Evacuation and repatriation cover for expatriates

Employing expatriates across the globe throws up challenges for multinational organisations, but one basic step in designing an international private medical insurance (IPMI) scheme is to include an appropriate level of evacuation and repatriation cover.


  • Most international PMI schemes include standard evacuation and repatriation cover, but this can be extended.
  • When determining the level of cover, employers should consider location and the availability of medical facilities.
  • Employers would be wise to consult their insurance provider and keep detailed information on the countries to which employees are being sent and which countries they came from.

IPMI plans offer a menu of options, so employers can pick a level of evacuation and repatriation cover or include it as a standard, bundled package, whichever suits their staff.

Latif Sayani, managing director, insurance solutions at Aria International Health Solutions, says: “If you are an expat and you are going to a foreign country, you really don’t know what you will need. When [employers] tick these unbundled things, are they assembling something that is a proper dish or have they missed an important ingredient?”

Employers can also choose to extend cover. For instance, a regional level of cover will be used when an expat based in Malaysia is taken to Singapore for treatment, or an expat based in Nigeria is flown to Johannesburg. However, certain situations will require the employee to be taken all the way back to their home country, which would be covered by an extended plan.

While employers are advised to include some evacuation and repatriation cover in an IPMI scheme, there will be scenarios where extended cover is not necessary.

Quality of healthcare

“The most benign thing would be a British employer sending staff to France or Germany,” says Sayani. “There are times when you can say you don’t need evacuation and repatriation cover: when the person is just going to stay in France or Germany, where the quality of healthcare is sufficient. But if there is out-ofregion travel, that cover should be included.”

Key considerations are the location and the availability of adequate medical facilities. Alan Parker, head of international underwriting at Aetna International, says: “Singapore is a long way away, but medical facilities are really good. Sometimes people will send staff to some African regions where there are no medical facilities. If [employers] have not provided a good level of cover in a region where there aren’t that many facilities, they might be leaving employees in a difficult situation.”

On the other hand, when a country offers a comparable level of medical assistance to the expat’s home country, employers can simply put staff into that country’s local PMI scheme.

Dangerous game

Most IPMI providers will not allow employers to turn down evacuation and repatriation cover. Stephen Ryan, director of medical services at Axa PPP International, says: “It is a dangerous game to try to work out whether they do or don’t need evacuation or repatriation services. These situations can get expensive quickly.”

Parker adds: “On a daily basis, [employers] might be dealing with pharmacy or physiotherapy stuff, which is quite predictable and reasonably priced. But something like an evacuation is a catastrophe risk. There are far fewer of them, but when they do happen, [employers] can’t afford not to be insured.”

Employers should consult their insurance provider to determine what level of cover is best for them. It also helps to have detailed information on which countries employees are being posted to, as well as which country they have come from.

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Ryan adds: “It doesn’t necessarily follow that an employee covered by a certain policy will want to be repatriated to the UK. They could be third-party nationals. It is important to make sure the right infrastructure is in place.”