Private medical insurance in a disaster zone

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• International PMI typically includes inpatient and outpatient services.

• Many international PMI policies will include medical evacuation and repatriation services, or will offer these as additional extras.

• Exclusion clauses may be included for areas that the Foreign Office advises against travelling to.

• Emergency non-medical evacuation can be arranged via security organisations that partner PMI providers

Recent global disasters have sharpened employers’ focus on adequate repatriation cover for expatriates, says Tynan Barton

As the world grapples with earthquakes, tsunamis and political unrest, an increasing number of employers with staff in geographically and socially turbulent countries are scrabbling to find out whether expatriates are insured for repatriation costs.

International private medical insurance (PMI) typically covers hospital treatment, consultations, scans or diagnostic checks, and surgeons’ fees. It also includes outpatient services such as GP visits and medication.

Although policies vary between insurers, some will include evacuation and repatriation services. A few providers will include these within the policy, while others offer these as an added extra.

Medical evacuation can be an essential benefit for overseas workers, particularly if they are in a location that may not offer the same level of medical treatment they would receive in their home country. The insurer will evacuate the worker to the nearest country where suitable treatment can be offered or a procedure carried out safely. For example, staff working in South-East Asia, perhaps Vietnam or Thailand, may be moved to Singapore or Hong Kong for treatment.

Nearest centre of medical excellence

Simon Ball, principal, Europe Middle East and Africa (EMEA) of global benefits at Aon Hewitt says: “An employee may have to be moved to the nearest centre of medical excellence to attain an expected standard of care.”

An employee who contracts a serious illness or disease overseas may prefer to return home to be among family and friends. In this case, the insurer will arrange for their repatriation. Chris Beardshall, global account executive at PMI Health Group, says: “It is something we are very keen to include in a benefits package for expatriates, because it cannot really be overlooked.”

He adds that as an added option, evacuation and repatriation can be relatively inexpensive to offer in comparison to the cost of a full-blown medical evacuation.

Although non-medical evacuation is not usually included in PMI, many providers partner organisations that offer international security services, such as emergency evacuation. Some providers will include such services in a PMI policy or as an add-on.

Paul Weigall, group head of sales and marketing at Interglobal, says: “If an employer sends staff abroad, it does not know what situation they could be in. An employee never knows when they might be in an emergency.”

While medical evacuation and repatriation benefits will always be a priority for employers, the recent crises in North Africa and Japan have increased concerns over workers’ safety. Steve Desborough, senior consultant at Towers Watson, says: “We are starting to see a thirst for knowledge of the processes for repatriating and evacuating employees from war-torn countries.”

But many international PMI plans have exclusion clauses which mean employees working in areas the Foreign Office advises against travelling to, are not always covered. Richard Saunders, sales director at Healix, says employers must check the wording of expatriate policies to be sure what is covered.

Evacuation and repatriation benefits must also take account of unforeseen circumstances. For example, New Zealand has good medical facilities, but if its hospitals were put out of action by an earthquake, there could be a need to evacuate expatriate staff.

Desborough says: “Employers are starting to realise that the unforeseen can occur, and it is vital to have the right healthcare policy, with evacuation and repatriation services attached, and reputable providers to make sure of the best possible treatment.”

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