market.Trace Devanny, president of Cerner, commented: “The Middle East market is a strategic focal point for Cerner. Rich brings more than 15 years’ experience in technology and healthcare and has had great success leading the roll out of healthcare technology at some of

Cerner’s largest and most complex clients.”Prior to his appointment, Rich held the position of vice-president and general manager of the company’s academic and paediatric healthcare segment in the US, where he was responsible for delivering results for clients that use healthcare IT to optimise workflow and patient care.“It is an exciting time to be in healthcare in the Middle East,” said Rich, “as the region is uniquely positioned to connect patients and healthcare providers to improve safety, quality and operational effectiveness.”

The board of Hibernian Group has announced the appointment of David Simpson as its new chairman, with immediate effect. David succeeds Dónal Byrne, whose term of office as chairman came to a conclusion after 10 years of service – Dónal will, however, continue in his

role as chairman of Norwich Union International.

David was a founding partner of Simpson Xavier in Ireland in 1982 and went on to become the managing partner of BDO Simpson Xavier. A former president of the Institute of Chartered Accountants in Ireland, David has been senior independent director on the board of the Hibernian Group since October 2007.Commenting on the appointment, Stuart Purdy, chief executive of the Group, said: “I am delighted that David has agreed to take on the role of chairman and under his leadership we look forward to his insight and financial skills brings a considerable amount of benefit to us.”

International health insurer InterGobal, which earlier this year joined forces with Bao Viet in Vietnam, has recently recruited Alistair Dickman to sell its health insurance plans in the country. With over 30 years of insurance experience in both the UK and Asia, Alistair will be working to build up sales and distribution as well as the service business in Vietnam.David Bouzaid, general manager in Asia for InterGlobal, said: “We are growing our business through developing opportunities in

new markets. With Alistair’s experience and knowledge of the Asian region, Alistair will be able to expand and support our Vietnam-based intermediaries and clients as well as increase [the firm’s] presence in Asia.”Alistair has extensive experience in the life and health insurance markets, as well as health benefits gained by working for some of the world’s largest insurers in the UK and Asia. His focus will be to support and develop the intermediary base in Vietnam to drive InterGlobal’s worldwide growth plans.

Kevin Hammond and Sandy Michelson have been appointed key account managers at Healthplan provider HSA, in recognition of the buoyant B2B marketplace and the company’s continued growth in the sector.Commenting on his new role, Kevin said: “My experience in dealing with companies indicates a desire to work with other companies that share a similar ethical stance and excellent service standards. Currently, the economic climate is a tough one and I believe there is a tremendous opportunity with companies by

offering them affordable and valuable employee benefits.”Sandy added: “Supported by my team, I will work across a host of national accounts, where I look forward to further strengthening existing client relationships. Having

gained experience within a mutual company environment and an expertise in business development, I will be exploring new business opportunities so that more businesses recognise that simple and affordable HSA Healthplans can extend to and benefit the entire workforce.”

Dr. Colin Plotkin Consulting

27-3088 Francis Road, Richmond, British Columbia, CANADA V7C 5V9

Tel: +1 604 241 9677Facsimile: +1 604 241 0733

Web: www.plotkinconsulting.com email: colin@plotkinconsulting.com

privatehospitals

Portugal

Rua 25 de Abril, 12 Vila da Luz, 8600-174, LGS, Portugal

Web: www.luzdoc.come-mail: info@luzdoc.comTel: +351 282 780 700

Facsimile: +351 282 780 709specialiTy: General Medical

Spain

Medical CenterVirginia Villanueva de Pedro

Medical Director

Web: www.caribeasistencia.com/cmcbwww.centromedicocaribecancun.com

e-mail: vvilla@mapfre.comTel: +00 34 91 581 6707

specialiTy: Primary Care Attention

Thailand

Bangkok International Hospital. 2, Soi Soonvijai 7, New Petchburi Rd,

Bangkok 10320 THAILAND

Web: www.bangkokhospital.come-mail: jane@bgh.co.thTel: +66 2 310 3000

Facsimile: +66 2 310 3105specialiTy: general medical

8940 North Kendall Drive, Suite 601-E, Miami, FL 33176

Web: www.baptisthealth.net/internationalemail: international@baptisthealth.net

Tel: +1 786 596 2373Facsimile: +1 786 596 5979specialiTy: General Health

United States

Jackson Memorial Hospital International Jackson Medical Towers, East Tower, Suite 829, 1500 NW 12th Avenue,

Miami, FL 33136 - 9998 USA

Web: www.jmhi.org e-mail: info@jmhi.org

24hr Tel: +1 305 355 1212 Tel: +1 305 355 5544

Facsimile: +1 305 355 5545

Private Bag X5, Benmore Gardens 2010, Johannesburg, SoUTH AFRICA

Tel: +27 11 245 5777Facsimile: +27 11 783 9277

Web: www.aims.org.zae-mail: contact@aims.org.za

costcontainment

Jeffrey Baker – President390 Rabro Drive, Hauppauge,

NY11788 USA

e-mail: jbaker@medsaveusa.com Web: www.medsaveusa.com

Tel: +1 516 622 1784 Facsimile: +1 516 294 6761

Gigi Galen – President850 7th Avenue, Suite 803

New York, 10019 USA

e-mail: ggontheroad@aol.com Web: www.starhealthcarenet.com

Tel: +1 212 581 8228 Facsimile: +1 212 581 8272

healthcareinsurance

1st Flr Suite, West Hs, 46 High St, orpington, Kent, BR6 0JQ, UK

Web: www.travelandmedical.co.uke-mail: sales@travelandmedical.co.uk

Tel: +44 845 058 8000Facsimile: +44 845 053 3000

1099 N.W. 14th StreetMiami, Florida, USA

Web: www.uhealthinternational.comTel: +1 305 243 9100

Facsimile: +1 305 243 9101

privatehospitalsOn tHe MOVe

Sandy MichelsonKevin Hammond

David Simpson

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GLOBAL HEALTHCARE • IPMI • CORPORATE BENEFITS 37

It has been reported in the Australian press that healthcare giant Bupa is considering leaving behind the HBA and MBF brand names, and that the firm has yet to decide whether to hold on to all the assets it bought as part of its AU$2.41-billion buyout of MBF. Although the deal was formally completed in June, Bupa has yet to announce its plans for integration of the company, products and branding.Dean Holden, who was recently appointed as managing director of Bupa Asia-Pacific, said that the first step for the firm would be to ‘tweak’ its main insurance brands to indicate that they were all part of the Bupa group of companies, although he added that a decision had not been made as to whether it is a temporary arrangement leading to the stand-alone use of the Bupa brand. Sounding a note of caution, he added: “You can destroy a lot of value by suddenly saying, ‘Oh, we’re just going to call it Bupa from day one’, and you find that your three million customers have never heard of you. Being a retail brand, I think you’d have to move away from that very, very carefully and over a long period of time.” He also mentioned that although there are no other specific acquisitions being considered at the moment, ‘we would be interested in increasing our influence across the Australian market’.Commenting on the recent government increase in income threshold for the Medicare levy, Holden said that while the change could make insurance a less attractive proposition to some, the fact that the change had not passed the Senate still left uncertainty for the company in forecasting the drop-off in customer figures.

Medtral partners with Pinnacle Health

MedTral New Zealand, an agency offering healthcare treatment in NZ to Americans, has partnered with Pinnacle Health, a preferred provider organisation that offers network and administrative services to self-funded employers in Northeast America.

Paul Brough, president of Pinnacle Health, said: “An attractive destination for medical care and surgery, New Zealand is a first-world, English-speaking country with very high quality medicine and a clean, green environment that is ideal for recuperation. Our customers are requesting options for medical travel, and New Zealand fits the bill.”MedTral New Zealand offers care at two local private hospitals, the owners of which, the MercyAscot Group, are also shareholders in the firm. Air New Zealand,

another partner in MedTral, arranges the travel packages to and from the country. Since MedTral’s website was launched last year, just 29 Americans and one Canadian have registered on the site, most of whom have yet to travel to New Zealand.

Expat Financial, an American website owned by TFG Global Insurance Solutions Ltd, has urged students who are planning to study overseas this academic year that they must have adequate protection in place to ensure they are not caught out abroad. The website points out that in 2007, there were around 582,000 international students in the US at various colleges and universities and over 2,000 Americans studied abroad last year. Although some educational establishments have compulsory health plans for their students, others allow students to obtain their own cover.

David Tompkins of TFG Global Insurance Solutions commented: “For Americans getting their education abroad, their health insurance plan may not cover treatment back in the US. If a student

gets a serious illness or injury, his or her family would probably want to have the student’s extensive treatment done at home.” He also noted that a simple travel insurance policy might not be sufficient, as most do not offer cover against serious illness such as MS or cancer, but focus

instead on emergency care and treatment. Expat Financial offers a range of cover to students from the US and elsewhere.

People living and working in new European Union countries such as Bulgaria and Romania now have access to the international private medical insurance offered by BUPA International.A new policy, called The European Health Plan, provides peopled living in Bulgaria, Czech Republic, Estonia, Hungary, Latvia, Lithuania, Poland, Romania, Slovakia and Slovenia with access to treatment in hospitals or clinics anywhere in Europe and includes cover for chronic conditions such as diabetes and worldwide emergency travel care, as well as the facility to add dental and optical cover. Customers of the European Health Plan also gain access to BUPA’s 24-hour worldwide medial assistance helpline, which is manned by a team of multi-lingual advisors.Steven Martin, European development consultant for BUPA International, said: “Because the plan is focused on European coverage, medical costs and premiums are more affordable. The region is growing rapidly and with the European Health Plan, BUPA International is meeting the growing demand for international health insurance from companies and expats, as well as local professionals who want to ensure all their health needs are covered.”Meanwhile, the company has also reported that

demand for international PMI in Egypt is rising rapidly, where it has seen its customer base increase by 25 per cent in just three years.General manager and original founder of the Egypt office Sherif ElGhatrifi said: “Our first three years in Egypt have been phenomenally successful, thanks to an excellent team, high-quality products and rising demand. The market for international private medical insurance here is thriving and has enormous potential as the number of expatriates based in Egypt continues to rise annually.”

COMPAny BrIef

International students need cover

BUPA covers new eU countries

UHP signs exclusive agreement

United Health Programs of America (UHP) has announced it has completed an exclusive agreement with Americare Services Inc. to be the sole distribution partner of Americare Services CallMD physician phone consultation service for the group, affinity and self-insured markets.Jason Krouse, CMO of UHP, said: “Rising healthcare costs, increased medical-related absenteeism, treatment delays and after-hour emergencies result in diminished productivity and diminished profitability. Implementing CallMD is a proven way to minimise these challenges while increasing the quality of medical care.”Edward Mandel, chairman of Americare Services Inc., commented: “CallMD is the answer for people with a non-emergency medical question, or those who need a non-narcotic prescription, and would like a doctor’s advice at a time that’s convenient for them – without missing work, or spending hours waiting at the doctor’s office.”

young adults get bodyguardsIn order to address the issue of younger people in the US being the most likely to not have any form of health insurance, Aetna has introduced its BodyGuard Plans for individuals, with affordable rates. Three simple products have been designed with young people in mind, and are now available from the company’s website. The plans are initially on offer in the state of Illinois, though there are plans to expand their availability to other states in the future. Frank McCauley, head of Aetna’s Consumer Business Segment, said of the BodyGuard plans: “Young adults have very different priorities than most other individuals when it comes to health insurance, and we developed the Aetna BodyGuard plans to try to meet those unique needs. We think these plans offer affordable choices for individuals who usually have a number of competing financial interests, and will also give these individuals a much-needed safeguard for their health and financial wellbeing.”The plans – Basic, Intermediate and Advanced, offer varying premiums and levels of coverage to give people the opportunity to find the plan that best suits their situation. Aetna is keen to point out that despite their low cost, the plans do not have limited benefits, rather they focus on the type of coverage that young adults are most likely to use.

A fine balanceA survey conducted by IVANS, Inc. in the US has shown that healthcare providers in today’s market are challenged between the desire to improve patient care and the problem of having less funding to provide that care due to restrictions in insurance payouts and increased costs in administration and technology. Nearly 50 per cent of providers surveyed agreed that more than half their revenue comes from Medicare payments, meaning a reduction in such payment would have dramatic effects on their facility. They also pointed out that as the baby boomer generation retires, the demand for medical services that follows will increase operations and administrative challenges, worsening the problem further.In order to try and close this widening gap, many of the healthcare providers surveyed said they had turned to technology. In response to questions, more than 60 per cent said they believe use of electronic health records can have a significant impact on improving their business, while more than 65 per cent have already implemented or plan to implement such IT systems. Eighty-five per cent of those surveyed said they believe that Health Information Exchanges can facilitate information sharing, thus improving patient care. However, much as these hospitals and healthcare providers would like to implement new technologies, over two-thirds of respondents cited a lack of budget as the biggest hurdle to obtaining it, followed by lack of expertise and actually getting staff to make use of the system. So while healthcare providers view technology as a viable method for doing more with less, they are not sure whether the internal resources are available.Clare DeNicola, president and CEO of IVANS, Inc., commented on the findings: “The results of this survey further highlight the struggle in the healthcare community to finds the right balance between cost and care. Technology can help bring together these opposing objectives, and many providers view technology as a critical element to closing this divide.”

Bupa could integrate brands

International Travel Insurance Journal

feature38

If you work in the States, chances are you don’t even think about signing up to an employer-sponsored health plans – it’s there and you take

advantage of it. In the UK, the National Health Service traditionally takes care of all medical needs, and so companies haven’t been quite so quick off the mark to offer their staff health cover.Some do, though, and their provision makes them stand out in their sector.

Links across the pondIt’s not surprising that many of the companies that do offer health plans have strong links with the US market. Hudson recruits and manages talent in the professional services sector, with the aim to help people deliver, working across Europe, North America and the Asia-Pacific region in the key markets. As an employer, they have 800 staff in the UK and Ireland alone. Hudson, like Monster.co.uk, is a break-off from TMP, so as a stand-alone company they have been operating for five years, and since their inception, they have always offered private healthcare cover.“In the US, it’s much more expected that you choose your healthcare. In the UK, you receive it,” explains Rob Chandler, head of HR at Hudson. “We want to change that, by making sure people understand what they’re entitled to, and bring in that element of choice.”Schemes can offer multiple benefits to staff – critical illness cover, emergency operations, physiotherapy, optical care, dentistry, even childcare in some circumstances. The benefits may also be extended to the employee’s partner and dependents. “Our scheme covers everything,” says Chandler. “We also offer a variety of levels of cover, according to what the individual wants – they can be covered alone, or with their partner, or with their dependents.”Chandler thinks that the mindset on employer-provided healthcare schemes is now changing in the UK. “Healthcare as a benefit is something that is now becoming a starting point of any employer-employee relationship,” he says. “This kind of issue is now being brought up during the recruitment process, so whereas once people asked solely about their salary, they’re now asking about these additional benefits. “We’re also keen to ensure that people understand exactly what benefits they are entitled to and how they can access them, so that healthcare isn’t something in the background to be forgotten about, but it’s there and available to you.”

The optionsCash plans are one way in which employers are now offering healthcare benefits. Rather than the traditional method of employer-provided healthcare, where the cover offered usually allows treatment in a private facility as a matter of course, cash plans pay actual cash sums towards the cost of a wide range of treatments – for example, if you have to go into hospital, see a specialist, visit the dentist or optician, give birth or require alternative therapies such as homeopathy, acupuncture or physiotherapy. Stephen Duff, HSF health plan’s sales and marketing director, has noticed an increase in the number of businesses providing this kind of cover for their employees – and it’s not necessarily the big corporations who are offering this added value. “Smaller companies are becoming much more aware of their duty of care to staff,” says Duff. “Often, many will not have HR advisers, so managing directors see the value in paying a

monthly fee for what is essentially a much cheaper outsourced benefits or HR function.”These smaller companies aren’t scrimping on their outlay, either. “We’re seeing particularly high growth in our mid-priced cash plan rather than the cheapest,” explains Duff. “More SMEs are spending a higher average about £26 a month, suggesting they don’t want the basic cover, but see it as an attractive incentive they can offer their staff. In fact, I’ve known plenty of directors who have found out about a good cash plan being offered to employees and decided to take one out as well. This cover is affordable, an employer could pay as little as £1 per week and perhaps give the employee the opportunity to top it up. Cover is simple to understand – there is a choice of options based on the level of benefits and it’s easy to claim.”Microfiltrex, part of Porvair Filtration, is an international supplier of filters and filtration systems. It has an annual turnover of £10 million, and like any other company it needs to have its staff fit and healthy, which prompted the decision a decade ago to put an HSA healthcare plan in place. With the scheme now well established, Porvair have decided to roll it out across its other three divisions as from the start of 2008, giving 150 more employees the additional security of health cover. Bridget Small of Microfiltrex believes employer-provided health cover is highly effective. She says, “The scheme has not only helped to reduce sickness and absence and improve retention but it’s also given the company an edge over our competitors.”

WellbeingSimilarly, HSA’s Work Well plan has been living up to its name for Miller Hendry, one of the biggest legal firms in Tayside, Scotland. They introduced the plan when they wanted to demonstrate its commitment to employees and encourage them to look after their health and wellbeing. Mark Jackson, HR Advisor for Miller Hendry, explains, “We recognise that as a leading employer in Tayside it’s important to make our employees feel valued so we decided to put a healthcare plan in place for them.”

One hundred and thirty employees at Miller Hendry are now benefiting from Work Well, a company-paid benefit which costs the company £6 per month per individual. As well as the standard comprehensive medical cover, Work Well also provides an Employee Assistance Programme and face-to-face counselling which can help to manage stress and anxiety. The company think that this kind of provision isn’t just of immediate benefit, but will stand everyone – staff and management alike – in good stead in the future by setting up a caring ethos where everyone in the organisation feels valued, and which will attract top talent too. Jackson says, “Miller Hendry believes the health plan will assist in both recruitment and retention and we will continue to monitor sickness and absence levels to see if there is any change in patterns.”

Carrie Dunn assesses the value that an employer-offered health plan can give to the employees and the business they support

Wellness at work

The benefits may also be extended to the

employee’s partner and dependents

www.itij.co.uk

39 feature

Similarly, a Liverpool IT firm, Gardner Systems, is now offering its employees a cash plan with a difference - Medicash’s company-paid healthcare cash plan, Reward. With Reward, the preventative role of the traditional cash plan remains, with financial assistance for standard health checks. However, this new scheme extends this to include some less everyday options.One addition is health screening, so individuals can keep a watch on silent and symptomless issues such as cholesterol, a contributory factor in circulatory and cardiac problems, or blood sugar, which is an early warning sign for diabetes. Reward also offers discounted membership to gyms and fitness clubs so staff are motivated to become more active, keep their weight down, improve their diet – and their mood, through the ‘happy hormone’ endorphins produced – and fundamentally stop health problems before they strike.Another strand of the offering is the provision of discreet helplines that help employees address stress and its causes of stress – even if they are outside the workplace. That means that a staff member experiencing problems at home with relationships or finances can seek help from a professional, safe in the knowledge that it is covered by the cash plan, and will, of course, remain confidential. Phil Corfield, finance manager at Gardner Systems, says: “Everyone with a plan has taken advantage of the health screening and I would say that around 90 per cent of those have changed their lifestyle as a result. The changes vary from person to person, but we know that some have reduced their daily calorie intake, some are taking more exercise and others are keeping a check on their cholesterol levels.” He continued: “When we decided to use a healthcare cash plan as an employee benefit, it was with the sole aim of making people aware of their lifestyle, in health terms, and motivating them to proactively improve both their health and well-being. Our staff have been delighted with their health insurance benefit and we’re pleased that it has had the desired effect on our employees, who have made positive lifestyle changes.”Staffords, a UK office and equipment repair company, is using the same cash plan to help it

reduce absenteeism in the workplace, and has found the counselling helpline of immense benefit. Dave Latham, the company’s business development director, explains: “Absenteeism has been a major headache for us, so we decided to tackle this problem by providing a healthcare cash plan as an employee benefit, and which also helps the company fulfil its duty-of-care responsibilities. Several members of our staff have had to take time off due to depression. Even though this depression is caused by factors outside of work, we are now able to encourage them to call the stress helpline provided to talk about the issues causing their depression and ultimately help them reach a positive solution. Face-to-face counselling is also offered, if it is deemed necessary. We’ve been delighted with the feedback we’ve had from the staff so far – I believe our commitment to their health has improved morale amongst our staff and has also improved their motivation.” Clear resultsPeter Lauris, sales and marketing director at Medicash, is not surprised at all by the increased productivity and improved morale noted by management in companies where healthcare cover is offered as an employee benefit. He concludes: “There’s a clear link between reducing absenteeism and increasing business performance. Unmanaged absenteeism has a negative financial, social and psychological impact - forward thinking action by organisations should be commended.”Stephen Gates, MD of Denplan, agrees that employers can now see the value of keeping their staff happy and healthy: “Much importance is placed these days on issues such as employee ‘engagement’. Employers have an opportunity to genuinely demonstrate that they care by providing health plans to their employees. These health plans should have a double benefit - for the employee it should mean that they can get their medical or dental treatment done earlier and without an impact on their take-home pay: for the employer they have a healthier workforce, with fewer absences and their teams concentrating on the job in hand.” He continued: “We are

being told increasingly by companies that they want to be able to provide benefits to their employees that actually are seen to be closely connected to working life. While death-in-service

and pension benefits clearly have an attraction they are nowhere near as attractive as benefits that are used - for example health plans, and particularly dental and optical health plans where the employee is likely to ‘use’ the plan without needing to be ill.”In these trying times for companies, as the worldwide economy slows down, some firms try and offset higher costs elsewhere in the business by cutting their employee health cover, as has been reported in previous issues of PHN. James Glover, member services director at Manchester-based health cash plan provider HealthSure, believes this is not the best way for a business

to recoup costs. “In this situation,” he told PHN, “I ask businesses to give some thought to the longer term perspective and the potential negative perceptions from employees who may already be nervously worrying about the widely reported credit crunch and how it will affect them. Health cash plans are a great way to reward, recognise and prove that you can care for employees during times like these – and showing that you care can often be the difference in retaining good staff during periods of uncertainty, thereby eliminating further unnecessary recruitment and selection costs.” During stressful times, ie right now, some sort of health protection is more vital than ever, as Mr Glover pointed out: “Worries of an economic downturn may put further strain on employees, which may result in a growing number of cases of work-related emotional and physical illness and absence from work – all of which may have serious implications on a business struggling to meet its targets and compete in a pressured economic environment.”Private healthcare, then, isn’t just for senior executives who can offer top-of-the-range cover for themselves and their families; nor is it just for hospital trips and emergencies. New provisions mean that it’s a wise business that puts one of these wide-ranging, overarching schemes into practice, demonstrating how much they value their staff – and not just in times of crisis, but every day.

Smaller companies are becoming much more aware of their duty of

care to staff

The scheme has not only helped to reduce sickness and absence and improve retention but it’s also given the

company an edge over our competitors

International Travel Insurance Journal

40 SERVICEDIRECTORY To have your company listed in the Service Directory email: dave@itij.co.uk

CATEGORY KEY Air Ambulance

Air Ambulance Interior

Aircraft Performance Solutions

Assistance Companies

Catastrophic Claims Specialist

Cost Containment

Claims Management

Claims Subrogation

Commercial Repatriation Specialists

Critical Care Patient Transport

Funeral Directors

Healthcare Clinics

Hospitals

Legal Services

Medical Escort on Commercial Airlines

Medical Provider

Medical Screening

Re-insurance

Travel Agents

Web & Design Services

AFRICA Air Ambulance Network Kirk Pacheco – President

905 Martin Luther King Jr Drive inquiries@airambulancenetwork.com Suite 330 www.airambulancenetwork.com Tarpon Springs Tel(24hr): +1 727 934 3999 Florida 34689 Tel(toll free): +1 800 327 1966 USA Fax: +1 727 937 0276

Air Ambulance Worldwide Inc. Mark Jones – President 35246 US Hwy 19 North mjones31@tampabay.rr.com

#210 www.airambulanceworldwide.com Palm Harbor Tel: +1 727 781 1198 Florida 34684 Fax: +1 727 786 0897 USA

AMREF Flying Doctor Service Dr Bettina Vadera – Medical Director Wilson Airport emergency@flydoc.org LangataRoad www.amref.org PO Box 18617 Tel: +254 20 600 090

Nairobi Fax: +254 20 344 170 KENYA

European Air Ambulance Patrick Schomaker – Director Sales & Mkt 175A, rue de Cessange alert@air-ambulance.com L-1321 www.air-ambulance.com LUXEMBoURG Tel (24 hr): +49 711 7007 7007

Fax: +49 711 7007 7009

JET ICU Bart Gray – President 17076 Helicopter Drive email@jeticu.com Brooksville www.jeticu.com FL 34604 Tel: +1 877 453 8428

USA Tel: +1 727 524 9825 Fax: +1 727 524 982

Netcare 911 Aeromedical Wayne Thomson - Flight Operations Mgr Netcare 911 House flight@netcare.co.za

49 New Road www.netcare911.co.za Halfway House Tel: +27 11 254 1392 Midrand 1685 Fax: +27 11 254 1405 SoUTH AFRICA

Skyservice Air Ambulance David Ewing – VP Int. Market Development YUL/Trudeau Int Airport david_ewing@skyservice.com 9785 Avenue Ryan www.skyservice.com/airambulance

Montreal (Quebec) N AmericaToll Free: +800 463 3482 H9P 1A2 Tel: +1 514 497 7000 CANADA Fax: +1 514 636 0096

AUSTRALASIAAir Ambulance Network Kirk Pacheco – President

905 Martin Luther King Jr Drive inquiries@airambulancenetwork.com Suite 330 www.airambulancenetwork.com Tarpon Springs Tel(24hr): +1 727 934 3999 Florida 34689 Tel(toll free): +1 800 327 1966 USA Fax: +1 727 937 0276

Air Ambulance Worldwide Inc. Mark Jones – President 35246 US Hwy 19 North mjones31@tampabay.rr.com

#210 www.airambulanceworldwide.com Palm Harbor Tel: +1 727 781 1198 Florida 34684 Fax: +1 727 786 0897 USA

Asia Assistance Partners Siriporn Wongurai – Int. Ops. Director 184/235 Forum Tower thailand@aapartners.net 36 Flr Ratchadapisek Rd www.aapartners.net Huaykwang Tel: +662 645 3733-5

Bangkok 10320 Fax: +662 645 3732 THAILAND

Asia Medical Assistance Abhijeet Sachdev – Vice President DLF City-ll privat.airambulance@asiamedassist.org M.G Road www.privathealthcaregroup.com New Delhi Tel: +91 9899 198 198

Gurgaon 122002 Fax: +91 1242 235 2527 INDIA

CareFlight International Colin Robshaw – Co-ordinator Westmead Hospital Campus international@careflight.org PO Box 159 www.careflight.org Westmead Tel: +61 1300 655 855

NSW 2145 Fax: +61 2 4751 2995 AUSTRALIA

European Air Ambulance Patrick Schomaker – Director Sales & Mkt 175A, rue de Cessange alert@air-ambulance.com L-1321 www.air-ambulance.com LUXEMBoURG Tel (24 hr): +49 711 7007 7007

Fax: +49 711 7007 7009

Goodmans Rescue 24 Hrs Ground & Air Ambulances Dr Satish K Bhardwaj – Director M-2 Greater Kailash-Part 1 grskb@yahoo.com New Delhi 110048 www.goodmansrescue.com INDIA Tel: +91 11 2923 1665

Mob: +91 98 1001 2126 Fax: +91 11 2923 4665

Hope Ambulance Service Dr Charles Johnson – Medical Director 56 Upavon Road info@hopeambulance.com Singapore 507745 www.hopeambulance.com SINGAPoRE 24hr Tel: +65 6100 1911

Fax: +65 6400 5254

JET ICU Bart Gray – President 17076 Helicopter Drive email@jeticu.com Brooksville www.jeticu.com FL 34604 Tel: +1 877 453 8428

USA Tel: +1 727 524 9825 Fax: +1 727 524 982

Medical Wings Dr Sommart Somsiri – Medical Director 222 Room 3259 m.w@medicalwings.com

Donmuang Int Airport Moo 10 www.medicalwings.com Viphavadee-Rangsit Rd, Sikan Tel: +662 247 3392 Don Muang, Bangkok 10210 Fax:+662 535 4355 THAILAND

Mediflight Chris Craft – Operations Manager Royal Adelaide Hospital info@mediflight.com.au

North Terrace www.mediflight.com.au Adelaide Tel: +61 8 8378 6938 SA 5000 Fax:+61 8 8423 3077 AUSTRALIA

ozevac Anne Mordey – Operations Manager PO Box 299 info@ozevac.com Hampton www.ozevac.com

Victoria 3188 Tel: +61 409 537 333 AUSTRALIA

Pacific Flight Services Pte Ltd Katherine Yeo – Assistant Marketing Mgr ST Aerospace Engineering Bldg charter_flight@pacific.net.sg

Seletar West Camp www.fly-pfs.com Seletar Airport Tel: +65 6481 3756 797796 Fax: +65 6482 1727 SINGAPoRE

Skyservice Air Ambulance David Ewing – VP Int. Market Development YUL/Trudeau Int Airport david_ewing@skyservice.com 9785 Avenue Ryan www.skyservice.com/airambulance

Montreal (Quebec) N AmericaToll Free: +800 463 3482 H9P 1A2 Tel: +1 514 497 7000 CANADA Fax: +1 514 636 0096

South Pacific Air Ambulance Scotty Watson – Managing Director ops@spaa.co.nz NEW ZEALAND www.spaa.co.nz

AUSTRALIA Tel: +64 9256 9000 SINGAPoRE Fax: +64 9256 9111

EURoPEADAC-Ambulance Service Robert Glueck – Marketing & Sales Director Am Westpark 8 info-ambulance@adac.de 81373 Munich www.adac.de/ambulance GERMANY Tel: +49 89 76 76 52 85 24-h alarm centre:

+49 89 76 76 50 05

AeroMed 365 Brian Brooker – Clinical Director Worth Corner Business Cntr brian.brooker@aeromed365.com

Turners Hill Road www.aeromed365.com Pound Hill Tel: +44 8707 596 999 Crawley RH10 7SL Fax: +44 8707 559599 UK

AIR AMBULANCE (CoNT.) AIR AMBULANCE

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Med Call GmbH Michael Diefenbach – CEO Black and Decker Str. 1-3 info@medcallgmbh.com 65510 www.medcallgmbh.com

Idstein Tel: +49 61 2695 3708-0 GERMANY Fax: +49 61 2695 3708-11

Medic’Air International Dr Herve Raffin – General Manager 35 rue Jules Ferry operations@medic-air.eu 93170 Bagnolet www.medicair.com Paris Tel: +33 141 72 1414 FRANCE Fax: +33 148 57 1010

Medical Jet Services & Partner W Dichtl Radetzkystr 19 office@medicaljetservice.com Vienna www.medicaljetservice.com 1030 Tel: +43 1 600 1212 AUSTRIA Fax: +43 1 713 2799-19

Red Star Aviation Mustafa Atac – CEO Sabiha Gokcen Int Airport redstar@redstar-aviation.com J Blok Kurtkoy www.redstar-aviation.com 34912 Tel: +90 216 588 0216

Istanbul Fax: +90 216 588 0225 TURKEY

Skyservice Air Ambulance David Ewing – VP Int. Market Development YUL/Trudeau Int Airport david_ewing@skyservice.com 9785 Avenue Ryan www.skyservice.com/airambulance

Montreal (Quebec) N AmericaToll Free: +800 463 3482 H9P 1A2 Tel: +1 514 497 7000 CANADA Fax: +1 514 636 0096

Swiss Air Ambulance/REGA Walter Stunzi – PR/Marketing Mgr PO Box 1414 ops@rega.ch Zurich Airport www.rega.ch

CH-8058 Tel: +41 333 333 333 SWITZERLAND Fax: +41 44 654 3590

Tyrol Air Ambulance Jakob Ringler – Managing Director PO Box 81 taa@taa.at A-6026 www.taa.at Innsbruck Airport Tel: +43 512 224 220

AUSTRIA Fax: +43 512 288 888

Air Ambulance Network Kirk Pacheco – President 905 Martin Luther King Jr Drive inquiries@airambulancenetwork.com

Suite 330 www.airambulancenetwork.com Tarpon Springs Tel(24hr): +1 727 934 3999 Florida 34689 Tel(toll free): +1 800 327 1966 USA Fax: +1 727 937 0276

Air Ambulance Worldwide Inc. Mark Jones – President 35246 US Hwy 19 North mjones31@tampabay.rr.com

#210 www.airambulanceworldwide.com Palm Harbor Tel: +1 727 781 1198 Florida 34684 Fax: +1 727 786 0897 USA

AirMed International LLC Jeffrey T Tolbert – President 1000 Urban Center Drive mgoodwin@airmed.com Suite 470 www.airmed.com Birmingham Tel: +1 205 443 4840

AL 35242 Fax: +1 205 443 4841 USA Toll Free: +1 877 633 5387

Air Medical Ltd Glenn Salt – Flight Operations Manager Oxford Airport operations@airmed.co.uk Kidlington www.airmed.co.uk Oxfordshire Tel: +44 1865 842 887

OX5 1QX Tel: +44 1865 370 642 UK

Augsburg Air Ambulance Roland Schoberth – Director Roseggerstr 17 info@ambulanzflugdienst.de D-86368 www.ambulanzflugdienst.de Gersthofen Tel: +49 821 299 1020

GERMANY Tel: +49 821 299 2030

EMC Meditrans Servé de Klerk – President Hoevestein 23 info@emc.nl Postbus 4190 www.emc.nl 4900 CD Tel: +31 162 496 000 Oosterhout Fax: +31 8 42 24 64 86

THE NETHERLANDS

Euro-flite Air Ambulance Juhani Missonen – Coordinator Helsinki International Airport juhani.missonen@jetflite.fi PO Box 187 Tel: +358 20510 1900 FIN-01531 Fax: +358 20510 1901

Vantaa FINLAND

European Air Ambulance Patrick Schomaker – Director Sales & Mkt 175A, rue de Cessange alert@air-ambulance.com L-1321 www.air-ambulance.com LUXEMBoURG Tel (24 hr): +49 711 7007 7007

Fax: +49 711 7007 7009

FAI – rent-a-jet AG Volker Lemke – Director Sales & Marketing Flughafenstrasse 100 lemke@fai-ag.de D-90268 Nuremberg www.rent-a-jet.de

GERMANY Tel: +49 911 36009 31 Fax: +49 911 36009 59

German Red Cross Air Amb. Serv. Andreas Speich – Managing Director Aufm Hennekamp 71 a.speich@grcairambulance.de 40225 Düsseldorf www.grcairambulance.de

GERMANY Tel: +49 211 917 49911 NEW

24 hr Alarm: +49 228 230 023 Fax: +49 211 917 49921

Global Medical Support otto Karud – Marketing Director Ullevaal University Hospital gms@snla.no 0407 Oslo www.globalmedicalsupport.com NoRWAY Tel: +47 22 96 50 50

Tel/Fax: +47 22 96 50 51

IFRA Dr Christian Steindl – Director Bahnhofplatz 13/5 office@ifra.at POB 160 www.ifra.at 3500 Krems Tel: +43 2732 825 610

AUSTRIA Fax: +43 2732 851 01

Jet Executive International Charter Günter Krahé – Marketing & Sales Mündelheimer Weg 50 sales@jetexecutive.com D-40472 www.jetexecutive.com Düsseldorf Tel: +49 211 602 7775

GERMANY Fax: +49 211 602 77766 “Homebase FRA & MUC”

JET ICU Bart Gray – President 17076 Helicopter Drive email@jeticu.com Brooksville www.jeticu.com FL 34604 Tel: +1 877 453 8428

USA Tel: +1 727 524 9825 Fax: +1 727 524 982

Mayoral Executive Jet Paulo Vassar – Commercial Director Dominguez Toledo S.A. paulo@mayoral.es 118 La Orotava www.mayoralexecutivejet.com Malaga 29006 Tel: +34 952 048 609

NEW SPAIN Fax: +34 924 048 612

AIR AMBULANCE (CoNT.) AIR AMBULANCE (CoNT.)

International Travel Insurance Journal

42 SERVICEDIRECTORY To have your company listed in the Service Directory email: dave@itij.co.uk

AIR AMBULANCE (CoNT.)

NoRTH AMERICAAerojet Stuart Hayman – President 4631 NW 31st Ave info@aero-jet.com #220 www.aero-jet.com Ft Lauderdale Tel: +1 954 730 9300

FL 33309 Fax: +1 954 485 6564 USA

Aeromedevac Air Ambulance Jesus Mendez – Provider Relations 681 Kenney Street flightrequest@aeromedevac.com Gillespie Field Airport www.aeromedevac.com El Cajon Tel: US: +1 619 284 7910 CA 92020 Tel: Mexico: 00 1-800-832-5087

USA Fax: +1 619 284-7918

Air Ambulance Network Kirk Pacheco – President 905 Martin Luther King Jr Drive inquiries@airambulancenetwork.com

Suite 330 www.airambulancenetwork.com Tarpon Springs Tel(24hr): +1 727 934 3999 Florida 34689 Tel(toll free): +1 800 327 1966 USA Fax: +1 727 937 0276

Air Ambulance Professionals, Inc. Brian L. Weisz – President Ft. Lauderdale Executive Airport sales@airambulanceprof.com 1535 South Perimeter Rd www.airambulanceprof.com Hangar 36B Ft. Lauderdale Tel: +1 954 491 0555

Florida 33309 Fax: +1 954 491 6114 USA

Air Ambulance Specialists, Inc. Donald Jones – President 8001 S.Interport Blvd. info@airaasi.com Suite 250 www.airaasi.com Englewood Toll Free: +1 800 424 7060 CO 80111 Tel: +1 720 875 9182

USA Fax: +1 720 875 9183

Air Ambulance Worldwide Inc. Mark Jones – President 35246 US Hwy 19 North mjones31@tampabay.rr.com #210 www.airambulanceworldwide.com Palm Harbor Tel: +1 727 781 1198 Florida 34684 Fax: +1 727 786 0897

USA

AirMed International LLC Jeffrey T Tolbert – President 1000 Urban Center Drive mgoodwin@airmed.com Suite 470 www.airmed.com Birmingham Tel: +1 205 443 4840

AL 35242 Fax: +1 205 443 4841 USA Toll Free: +1 877 633 5387

American Care Air Ambulance Joel Reynolds – General Manager 8775 Aero Drive americancareair@aol.com Suite 120 www.americancareairambulance.com San Diego Tel: +1 858 627 0515

CA 92123 Fax: +1 858 627 0534 USA

Canadian Global Air Ambulance Jeff McIntosh – President Toronto jmcintosh@canadianglobalair.ca Winnipeg www.canadianglobalair.ca Vancouver Toll Free: +1 800 563 3822 CANADA Tel: +1 204 888 5555

Fax: +1 204 888 9111

European Air Ambulance Patrick Schomaker – Director Sales & Mkt 175A, rue de Cessange alert@air-ambulance.com L-1321 www.air-ambulance.com LUXEMBoURG Tel (24 hr): +49 711 7007 7007

Fax: +49 711 7007 7009

JET ICU Bart Gray – President 17076 Helicopter Drive email@jeticu.com Brooksville www.jeticu.com FL 34604 Tel: +1 877 453 8428

USA Tel: +1 727 524 9825 Fax: +1 727 524 982

Life Flight International Inc. Chris Connor – Operations Victoria International Airport info@lifeflight.ca Viscount Business Center www.lifeflight.ca

103-9800 McDonald Pk Rd Tel: +1 250 655 1630 Sidney, British Columbia Fax: +1 250 656 9394 CANADA

National Air Ambulance George Martinez – Mgr Flight Co-ordination 3495 SW 9th Ave inquiry@nationalairambulance.com Fort Lauderdale www.nationalairambulance.com

FL 33315 Tel: +1 954 359 9900 USA Fax: +1 954 359 9500

Skyservice Air Ambulance David Ewing – VP Int. Market Development YUL/Trudeau Int Airport david_ewing@skyservice.com 9785 Avenue Ryan www.skyservice.com/airambulance

Montreal (Quebec) N AmericaToll Free: +800 463 3482 H9P 1A2 Tel: +1 514 497 7000 CANADA Fax: +1 514 636 0096

AIR AMBULANCE INTERIoRAir Ambulance Technology Egon Kuntner – President A-5282 aat@airambulancetechnology.com Ranshofen www.airambulancetechnology.com

AUSTRIA Tel: +43 7722 85051 Fax: +43 7722 85051-22

AIRCRAFT PERFoRMANCE SoLUTIoNSRAISBECK Engineering Nick Nicholson – Sales Manager 4411 South Ryan Way nick@raisbeck.com Seattle WA98178 www.raisbeck.com

USA Tel: +1 206 723 2000 Fax: +1 206 723 2884

ASSISTANCE CoMPANIESAFRICA

AIMS Bernadette Breton – Managing Director Private Bag X5 contact@aims.org.za Benmore Gardens 2010 www.aims.org.za

Johannesburg Tel: +27 11 245 5777 SoUTH AFRICA Fax: +27 11 783 9277

AMREF Flying Doctor Service Dr Bettina Vadera – Medical Director Wilson Airport emergency@flydoc.org Langata Road www.amref.org PO Box 18617 Tel: +254 20 600 090 Nairobi Fax: +254 20 344 170

KENYA

Netcare 911 International Assistance Brenda Durow - International Assistance Mgr Netcare 911 House assist@netcare.co.za

49 New Road www.netcare911.co.za Halfway House Tel: +27 11 254 1387 Midrand 1685 Fax: +27 11 254 1405 SoUTH AFRICA

West African Rescue Association Florian Zagel - Managing Director Klotey Cresent 6 assist@westafrican-rescue.com

North Labone www.westafrican-rescue.com Accra Tel: +233 21 781 258 GHANA Tel: +233 244 312 496/7 Fax: +233 21 781 259

AUSTRALASIAAsia Assistance Partners Siriporn Wongurai – Int. Ops. Director 184/235 Forum Tower thailand@aapartners.net 36 Flr Ratchadapisek Rd www.aapartners.net Huaykwang Tel: +662 645 3733-5

Bangkok 10320 Fax: +662 645 3732 THAILAND

Asia Medical Assistance India Abhijeet Sachdev – Vice President DLF City-ll opsindia@asamedassist.org

M.G Road www.privathealthcaregroup.com New Delhi Tel: +91 9899 198 198 Gurgaon 122002 Fax:+91 2440 147 28 INDIA

Asia Medical Assistance Thailand Abhijeet Sachdev – Vice President 50 Soi Sukhumvit opsbangkok@asamedassist.org

19 Sukhumvit Road www.privathealthcaregroup.com Klongtoey Nau, Wattana Tel: +66 225 833 55 Bangkok 10110 Tel: +91 9899 198 198 THAILAND Fax:+66 225 822 77

Assistance online Bertrand Guichoux – CEO Zendai Cube Edifice 6/F bertrand-guichoux@assistance-online.com.cn

58, Changliu Road, www.assistanceonline-china.com Pudong Tel: +86 21 6104 9500 200135 Shanghai Fax: +86 21 6104 9484 CHINA

Customer Care Pty Ltd Janine Benson – Operations Manager Level 3 janineb@customercare.com.au

60 Miller Street www.customercare.com.au North Sydney 2060 Tel: +612 9202 8222 NSW Fax: +612 9202 8220 AUSTRALIA

First Assistance Mary-Jo McDonald – General Manager PO Box 17-310 rescue@firstassistance.co.nz Greenlane www.firstassistance.co.nz Auckland Tel: +64 9 356 1650

NEW ZEALAND Fax: +64 9 525 1278

Global Assistance & Healthcare Mario Babin – Chief Executive Officer Jalan Pattimura global@global-assistance.net 15 Kebayoran Baru www.global-assistance.net Jakaita Tel: +62 21 725 8115 12110 Fax: +62 21 725 7961

INDoNESIA

South Pacific Air Ambulance Scotty Watson – Managing Director ops@spaa.co.nz NEW ZEALAND www.spaa.co.nz

AUSTRALIA Tel: +64 9256 9000 SINGAPoRE Fax: +64 9256 9111

EURoPE & THE MEDITERRANEANADAC-Ambulance Service Robert Glueck – Marketing & Sales Director Am Westpark 8 info-ambulance@adac.de 81373 Munich www.adac.de/ambulance GERMANY Tel: +49 89 76 76 52 85 24-h alarm centre:

+49 89 76 76 50 05

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AGI Assistance Dr Jacques Guedj – Medical Director 99 Bis, Avenue du agiassistance@free.fr Général Leclerc 75014 Paris Tel: +33 1 43 95 00 55

FRANCE Fax: +33 1 43 95 00 66

ARC Transistance Hans Biekmann – Network Director Avenue des Olympiades 2 hans.biekmann@arctransistance.com 1140 Brussels www.arctransistance.com BELGIUM Tel: +32 2 706 6660

Fax: +32 2 706 6601

Assistance Plus Liana Absaliamova – General Manager 6th Floor info@assistplus.ru 19 Zhukov Proezd www.assistplus.ru Moscow 115054 Tel: +7 495 748 8735

RUSSIA Fax: +7 495 748 8741

Atlantic Assist Adriano Gouveia – Operations Manager Rua da Alfandega 10-2.D info@atlanticassist.com PO Box 750 www.atlanticassist.com 9000-056 Funchal Tel: +351 291 214 200 Madeira Fax: +351 291 214 202

PoRTUGAL

Express Assist Vardan Azatian – General Director 11-th Radialnaya, 2 eac@expressassist.ru

115404 www.expressassist.ru Moscow Tel: +7 495 775 2090 RUSSIA Fax: +7 495 775 2091

Global Voyager Assistance Costas Danilenko – CEO PO Box II cdanilenko@gvassistance.com 125124 www.gvassistance.com Moscow Tel: +7 495 775 0999

RUSSIA Fax: +7 495 775 0998

Mapfre Asistencia Natalia Jorquera – Int Com & Mkt Mgr Sor Ángela de la Cruz, 6 najorqu@mapfre.com 28020 Madrid www.mapfreasistencia.com SPAIN Tel: +34 91 581 4998

Fax: +34 91 581 1850

Marm Assistance Jill Atac – CEO Sabiha Gokcen Int Airport marm@marmassistance.com J Blok Kurtkoy www.marmassistance.com 34912 Tel: +90 216 588 0588 Istanbul Fax: +90 216 588 0602

TURKEY

med con team GmbH Michael Weinlich – Managing Director Gerhard-Kindler-Str.8 operations@medconteam.com 72770 Reutlingen www.medconteam.com Tel: +49 7121 433 660

GERMANY Fax: +49 7121 433 619

MK International Emergency Serv Minas Kaloumenos – General Manager 95, Ioanninon Street mk@mkassist.gr 10444 Tel: +30 210 5154600 Athens Fax: +30 210 5131660

GREECE

Save Assistance France Franck Molinier – Director of Business Dev. 19 rue de Provence molinier@saveassistance.com 78310 www.saveassistance.com

Maurepas Tel: +33 13062 6752 24hr Alarm Cntr: +33 13062 1122 FRANCE

SoS International Helle Drager – Comms & Marketing Manager Nitivej 6 sos@sos.eu DK-2000 www.sos.eu

Frederiksberg Tel: +45 7010 5055 Copenhagen Fax: +45 7010 5056 DENMARK

TBS Team 24 d.o.o Edvard Hojnik – General Manager Ljubljanska Ulica 42 info@tbs-team24.com

2000 Maribor www.tbs-team24.com SLoVENIJA Tel: +386 2618 2301 (Croatia, Slovenia, Fax: +386 2618 5800 Bosnia-Herzegovina, Macedonia, Serbia-Montenegro, Kosovo)

NoRTH & CENTRAL AMERICAASISTUR Emilio Guevara – Managing Director Prado 208 asisten@asistur.cu e/ Colon y Trocadero www.asistur.cu Habana Vieja Tel: +537 8664499

Ciudad Habana 10100 Fax: +537 8668087 CUBA

Assured Assistance Inc. Martha Turnbull – Director of Operations 6880 Financial Drive martha.turnbull@rbc.com Mississauga Tel: +1 905 816 2495

Ontario Fax: +1 905 813 4719 L5N 7Y5 CANADA

ASSISTANCE CoMPANIES (CoNT.)ASSISTANCE CoMPANIES (CoNT.)Global Excel Management Brian Allatt – CEO 73 Queen Street corpinfo@globalexcel.ca Lennoxville, Quebec www.globalexcel.ca JIM IJ3, CANADA Tel: +1 866 566 1130

4242 Cranmore Court Fax: +1 819 566 8335 Belle Isle, Fl 32812, USA

Medex Assistance Corporation Linda McGee – SVP of Sales 8501 LaSalle Road info@medexassist.com Suite 200 www.medexassist.com Baltimore Tel: +1 410 453 6300

MD 21286 Fax: +1 410 453 6301 USA

on Call International Michael J. Kelly – President & CEO One Delaware Drive sales@oncallinternational.com Salem www.oncallinternational.com

NH Tel: + 888 289 0567 03079 Fax: +1 603 328 1770 USA

oneWorld Assist Taka Katsube – Dir Assist & Cost Mngment 10th Floor tkat@oneworldassist.com 6081 No.3 Road www.oneworldassist.com

Richmond, BC Tel: +1 604 303 2113 V6Y 2B2 Fax: +1 604 276 4593 CANADA

SelectCare Worldwide Jacques LeTual – Director of Business Dev. #1201 jacques.letual@selectcareworldwide.com 438 University Avenue www.selectcareworldwide.com

Toronto Tel: +1 416 340 7265 NEW

M5G 2K8 Fax: +1 800 533 2350 CANADA Toll Free: +1 866 261 6718

TMCA Margaret Whartom – Ops Manager 217 Broadway margaret@tmcatravel.com Suite 600 www.tmcatravel.com NYC Tel: +1 212 964 8580

NY 10007 Fax: +1 212 406 1520 USA

World Travel Protection Canada Inc. Dr Ron Mayer – President & Chf Med Officer 400 University Avenue ron.mayer@wtp.ca 15th Floor www.wtp.ca

Toronto Tel: +1 416 977 3565 Ontario M5G IS7 Fax: +1 416 205 4676 CANADA

SoUTH AMERICACardinal Assistance Alberto C. Chapur – President Av. Cordoba 890 7° piso albertoch@cardinalassistance.com (C 1054AAU) www. cardinalassistance.com

Capital Federal Tel: +54 11 4129 7514 Buenos Aires ARGENTINA

CATASTRoPHIC CLAIMS SPECIALISTDr Colin Plotkin Consulting Dr Colin Plotkin – Managing Director 27-3088 Francis Road colin@plotkinconsulting.com Richmond Tel: +1 604 241 9677 British Columbia Fax: +1 604 241 0733 V7C 5V9

CANADA

CoST CoNTAINMENTAFRICA

AIMS Bernadette Breton – Managing Director Private Bag X5 contact@aims.org.za Benmore Gardens www.aims.org.za 2010 Tel: +27 11 245 5777

Johannesburg Fax: +27 11 783 9277 SoUTH AFRICA

EURoPEChargeCare International Christiane Burniston – Managing Director Monument Business Park admin@chargecare.co.uk 1D, Park Offices www.chargecare.co.uk Warpsgrove Lane Tel: +44 1865 400 007

Chalgrove, Oxford Fax: +44 1865 400 707 UK Mobile: +44 777 44 35 649

Marm Assistance Jill Atac – CEO Sabiha Gokcen Int Airport marm@marmassistance.com J Blok Kurtkoy www.marmassistance.com

34912 Tel: +90 216 588 0588 Istanbul Fax: +90 216 588 0602 TURKEY

Medical Claims International Spain Fatima Guillen Grande – Managing Director C/Ciudad de Aguilas No.2 mcispain@mcimanager.com Local 2A www.mcimanager.com Madrid 28030 Tel: 00 34 913 016 145

SPAIN Fax: 00 34 913 016 160

NEW

International Travel Insurance Journal

44 SERVICEDIRECTORY To have your company listed in the Service Directory email: dave@itij.co.uk

CoST CoNTAINMENT (CoNT.) CoMMERCIAL REPATRIATIoN SPECIALISTS

MedEscort International Craig Poliner – President 1730 Vultee Street medescort@fast.net Allentown www.medescort.com PA 18103 Toll Free: +1 800 255 7182

Tel (US): 610 791 3111 USA Fax: +1 610 791 9189

Voyageur Aeromedical Travel Marc Lucas – General Manager Voyageur Buildings marc@voyageur.co.uk 43 Colston Street www.voyageur.co.uk Bristol Tel: +44 (0)117 927 3554 BS1 5AX Fax: +44 (0)117 925 5940

UK

FUNERAL DIRECToRSAntea International Funeral Assistance Marica Hunyadi – Managing Director Mihálkovics utca 12 antea@t-online.hu H-1091 www.antea.hu Budapest Tel: +36 30944 0944 HUNGARY Fax: +36 1216 6107

Funeral Home AURIGA Ltd. Helen Pradova – Chief of Intnl Dept B. Nmcové Street 1052/1 pradova.auriga@iol.cz 412 01 aurigalt@iol.cz Litomerice www.funeral-assistance.cz CZECH REPUBLIC Tel: +420 724 257 899

Fax: +420 416 735 800

Funeralcare International Roger Waddington 221 Upper Richmond Road funeralcare.international@letsco-operate.com Putney www.co-operativefuneralcare.co.uk

London Tel: +44 20 8788 5303 SW15 6SQ Fax: +44 20 8788 2525 UK

Global Networks Funeral Assistance Cristina Almudi – Managing Director 23 Blindmans Lane info@gnfa.info Cheshunt www.gnfa.info Hertfordshire Tel: +44 1992 640 066 EN8 9DR Fax: +44 1992 785 030

UK

John Allison Monkhouse Co., Ltd (Thailand) Apple Kaewprasert – General Manager President Park View Tower apple@monkhouse.com.au 99/243 (30B) Pine Tower www. monkhouse.com.au Sukhumvit soi 24 Tel: +66 2382 5345-7

Klongton Klongtoey, Bangkok Fax: +66 81 584 5942 THAILAND

KCH Repatriation Specialists Robert Rowntree – Managing Director 83 Westbourne Grove info@kchrepatriation.com Bayswater www. kchrepatriation.com London W2 4UL Tel: +44 20 7313 6920

UK Fax: +44 20 7313 6999

MK Funeral & Transportation Services Minas Kaloumenos – General Manager 95, Ioanninon Street mk@mkassist.gr 10444 Tel: +30 210 5154600 Athens Fax: +30 210 5131660

GREECE

Rowland Brothers International Melanie Walkling – Partner 299-305 Whitehorse Road info@rowlandbrothersinternational.co.uk West Croydon www.rowlandbrothersinternational.co.uk Surrey Tel: +44 20 8684 2324

CR0 2HR Fax: +44 20 8684 8000 UK

Servilusa Vanda Castro – Manager Int Dept Agencias Funerarias SA internacional@servilusa.pt International Dept. www.servilusa.pt Rua do Entreposto Industrial Tel: +35 121 470 6300

8-2 Esq, 2610-135 Amadora Fax: +35 121 470 6499 PoRTUGAL

ZEGA Roberto Funeral Home Cristina Zega – General Manager Via Clelia, 26/28 cristina@zega.it 00181 Rome www.zega.it ITALY Tel: +39 06 78 40 300

Fax: +39 06 78 02 488

HEALTHCARE CLINICSAmerican Medical Center Natalia oleinik – Insurance & Assistance Companies 26 build 6 Prospekt Mira info@amcenter.ru 129090 www.amcenter.ru

Moscow Tel: +7 495 933 7700 RUSSIA Fax: +7 495 933 7701

Luzdoc Dr Maria Alica Silva – Medical Director Rua 25 de Abril info@luzdoc.com 12 Vila da Luz www.luzdoc.com

8600-174 LGS Tel: +351 282 780 700 PoRTUGAL Fax: +351 282 780 709

oneWorld Assist Taka Katsube – Dir Assist & Cost Mngment 10th Floor tkat@oneworldassist.com 6081 No.3 Road www. .com

Richmond, BC Tel: +1 604 303 2113 V6Y 2B2 Fax: +1 604 276 4593 CANADA

NoRTH AMERICAGlobal Excel Management Brian Allatt – CEO 73 Queen Street, Lennoxville corpinfo@globalexcel.ca Quebec, JIM 1J3, CANADA www.globalexcel.ca

4242 Cranmore Court Tel: +1 866 566 1130 Belle Isle, FL 32812, USA Fax: +1 819 566 8335

Global Medical Management Raija Itzchaki – COO 7901 SW 36th Street contact@gmmusa.com Suite 100 www.gmmusa.com

Davie Tel: +1 954 370 6404 FL 33328 Fax: +1 954 370 8613 USA

Health Systems International Peggy Novotny – VP / Gen Mngr Intl Bus. 5975 Castle Creek Parkway pnovotny@us-hsi.com Suite 100 www.us-hsi.com Indianapolis Tel: +1 317 806 2000

IN 46250 Fax: +1 317 806 2033 USA

Medsave USA Jeffrey Baker – President 390 Rabro Drive jbaker@medsaveusa.com Hauppauge www.medsaveusa.com NY 11788 Tel: +1 516 622 1784

USA Fax: +1 516 294 6761

SelectCare Worldwide Jacques LeTual – Director of Business Dev. #1201 jacques.letual@selectcareworldwide.com 438 University Avenue www.selectcareworldwide.com

Toronto Tel: +1 416 340 7265 NEW

M5G 2K8 Fax: +1 800 533 2350 CANADA Toll Free: +1 866 261 6718

Star Healthcare Gigi Galen – President 850 7th Avenue ggontheroad@aol.com Suit 803 www.starhealthcarenet.com New York 10019 Tel: +1 212 581 8228

USA Fax: +1 212 581 8272

TMCA Margaret Whartom – Ops Manager 217 Broadway margaret@tmcatravel.com Suite 600 www.tmcatravel.com NYC Tel: +1 212 964 8580 NY 10007 Fax: +1 212 406 1520

USA

United Health International Philip Brun – Director of Business Development 15500 New Barn Road p.brun@hygeia.net Suite 200 www.hygeia.net Miami Lakes Tel: +1 305 594 9291 Ext.3312 FL 33014 Fax: +1 305 594 9201

USA

CLAIMS MANAGEMENTGlobal Assistance & Healthcare Nathan Hannah – TPA Mgr Asia/Pac Jalan Pattimura nathan.hannah@global-assistance.net 15 Kebayoran Baru www.global-assistance.net Jakaita Tel: +62 21 725 8115

12110 Fax: +62 21 725 8951 INDoNESIA

Global Excel Management Brian Allatt – CEO 73 Queen Street, Lennoxville corpinfo@globalexcel.ca Quebec, JIM 1J3, CANADA www.globalexcel.ca 4242 Cranmore Court Tel: +1 866 566 1130

Belle Isle, FL 32812 USA Fax: +1 819 566 8335

SelectCare Worldwide Jacques LeTual – Director of Business Dev. #1201 jacques.letual@selectcareworldwide.com 438 University Avenue www.selectcareworldwide.com

Toronto Tel: +1 416 340 7265 NEW

M5G 2K8 Fax: +1 800 533 2350 CANADA Toll Free: +1 866 261 6718

Star Healthcare Gigi Galen – President 850 7th Avenue ggontheroad@aol.com Suit 803 www.starhealthcarenet.com New York Tel: +1 212 581 8228 10019 Fax: +1 212 581 8272

USA

CLAIMS SUBRoGATIoN

Medsave USA Jeffrey Baker – President 390 Rabro Drive jbaker@medsaveusa.com Hauppauge www.medsaveusa.com NY 11788 Tel: +1 516 622 1784

USA Fax: +1 516 294 6761

www.itij.co.uk

45SERVICEDIRECTORYcall +44 (0) 117 925 5151 To make an alteration to a listing email: dave@itij.co.uk

HEALTHCARE CLINICS (CoNT.)AUSTRALASIA

CareFlight International Sue Robshaw – Co-ordinator Westmead Hospital Campus international@careflight.org PO Box 159 www.careflight.org

Westmead Tel: +61 1300 655 855 NSW 2145 Fax:+61 2 4751 2995 AUSTRALIA

Medic’Air International 每递安国际 Dr Huaqun Gao – Medical Director 885 Renmin Road operations@medic-air.cn Huaihai China Building www.medic-air.com Room 808 Tel: +86 2163 558289 200010 Shanghai Fax: +86 2163 558285

CHINA

Medical Wings Dr Sommart Somsiri – Medical Director 222 Room 3259 m.w@medicalwings.com

Bangkok Int Airport www.medicalwings.com Viphavadee-Rangsit Rd, Sikan Tel: +662 247 3392 Don Muang, Bangkok 10210 Fax:+662 535 4355 THAILAND

Mediflight Debra o’Brien – Operations Manager Royal Adelaide Hospital info@mediflight.com.au North Terrace www.mediflight.com.au

Adelaide Tel: +61 8 8223 6618 SA 5000 Fax: +61 8 8223 6340 AUSTRALIA

EURoPEAeroMed 365 Brian Brooker – Clinical Director

Worth Corner Business Cntr brian.brooker@aeromed365.com Turners Hill Road www.aeromed365.com

Pound Hill Tel: +44 8707 596 999 Crawley RH10 7SL Fax: +44 8707 559599 UK

EMC Meditrans Servé de Klerk – President Hoevestein 23 info@emc.nl Postbus 4190 www.emc.nl 4900 CD Tel: +31 162 496 000 Oosterhout Fax: +31 8 42 24 64 86

THE NETHERLANDS

Voyageur Aeromedical Travel Marc Lucas – General Manager Voyageur Buildings marc@voyageur.co.uk 43 Colston Street www.voyageur.co.uk Bristol Tel: +44 (0)117 927 3554 BS1 5AX Fax: +44 (0)117 925 5940

UK

NoRTH AMERICAAeromedevac Air Ambulance Jesus Mendez – Provider Relations 681 Kenney Street flightrequest@aeromedevac.com Gillespie Field Airport www.aeromedevac.com El Cajon Tel: US: +1 619 284 7910 CA 92020 Tel: Mexico: 00 1-800-832-5087

USA Fax: +1 619 284-7918

Air Ambulance Network Kirk Pacheco – President 905 Martin Luther King Jr Drive inquiries@airambulancenetwork.com

Suite 330 www.airambulancenetwork.com Tarpon Springs Tel(24hr): +1 727 934 3999 Florida 34689 Tel(toll free): +1 800 327 1966 USA Fax: +1 727 937 0276

Air Ambulance Worldwide Inc. Mark Jones – President 35246 US Hwy 19 North mjones31@tampabay.rr.com #210 www.airambulanceworldwide.com Palm Harbor Tel: +1 727 781 1198

Florida 34684 Fax: +1 727 786 0897 USA

American Care Air Ambulance Joel Reynolds – General Manager 8775 Aero Drive americancareair@aol.com Suite 120 www.americancareairambulance.com San Diego Tel: +1 858 627 0515

CA 92123 Fax:+1 858 627 0534 USA

Life Flight International Inc. Chris Connor – Operations Victoria International Airport info@lifeflight.ca Viscount Business Center www.lifeflight.ca

103-9800 McDonald Pk Rd Tel: +1 250 655 1630 Sidney, British Columbia Fax: +1 250 656 9394 CANADA

National Air Ambulance George Martinez – Mgr Flight Co-ordination 3495 SW 9th Ave inquiry@nationalairambulance.com Fort Lauderdale www.nationalairambulance.com

FL 33315 Tel: +1 954 359 9900 USA Fax: +1 954 359 9500

MedEscort International Craig Poliner – President 1730 Vultee Street medescort@fast.net Allentown www.medescort.com PA 18103 Toll Free: +1 800 255 7182

Tel (US): 610 791 3111 USA Fax: +1 610 791 9189

MEDICAL ESCoRT oN CoMM. AIRLINES (CoNT.)Number one Health Group Dr Charlie Easmon – Director 1 Harley Street info@numberonehealth.co.uk London www.numberonehealth.co.uk

W1G 9QD Tel: +44 207 307 8756 UK Fax: +44 207 504 3758

HoSPITALSASIA

Bangkok Hospital Medical Center Judy Mitchell – Third Party Payor Services Bangkok International Hospital judy@bgh.co.th 2 Soi Soonvijai 7 www.bangkokhospital.com New Petchburi Road Tel: +66 2310 3000

Bangkok 10320 Fax: +66 2310 3105 THAILAND

Piyavate Hospital Intl. Health Care Dr. Tanatip Suppradit – CEO Piyavate International Hospital akanit@piyavate.net 998 Rimklongsamsaen Rd. www.piyavate.com (Rama IX Rd.), Bangkapi, Tel: +66 2625 6500

Huay Kwang, Bangkok 10310 Fax: +66 2625 6890 THAILAND

Privat Hospital Abhijeet Sachdev – Vice President DLF City-ll info@privathealthcaregroup.com M.G Road www.privathealthcaregroup.com New Delhi Tel: +91 9899 198 198

Gurgaon 122002 Fax: +91 124 235 3794 INDIA

Wockhardt Hospitals Pradeep Thukral – Head International Mrktg Mulund Goregaon pthukral@wockhardt.com, wockhosp@gmail.com Link Road www.wockhardthospitals.net Mumbai Tel: +91 9819015749 400 078 Tel: +91 22 26596502

INDIA Fax: +91-22-55994242

EURoPEAmerican Medical Center Natalia oleinik – Insurance & Assistance Companies 26 build 6 Prospekt Mira info@amcenter.ru 129090 www.amcenter.ru

Moscow Tel: +7 495 933 7700 RUSSIA Fax: +7 495 933 7701

Xanit Hospital de Benalmadena Dr. Juan Bosco Rodriguez Hurtado – Director Camino de Gilabert s/n xanit@xanit.net Benalmadena www.xanit.net 29630 Tel: +34 952 367 190

Malaga Fax: +34 952 367 191 SPAIN

NoRTH AMERICABaptist Health Int. Center of Miami Yohandra Fuentes – Business Director 8940 North Kendall Drive international@baptisthealth.net Suite 601-E www.baptisthealth.net/international Miami Tel: +1 786 596 2373 Fl 33176 Fax: +1 786 596 5979

USA

Jackson Memorial Hospital Int. Abbe Bendell – Interim Vice President Jackson Medical Towers info@jmhi.org East Tower, Suite 829 www.jmhi.org 1500 NW 12th Avenue 24 hr: +1 305 355 1212 Miami, FL 33136-9998 Tel: +1 305 355 5544

USA Fax: +1 305 355 5545

University of Miami Health System Jose Quesada M.D., M.B.A. – Dir Finance & Operations 1099 N.W. 14th Street ihcinfo@med.miami.edu Miami www.uhealthinternational.com Florida Toll Free: +1 877 442 8676 USA Tel: +1 305 243 9100

Fax: +1 305 243 9101

LEGAL SERVICESPannone LLP Andrew Morton – Head of Travel Litigation 123 Deansgate law@pannone.co.uk Manchester www.pannone.com M3 2BU Tel: +44 (0)161 909 3000 UK Fax: +44 (0)161 909 4444

MEDICAL ESCoRT oN CoMMERCIAL AIRLINES

AFRICAAMREF Flying Doctor Service Dr Bettina Vadera – Medical Director Wilson Airport emergency@flydoc.org Langata Road www.amref.org PO Box 18617 Tel: +254 20 600 090

Nairobi Fax: +254 20 344 170 KENYA

International Travel Insurance Journal

46 SERVICEDIRECTORY To have your company listed in the Service Directory email: dave@itij.co.uk

Bandits become tour guidesBritish newspapers have reported moves by tourism authorities in Rajasthan, India to recruit former bandits as tour guides, offering tourists the chance of guided tours of high-crime areas. The authorities believe that the chance to experience the legends of notorious criminals will draw in thousands more curious foreigners to the region. While the problem of banditry is endemic in India, many criminals are seen as heroes to the poor – Phoolan Devi, known as the ‘bandit Queen’, murdered many high caste Indians, but was so popular upon her release from jail that she became a member of parliament.

Under the new scheme in Rajasthan, recently surrendered bandits, locally known as dacoits, will entertain the foreign visitors under the watchful eyes of government offi cials. As part of their guided tour, tourists will be taken to bandit-infested areas in the Chamba Valley, where they will meet local high-ranking criminals and follow a ‘dacoit trail’ to see where they live, as well as being allowed to visit the scenes of the bandits’ worst crimes.One travel industry offi cial was quoted as saying: “The very idea of having the morning cuppa with a bandit on the banks of the Charmal will appeal to tourists.” The whole Chambal Valley remains an area in the hands of the bandit, where there are regular shoot-outs between gangs and the police. Another addition to the ‘extreme sports’ coverage

of a travel insurance policy?

A step too far?An airport in the UK has taken political correctness a step too far, after an advertisement for a new air traffi c controller was made available in braille and audio format – despite the fact that an applicant

must have 20/20 vision in order to carry out the role. Operators of St Mary’s Airport on the Isles of Scilly say they are merely adhering to equal opportunity guidelines in order to avoid accusations of discrimination.The advertisement for the third air traffi c controller states that applicants must have excellent vision in order to guide aircraft safely into the hilltop airport, which is often fogbound. Yet at the bottom of the advertisement is a note that states: “If you require this document in an alternative language, larger text, braille, easy read or in an audio format, please contact the Community Relations Offi cer.”

Space fl ight for air hostessA French fl ight attendant has won a fl ight to the edge of space, after picking up her KitKat wrapper from the bin! The wrapper contained a winning code for a competition to fl y into sub-orbital space onboard a new Rocketplane spacecraft.Mathilde Epron said she bought the chocolate bar at her local supermarket, but threw the wrapper away, thinking ‘it’s only other people that win’. Two hours later, she returned to try her luck, found the wrapper and discovered the winner’s code. Ms Epron told a French radio station that ‘for someone who works in air travel it’s really a dream come true’.

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DIAry DAteS2 October

Life and Pensions ItaliaMilan, Italy

www.life-pensions.com

12-15 OctoberGlobal Business Development Institute 10th Annual Conference

Las Vegas, NV, USwww.gbdi-conference.org/8.html

14-17 October15th International Association of Insurance Supervisors

Budapest, Hungarywww.iais2008.org

30 OctoberSolvency II and Risk Management for European Insurers

Brusselswww.life-pensions.com

5-6 NovemberTh e IEA & Marketforce’s 8th Annual Conference

� e Queen Elizabeth II Conference CentreLondon, UK

10-14 NovemberInternational Travel Insurance Conference (ITIC)

Intercontinental Hotel, Budapest, Hungarywww.itic.org.uk

11-12 NovemberTh e Reactions Insurance Conference 2008

� e Westin, Times SquareNew York, US

14 NovemberWorkplace Safety and Insurance Conference

Lancaster House, Toronto, Ontario, Canada

23-26 NovemberDIFC Week 2008

Dubai, UAEwww.arabianbusiness.com

3-5 December12th Annual Texas Workforce Conference

Grand Hyatt, San Antonio,Texas, USwww.riskvue.com/calendar

6-9 DecemberNAIC National Winter Meeting

Gaylord Texan Resort and Convention CenterGrapevine, TX, US

www.riskvue.com/calendar

7-10 DecemberSociety for Risk Analysis Annual Meeting

Boston, Massachusetts, USwww.riskvue.com/calendar

15-17 December6th GCC and Global Financial Markets Summit

Dubai, UAEwww.arabianbusiness.com

Grapevine

MEDICAL SCREENINGTravel & Medical Insurance Services Lara Suttie – Call Centre Manager 1st Flr Suite, West House sales@travelandmedical.co.uk 46 High Street www.travelandmedical.co.uk Orpington Tel: +44 845 058 8000

Kent BR6 0JQ Fax: +44 845 053 3000 UK

Travel Screen Sandra Howell – General Manager The Seedbed Centre info@travelscreen.co.uk Vanguard Way www.travelscreen.co.uk Shoeburyness Tel: +44 1702 587 007 Essex SS3 9QY Fax: +44 1702 584 731

UK

WEB & MEDIA ADVERTISINGV Creative Design Steve Annette – New Media Director Voyageur Buildings info@vcreativedesign.co.uk 43 Colston Street www.vcreativedesign.co.uk Bristol Tel: +44 (0)117 922 6600 BS1 5AX Fax: +44 (0)117 925 2040

UK

MEDICAL PRoVIDERAMREF Flying Doctor Service Dr Bettina Vadera – Medical Director Wilson Airport emergency@flydoc.org Langata Road www.amref.org PO Box 18617 Tel: +254 20 600 090 Nairobi Fax: +254 20 344 170

KENYA

Atlantic Assist Adriano Gouveia – Operations Manager Rua da Alfandega 10-2.D info@atlanticassist.com PO Box 750 www.atlanticassist.com 9000-056 Funchal Tel: +351 291 214 200

Madeira Fax: +351 291 214 202 PoRTUGAL

TRAVEL AGENTSVoyageur Aeromedical Travel Marc Lucas – General Manager Voyageur Buildings marc@voyageur.co.uk 43 Colston Street www.voyageur.co.uk Bristol Tel: +44 (0)117 927 3554 BS1 5AX Fax: +44 (0)117 925 5940

UK

47ONTHEMOVE

www.itij.co.uk

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

Movers and shakers at Aon

AIG focuses on travel

Zurich chooses Bouts

Groupama appoints new claims director

Bhandari takes on additional role

Merlin opens London office

Aon UK has revamped its public sector risks team under new national head Phil Tompsett, with the goal of bringing further flair and commitment to public

sector risk management to help reduce potentially crippling claims from rising litigation. Phil’s other goal is to offer support to risk managers in the public sector by bringing in talent and expertise from Aon, such as in fine art for museums and marine knowledge for local authority ports.

Phil commented: “The new Corporate Manslaughter Act, ever-present flood threats and data loss issues mean that managing risk is more important than ever for the public sector. Unfortunately, risk managers can be hampered by restrictive European legislation and fixed criteria from the procurement team, which can potentially reduce the flair seen in the commercial works in terms of managing risk.”Elsewhere in the company, Mark Chessher has been appointed to the position of chief financial officer of Aon Limited and Aon Risk Services (UK). Mark will join the company later in the year, subject to approval from the Financial Services Authority, and will sit on the board, replacing John Cullen, who was promoted earlier this year. Mark joins Aon from Zurich Financial Services, where he was CFO of the North American larger corporate customer division.Meanwhile, as part of the ongoing leadership restructure, Aon Risk Services has also appointed Chris Dale as branch director in Sheffield, and Graeme Cant as branch director of Aberdeen and Newcastle. Chris has been given the task of consolidating and growing the company’s position in the region, as well as ensuring clients and prospective clients receive the best possible service. Graeme will be responsible for the day-to-day management of the Aberdeen and Newcastle offices, with an emphasis on growing revenue through the development of existing client accounts.The Aon Risk Services team on the Isle of Man has also received a boost recently, with the appointment of Gaynor Brough as business development director within Aon Global’s captive team. Gaynor will manage all aspects of business development, including the growth of existing accounts, as well as creating and implementing strategies to capture new lines of business.

AIG UK is maintaining its focus on travel insurance with the appointments of two new people to its business development team. Adam Finch has now stepped in as the firm’s head of sales and account management for travel insurance, bringing with him over 16 years of experience within the marketplace. Adam joins AIG from Preferential Insurance Services Ltd, where he was involved in growing the company’s portfolio of travel insurance clients across all sectors.Said Adam of the appointment: “It was a very easy decision for me to join AIG UK. It is recognised as a market-leading supplier of travel insurance products and is one of the few insurers that views travel insurance as a priority product worthy of heavy investment; the recent

launch of AIG Travel Assist goes to show this.”Meanwhile, Victoria Lawson has joined the company from her business development role with Mondial Assistance UK. Victoria is a specialist in identifying new revenue streams and has previous experience

of working on pan-European accounts. Speaking on her appointment as account manager, she said: “I’m excited to be joining a company which boasts such an impressive, blue-chip client base and places importance on investing in new innovative technological solutions.”

Zurich Financial Services Group has announced that Theo Bouts will succeed Thomas Buess, who has decided to pursue opportunities elsewhere. Theo, currently chief executive officer of the European Direct Business and Partnership unit of Zurich, will transition to the role of chief operating officer of Global Life Cover over a period of several weeks. In his new role, Theo will focus on implementing the strategy of Global Life in the areas of operational transformation and platform convergence. Mario Greco, CEO of Global Life, said: “This internal appointment affirms once more the strength of our internal talent, we wish Theo all the best for his endeavours.”

Groupama Insurances has announced that Phil Bird, currently non-motor and SME underwriting director at the insurer, has been chosen as claims director for the company, and is to take up his new position on 1 October this year. In his new role, Phil will report to managing director Laurent Matras, and will head a claims team of over 250 employees based in London. He will also be responsible for the technical integrity and operational effectiveness of UK claims operations and will assume line control of the firm’s three claims centres and the current head office claims team.Phil joined Groupama in 2004 from AXA, where he held the position of head of product development.Commenting on the appointment, Laurent Matras said: “Phil’s extensive experience, coupled with his deep knowledge and understanding of our business means that he is ideally placed to move across and manage our claims operations, an area of the company that remains fundamental to the continuing success of Groupama Insurances.”Phil added: “This new role will offer me an exciting new challenge and is one that I really relish. Groupama Insurances has an award-winning claims team that enjoys considerable respect within the industry and offers high levels of customer satisfaction.”Elsewhere in the business, Groupama has appointed David Ragan as group compliance officer, following the retirement of Colin Darnell. In his new position, David will be responsible for addressing current and forthcoming regulatory issues, advising on regulatory risks that will impact the business, and offering advice to areas of the business that must be compliant with rules set by the Financial Services Authority (FSA). His role also requires him to monitor

and report on regulatory aspects of the company as well as close communication with the FSA.Rosemary Whitfield-Jones, to whom David will be reporting, said: “David brings a wealth of knowledge and experience in compliance management. This is a critical area of our business and we believe David has the right skill set to ensure Groupama continues to operate within the current regulatory regime whilst working closely

with the FSA to understand and address and new regulatory changes that arise.”Before joining Groupama, David was the property and casualty compliance officer for ACE European Group, where he was responsible for planning and managing the firm’s commercial insurance regulation activity in Europe.

Assist America Inc., a global emergency assistance provider, has announced that Abhijit Bhandari has been appointed a director of sales and marketing for Assist America Asia Ltd, the company’s affiliate in the Middle East. The new role is in addition to Abhijit’s existing job as the managing director of the company’s India affiliate, Assist

America Medical Emergency Services (Pvt.) Ltd.Originally from Jaipur, Abhijit worked for many years in sales and marketing before joining Assist America in 2006 in its corporate US office.George Howard, president of the firm, noted: “Companies in the Middle East have recognised the immense value of having assistance as a component of their benefit plans. We look forward to Abhijit’s success as our business continues to grow in the region.”

Merlin Professional Claims Services has appointed Graham Cranford Smith, a former director of Carr Greenwood Smith, to head up a new London, UK office as part of the company’s strategy of delivering nationwide claims management operations.Said Graham: “Merlin has a very credible London market offering and having a base in the City will help us service existing clients as well as being able to promote our expertise to the wider insurance community.”Graham has been a professional loss adjuster for nearly 30 years, having started his career with Cunningham Hart in Plymouth in 1980. He became a member of the Channel Islands operations following the ‘big freeze’ of January 1987 and the hurricane that hit the UK in October that same year. He said that both events helped to shape his knowledge and experience of working in the specialist catastrophic claims arena.Richard Webster, chief executive of Merlin Professional Claims Services, commented: “A London office is a significant step and signals our serious commitment to get even closer to the London markets. Graham has exactly the credentials we need, having been a founding partner of commercial and major loss adjusters CGS. He is well known in the London market with an excellent reputation and we are delighted to have him leading the London office.”

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Adam Finch

Vicky Lawson

Theo Bouts

Abhijit Bhandari

Phil Thomsett