E S S E N T I A L R E A D I N G F O R T R A V E L & H E A L T H I N S U R A N C E I N D U S T R Y P R O F E S S I O N A L S

visit www.iti j .com for the latest news JANUARY 2014 • ISSUE 156

Prof. Allan Manning, managing director of risk management and insurance comparison agency LMI Group, has warned Australians that travel insurance cover included for free with credit cards can be, at best, ‘very basic’. Sarah Watson reports

Manning was recently quoted in an article in The Sydney Morning Herald, which noted that although travel insurance providers, who have a vested interest in this issue, often tell consumers that the cover they have bundled with their credit cards may be ‘limited’

or ‘restricted’, this time the message is coming from Manning, who is an ‘independent expert’. “I’ve got credit cards like most people, but I always buy my own insurance,” Manning told the Herald. “It’s a very important purchase. It can cost you everything if you get it wrong.”Adding that if a traveller has had a heart attack in the past or has high blood pressure, insurers are ‘always looking for a reason not to pay’, Manning highlighted the problem that credit card travel insurance seldom has the capacity for pre-existing conditions to be

catered for. Other limitations cited include a limited maximum trip duration, limited cancellation cover, little or no death benefi t and a lack of protection for kidnapping or political evacuation.Recognising an alternative view, the Herald noted that Choice, a consumer review group, said that some credit cards boast travel insurance cover on a par with separately bought policies. Admitting that compared to stand-alone products, credit card policies may lack the same level of fl exibility, with fewer options for customising the policy, the

With the northern hemisphere now focused on winter sports holidays, a UK insurer has warned that many enthusiasts will be hitting the slopes without the appropriate insurance in place. James Paul Wallis has more details

Almost one in seven (15 per cent) of winter sports-goers don’t take out the appropriate insurance cover for winter sports such as skiing, snowboarding or tobogganing, despite the fact that almost half (46 per cent) of snow-lovers admit to being involved in an accident or a near miss whilst on holiday, resulting in three-quarters (76 per cent) of them needing emergency medical treatment paid for by their insurance, according to research commissioned by Aviva. A thousand adults who go on winter sports holidays were surveyed on behalf of the UK-based insurer between 15 and 20 November last year.Almost half (43 per cent) of those surveyed who didn’t buy winter sports insurance said it was because they didn’t think they would ever need it, with 36 per cent wrongly believing that they don’t need insurance if they have an European Health Insurance Card (EHIC) and 11 per cent simply forgetting to buy it. Yet when asked if they could afford to pay for any medical treatment themselves, without insurance, 64 per cent of the respondents admitted they couldn’t.Aviva said that the research showed that many winter sports fans are unaware of the actual cost of receiving

medical treatment abroad for winter sports-related injuries. When asked what they could afford to pay if they needed emergency medical treatment (and didn’t

have insurance), the average amount that respondents said they could afford was £492, but in fact the average winter sports claim last year was far higher at £740,

said the company.Heather Smith, director of Aviva general insurance, warned travellers: “We never

Winter wipeout warning

Credit card cover questioned

continued on p.4

continued on p.6

News continued p.4

Industry Voice p.8

Company brief p.12

Insurance matters p.13

Travel matters p.18

Health matters p.20

IPMI news p.22

ITIC Schedule 2014 p.24

Profile p.34

Service directory p.35

Grapevine p.42

On the move p.43

Editor-in-chief:Ian Cameron

Editor:Sarah Watson

Title editor:Mandy Langfield

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US correspondent:Milan Korcok

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Finance:Elspeth Reid & Louise Goddard

Design:V Creative Design vcreativedesign.co.uk

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INTERNATIONAL TRAVEL INSURANCE JOURNAL ISSN 1743-1522

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Happy New Year! So, 2014 is upon us, and what has the travel health insurance industry got to look forward to this year? Call me an opti mist, but I’m hoping for a bit more controversy – aft er all, our job is much more fun when life doesn’t run smoothly! Maybe we will see the EHIC being refused again, and maybe insurers will have another opportunity to band together to defend their rights and those of their policyholders. Perhaps

this year will see Thailand, and potenti ally other nati ons, introduce compulsory travel insurance for internati onal visitors. While tour operators lament the possibility of having to cope with the introducti on of the ‘tourist tax’, personally I am prett y confi dent that most people holidaying in the Land of Smiles won’t be averse to paying a few euros/dollars/pounds into the country’s public healthcare system, which copes so admirably with the

huge number of tourists it treats for free each year.While the Aussies and Kiwis sun themselves in Asia (hopefully not riding too many scooters while imbibing ethanol-laced cocktails), northern hemisphere insurers’ eyes are fi rmly on winter sports enthusiasts. With a renewed focus on safety, and the use of helmets becoming ever more commonplace, fi ngers are crossed for a season with minimal injuries.

Threat Forecast 2014 page 30

Red24 issues its 2014 Threat Forecast, which describes the latest dangers to safe travels around the world, with a focus on security and political unrest

Confusion reigns supreme page 10

Customers need to read the small print to avoid being disappointed by unrealistic expectations when it comes to compensation for cancelled trips. But are travel insurance vendors failing to make it clear what their clients are covered for?

Crunching the numbers page 26

Fraud continues to plague the travel and health insurance industries around the world. UK-based expert Gary Sommerford offers information and advice to insurers seeking to set up or augment their current anti-fraud measures to better control the increasing cost of fraudulent activities security and political unrest

Mandy Langfi eldTitle Editor of ITIJ

International Travel & Health Insurance Journal

4 NEWS

And so with the ski season in the northern hemisphere well under way, as usual the analysis has begun on a) the number of people stupid enough go without winter sports insurance and b) how best to protect those who choose to strap a plank of wood (now fibreglass) onto their feet and career down mountain slopes formerly reserved for goats (see pages 1 and 6).

As an avid skier and practiser of the school of ‘get the first lift at the crack-of-midday, ski to the first bar, down a ‘refreshing’ drink and continue on to the next bar’, and so on until the lifts close, I for one would encourage the use of safety helmets. For instance, when you’re flat out in the powder snow, it would protect your head when your friends amuse themselves by skiing over it.

I’m also in favour of the introduction of a breathalyser test on the piste. Those then found with insufficient alcohol in their bloodstream would be asked to remove their skis and help roll the other 90 per cent of skiers down the slope to the nearest bar/hospital/Alcoholics Anonymous meeting.

As far as the uninsured are concerned, there’s probably little more promotionally that can be done to dissuade them from their stupidity ... I understand that frisking every passenger as they board the plane, and then slapping those that are found without adequate insurance cover, is frowned upon…

Ian CameronEditor-in-Chief

ian@itij.com

New research from UK consumer group Which? has suggested that for British travellers, it can be cheaper to buy three single-trip travel insurance policies instead of an annual one – though it does depend on the destination. Which? found an example of a single-trip travel insurance policy to the US costing £400, more than an annual policy covering the same holiday. However, with more than a third of travel

insurance companies, it is cheaper to buy as many as three separate policies to cover European trips rather than an annual policy, said the organisation. Based on the most popular destinations for European holidays, Which? gathered quotes for a 60-year-old buying three single-trip policies to Europe (four days in France, seven days in Italy and 15 days in Spain), as well as a quote for an annual European policy, covering all trips. Out of the 69 insurers analysed, the organisation found that 37 per cent worked out to be cheaper if you bought three single-trip policies to Europe, rather than an equivalent annual multi-trip

policy from the same provider.Which? reported that the two insurers that stood out as being most expensive for European annual cover were Topnotchcover and Insurewithease – costing £120.58 and £108.93 respectively, but buying three single-trip policies with these providers for the holidays listed above would cost just £81.63 and £75.69 respectively. Topnotchcover told Which?: “There’s a current price anomaly with our Gold annual multi-trip policy for those over the age of 55 years. We hope to have the matter resolved in the not-too-distant future.”Insurewithease responded: “The older the client (e.g. retired), the more likely they are to take multiple trips in a year, as they are not restricted by their working holiday allowance. Therefore, annual multi-trip policies are more expensive for the elderly.”The research showed that it’s a different story when it comes to buying worldwide cover to include the US and Canada, where medical bills can be high. Almost a third of the 67 insurance providers Which? looked at charge more for one worldwide single-trip policy lasting 24 days than they do for a worldwide annual policy. The organisation said this was ‘surprising’, as the maximum length of a trip allowed on an annual policy is typically 31 days. In some cases, there were extreme differences in the cost of buying an annual worldwide policy versus a 24-day single-trip worldwide policy. For example, Which? reported that OUL Direct charges £82.15 for its Gold annual worldwide policy (including US) for a 60-year-old, but the premium for a 24-day worldwide single-trip policy (including US) for a 60-year old is a staggering £482.95 – a difference of £400.80.OUL Direct told Which?: “We have found that the risk of insuring clients on our single-trip policies is much higher than the risk of insuring someone of the same demographic on an annual multi-trip policy.”

Travellers using drugs risk jailThe UK’s Foreign & Commonwealth Office (FCO), in conjunction with the charity Prisoners Abroad, has launched a campaign to highlight the consequences of the use, possession and smuggling of drugs in countries around the world. More than 850 British nationals are currently locked up in prisons across the globe for drug-related offences, said the FCO, often being detained for months without trial and facing distressing living conditions. The zero-tolerance approach of some countries often results in strict penalties, which can come as a shock to British travellers; and offences that may carry cautions in the UK are often penalised with long prison sentences when committed overseas, the FCO advised. Some drug crimes can lead to even more severe penalties, and in 33 countries or territories some drug offences carry the death sentence, according to the Foreign Office.Some nations keep people on remand for years before their case is heard, and Prisoners Abroad is currently supporting 80 Brits between the ages of 18 and 30 held in foreign countries for drugs offences – two-thirds of these are still awaiting trial while others are serving sentences from a year to nearly 39 years.As part of the campaign, the FCO has reissued its Too late now information film about the risks of drug trafficking, originally released in 2011. In the video, two British nationals who spent years in prisons overseas describe their experiences and warn others not to repeat their mistakes.Mark Simmonds, UK minister for consular affairs, commented: “People continue to be astonished at some of the penalties handed down for certain crimes overseas. In some countries, possessing small amounts of marijuana can lead to decades in prison. In the last year alone, [British] consular staff handled over 650 drug-related cases. We want to reduce this number significantly.” He added: “Laws, penalties and sentences vary considerably around the world for the use, possession and trafficking of all types of drugs. When it comes to drugs our message is clear – don’t take risks, the consequences are simply not worth it. Prison conditions also vary significantly from country to country. Some Brits spend years behind bars confronting tough conditions every day. Sanitary standards and food can be very poor and some find themselves detained in crowded cells with many other inmates. Being far away from home and unable to speak the local language, many also feel isolated.”Pauline Crowe, chief executive of Prisoners Abroad, said: “In many countries, men and women find themselves without access to food, clean water and the most basic of medical care. We urge people to consider the unsanitary

Single-trip or annual?

conditions, overcrowded cells and the constant threat of disease before they get involved in drugs. They may have to live through these conditions for many, many years.”The FCO and Prisoners Abroad listed some of the penalties travellers could face around the world. For example, in Thailand, possession of even very small quantities of drugs can lead to imprisonment, and possession of more than 20 grams of a Class A drug can result in the death sentence; in the UAE, possession of even the smallest amount of illegal drugs can lead to a minimum four-year jail sentence, and the presence of drugs in the blood stream is counted as possession; and in Indonesia, the authorities have a zero-tolerance policy and those caught face lengthy prison sentences or the death penalty, usually after a protracted and expensive legal process.

Watch the campaign video at www.itij.com/drugs

Credit card cover questionedgroup added that they often also lack the age limits seen on stand-alone products.Manning also admitted that travel insurance providers are not all the same when it comes to making a claim: “Some [providers ] look for any excuse not to pay and some are very good.” To help consumers to make an informed choice, LMI Group offers a claims comparison website that gives information on topics such as how claims are dealt with and how many disputes occur.

continued from p.1

International Travel & Health Insurance Journal

6 NEWS

UK-based insurer Direct Line has released the results of research carried out into the benefits of wearing a helmet when skiing. As part of the study, a crash test dummy wearing ski gear was made to collide with a tree trunk to analyse the extent to which wearing a helmet reduces the risk of suffering a serious head injury, and how it reduces the severity of head injuries in higher-speed crashes. Tom Bishop, head of travel insurance for Direct Line, explained: “[We] decided to undertake this research because there is a debate in the UK travel insurance industry at the moment as to whether or not the use of ski helmets should be made compulsory and, as far as we’re aware, this is a UK first in terms of the scientific use of crash test dummies to carry out these tests.”The study by Direct Line and the Transport Research Laboratory (TRL) simulated six collisions with a crash test dummy hitting a tree at 10, 20 and 30 kilometres per hour (kph), both with and without a ski helmet. Three key areas of the body were monitored for the force of the impacts and likely injuries – namely the head, neck and chest.The results revealed that skiers wearing helmets experience at least two-thirds less g-force than skiers without helmets, representing a greatly reduced risk of suffering a serious head injury, such as a brain contusion, said the insurer. The compression force on a skier’s neck during a collision was also reduced when wearing a helmet, although not enough to significantly decrease the risk of serious neck injuries, such as fractured vertebrae, at 20 or 30 kph. The risk of a serious chest injury, such as multiple rib fractures or a lung laceration, was low in the tests at 10 and 20 kph, but at 30 kph was moderate, said Direct Line. The company stated that a test at 30 kph without a helmet was not conducted, as the pattern of results from the previous tests indicated that the risk of damaging the dummy was too great, and suggested that this crash would be fatal for a human.Mark Riddell, group testing manager at TRL said: “Head injuries can be life-threatening when they occur. When you consider that during the collision at 20 kph, the head experienced a force of nearly two tonnes, this is an incredible amount of strain to be put under. This research certainly supports the argument to wear an approved ski helmet on the slopes from a safety perspective.”Bishop added: “Although we do not enforce the use of helmets when taking part in winter sports, the safety of our customers on the slopes is paramount to us. This is why we strongly encourage the use of approved helmets when skiing or snowboarding, especially in light of this illuminating research. We deal with around 3,000 winter sports claims per year, the majority of which will be medical, and unfortunately three or four of these per year will be fatalities. Even one fatality is one too many.” He continued: “Winter sports injuries can be very costly, and even when treated in a hospital which accepts the [European Health Insurance Card], a skier could face thousands of pounds in charges for mountain rescue, ambulances, new flights and additional accommodation. For example, a helicopter piste rescue to a local hospital will typically cost around £2,000, and if you need to be brought home from an Alpine resort by stretcher on a commercial flight, or on an air ambulance, this can cost at least £10,000. This is why taking out appropriate travel insurance is so crucial.”

Further explaining the potentially devastating effects of head injuries received in skiing accidents, Dr Rob Goodall, medical director for Capita Health & Wellbeing, stated: “When the skull strikes an object and is decelerated very rapidly, the brain will move within the skull and will push up against it, causing bruising and damage to the brain itself. There are lesser injuries that can cause symptoms to develop later, particularly if the damage causes slow bleeding in the brain, and that can manifest as altered consciousness (becoming increasingly drowsy), perhaps an unpleasant headache, sickness is often a common sign, and if these things occur after a head injury then they need to be taken very seriously and urgent medical attention sought.”Bishop warned travellers: “What this test has shown us is that absolutely it’s in your own interests to ski as safely as possible, particularly if you’re with a young family. We would certainly recommend the use of ski helmets at all times.”In related news, a study from Irish travel insurer GetCover has revealed that a third of travel insurance skiing claims come from holidaymakers who have suffered an injury in Austria, with knee injuries being the most common claim. France and the US also accounted for a significant proportion of winter sports claims received by the company. The study further showed that people aged between 18 and 24 often travel without insurance cover, and are also less likely

to wear a helmet for their winter sports holiday. A spokesperson for the company commented: “It seems that younger travellers adopt a more carefree attitude – even though our claims stats would indicate that they are involved in as many accidents.” The spokeswoman urged winter sports enthusiasts to shop around for their cover, and added that the appropriate insurance should include emergency assistance, personal liability and ski equipment cover.Watch dramatic footage of the dummy smashing into the tree at www.itij.com/skistudy

Direct Line announces ski helmet study results

Cancellation cover misunderstoodCompare Travel Insurance, an Australian travel insurance comparison site, has reported that feedback it has received from customers reveals that cancellation cover, travel delays and alternative transport expenses are the most misunderstood features of travel insurance. Natalie Ball, director of parent site Compare Insurance, revealed: “The most common negative travel insurance reviews we receive on our website are regarding cancellation cover – and the misconception that all cancelled or missed travel situations are covered. We often read feedback from customers who are unhappy because of unpaid claims, but the majority of complaints are for situations that are not covered. Our aim is to set the record straight and clearly explain to travellers when they will and won’t be covered for cancellation and delays when travelling.”The site has issued advice to travellers to help explain the misunderstanding around travel insurance and cancellation cover, ‘so that travellers can head on holiday stress-free and avoid being crushed by unrealistic expectations’. Various scenarios are given to explain when policyholders are – and are not – covered for travel delays, alternative transport and cancellation. For example, a flight cancellation will likely be covered, says the site, if it is due to severe weather or airline strike. However, if the flight cancellation was due to a mechanical fault or overbooking, then it is the airline’s responsibility to compensate, reimburse or find an alternative flight for the customer, not the insurer’s.Compare Travel Insurance reminded travellers that travel insurance will only reimburse them for the non-refundable cost of the trip they have already paid for, and that they must be able to prove that they’ve done everything reasonable to avoid delay expenses.For more detailed analysis about consumer confusion regarding cancellation cover in travel insurance policies, please see the News Analysis on p.10, Confusion reigns supreme.

FCO focus on kidnap threatUK Foreign and Commonwealth Office (FCO) Minister Hugh Robertson recently met travel industry representatives to emphasise the continuing threat of kidnapping in Sahel and North Africa. Robertson said: “Despite the success of military intervention in Mali, there remains a very real threat of kidnap to westerners in areas of the Sahel and North Africa. Our travel advice provides a detailed assessment of the threat in individual countries. This allows individuals to make informed decisions about where they travel.” He went on to say that the British Government takes the threat to British nationals overseas extremely seriously, clarifying that the UK, along with G8 partners, has committed to reducing terrorist groups’ access to funding by rejecting ransom payments. “It is a very tough policy to follow,” added Robertson, “but we believe that this is the only way to prevent further kidnappings.”

During the meeting, Foreign Office officials underlined that the threat makes some areas, which may appear to be attractive destinations, unsafe for tourism. The threat from groups such as Al Qaeda in the Islamic Maghreb (AQ-M) and Al Murabitun has been demonstrated by a number of recent attacks, including in In Amenas in January 2013. Groups like AQ-M rely on kidnap for ransom as their major source of funding and are prepared to go to extreme lengths to secure hostages.

helmet KPHForce (in g) on the head

Risk of serious injury

Compression force on the neck (kN)

Risk of serious neck injury

Chest deflection (mm)

Risk of serious chest injury

Yes 10 36 Very Low 3.9 Low 0 Neglible

No 10 106 Low 3.8 Low 0 Neglible

Yes 20 110 Low 8.4 High 22 Low

No 20 425 Very High 9.6 High 5 Neglible

Yes 30 323 Moderate 15 Very High 40 Moderate

Figure 1: Direct Line’s table showing the summary of head, neck and chest injuries in simulated skiing crashes

�e study being set up

A collision in action Direct Line

Direct Line

Winter wipeout warning like to think about the worst-case scenario, especially when going on holiday, but when it comes to winter sports this can be a costly error. Even if you consider yourself to be a competent skier, remember that mishaps can happen to anyone and the cost of even a minor accident can run to hundreds of pounds.” She added: “It is worth taking the time to make sure you have the right insurance when you book up your winter holiday. It could save a lot of worry and inconvenience should your holiday somehow go off-piste.”Treatment for extreme injuries, such as a damaged spinal cord, can be very costly, said Aviva, noting that in one claim, the cost of emergency medical treatment was £31,000. Given a range of costs to choose from for examples of actual winter sports injury claims, the survey revealed that these costs were grossly underestimated for serious injuries – in the case of one specific injury by more than £12,000. Specific scenarios – based on real claims that Aviva has paid – were described to the respondents, who were then asked to estimate the associated medical treatment costs. The cost of a spinal cord damage claim was estimated at an average of £18,917, whereas the real cost in the case was £31,000. The average estimate for a knee damage claim, real cost £24,000, was estimated at just £13,570; whereas a £22,000 actual bill for the treatment of a dislocated ankle compared to a £12,420 average estimate by the respondents. The final case, which concerned a fracture or break around the knee, prompted an average estimated cost of £13,665, whereas the real cost was £16,000.Furthermore, in late November, as good snow fall led to an early start for the ski season, The Travel Association (ABTA) in the UK revealed that the number of skiers and snowboarders travelling without adequate winter sports travel insurance has increased. Research conducted for ABTA showed that over a third (36 per cent) of Brits taking a winter sports holiday now go without purchasing specific winter sports insurance, an increase from 30 per cent in 2012. The number rises to nearly half (47 per cent) of under 35s, the age group most likely to take a winter sports break, said ABTA.The association said that the news came as winter sports holidays were seeing a real boost in popularity; ABTA research has shown that 15 per cent of those taking a winter holiday were planning to take a winter sports holiday, an increase from 10 per cent in 2012. Additionally, skiers can look forward to a ‘bumper season’ as early snow has allowed resorts all over Europe and North America to open ahead of schedule, said ABTA.Victoria Bacon, ABTA head of communications, told consumers: “It is great to see winter sports holidays continuing to grow in popularity, and we would urge anyone planning a winter sports holiday to make sure that they have specific insurance. Unfortunately, accidents can happen and can lead to costly medical bills, but having the right kind of cover means people can make the most of their time on the slopes without having to worry.”

continued from p.1

www.itij.com

NEWS 7

Recent political unrest in Thailand has once more brought the problem of tourist safety in the country to the fore, prompting warnings to visitors to be aware of the latest developments and to make sure they are prepared to deal with an escalation of political violence. Phil Sylvester of Australian provider Travel Insurance Direct urged Australian tourists to ‘steer clear’ of protest areas because, quite apart from their own safety, their travel insurance would most likely not

pay out if it is thought that they deliberately put themselves in a dangerous situation.Figures from the Australian Department of Foreign Affairs and Trade, meanwhile, have shown that Thailand is the most dangerous country for an Aussie tourist to visit, with more people being hospitalised there than in any other country. Consular figures showed that 1,372 Australians ended up in a foreign hospital in the 2012-2013 financial year, with Indonesia, the US, China, Italy, the Philippines, the UK, India, Cambodia and Vietnam completing the list of the top 10 countries where Australian tourists are hospitalised. The most common causes for medical treatment were motorbike accidents, brawls and dehydration.

Looking aheadA survey by the US Travel Insurance Association (UStiA) has found that one in eight travellers either had their travel impacted, or considered changing their travel plans, because of world events or natural disasters in 2013. Despite this high proportion of people whose travel could have been, or was, affected, just 29 per cent had purchased travel insurance. Alan Josephs, chief marketing officer for Allianz Global Assistance USA, commented: “If we learned anything from 2013, it’s that no form of travel is without its risks. Whether it’s cruise ship breakdowns or large events such as fires, floods or earthquakes that may disrupt plans, no-one can guarantee a trouble-free trip. In an increasingly risky world, trip insurance gives travellers the confidence to travel.”Looking ahead to the coming year, US-based travel insurers have been identifying the travel protection trends that are going to become more prevalent in 2014. The first trend noted is that there will be more creative and inexpensive insurance options brought to the marketplace, allowing for more flexibility in cover that can meet the needs of more travellers. There will, say the experts, be an enhanced focus on government legislation and improved regulations. Sheri Machat, executive vice-president of industry relations for TravelSafe Insurance, reported that the UStiA and the American Society of Travel Agents are working together to come up with uniform licensing requirements for agents who wish to sell insurance: “That model,” said Machat, “has been approved in 20 states and is being discussed or proposed for future legislation in other states.” Scott Akerman, senior vice-president of sales for Travel Guard North America, added: “Industry associations are pressing for important reforms like the Travel Retailer Model Law, which will enable travel agents to discuss travel insurance with their clients in a meaningful way, but without the need to secure potentially dozens of licenses to sell insurance.”2014 will also see more resources being added to the travel industry to allow for easier sales of insurance, with Isaac Cymrot, vice-president of sales and industry relations at Travel Insured International, explaining that his company has a new travel agent portal that allows agents to offer quick quotes and purchases to customers. Part of the new portal also allows for follow-ups to be made, said Cymrot: “Too often, the agent quotes insurance once, and never follows up, even when the client doesn’t say no. Follow-up, like with anything you sell, is vital and there are resources available to help.” Allianz Global Assistance USA’s Josephs added: “Travel agents are doing more with less and they tell us they want selling travel insurance to be a very simple process. We’ve eliminated non-commissionable fees and made selling travel insurance easier for agents.”The value of travel assistance services will also be brought to the fore by the travel industry in 2014, with Cymrot saying: “Probably the most important thing to take away from the events of 2013 is the impact of a good travel assistance company. The ability to contact an expert at a moment’s notice was vital to so many travellers [in 2013].” Other important points noted by travel insurance providers include the need to educate consumers about policy terms and conditions, the rise of social media for insurance content, and a shift in the length of coverage and costs, about which Cyrmot said: “[In 2013] we saw a trend back towards longer trips and higher trip costs.”

Risky times in Thailand

International Travel & Health Insurance Journal

8 INDUSTRY VOICE

“ITIJ’s extraordinarily informative Cost Containment Review 2013 made for fascinating reading, and provoked a number of thoughts and reactions,” said Dr Cai Glushak, medical director of AXA Assistance USA. Bottom line, his response was: “How the h… long are we going to put up with the same bad news before we start taking real action?!” Here, Dr Glushak says what he really thinks about the industry

�e Cost Containment Review 2013 contained much wisdom from a number of truly expert and highly experienced specialists in our �eld – all o�ering sage insights we would all do well to ponder seriously. It is certainly essential that we all keep a close eye on the trends in our industry that perpetuate medical in�ation, new centres of medical excellence – or does that mean medical expenditure? – and ever-increasing challenges of keeping costs reasonable while providing a responsible service to travellers who need protection.I cannot help feeling that despite all of the rich information at our disposal and the resourcefulness of our talented contributors, the real challenges that travel insurers and assistors face will only magnify:• Medical costs will continue to rise, proportionate

to the usage by insured travellers and the rise of the middle and privileged classes in emerging countries.

• While there are many legitimate medical providers of high quality that serve us, ambitious providers will continue to target dependable payers – they know how to play us.

• Travel providers will become ever more sophisticated and educated on our insurance behaviors to maximise their revenues and strategies to spend our funds, especially in poorly regulated tourism locations.

• Competition among insurers will impede initiatives to impose reasonable expectations on insured travellers – that is, instead of enforcing reasonable conditions for coverage at the risk of being a less attractive policy, they will avoid any imposition on the traveller and thus remain obligated to pay any charges the medical provider decides to levy.

• We will continue not to be smart and not engage the consumer at the earliest possible point of contact to encourage responsible behavior.

As a US citizen and emergency physician who experiences all sides of the equation – using health services, providing medical care and working to e�ect cost control and responsible assistance on behalf of insurance clients, I can attest to the validity of the excellent points made by Reid Cawston in his pro�le of US healthcare and travel dynamics (ITIJ Cost Containment Review 2013, A global perspective). Yet on a very palpable level, Americans have learned from our environment; tight private insurance conditions have indeed modi�ed our behavior and we live with limited choices. It is virtually impossible to �nd a private health insurance policy that allows

totally free choice of medical providers without any cost-sharing with the consumer. Typically, if I choose to go out of network, I am obligated to pay 20 to 40 per cent of the charges – this certainly makes me think twice about whom I choose to see. When I

decide on the emergency room I will use, I choose one that is in-network, otherwise I risk assuming thousands of dollars of charges that will constitute my percentage of the bill. Americans no longer go to just any provider without �rst checking whether they are in network. Why don’t we do this in the travel insurance industry?�e bottom line is there are only two conditions that really enable cost control in our industry:Competition among insurance providers – plenty of it – and terms and conditions that

place some key responsibilities on consumers, especially on network choice and early noti�cation to their assistor/insurer.So my plea to insurers: give us front-liners something to work with. Clearly, competition to o�er consumer-friendly choices with minimal restrictions has driven insurers in some markets to strip policies of key consumer obligations that would allow us to impose network preferences and encourage responsible behavior. On the other hand, given all the attention and frustration consumers express about pre-existing medical restrictions, screening and other exclusionary conditions, mightn’t it be more palatable to apply reasonable provider network conditions that apply to all insureds? In my experience, the number and size of claims that we end up rejecting for typical UK policies, in which the burden of proof regarding a pre-existing condition is generally quite high, represents a very small percentage of cases. On the other hand, if our policies had heftier co-pays (say 20 per cent or higher) for going out-of-network for anything other than life-threatening conditions, paired with a strong ‘phone �rst’ requirement that would give us the opportunity to direct patients to preferred providers, I could negotiate considerable discounts in currently highly resistant provider markets that would apply to all insureds (not just the few that we end up excluding). �ere is no getting away from it – local tourist providers have you in a stranglehold. As much as possible they monopolise the tourist sites, provide incentives to hotels and tour companies for referrals

and are in the faces of travellers wherever convenient. On a recent site visit to medical providers in the Dominican Republic, the welcome packet in my hotel included an eye-catching glossy ‘advertisement’ for the local medical provider alongside the sun and fun promotions. And it was oh-so-conveniently located near the bu�ets and reception areas. I was even recounted stories of guests being approached because they looked a bit piqued and being urged to visit the clinic. �is is how your travellers are greeted at their destinations.And don’t kid yourself – these providers have expert knowledge about your individual programmes (yes you, the insurer behind the assistance company): your practices, personalities and the insurance climate in

your home country. �ey know the VIP programmes that give the ship away and the budget ones that have tight requirements. �ey know what will happen back home when the case is appealed and which companies wish to avoid bad press and complaints above all else. One highly respectable provider recently compared UK and Latin American traveller behavior. �ey said that whereas British travellers do not tend to notify their assistance/insurance

plans early in their quest for care, generally counting on the companies to pay up, most South American travellers insist on calling their insurer to identify a provider and always before getting deep into their treatment because they are at serious risk of not being covered if they do not phone early for approval and direction. So what do medical providers do? When dealing with South Americans, they are very careful about contacting the assistor/insurer before they get too far into treatment to be sure they will get paid. By comparison, the same providers know that back in the UK, rarely will network restrictions be applied and that disputes over the necessity of excessive treatment will generally favor the side of the ‘unwitting’ consumer, so why phone the insurer before the service is provided? Again, some of our Canadian clients accept our conclusions when we advise that treatment has been excessive. �ey frequently will not cover that portion of the care. Either the provider is not paid for it or

they have to pursue the customer. �ese Canadian clients are �ne with that and realise the consumer may not be pleased. But again – this consumer market is

already prepared to hear this. �e end result is that consumer behavior adapts and enables us to negotiate with providers.So where do we go in the future? We will all enjoy reading the updates and caveats from our

excellent insurance and assistance pundits. Trends in medical prices will undoubtedly continue to rise, and travel providers will continue to become ever more savvy about collecting as much as possible from those rich schemes behind the unprepared traveller.�e only weapons you have are your assistance network negotiators, but more importantly, your terms and conditions. Believe me, we all like to service policies that really respond to patient’s needs. However, we are only as good as the Ts and Cs, and rely entirely on policy wording that empowers us to take cost-e�ective measures: ensure excellent care while compelling responsible behavior from the provider and the customer. So, what do we need from you?Give the Ts and Cs some teeth:• Clear wording obligating the customer or family

to contact the assistance company before seeking medical care unless they are facing a life-threatening emergency, and at the earliest point possible in their care (always before accepting admission);

• Reasonable provider network conditions that incent or require use of the approved medical network;

• Clear wording which states that failure to communicate and follow instructions of the assistance organisation will/may result in annulment of bene�ts.

What should you expect from assistors?• First, contact practices that engage the customer

on the �rst call and that make further requirements for coverage crystal clear: their obligation to communicate, and when and for what they need approval, before going any further;

• Medical network direction (patient steering) from the very �rst contact to our preferred providers;

• Meticulous documentation (and preferably recordings) of communication attempts and conversations detailing the above;

• Early intervention by assistance medical sta� to discuss and, if necessary, dispute necessity of the medical plan, including admission.

• With the above weapons, aggressive negotiation with local providers who will now know we have real control over payment approvals.

Let’s start take real measures to rein in our costs to reasonable levels. Give us the teeth we need and we will deliver excellent service and acceptable costs.

my plea to insurers: give us front-liners something to

work with

The global travel insurance industry needs to take some de�nitive action with regards to cost containment

practices in the real world

Do you have some-thing you think needs saying?

Write to us and we will give you an Industry Voice

editor@itij.com

Call to actionCai Glushak of AXA Assistance USA

Cai Glushak

Dr Glushak is the international medical director of AXA Assistance, an international medical and travel assistance company with offices in over 30 countries, including the UK. He is currently Professor of Medicine in emergency medicine at the University of Chicago.

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NEWS 9

In a recent survey, Allianz Global Assistance USA found that its average customer is female and in their mid-50s; it also found that, frequently, the person booking the travel insurance is doing so for more than one person at a time. Alan Josephs,

the company’s chief marketing officer, said: “While we have many other customers with different characteristics, the trend points to the importance of empty nesters. They tend to be thoughtful and conservative and are very interested in protecting their travel investment with trip insurance.”The company’s research also asked customers the top reasons why they buy insurance, with the results showing that most (46 per cent) buy it to protect against the loss of pre-paid trip costs if they had to cancel. The second most popular reason for buying insurance was for medical evacuation, while other reasons cited by customers were: to protect against trip interruption, to protect against loss of luggage, and to obtain travel assistance services.

Small print warningA recent TV news report from Australia has warned that customers with travel insurance are still being left with medical bills for thousands of dollars as they were not aware of the limitations of their coverage. Several examples were given of such situations – for example, a female traveller who had an accident riding a bike and whose teeth were damaged, but whose travel insurance did not cover dental costs. Justin Brown, head of the consular division of the Department of Foreign Affairs and Trade, said: “We do recommend that people read the fine print of their policies. We can’t and don’t, as a department, recommend particular types of insurance policies, but we do believe that people need to be aware of what the policies cover and make decisions that are well-informed on what’s going to suit their circumstances the best.”

Bali braced for influxMedical providers on the holiday island of Bali are gearing up for a busy season, with the BIMC Hospital Group saying they typically see around 15 young Australian travellers every day who are enjoying the first taste of freedom, having completed their education. Medical director Dr Reno Riandito said: “We are expecting the number of schoolies to go up this coming season as the number of Australian tourists goes up each year. Most schoolies will likely stay in the Kuta area if they come here with their friends. The important thing is that they need to get travel insurance.” Nicole Bayuntara, BIMC Hospital Nusa Dua Australian nurse leader, said: “They should make sure they take out travel insurance but should be aware that most travel insurance will not cover injuries related to alcohol, drugs and risk taking activities.”

Australian research revealedResearch and Markets has published its Travel Insurance and Assistance in Australia report, which is about the current status and likely future development of the market for stand-alone policies in the country. The data includes information from 2008 to 2012, analysing the size of the market in terms of premiums and policies, with a segmentation between single-trip and annual travel insurance policies. Furthermore, the research analyses the share of distribution relationships of travel insurance providers, split between the travel trade, transportation and financial organisations, based on a primary survey of over 100 actual and potential distributors of stand-alone cover. There is also a review of other direct and affinity distribution channels used in Australia, including cover with package back accounts, automotive clubs, direct sales, online aggregators and brokers. The report concludes with forecasts up to 2016 of both the underlying travel market and for the size of the market for travel insurance and assistance in terms of premiums and policies.Meanwhile, the Australian Federation of Travel Agents (AFTA) has expressed its support for a new government campaign urging tourists to insure themselves, and to register with smartraveller.gov.au before travelling. The adverts tell the story of tourist Natalie Hensby, who was saved $100,000 – as well as her life – by registering and taking out insurance, when she was injured in a boat crash in Thailand. “AFTA and our members are very proud supporters of this important campaign,” commented AFTA’s chief executive Jayson Westbury, “and we congratulate the federal government on their ongoing commitment to ensuring Australians travelling overseas are aware, insured and contactable in the event of the unexpected happening.”

Focus on driving safety in NZThe son of a man who was killed by a tourist driving on the wrong side of the road in New Zealand has pleaded with the coroner who examined the case to make safety warnings on hire cars mandatory in the wake of the accident. The tourist was driving a camper van and had been travelling on the wrong side of the road when she crashed into David Morris’s car on a bend.Simon Burbury, a police senior crash investigator, recommended that rental companies and the New Zealand Transport Agency improve and regulate road markings and vehicle signs in an effort to stop such accidents from occurring.

Customer profile identified

Cai Glushak

International Travel & Health Insurance Journal

10 NEWSANALYSIS

Customers need to read the small print to avoid being disappointed by unrealistic expectations when it comes to compensation for cancelled trips. But are travel insurance

vendors failing to make it clear what their clients are covered for? Robin Gauldie investigates

This has long been a thorny problem for the travel industry, and some might argue that the plethora of policies now available online – either from direct-sale sites or aggregators – may confuse customers even more. Insurers tend to say that the information is all there in the policy if customers take the trouble to look for it, but the prevalence of negative feedback from clients shows that many are still baffled by legal language, or by unclear definitions of conditions under which a claim will be allowed.

Understanding coverA common cause of confusion arises when clients are ill-informed about the distinction between ‘cancellation cover’ – which generally relates to events that arise before departure – and ‘alternative transport expenses’ or ‘travel delay’, relating to anything that happens after departure. Many clients also remain unclear over how responsibility for compensation and reimbursement of expenses is shared between travel providers, insurers, and schemes operated by national travel industry

organisations or government bodies.Recent events in the UK, where a meltdown of southern England’s main air traffic control system brought chaos to the busiest airspace in the world and caused hundreds of flight cancellations, should highlight this recurring issue and its significance for travel insurers and the broader travel industry.Eventualities such as extreme weather events, emergency evacuation of tourists from destinations struck by unexpected civil strife – as in the events of the Arab Spring – or high-profile air ambulance operations, may be more traumatic, but in practical terms, travellers are statistically more likely to be caught up in the humdrum reality of sitting in a crowded departure lounge – or, still worse, on an aircraft on the taxiway – while waiting to hear when or whether their flight will ever take off. Increasingly, most of us realise that, at some point, we are going to be among those huddled masses. Statistically, it’s inevitable. So it’s not surprising that many consumers regard trip cancellation cover as one of the most important elements of their chosen travel policy.Perhaps it’s also unsurprising, then, that trip cancellation is a common source of customer complaints. It is, according to some sources, the most misunderstood element of travel insurance. “Feedback from customers shows that cancellation cover, travel delays and alternative transport expenses are the most misunderstood features of travel insurance,” confirmed Natalie

Ball, director of Compare Insurance, an Australian comparison website. The most common negative comments that Compare Insurance receives stem not from refused claims, but from the misconception that all cancelled or missed travel situations are covered by insurance, Ball says. “We often read feedback from customers who are unhappy because of unpaid claims, but the majority of complaints are for situations that are not covered.” The comparison site is trying to address the problem of customer confusion by issuing its own set of guidelines clarifying what is, and is not, covered by most travel insurance policies in terms of cancellation insurance (see news story, p6). It outlines the different responsibilities of travel suppliers, travel insurers, and clients themselves, reminding

customers that their policy will cover only non-refundable costs that they have already paid for, and that they must prove that they have done their best to avoid unnecessary expenses due to delays.“Cancellation cover is explained legally in policy documents as ‘lost deposits and cancellation fees for pre-paid travel arrangements due to unforeseen circumstances neither expected nor intended by you or which are outside your control’,” explained Ball. “A travel insurance policy is a legal document and yet so many travellers chose not to read the Product Disclosure Statement which explains in detail all the policy benefits,” she lamented.Compare Insurance’s guidelines aim to cut through the legalese, defining clearly what is meant by ‘unforeseen circumstances’ and explaining when customers are covered for delays, cancellations and alternative travel arrangements. It points out that insurance normally covers clients for a range of scenarios, which include accidents that cause clients to miss flights; flight cancellations due to weather or industrial action; missed accommodation; extreme events that begin after the policy starts; severe sickness, injury or death of the insured or a close relative; theft of passports or travel documents; disruption of journey; and alternative travel expenses.“The most common misunderstanding is that all cancelled flights, for any reason, are covered,” said Ball. “This is not the case. For example, if your flight was cancelled due to a mechanical fault, overbooking, maintenance, repairs, rescheduling,

Confusion reigns supreme

trip cancellation is a common source of customer complaints

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NEWSANALYSIS 11

service faults or the airline closing down then you are not covered. It is the airline’s responsibility to compensate, reimburse, or find an alternative flight for the traveller – not the insurer.” Clients also need to be made aware that travel providers are responsible for reimbursing extra accommodation costs if a flight is cancelled because of a non-covered event such as a mechanical fault, Ball says. Compensation also becomes the responsibility of the travel provider when a tour operator cancels a package holiday due to underbooking. Compare Insurance’s guidance aims to make it clear that customers are not normally covered if they cancel their trip at a whim or for reasons such as cancellation of their annual leave, or exam dates that clash with travel arrangements.

Global issueMight insurers in other markets – such as the UK or North America – follow Compare Insurance’s lead by giving similar sets of guidelines more prominence on their sites or in policy wording? Most seem to feel that the information is already there, or that it is largely up to the customer to read the small print – preferably before travelling, or even before buying a policy.Jim Grace, president and CEO of US aggregator InsureMyTrip, says trip cancellation cover is the most popular product among customers buying travel insurance policies through aggregators in the US. Policies available through aggregators contrast favourably, he says, with those offered by online travel agencies and airline sites, which are often cheap and provide poor coverage. Travel insurance purchasers, Grace says, are increasingly choosing to visit aggregator sites that offer more comprehensive information about the product they are buying. “Travel insurance companies try to clearly spell out their coverage in their policies,” confirmed Linda Kundell, a spokesperson for the US Travel Insurance Association (UStiA). “UStiA always recommends that travellers familiarise themselves with their policy, that they understand their policy, and that they contact the company whose policy has been purchased with any questions,” she added. Travel insurance in the US typically reimburses the traveller up to a set amount for travel delay past a certain number of hours, and for cancelled flights under covered reasons. If the tour operator cancels, that is normally the tour company’s responsibility. Travel insurance would cover cancellations for reasons such as illness and weather delays, and will reimburse passengers if the airline or tour operator does not. But some industry sources say that there is still confusion in customers’ minds when it comes to their level of cover for delays and trip cancellations.Unlike in Australia or the US, the role of the insurer in the UK when a flight is cancelled is relatively minor, says Sean Tipton, media relations manager at The Travel Association, ABTA, in the UK. But this is not always clearly understood by customers. “In the vast majority of cases, the client’s first recourse will be the airline or tour operator. However, the public are not fully aware of this, and insurers need to make it clearer,” Tipton says.

In the past, the insurance sector in the UK has received bad publicity because customers failed to realise that most cancellations are not the insurer’s responsibility. Insurers should also make it clear that in turning down claims in cases in which the airline or tour operator should provide compensation, they are not abnegating responsibility.“They need to clarify that the clients will be covered, but by the travel provider, not the insurer,” Tipton says. However, he added: “There are instances when the insurance company is the only place a customer can go, for example when a flight is cancelled due to extreme weather. The airline may take responsibility for compensation and rebooking, but people who are travelling independently, not as part of a package, may find that they are out of

pocket for alternative accommodation expenses. This is one of the few areas where the only recourse is the insurer, and many policies do not cover clients for such expenses. Cheaper policies are, of course, more likely to have more exclusions.”Most insurers will argue that it is the client’s responsibility to read the small print and understand what they are covered for and by which provider. “If an airline or tour operator cancels a trip or flight, it is down to them to refund the customer or provide an alternative trip. Insurance for travel delays usually applies after a number of hours’ delay. It will vary from scheme to scheme from five hours upwards,” commented Jade Trimbee, senior marketing executive at AXA Insurance. When asked how customers can be better informed about where a travel supplier’s responsibility to compensate passengers for delays lies, she said that customers ‘should speak to their travel agent or tour operator’. Aggregators make information on policies widely available in their policy wording pages, Trimbee said, adding: “If the customer has a specific query about the terms and conditions, they should talk to their insurer.”Via aggregators, AXA Insurance offers a high level of cover on products including Travel Disruption Cover (TDC), said Trimbee. Such products fill the gap between the protection and compensation offered by travel industry principals such as airlines and tour operators: “The main sections of cover will be cancellation should a customer not be able to travel due to health reasons; this typically covers the gap between the tour operator refund and the cost of the holiday, less the excess. Curtailment cover provides cover for customers who need to return home early. We are not aware of any tour operator cover that applies here. Travel delay, missed departure and AXA’s TDC cover all provide elements of cover around trip delays.”

Clarity of coverGenerally, between travel providers and travel insurers, travellers are quite well provided for in the event of cancellation. But it does appear that – if only to avoid bad publicity and the unnecessary administration hours incurred in turning down a claim and redirecting insureds to travel providers for compensation – travel insurers could spell out more clearly who takes responsibility in each scenario. n

“In the vast majority of cases, the client’s first recourse will be the airline or tour operator. However, the public are not fully aware of this, and insurers need to make it clearer,”

International Travel & Health Insurance JournalInternational Travel & Health Insurance Journal

12 COMPANYBRIEF

AIG inks UAE Exchange dealA United Arab Emirates (UAE)-based provider of global remittance and foreign exchange services, UAE Exchange, has inked a deal with AIG, under which the former company’s gocash prepaid travel card customers will be offered a range of travel insurance benefi ts. Customers travelling with the cards will be covered for travel inconveniences, personal accidents, free medical benefi ts and round-the-clock professional assistance.Chandra Shekhar, head of consumers at AIG’s Arabia branch, said: “AIG always looks for opportunities to add value and convenience to customers and in partnering with UAE Exchange, we are able to do this, as they share our values and approach. The gocash card is for the new generation of travellers and AIG understands their needs perfectly … we can provide real protection for gocash cardholders when they travel.”Promoth Manghat, vice-president of global operations at UAE Exchange, added: “This kind of partnership for free insurance coverage is a fi rst-of-its-kind arrangement in its class … we take pride in partnering with AIG and look forward to transforming this relationship into a strong and meaningful one.”

Allianz signs Virgin and Travel CityAllianz Global Assistance UK recently signed Virgin Holidays and Travel City Direct Travel Insurance as appointed representatives. Under the new partnership, Virgin Holidays will be able to sell travel insurance directly to its customers via its call centre and nationwide retail network, and nine products – including single and multi-trip options – will be released as part of the launch. “The ability to offer travel insurance alongside the holidays we sell has been something that our customers have sought from us for some time,” said Mark Anderson, Virgin Holidays’ customer and sales director. “We’re really pleased to achieve Appointed Representative status, and this is a fantastic addition to the range of benefi ts we already offer our customers – refl ecting our own commitment to creating bespoke, differentiated and innovative products.”

Global Rescue to offer Olympic supportGlobal Rescue, a provider of medical, security, intelligence, transport and other services, is to provide support for the US Ski and Snowboard Association (USSA) at the 2014 Winter Olympic Games, to be held in Sochi, Russia. The Olympics run from 7-23 February, and Global Rescue – which has provided

services to the USSA since 2006, is ‘committed to protecting the health and safety of our athletes, both at Sochi and year-round’, commented CEO Dan Richards. USSA’s chief operating offi cer Tiger Shaw, meanwhile, said: “With Global Rescue providing the highest level of medical and security services for USSA, we’re well prepared for Sochi. Our athletes can focus on delivering exceptional performances with the knowledge that Global Rescue is at the ready.”

Online tool from HealthQuotesHealthQuotes, a provider of health and travel insurance based in Canada, launched its new online travel insurance tool at the end of last year. Canadians are now able to use the site to obtain quotes for single, multi-trip and all inclusive plans from multiple insurance companies, and the site also includes a secure medical questionnaire that can accurately determine customers’ health ratings, which determine eligibility and rates of premiums. “Developing this … site was a challenge that required substantial time and resources,” commented Ian Baker, HealthQuotes’ president. “Close collaboration between our IT and t ravel departments, along with lots of hard work, has resulted in a great web tool Canadians can use to shop for their travel medical insurance online.” The site also includes side-by-side comparisons of all quoted plans, accurate assessments of stability periods, and an option for a free consultation with an experienced travel insurance expert.

Partnership for Barclays Pingit

and CEGABarclays Pingit, a UK-based service for sending and receiving money via mobile phones, has partnered with CEGA Group, allowing any customers that use the Barclays Pingit ‘send a payment’ app to receive claims payments within as little as an hour of their claim receiving approval. “CEGA has been working closely with Barclays during the development of ‘send a payment’,” commented Warwick Hoddy, fi nancial director at CEGA, “and we are delighted to be the fi rst business to be signed up to use the facility. ‘Send a payment’ exemplifi es CEGA’s innovative and progressive approach to customer service and supports our commitment to fast track claims payments.”

Resolution to capitalise on intra-Africa travel South Africa-based Resolution Insurance is planning to increase the sale of travel insurance coverage by targeting travellers visiting countries where coverage is not mandatory. The company recently diversifi ed its operations – having offered purely medical coverage options, it is now a general insurer – and this is part of its growth strategy. “People buy cover because they want a visa from some embassies, they do not usually ask themselves why that country asks them to buy that cover,” commented Peter Nduati, Resolution’s managing director. Although travel insurance is mandatory when applying for a Schengen visa to travel from Africa to the Schengen zone, some countries are not strict, making coverage sold in Kenya, for example, more popular. Resolution’s new portfolio contains fi ve plans – Schengen , Africa, student, premier and standard – and the company has partnered with Linkham to offer the coverage.

‘Top-up’ cancellation from PJ HaymanUK-based travel insurance provider PJ Hayman is now offering a ‘Top-Up’ cancellation scheme to prevent travellers from going abroad under-insured, responding to the fact that many people are taking increasingly expensive holidays, and could thus fi nd themselves out of pocket were they to cancel their trips. The key features of the ‘Top Up My Cover’ policy include up to £15,000 of cover per person, an upper age limit of 79, no need to declare medical conditions and no limit on the trip duration. “Cover for high- cost holidays is often only available via cruise companies or tour operators,” explained Peter Hayman, director of the company. “This can be expensive, particularly for older travellers or people with medical conditions. Our approach is to allow the consumer to use their existing policy and simply top it up to the level of cover required so that their holiday costs can be fully protected.”

TrawellTag partners with Cover-MoreTrawellTag, an India-based provider of assistance and travel insurance, recently partnered with Australian insurance and assistance provider Cover-More. Re-branding as TrawellTag Cover-More, the companies’ intention is to combine their respective local and global knowledge bases and create ‘compelling’ insurance products. Dev Karvat, TrawellTag’s managing director, commented: “TrawellTag Cover-More represents an amalgamation of two expert, energetic and expanding companies. We are looking to create a new customer benchmark in travel insurance and assistance, both online and offl ine. TrawellTag Cover-More will offer global assistance services such as online tracking of lost luggage, medical and travel insurance, family protection, concierge assistance and ancillary products such as global SIM cards. We will add new products and service dimensions, including e-commerce and m-commerce platforms. In addition, we will have greater focus on claims handling effi ciencies and customer claims experience.”In other Cover-More news, the insurer has announced plans to raise $521 million in an initial public offering, joining many other private equity-owned companies that joined last year’s year’s ‘fl oat rush’. Cover-More’s offer to sell 260.2 million shares for around $2 each closed shortly before Christmas.

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INSURANCEMATTERS 13

The Microinsurance Network has released a report that details the role that microinsurance is playing in the developing world, which states that the recent typhoon disaster in the Philippines has left millions of people without access to basic food and shelter, and saying that in such situations, microinsurance can play a signifi cant role in providing people with means to rebuild their lives.Microinsurance has boomed in the Philippines over the last decade. With a population of 98 million, it has the highest insurance penetration rate in all of Asia and Oceania, with an estimated 19.9 million individuals and properties covered. “This success can be attributed both to the Philippines’ adoption of conducive legislation regulating their insurance market, as well as the establishment of a network of effective distribution channels that can be easily accessed by low income people,” said Dr Antonis Malagardis, programme director of the GIZ Programme ‘Regulatory Framework Promotion of Pro-poor Insurance Markets in Asia’ (RFPI Asia).Yet the challenges faced by clients and insurers in claims repayment following a catastrophic event are not to be underestimated. For instance, the diffi culty that clients have in providing even the most basic documentation to insurers whilst they are left without a home, water, food and electricity. Furthermore, damage to infrastructure and communication channels often mean that it is diffi cult for clients to get information to the insurers, and for insurers to reach their clients. Richard Leftley, CEO at MicroEnsure, a company that has 1.3 million clients in the Philippines alone, reported: “We are aware of over 50,000 claims for calamity related damage to property in the Philippines. However, we have no data on lost lives yet, due to poor communications with affected areas.”At Ahon Sa Hirap (ASHI), a Filipino NGO and microfi nance institution (MFI) that offers a wide range of fi nancial services to clients, the organisation has taken a proactive approach to supporting their clients with claims submissions. The MFI, which counts nine branches in the disaster-struck Panay area, has sent out its agents, equipped with cameras, to help clients document claims and take picture of their houses. Laarnie A. Aquino, one of the agents, reported: “The wide road is blocked due to the falling trees destroyed by the typhoon, and there are no electricity and telecommunication services in the area until now.” The ASHI team was able to take pictures of a number of their clients’ damaged properties, but eventually their camera ran out of battery, and, with no electricity in the area, they continued their documentation work with pen and paper alone. In total, they were able to document damage to over 2,700 of their clients’ properties, with 700 properties completely destroyed.Other insurers, based abroad, are taking a different approach by providing monetary grants to clients affected by the typhoon through local partners on the ground. For example, the Grameen Credit Agricole Microfi nance Foundation has announced that the Group Credit Agricole SA will dedicate €1 million to support rehabilitation work through one of its associations, providing rehabilitation on site.When it comes down to catastrophic risk, the Microinsurance Network said that the sector is still at an early stage of development. “The business case for catastrophic risk still has to be proven; current experiences have not demonstrated the existence of a business case for the private risk carriers unless the public sector is involved to support the initiatives,” said Clémence Tatin-Jaleran of the MicroInsurance Centre. Beyond the business case, it is clear that for catastrophic risk products to be of true value to clients, the sector needs to come up with innovative ways to ensure clients are able to submit and receive their claims swiftly after such an event.According to the 2012 World Disaster Report, the Philippines ranked as the third most disaster-prone country in the world, with an average of 20 typhoons per year. According to the report, typhoon-related damages from 2009 had totalled

US$2.5 billion, and the poverty levels among farmers and fi shermen remained three times higher than the rest of the population. An example of a recently established partnership that aims to offer microinsurance tailored to farmers in the Philippines is that of the International Finance Corporation (IFC), the Center for Agriculture and Rural Development (CARD), and the Pioneer Insurance and Surety Corporation. The new partners will work together to design affordable insurance products for farmers against typhoon-related losses in the Philippines, allowing for risk mitigation for farmer clients of CARD, the largest MFI in the country.The Microinsurance Network and its members believe that microinsurance is an essential component of

sustainable development. “The importance of insurance is clearly evident by the typhoon that ravaged the Philippines,” stated Craig Churchill, chairman of the Microinsurance Network and head of the ILO’s Microinsurance Innovation Facility, during this year’s Ninth International Microinsurance Conference. “While you might argue that for catastrophes such as these, one needs macro insurance, not micro, I contend that they are in fact intimately related,” he continued. “We need to dramatically expand access to better insurance services to build safety nets and enhance the resilience of low-income communities. And the development impact of insurance isn’t just seen at the household level, but also within the

economy as a whole. By managing and diversifying risks, insurance supports entrepreneurs to make higher risk, and higher return investments, thus stimulating growth and bolstering economic development.”

Microinsurance plays increasingly vital industry role

International Travel & Health Insurance Journal

14 INSURANCEMATTERS

Jonathan Tang, an economist for Switzerland-based reinsurer Swiss Re, has said that the structure of the worldwide insurance market is certain to change considerably going into the future, with global business becoming more reliant on Asia. The region’s importance is only going to increase, as the purchasing power of its middle-income earners grows and life expectancy throughout the region rises. It is estimated that life insurance premiums in Asia will rise, making up

six per cent of the global market in 2013, compared with four per cent in 2012, and non-life premiums are expected to rise from three per cent to four per cent over the same span. When global markets were analysed in 2012, the US ranked first for total insurance premiums, followed by Japan, then Britain, then China. Tang also believes that many developed countries, particularly the US, Europe and Japan, face uncertain economic futures.

India’s general insurance market to growA report by India-based insurance broking agency India Insure has suggested that India’s non-life insurance industry will grow by between 17 and 18 per cent by the end of the current fiscal year on 31 March 2014. Premium collections are forecast to reach Rs800 billion, and the middle class will be a major contributor to this growth, particularly with regards to the health segment. The report also states that insurance penetration in rural areas will increase ‘exponentially’, as the country’s Insurance Regulatory and Development Authority begins to allow banks to sell multiple insurers’ products. Bancassurance is reported to be showing good results already as companies’ footprints expand in rural areas, areas that until now have not been well catered for.“The biggest advantage,” commented C. R. Mohan, regional manager of Bajaj Allianz General Insurance, “is that it gives us the distribution muscle in several untapped areas by using the wide reach of our bancassurance partners.”

New rules for China bancassuranceA draft proposal has been issued by the China Banking Regulatory Commission (CBRC) suggesting new rules for banks and postal agencies selling insurance policies, with an emphasis on protection products. The new requirements laid out within the draft include the

suggestion that premiums collected by banks and postal agencies through the sale of protection products need to be at least 20 per cent of the total overall premiums received, and banks and postal agencies are advised that when selecting an insurance partner with which to work, it is essential that they consider the 13-month persistency ratio of the insurer’s bancassurance products, its operating structure and the various functions of the other products it offers.

As well as these proposals, the draft makes an allowance for a certain degree of loosening of the current rules that prohibit insurers from inserting their personnel into bank branches – companies will now be allowed to station their representatives in banks and postal agencies to aid customers with enquiries, although the representative must wear an identity tag clearly identifying them as an employee of an insurer, not the bank or post office in which they are stationed. Feedback on the draft proposal is currently being sought, and the CBRC expects that the new rules will take effect from the beginning of January 2014.

Online opportunities for foreign insurersTony Compton, the head of insurance consulting at KPMG China, an international accounting firm, has said that foreign insurers based in China should take advantage of rapid digitisation of the consumer market to directly target customers and bypass middlemen and other parties who tend to dominate the market. Expanding on this, Compton said that foreign players, having small operations, are in a better position to create innovative online distribution models, whose competitive benefits will attract and lock-in buyers. “The Chinese consumer is forever online,” he explained, “researching products and services, reading and commenting about them on Chinese social networks such as Weibo.”Compton said that the big domestic insurers that exercise the most control over the market – over 90 per cent of China’s insurance market is accounted for by the biggest 10 companies – are so big, and so ‘wedded’ to their traditional product sets and approaches to distribution, that they lack agility, and cannot be as effectively responsive to developing consumer habits and behavioural changes. Risk selection ability is another area that Compton highlighted where foreign insurers possess an advantage, as they have already been practising risk selection and sophisticated pricing for many years, with a number of varied and correlated risk factors, and as the online model is adopted, advanced risk selection will come easier to them.

Willis Re estimates typhoon lossesWillis Re Singapore’s executive director Richard Sanders has offered an estimate for the losses likely to be received by the Philippines insurance market in the wake of Typhoon Haiyan.“Willis Re believes that the potential insurance market loss from this event could be in the region of US$500 million to US$700 million,” Sanders said. “This estimate is based on detailed wind speed data from a range of sources that allowed Willis Re to derive a wind field map for the storm. We combined this wind field with our view of exposure and vulnerability from published academic sources to calculate the market loss. As many of the exposures in the affected regions are uninsured or underinsured, potential post-catastrophe insurance recoveries are likely to be a relatively small proportion of economic losses. Whilst anecdotally, premium volume is growing faster than in many other regions of the world, the Philippines still has one of the lowest insurance penetration rates. Current estimates indicate that Haiyan will be counted as one of the most significant storms in recent times for the Philippines, however it is too early to state with any certainty how much of the damage will end up as recoveries for the reinsurance market.”

Italian outlook is negativeFitch Ratings says in its 2014 Outlook report for the Italian insurance sector that eurozone sovereign risk continues to negatively affect Italian insurers given the significant amounts of government and corporate debt held in their investment portfolios. This is explained by the need to match Italian life liabilities with Italian bonds yielding more than the average guaranteed return and to minimise the risk of lapses. Fitch currently rates Italy at a long-term IDR of ‘BBB+’, with a negative outlook. The eurozone risk is the main factor behind Fitch’s negative rating outlook for the sector. Non-life insurers’ credit fundamentals have improved dramatically since the lows in 2010, said Fitch in its report, adding that a sharp rise in motor tariffs and a fall in claims frequency have been the main drivers of this strengthening. However, Fitch expects a marginal deterioration in technical profitability in 2014 as pricing conditions deteriorate and claims frequency increases as a result of slightly more buoyant economic activity. The report continued: “Life sales and profitability remain volatile. Fitch believes that life premiums are likely to continue to grow in 2014, albeit at a slower

pace than in 2013 (low single-digit percentage), as insurers respond to demand for guarantees and protection. In addition, volatility in the market value of Italian bonds creates volatility in reported profits and new business values because a significant proportion of changes in bond values flow through into reported profit. This trend is likely to continue while the eurozone crisis persists.”

Global industry to rely on Asia

Political risk ‘significant concern’A new report from the Multilateral Investment Guarantee Agency (MIGA) – a member of the World Bank Group – entitled World Investment and Political Risk 2013 has found that political risk remains an area of ‘significant concern’ for investors operating in development markets. This is despite the fact that macroeconomic instability is seen as the key constraint for investing in these economies. Important drivers of new issuance by the political risk insurance industry include persistent instability in the Middle East and North African regions, investor-state disputes and high-profile expropriations in Latin America, re-negotiations of contracts in some resource-rich economies, and general increased financial sector regulation. Public providers’ product lines have expanded – for example, MIGA offers its non-honouring product to state-owned enterprises – and the US-based Overseas Private Investment Corporation now covers investments on the part of private equity funds.Despite the perceived risk, however, most respondents to MIGA’s Political Risk Survey 2013 (cited in the World Investment and Political Risk report) do not plan to withdraw or cancel investments in developing markets.

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It has been reported that reinsurance rates in Malaysia are forecast to be flat in 2014, with reinsurance companies in a battle for larger shares of the market. This is considered to bode well for general insurers, as companies showing good results may be in for some rate cuts.Kong Shu Yin, CEO of RHB Insurance Bhd, described next year’s expected market conditions: “The motor non-proportional reinsurance rate may see some increase as we are seeing some increase in the frequency and severity of … motor bodily injury claim[s]. On the other hand, the increases in the Motor Act premium rates for the past two years as allowed by [Bank Negara Malaysia] may help to reduce the high bodily injury claim ratio and thus help to dampen reinsurance

rate increases.” He added: “I don’t expect to see widespread discounting or full-scale competition for

the motor and fire segments, not until the expected detariffication in 2016.”

Malaysian reinsurance to be flat in 2014Positive predictions from Swiss ReGlobal economic growth will continue to strengthen in 2014, Swiss Re says in its Global insurance review 2013 and outlook 2014/15. This economic growth will support ongoing premium growth in the non-life primary market, particularly in emerging markets, with reinsurance premiums following suit. Global premiums in the life market are expected to grow by around four per cent in real terms in 2014 and 2015. However, life reinsurance premiums are expected to continue to decline in advanced markets, while rising by about six per cent annually in emerging markets. Alternative capital has increased in recent years, putting pressure on prices and margins, particularly in the US catastrophe business. The alternative funds are expected to maintain a focus on established natural catastrophe markets, according to the report.The report also states that the momentum in global economic growth achieved in 2013 will continue into 2014. The US economy is still growing and the euro area, while not expected to accelerate rapidly, has returned to growth. The weaker yen has boosted growth and increased inflation in Japan, but the sustainability of this recent economic strength is uncertain. China’s growth trend is close to 7.5 per cent, down from 10 per cent previously.The gradual improvement in economic activity in key markets has supported continued growth in non-life premium rates, says the report. Real (after-inflation) premium growth in the primary market is projected to be around two per cent in the advanced economies, and close to eight per cent in the emerging markets in 2014. Premium growth in the reinsurance sector will follow suit, but be a little stronger. The low interest rate environment has weighed on investment returns in the primary life market, and reinsurers have been similarly impacted, with sector profitability estimated to be close to 10 per cent in 2013, down from 14 per cent in 2012.Kurt Karl, Swiss Re’s chief economist, commented: “A return to economic growth in the mature markets is a good sign for insurance and we see a positive outlook for the next two years. Emerging markets, especially in Africa and Asia, will definitely provide some of the more spectacular growth figures in non-life business as cities grow and people look for financial protection for their property.”The recent Typhoon Haiyan disaster in the Philippines is unlikely to generate large losses for non-life insurers, continued the report, because of the very low insurance penetration in the Philippines, currently at around 0.5 per cent, compared with an emerging market average of about 1.3 per cent.Global primary life premiums have continued to recover this year, with emerging market real premium growth above six per cent and advanced market growth at 2.3 per cent. Global life premium growth is projected to rise to around four per cent in 2014 and 2015, fuelled by robust emerging market growth on the basis of rising incomes and increased insurance awareness. Life insurance premium growth has rebounded sharply in emerging Asia, growing by about

six per cent in real terms in 2013.

Karl said: “The figures for emerging markets in 2013 have been robust and this is expected to continue. In Latin America, we saw 18-per-cent growth in 2012 and in 2013 we

are looking at 10-per-cent

growth, which is still very good.”

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16 INSURANCEMATTERS

NEWSWIREUS-based life insurer MetLife, which is pursuing business among Southeast Asian markets, has been granted a licence to open a representative officer in Myanmar. Dr Nirmala Menon, senior vice-president and head of designated markets and health in Asia for MetLife, said: “With its economic growth prospects and favourable demographics, Myanmar is an attractive market for MetLife’s continued expansion ambitions into Southeast Asia, and follows our recent announcement of the formation of a joint venture with Bank for Investment & Development of Vietnam.”

DWF, a UK-based business law firm, has announced that its insurance dvision’s income has increased by 34 per cent – from £30.6 million to £41 million – by diversifying and developing its core practice offering. These new results account for 47 per cent of total revenues for the firm, and have been contributed to by the company’s acquisition of a 48-strong team – including 11 partners – from specialist insurance law firm Greenwoods, boosting both its catastrophic and large loss personal injury and non-injury practices.

A new study from KPMG International, Global Profiles of the Fraudster, has highlighted the problematic role that new technology is playing in the expansion and advancement of fraudulent practices. “What we are seeing is a new generation of people able to use more technology and with access to much more information than past generations,” said KPMG Australia’s national head of forensic, Gary Gill, “all of which points to a new era for fraud and illegal activities.” The report reveals, worryingly, that most organisations do not seem to realise quite how exposed their systems are to loss of sensitive information.

AM Best, a provider of various services for the insurance industry, has said that Super Typhoon Haiyan is likely to be an ‘earnings event’ for reinsurers – a minor event for large global companies, but a substantial one for smaller, regional players. “Insured losses are expected to be minimal because of the country’s low non-life insurance penetration,” said AM Best, “significantly less than one per cent of gross domestic product. One preliminary estimate placed total economic losses at US$14 billion and insured losses at US$2 billion, but it is too early to calculate any reliable figures for this event.”

Allianz Group has posted its results for the third quarter of 2013, showing that the company has continued its good development from the first half of the year, despite negative foreign currency effects. Revenues were stable at €25.1 billion, with a high-level operating profit of €2.5 billion, while net income attributable to shareholders rose 6.3 per cent to €1.4 billion. Overall, 2013 operating profit is expected to be slightly above the target range previously outlined by Allianz.

It is feared that recent anti-government protests in Thailand are likely to undermine the confidence of investors and detract further from a 2014 growth outlook that is already seeming perilously fragile, according to Moody’s Investor Service. “Prolonged or escalating protests will adversely affect foreign investment and tourism, and exacerbate delayed public infrastructure investment, which will weigh on Thailand’s future growth in 2014 and beyond,” states a Credit Outlook report from the ratings agency. “While Thailand’s credit fundamentals still compare favourably with similarly rated peers, weaker growth will negatively affect the fiscal balance and contribute to rising debt ratios.”

The increasing levels and awareness of identity fraud, consumer concerns over insurance product mis-selling and calls for more help for victims, all serve to highlight the need for identity fraud insurance product providers to focus on robust and ethical cover if the market is to grow, according to UK-based company Arc Legal Assistance (Arc Legal). A recent online survey of over 2,000 adults in Great Britain commissioned by Arc Legal and conducted by YouGov found high levels of awareness of identity fraud. Ninety-four per cent of respondents said they were either fairly or very aware of identity fraud. Concerns about becoming a victim of identity fraud in the future were also high with a total of 79 per cent saying they were either fairly or very concerned.These concerns appear to reflect the growth in this kind of fraud. Figures from the UK’s Fraud Prevention Service, CIFAS, Fraudscape research show identity related fraud increased in 2012 by over nine per cent compared to 2011 and represented almost 50 per cent of all fraud recorded by its members. By far the largest increase was in loan fraud – where a loan is taken out in a fraudulent name – which increased by over 87 per cent compared to 2011. Richard Finan, director of Arc Legal, said: “The CIFAS report shows an overall five-per-cent increase in all frauds recorded in 2012 and this was driven exclusively by identity related crimes. This fact, together with the publicity given to recent product mis-selling, and general low levels of awareness of insurance products,

creates a mix of issues that insurance providers need to address to ensure cover is relevant, robust and accessible to meet the evolving needs of consumers.” Respondents to the Arc Legal survey gave a clear message about the need for information on identity fraud, with 83 per cent agreeing there should be more information available about identity fraud and how to avoid it. Similar numbers (80 per cent), wanted to see more being done to help victims of identity fraud.Arc Legal fully supports any move to increase the support available to victims. However, it believes more needs to be done to ensure consumers are aware that insurance protection is available. While nearly a quarter (24 per cent) of respondents indicated they would be likely to buy an insurance product that pays for any expenses, losses, and solicitors fees resulting from being a victim of identity fraud if it was available at an acceptable price, only 23 per cent said they were aware of such an insurance product.Finan continued: “Our own survey shows that consumers want to see more done to tackle the issue, but insurance to address the impact of this kind of fraud is not well known about. This is a worrying matter especially as the average cost to each victim is in excess of £1,190. We have our own initiatives including sales training on product benefits for our distribution partners, to try and increase awareness, but more can be done to ensure consumers are aware of the protection available addressing the actual needs of victims of identity fraud.”

In a recent survey of perceived insurance industry risks carried out by international professional services firm Towers Watson, the risk of a worldwide pandemic came first. It was followed by: natural catastrophe; food/water/energy crisis; cyber warfare/abuse of technology (e.g. hacking); economic depression; banking crisis; an extreme event leading to property damage, supply chain failure or business interruption; a rise in extreme weather; and sovereign default.Commenting on the results, Towers Watsons’ senior consultant for risk consulting and software Stephen Lowe said: “Much as we would have expected pandemics and natural catastrophes to figure prominently in insurers’ extreme risk thinking, the high rankings of concerns, such as cyber-warfare and a major data compromise in the cloud, illustrate how the industry is keeping up to date with risk assessment.”For an in-depth discussion of the topic of pandemics, see our feature Infections, Injections and Insurance Exemptions in ITIJ Issue 154, November 2013.

Hong Kong non-life in troubleA new industry forecast report from Timetric suggests that despite healthy growth rates in terms of premiums, Hong Kong’s non-life market is having trouble maintaining attractiveness in the region. Written premiums in the segment grew at a compound annual growth rate (CAGR) of 7.5 per cent between 2008 and 2012, from HK$14.3 billion to $19.1 billion, but Hong Kong retains one of the lowest growth rates of the Asia-Pacific markets, surpassing only Pakistan, South Korea and Taiwan. One positive point raised, however, was an expansion of construction projects, boosting the general liability

insurance category, and Carlos Pallordet, an economist for Timetric, commented: “The

large-scale construction projects being undertaken in Hong Kong [have] been beneficial to both the infrastructure and the economy. It has already had positive knock-on effects in the non-life insurance segment, and is expected to remain a positive influence over the coming years.”

PwC poll finds big data importantA new poll from PricewaterhouseCoopers (PwC) has found that the ‘vast majority’ – 91 per cent – of insurance executives believe that big data will be an important driver of competitive differentiation in the future. Over 90 per cent of respondents think that big data will drive the transformation of business models, while 44 per cent believe that it is at the heart of informing and shaping strategy, and over half believe that the biggest impact will be in terms of customer insight. The poll was conducted at the Insurance Insights Strategy conference, sponsored by PwC, and Jonathan Howe, PwC’s UK insurance leader, commented: “Big data and analytics are high on the agendas of nearly all insurance companies these days, and our poll confirms that the majority of insurers appreciate just how fundamental big data is to shaping their business and staying ahead of competition.” Twenty-four per cent of respondents also believe that big data will improve underwriting effectiveness, while 15 per cent think that pricing optimisation will be the most affected area. “This is a mandate for action,” said Michael Spiteri, insurance analytics partner at the firm, “and this can’t be left for another day or another budget cycle. When this is combined with a clear framework focused on enabling and embedding anlytics, insurers can create an insight-driven business model that can, in turn, create sustainable and repeatable business advantage.”

Need for ID fraud cover increases

Pandemic tops risk poll

NEWSWIREUS-based life insurer MetLife, which is pursuing business among Southeast Asian markets, has been granted a licence to open a representative officer in Myanmar. Dr Nirmala Menon, senior vice-president and head of designated markets and health in Asia for MetLife, said: “With its economic growth prospects and favourable demographics, Myanmar is an attractive market for MetLife’s continued expansion ambitions into Southeast Asia, and follows our recent announcement of the formation of a joint venture with Bank for Investment & Development of Vietnam.”

DWF, a UK-based business law firm, has announced that its insurance dvision’s income has increased by 34 per cent – from £30.6 million to £41 million – by diversifying and developing its core practice offering. These new results account for 47 per cent of total revenues for the firm, and have been contributed to by the company’s acquisition of a 48-strong team – including 11 partners – from specialist insurance law firm Greenwoods, boosting both its catastrophic and large loss personal injury and non-injury practices.

A new study from KPMG International, Global Profiles of the Fraudster, has highlighted the problematic role that new technology is playing in the expansion and advancement of fraudulent practices. “What we are seeing is a new generation of people able to use more technology and with access to much more information than past generations,” said KPMG Australia’s national head of forensic, Gary Gill, “all of which points to a new era for fraud and illegal activities.” The report reveals, worryingly, that most organisations do not seem to realise quite how exposed their systems are to loss of sensitive information.

AM Best, a provider of various services for the insurance industry, has said that Super Typhoon Haiyan is likely to be an ‘earnings event’ for reinsurers – a minor event for large global companies, but a substantial one for smaller, regional players. “Insured losses are expected to be minimal because of the country’s low non-life insurance penetration,” said AM Best, “significantly less than one per cent of gross domestic product. One preliminary estimate placed total economic losses at US$14 billion and insured losses at US$2 billion, but it is too early to calculate any reliable figures for this event.”

Allianz Group has posted its results for the third quarter of 2013, showing that the company has continued its good development from the first half of the year, despite negative foreign currency effects. Revenues were stable at €25.1 billion, with a high-level operating profit of €2.5 billion, while net income attributable to shareholders rose 6.3 per cent to €1.4 billion. Overall, 2013 operating profit is expected to be slightly above the target range previously outlined by Allianz.

It is feared that recent anti-government protests in Thailand are likely to undermine the confidence of investors and detract further from a 2014 growth outlook that is already seeming perilously fragile, according to Moody’s Investor Service. “Prolonged or escalating protests will adversely affect foreign investment and tourism, and exacerbate delayed public infrastructure investment, which will weigh on Thailand’s future growth in 2014 and beyond,” states a Credit Outlook report from the ratings agency. “While Thailand’s credit fundamentals still compare favourably with similarly rated peers, weaker growth will negatively affect the fiscal balance and contribute to rising debt ratios.”

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18 TRAVELMATTERS

New Zealand-based Southern Cross Travel Insurance (SCTI) CEO Craig Morrison has offered a warning to Kiwi tourists – although the advice is applicable to all tourists – enjoying the action in Las Vegas, US, saying that ‘opportunistic crooks’ are everywhere, waiting to take advantage of unsuspecting or careless travellers.“We certainly see the claims,” Craig said. “Vegas, like many party destinations, leaves people dazzled by the bright lights and hedonistic atmosphere and some seem to lose all common sense. But, like anywhere, you need to keep your wits about you. Though this might sound obvious, people need to be really careful about carrying unreasonable amounts of money on them, flashing wads of notes around, or counting money publically if they’ve had a win at the casino. And whatever you do – don’t put it in your back pocket!” He added: “You’d be surprised at the number of claims we see from travellers

who, having invited someone back to their hotel room, wake up in the morning having been totally cleaned out; wallet, camera, phone and computer.” He also explained that ‘if you invite someone back to your accommodation, they are your guest and you are responsible for them’, referring to the fact that SCTI’s policies do not cover claims incurred as a result of ‘unknown people’ being invited back to hotels by policyholders. “If you don’t know them well enough or don’t supervise them and they steal your property, it can’t properly be considered an unexpected event.” Craig also listed drink spiking and pickpocketing

as problems in the party city.That such seemingly obvious advice must still be offered, based on claims received, shows that there is still a long way to go when it comes to educating the public about their responsibilities.

Sharks a problem in Maui?Largely regarded as a paradise for tourists, there are fears for the reputation of Hawaiian island Maui, which suffered its eighth shark attack of 2013 (the thirteenth in the state as a whole) – statistically not a huge number of attacks, but potentially enough to dissuade visitors. A tourist had been fishing with his foot dangling over the edge of a boat when a shark bit him, and he was later pronounced dead. The attack occurred at Keawakapu Beach, around three miles from White Rock, where a 20-year-old German visitor died from a shark attack back in August last year.

Uganda updatesUganda’s tourism board, Tourism Uganda, wound up its operations for 2013 with a series of ‘consultative workshops’, which analysed input from the private sector and decided how best to develop tourism in the country. One initiative that was discussed was the United Nations Development Programme-supported (UNDP) co-operative agreement with the United Nations World Tourism Organization (UNWTO), under which the ‘Support for the Development of Inclusive Markets in Tourism’ will be implemented. The project aims to involve more poor and local communities in the tourism industry as consumers, employees and enterprises, and to empower the disadvantaged via access to labour and markets for their produce. Uganda has also scrapped VAT on certain key tourism services, as announced in a letter from the country’s permanent secretary to the Treasury: “I wish to inform you that during the passing of the VAT Amendment Bill 2013/14, exemption on the supply of hotel

accommodation in tourist lodges and hotels outside Kampala District was reinstated.” The now-

scrapped VAT added an 18-per-cent expense to accommodation packages for safaris in

Uganda, and foreign tour companies were refusing to pay as a result. The move has been welcomed by

tourism stakeholders. However, over in Kenya, VAT still stands at

16 per cent – it is expected that Uganda will now be

held up as an example by those wishing to

scrap the tax in Kenya.

British paraglider dies in KangraIn the wake of the death of a British paraglider in Kangra, Kapoor, India, a renewed focus has been placed on illegal paragliding activities occurring in the area. The tourism department has rules on the subject, but they are often violated as there is no distinct body in place to investigate.Richard Samson had apparently not sought permission or advice from relevant authorities before flying, although the rules state that permission must be sought. An inquiry has been ordered into the man’s death.“The incident has brought a bad name to Dharamsala [in Kangra] as a tourist destination,” commented Kishan Kapoor, a former BJP leader. “Earlier also a youth had died in a similar incident.”

Sustainable travel solutions promotedCalifornia-based Green Globe Certification is working hard to keep sustainable solutions at the top of the agenda for the international travel and tourism industry, and the organisation made sure that its presence was known at the Caribbean Tourism Energy Forum (CTEF) in December, with its Caribbean representative Wendy Walker-Drakes acting as a presenter at the new annual event, intended to connect the Caribbean hospitality industry with globally-renowned providers of capital, expertise and technology.Speaking before the event, Walker-Drakes said: “This CTEF meeting is very important, as it will bring together the major stakeholders in the energy and tourism sectors, technology and financing, along with policy agencies and local hoteliers, to examine the challenges of doing sustainable business in the region. Green Globe members are committed to continuously improve their energy performance.”

Australia’s Northern Territory among ‘Best of the World’The Northern Territory in Australia has been included in the National Geographic Traveler magazine’s 2014 top 20 Best of the World list – which reflects superlative authenticity, cultural richness and sustainability in the world of travel – and is the only area of Australia to receive a mention.“This is fantastic news for the territory,” commented Australian tourism minister Matt Conlan. “It means now the whole world knows the Territory is the place to visit.”Describing the Northern Territory, the magazine praised both its physical beauty and the people who live there.Other areas included in the list are: Alentejo, Portugal; Bolaven Plateau, Laos; Cathar country, France; New Orleans, Louisiana, US; Riga, Latvia; and Sochi, Russia.

China and Russia to ‘expand co-operation’Shao Qiwei, the chairman of China’s National Tourism Administration (CNTA), announced in November that China is to ‘expand tourism co-operation’ with Russia, and shared plans to promote less well-developed Chinese cities with huge tourist resources to Russian tourists. Shao was addressing the First China-Russia Culture and Tourism Forum in late November, and praised both countries’ rich cultural histories. “As for promoting tourism,” he said, “an important carrier of culture, we plan to refocus from such developed cities as Beijing and Shanghai to those less developed ones.”Last year, the two countries began the ‘China-Russia Tourism Year’, which included the Year of Chinese Tourism in Russia and the Year of Russian Tourism in China, as part of efforts to strengthen tourism ties and ‘humanistic exchanges’ between the nations.“We keenly invite more Russian friends to visit China and believe more Chinese nationals will travel to Russia,” wrote Chinese Premier Li Keqiang in a letter of congratulations.

Crooks lurking in Las Vegas

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TRAVELMATTERS 19

‘Economic airlines’ flourishing in Middle EastA new analytical report carried out by Amadeus, a provider of IT solutions to the travel industry, has found that low-cost ‘economic airlines’ are flourishing in the Middle East, and expressed confidence in these airlines’ ability to expand. Between the first half of 2012 and the first half of 2013, overall absorptive capacity has increased from 11.5 million seats to 13.5 million seats. Commenting on the findings, one of Amadeus’ economic airlines specialists, Alexander Gore, said: “We are seeing a boom in the capacity of low-cost airlines throughout Asia as the air travel sector is suffering from a big gap. However, the capacity across developed markets in Europe and North America is restricted. With 25-per-cent growth on an annual basis during the first half of 2013, airline reservations for low-cost airlines at Amadeus are increasing dramatically, which is an encouraging sign of our ability to adapt to the needs of these airlines.”

European tourism ‘upswing’ persistsThe annual ITB World Travel Trends Report released by tourism research company IPK International has found that despite lingering economic difficulties in many areas, in general, Europe’s tourism industry is remaining buoyant, showing a persistent upswing that bodes well for 2014. Outbound tourism grew by 2.5 per cent between January and August compared with 2012, although figures were very different depending on the source market – for example, Germany’s market expanded by two per cent, while the number of holidays taken by Italians dropped by five per cent. The biggest beneficiaries of the upswing were South America and the Pacific, which respectively reported nine and six-per-cent increases in arrivals. North America’s market maintained stability, but the market in the Caribbean shrank by eight per cent. Most countries reported an increase in arrivals from France, Germany, Norway, Russia, Switzerland and the UK.The report’s 2014 forecast is favourable. Twenty-eight per cent of survey respondents said that they intended to travel abroad more next year – the same amount as responded positively in the 2012 edition of the report – and 42 per cent said that they would continue to travel as they did in 2013. Only nine per cent of respondents said that they would be travelling less, and overall growth of between three and four per cent is predicted for 2014.

Kenya ‘leading safari destination’Kenya has had much to celebrate recently. As well as marking its fiftieth year of independence with a Golden Jubilee event, its Tourism Board was named Africa’s Leading Tourist Board at the Africa World Travel Award Ceremony in October, and received the World’s Leading Safari Destination trophy at the Global World Travel Award ceremony in November. These awards will bolster Kenya’s efforts to outstrip its competitors on the continent and bring more visitors to its famous parks, beaches and game reserves.

Travellers’ data not secure A study undertaken by software company AnchorFree, which provides secure web browsing capabilities, has found that an astonishing 90 per cent of travellers expose their data to cyber criminals. Travellers are apparently almost entirely unaware of the danger of unsecured public wi-fi networks,

with nine out of 10 UK travellers exposing financial and personal information over these, and although 77 per cent of respondents expressed an ‘awareness’ of the potential consequences of using unsecured overseas wi-fi networks, only 10 per cent took any kind of protective measure. The study also found that around 87 per cent of global wi-fi hotspots are not secure.

Colombia targets Trinidad and TobagoColombia’s government is aiming to earn US$4 billion in foreign exchange through tourism in 2014, and has announced that Trinidad and Tobago is one of the primary target markets from which it wants to attract visitors. Proexport Colombia, which is responsible for the promotion of Colombia’s international tourism, foreign investment and non-traditional export businesses, has launched a new strategy to achieve this aim, partly through a tourism campaign called Colombia is Magical Realism.“The message has switched from just coming to visit Colombia, to coming for an unforgettable magical experience,” commented Carlos Gonzalez, director-Caribbean for Proexport Colombia.The campaign is specifically designed to increase visitor arrivals, generate new opportunities for investment in the country’s tourism infrastructure, boost employment and generally promote Colombia to the same degree as other, more competitive destinations. According to the World Tourism Organization, foreign tourism to Colombia grew at an average rate of 10.4 per cent between 2005 and 2012 – three times higher than the average global rate for that period.

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20 HEALTHMATTERS

Diseases fly into AustraliaAccording to the Australian government-run National Notifiable Disease Surveillance System (NNDSS), there are a significant number of diseases imported into the country each year by travellers, or by someone who came into contact with an infected traveller. The diseases include hepatitis A, measles, typhoid, Japanese encephalitis, malaria, dengue fever, chikungunya and rabies. There were 161 cases of Hepatitis A imported in Australia in 2013, which was a decrease of four from 2012, almost all of which were imported by travellers or linked to travel in some way. Measles has been virtually eliminated in Australia, and the 129 cases reported in 2013 were either contracted during travel, or resulted from contact with a traveller. The majority of cases towards the tail end of 2012 were from travellers who had visited Bali. The average number of cases of Typhoid seen in Australia has increased dramatically from five years ago, which the NNDSS attributed to the rising number of travellers who choose to visit areas where the disease is endemic, such as India. Imported malaria cases continue to be a problem, with health authorities reporting 354 infections in 2013, while the incidence of Dengue fever is steadily increasing around the world, a fact reflected in Australia’s own figures. A rapid rise of Chikungunya infections is also concerning health authorities, with the NNDSS saying that in 2013, 120 travellers returned to Australia with the infection, compared to 19 the year before, which highlights the rising incidence of the disease in Asia and the Pacific region.

Researchers from Boston University Schools of Medicine (BUSM) and Public Health (BUSPH) and Boston Medical Center (BMC) have found that high-risk travellers account for nearly 20 per cent of patients using the five clinics of the Boston Area Travel Medicine Network (BATMN). The study, which appears online in Mayo Clinic Proceedings, also found that these travellers often visited destinations with malaria and typhoid risk.In 2010, an estimated 935 million travellers crossed international borders, including 28.5 million from the US. Certain travellers are at greater risk of disease because of age or underlying medical conditions. Information on numbers and characteristics of persons going overseas has not been as readily available as reports of disease in returning travellers, so this study is one of the first to provide information on high-risk persons where travel and demographic characteristics are stratified by traveller health status.In this study, high-risk travellers were categorised into one of three groups: immunocompromised travellers, persons with non-immunocompromising medical comorbidities (cardiac or pulmonary disease) and pregnant women. Of 15,440 travellers, 74.3 per cent had medical comorbidities, 23.3 per cent were immunocompromised travelers, 17.9 per cent were high-risk and 2.5 per cent were pregnant. High-risk travellers were older than healthy travellers and included a greater proportion of persons older than 60 years. Overall, 93.9 per cent of high-risk travellers visited countries with medium or high risk of typhoid fever, 85.7 per cent visited malaria-risk countries, and 22.8 per cent visited yellow fever-endemic countries.

Among travellers to yellow fever-endemic countries, 44.4 per cent of immunocompromised travellers and 34.8 per cent of pregnant women received the yellow fever vaccine. Among eligible high-risk travellers, 35.7 per cent received either tetanus-diphtheria or tetanus-diphtheria-pertussis vaccinations, 33.3 per cent received an influenza vaccination and 14.5 per cent received a pneumococcal vaccination. “We found that many travellers seeking pre-travel care are high-risk and that they have a unique set of needs in terms of travel risks, vaccinations and counselling,” said lead author Dr Natasha Hochberg, assistant professor of medicine at BUSM, assistant professor of epidemiology at BUSPH and co-director of BMC’s Travel Clinic. “We recommend that travellers, particularly high-risk travellers, seek care early in the course of their travel planning to allow adequate time to review their needs and that they be referred to experienced travel medicine providers,” she added.For example, most travellers to yellow fever-endemic countries received the yellow fever vaccine. However, the decision to provide live virus yellow fever vaccines to high-risk persons requires a complicated, informed decision-making process to review risks and benefits. “Travel clinic visits need adequate time to address the additional elements of the medical history as well as to allow counselling topics to be covered thoroughly. This information is meant to raise awareness of the benefit of pre-travel care for high-risk travellers and improve understanding among clinicians regarding their patients’ needs and the provision of appropriate advice,” added Hochberg.

New Caledonia authorities on alertHealth Services representatives on New Caledonia have introduced border control measures in an effort to identify travellers who are suffering from the mosquito-borne zika virus. Visitors to New Caledonia are required to fill out a health form on arrival, detailing any diseases they may have, and head of Health Services Jean Paul Grangeon said people need to be honest if they are carrying a disease. He added that zika virus could be confused with other similar illnesses, as the symptoms are akin to those suffered by people with dengue fever: “It’s quite the same symptoms except in zika virus there is more cutaneous rash. But we in New Caledonia can make a blood test to [tell] the difference.” Everyone, he said, entering the island with a fever or joint pain is being tested for dengue, chikungunya and zika viruses.Zika virus was first discovered in the Zika forest of Uganda in 1947, and was first detected in humans in 1968 in Nigeria. Since then, it has appeared in isolated areas of India, Malaysia, the Philippines, Thailand, Vietnam and Indonesia. The virus is passed on from person to person through bites from Aedes mosquitoes, most commonly Aedes aegypti, which also transmit dengue and chikungunya.Dr Eddy Bajrovic, medical director of Travelvax Australia, said the appearance of zika in more areas of Asia, as well as far-flung destinations in the Pacific (such as New Caledonia), is ‘yet another reason for Australians travelling in the region to protect themselves against biting insects’. He added: “Yellow fever and Japanese encephalitis are the only mosquito-borne diseases for which there are effective vaccines. However, as there are numerous insect-borne diseases, travellers should take the full range of measures to protect themselves from bites.” The ready availability of rapid international flights, he added, means there is a very real potential for the virus to become firmly established in Asia, Latin America, the Caribbean and southern states in the US.

Polio returns to East AfricaAccording to the Global Polio Eradication Initiative, as of 19 November 2013, 183 cases of polio had been reported from Somalia, 14 polio cases from Kenya and six cases from the Somali Region of Ethiopia since April 2013. These were the first wild poliovirus cases reported in Somalia since 2007, in Kenya since July 2011 and in Ethiopia since 2008. The US Centers for Disease Control and Prevention (CDC) has recommended that all travellers to the three nations be fully vaccinated against polio. In addition, adults should receive a one-time booster dose of polio vaccine.Because of the risk of cross-border transmission, the CDC recommends a one-time booster dose of polio vaccine for fully vaccinated adults who are traveling to Djibouti, Eritrea, Sudan, South Sudan, Uganda, and Yemen to work in healthcare facilities, refugee camps, or other humanitarian aid settings.

Travel linked to STI riskResearch from the World Health Organization has shown that travel is linked to an increased risk of catching sexually transmitted infections (STIs). The organisation warned: “Unprotected sex, in some

parts of the world, especially with high-risk groups like commercial sex workers, is more likely to expose [travellers] to STIs, including HIV.” Travellers were thus advised to pack condoms and ensure they get the necessary vaccinations for their destination.

Malarial spread slowsA Canadian citizen on holiday in Costa Rica became the sixth recorded case of malaria in the country in 2013, although health authorities have said that the traveller actually contracted malaria while in Peru. Director of Health Surveillance Mary Trejos said that the patient in question had spent two weeks travelling around Peru, followed by seven days in Panama, before arriving in Costa Rica, adding that due to the incubation period of the disease, it was possible to identify the time the disease was contracted.In Greece, meanwhile, the number of laboratory confirmed cases of malaria throughout 2013 was just 20, 17 of which were imported (10 cases were observed in migrants from malaria endemic countries and seven in returning travellers, while three were locally acquired). Health authorities in the country said that 2013 saw the lowest number of infections in four years.

Word Cup dengue warningBrazilian health authorities announced recently that as of November 2013, there had been 1.4 million suspected dengue cases nationwide throughout the year, including 573 deaths. Thus, football fans from Australia, Europe and other temperate regions outside the tropics should be prepared for dengue from the moment they arrive to enjoy the World Cup, according to Dr Eddy Bajrovic, medical director of Travelvax Australia, who said: “With dengue present, World Cup fans can’t afford to be complacent about mosquitoes. There is no vaccine for dengue, so spectators need to know where and when they are most likely to be at risk and how best to protect themselves.” He went on to say: “The disease is spread by two types of Aedes mosquitoes that are found close to human habitation – from the yards of private homes and backpacker hostels, to the gardens of outdoor restaurants and upmarket hotels. In fact, it’s quite possible that there

will be mosquito breeding sites in and around the stadiums themselves. If these mosquitoes are not already carrying the virus, they could bite spectators who are and pass it on to others.” The number one protection measure is an effective insect repellent applied to exposed skin at all times when outdoors. “Dengue-carrying Aedes mosquitoes can bite at any time during daylight hours,

but their main feeding times are a couple of hours after sunrise and just before sunset,’ Dr Bajrovic added. “Those are the times when travellers should not only be protected by repellent, but ideally be wearing a long-sleeved shirt, long pants, and shoes and socks if they plan to be outside.”

Measles spreadsAs of November 11, 2013, the World Health Organization reported more than 6,300 confirmed measles cases in Indonesia during the year. In August 2013, a US traveller returned from Indonesia with measles and spread the disease in a Texas community. In October, five Australians were diagnosed with measles after returning from Bali. As a result of the high number of infections reported from Indonesia, the US Centers for Disease Control and Prevention has issued a travel notice for Americans going to the region to be vaccinated against the disease.

High-risk travellers cause concern

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HEALTHMATTERS 21

Tuberculosis (TB) treatment has saved the lives of more than 22 million people, according to the World Health Organization’s (WHO) Global tuberculosis report 2013, which was published recently. The report also reveals that the number of people suffering from TB fell in 2012 to 8.6 million, with global TB deaths also decreasing to 1.3 million. The new data confi rms that the world is on track to meet the 2015 UN Millennium Development Goals (MDGs) target of reversing TB incidence, along with the target of a 50-per-cent reduction in the mortality rate by 2015 (compared to 1990). A special Countdown to 2015 supplement to 2013’s report provides full information on the progress to the international TB targets. It details if the world, and countries with a high burden of TB, are ‘on-track’ or ‘off-track’, and what can be done rapidly to accelerate impact as the 2015 deadline approaches.The report underlines the need for a quantum leap in TB care and control which can only be achieved if two major challenges are addressed: around three million people (equal to one in three people falling ill with TB) are currently being ‘missed’ by health systems; and the response to test and treat all those affected by multidrug-resistant TB (MDR-TB) is inadequate.Insuffi cient resources for TB are at the heart of both challenges, said the WHO. TB programmes do not have the capacity to fi nd and care for people who are hard-to-reach, often outside the formal or state health system. Weak links in the TB chain (a chain that includes detection, treatment and care) lead to such people being missed. “Quality TB care for millions worldwide has driven down TB deaths,” said Dr Mario Raviglione, WHO director of the Global TB

Programme. “But far too many people are still missing out on such care and are suffering as a result. They are not diagnosed, or not treated, or information on the quality of care they receive is unknown.” The WHO estimates that 75 per cent of the three million missed cases are in just 12 countries. On the second challenge, the problem is not only

that the links in the MDR-TB chain are weak, but that the links are simply not there, the report suggests. The WHO estimates that 450,000 people fell ill with MDR-TB in 2012 alone. China, India and the Russian Federation have the highest burden of MDR-TB, followed by 24 other countries.While the number of people detected worldwide with rapid diagnostic tests increased by more than 40 per cent to 94,000 in 2012, three out of four MDR-TB cases still remain without a diagnosis. Even more worrying, around 16,000 MDR-TB patients reported to the WHO in 2012 were not put on treatment, with long waiting lists increasingly becoming a problem. Furthermore, many countries are not achieving high cure rates due to a lack of service capacity and human resource shortages. “The unmet demand for a full-scale and quality response to multidrug-resistant tuberculosis is a real public health crisis,” commented Dr Raviglione. “It is unacceptable that increased access to diagnosis is not being matched by increased access to MDR-TB care. We have patients diagnosed, but not enough drug supplies or trained people to treat them. The alert on antimicrobial resistance has been sounded; now is the time to act to halt drug-resistant TB.” A further challenge identifi ed relates to the TB and HIV co-epidemic. While there has been signifi cant progress in the last decade in scaling-up antiretroviral treatment for TB patients living with HIV, less than 60 per cent were receiving antiretroviral drugs in 2012. This, the report urges, must improve.

Fake rabies vaccine alertThe Philippines Food and Drug Administration (FDA) has reported the detection of a fake rabies vaccine on Luzon Island, prompting the authority to warn citizens that the fake version of the Indian-made Rabipur

vaccine was being sold in vaccination clinics and drugs stores, as well as being available

online. The FDA has warned that it is currently unclear how

long the fake vaccine has been in circulation. News of the fake Rabipur has coincided with a renewed effort

by the United Nations to fi ght the

availability of fake drugs. The UN has

joined forces with the International Federation of

Pharmaceutical Manufacturers and Associations, creating a ‘Fight the

Fakes’ website to highlight the dangers of taking such drugs. According to Dr David Shlim, president of the International Society of Travel Medicine (ISTM), it would be ‘tantamount to murder if someone died as a result of receiving the fake rabies vaccine’. In a statement alerting ISTM members about the problem, Dr Shlim said: “Although most travel medical professionals will have been aware of the risk of counterfeit medications sold in pharmacies throughout the world, there has been less concern about counterfeit vaccines. It is especially troublesome when the vaccine is known to be life-saving. A fake vaccine could be the equivalent of murder if a patient were to subsequently die.”

TB control saving lives

International Travel & Health Insurance Journal

IPMI NEWS22

Broward Health joins IAGBroward Health International has been accredited as the International Assistance Group’s (IAG) first healthcare system Preferred Provider. The IAG consists of 66 global partners, divided into three categories – Core Partners, Assistance Partners and Preferred Providers.Broward Health International’s range of services include physician referral, medical documentation for visas, air ambulance co-ordination, translation services, and more.Abbe Bendell, senior vice-president and chief operating officer of Broward Health International, commented on the move: “Broward Health is honoured to become a Preferred Provider of the IAG. [We] are committed to providing excellent quality care for international assistance companies and their patients. We believe the IAG relationship strengthens Broward Health’s position in the international marketplace.”

Bupa collaborates with ITUThe International Telecommunication Union (ITU), the United Nations’ specialised agency for information and communication technologies, has signed a partnership agreement with international healthcare company Bupa, to collaborate on a global ‘m-Health’ initiative called Be Healthy, Be Mobile. Bupa and ITU will join forces to provide multidisciplinary expertise, health information and mobile technology to fight chronic non-communicable diseases (NCDs), including diabetes, cancer, cardiovascular and chronic respiratory diseases, in low- and middle-income countries. The programme is led by ITU and the World Health Organization (WHO). Welcoming the partnership, ITU secretary-general Hamadoun Touré said: “Non-communicable diseases are the single greatest factor contributing to mortality and the overall disease burden in developed countries and emerging economies alike. Where m-Health is concerned, ITU works with the WHO to share our long-standing experience and our competence in mobile technologies and healthcare as well as our network of partners. We are truly excited about the potential of this new partnership with Bupa to help us accelerate the adoption of mobile health interventions worldwide.”Bupa CEO Stuart Fletcher commented on the aim of the partnership: “Of the 36 million people who died from chronic disease in 2008, nine million were under the age of 60; and 90 per cent of these premature deaths occurred in low and middle-income countries. m-Health is a cost-effective and accessible way to get health information and tools to people so that they can keep well and we can reduce the impact of chronic diseases worldwide. Through this partnership, we will be at the heart of a systemic intervention in healthcare and will help millions of people to live longer, healthier, happier lives, fulfilling our purpose.”

Bupa will contribute with expert knowledge, health information and innovative technology to support the adoption of m-Health interventions by governments to address prevention and treatment of NCDs and their common risk factors, including tobacco use, poor diet, stress and physical inactivity.

Clements expands networkClements Worldwide, a UK-based provider of international insurance solutions, has announced the expansion of its Global Broker Network, which is now open to new brokers interested in joining and obtaining access to commercial and personal insurance schemes for their international clients. Through the Global Broker Network, Clements offers brokers a source of widely recognised international insurance products that deliver coverage to expatriate individuals and global organisations. With the ongoing support of a dedicated team, Clements’ Global Broker Network allows new broker partners to help their clients with comprehensive international insurance tailored to meet their needs.Reopened to fill the growing international insurance demand among expatriates and

international organisations, particularly in Africa, the Middle East, Asia, and Latin America, Clements’ Global Broker Network offers a platform for any broker in those regions to expand and deliver the solutions their clients need.Sam Sheibani, Global Broker Network manager at Clements, said: “In the ever-changing landscape of global commerce and humanitarian efforts, a one-size-fits-all solution is no longer a prudent approach to meeting insurance needs. We work with our agents and brokers globally to customise solutions that protect the financial interests of their client in their local markets.”

Zhang joins Aetna InternationalAetna, a global diversified healthcare solutions company, has named Dr Yehong Zhang as its new general manager in Greater China. Based in Aetna’s offices in Shanghai, Dr Zhang will be responsible for the company’s growth in China, Hong Kong, Macau and Taiwan. The appointment is effective immediately.“Yehong is a highly seasoned executive with a deep understanding of China’s healthcare system, regulations and reform efforts,” said Richard di Benedetto, president of Aetna International. “His appointment underscores our commitment to bring Aetna’s expertise in providing high-quality healthcare benefits and improving population health to Greater China. We are pleased to welcome him to lead our team of professionals in the region.”Dr Zhang joins Aetna International from his most recent role as CEO of Simcere MSD Pharmaceutical Co. Ltd, a joint venture established in 2012 between Simcere, a China-based pharmaceutical manufacturer, and Merck & Co., one of the world’s largest multinational drug companies. Previously, he was Simcere’s president, where he was instrumental in driving strategic partnerships with several large multinational pharmaceutical companies to serve China’s rapidly expanding healthcare needs. Prior to Simcere, Dr Zhang was a practice leader for McKinsey & Co.’s healthcare consultancy efforts in China, where he advised local healthcare companies and worked closely with government stakeholders. Earlier, he was the China president for Merck and held a similar role for IMS Health, a leading healthcare information, services and technology company.

ALC adds online toolsUK-based IPMI provider ALC Health has added more online tools and technology to its dedicated member-only service ALC World. Provided as part of each policyholder’s membership package, ALC World offers information covering medical facilities and services worldwide, including city profiles, a drugs and medical phrase translation service and local security updates. Adding a further 500 medical providers to its contracted community, an increase of nine per cent, and 200 additional facilities, an increase of 14 per cent, the web portal has also increased the number of countries included in its drug equivalency guide, bringing the total number of countries included to 42. Furthermore, additional languages are now included in its medical translation tool, which now includes audio and bilateral translations for 12 languages.Andrew Apps, a director of ALC Health, commented on the changes: “For many expatriates, finding the right doctor or medical facility in an unfamiliar country can be difficult at the best of times. With ALC World, our members have access to a wealth of comprehensive data covering doctors, specialists, clinics and hospitals, which enables the user to make an informed decision when making that all-important choice of who to use, for what and where. With a further expansion of the online drug translation tool, making sure the correct drug is prescribed when a repeat prescription is needed becomes simple and straightforward.”

InterGlobal improves cancer coverIPMI provider InterGlobal has improved the cover it offers for cancer treatment, and will now pay in full for all cancer care up to overall plan limits on its 2014 UltraCare health insurance plans. Previously, benefit limits and excesses for cancer had been stripped out of the 2014 plans. Furthermore, the company has increased its overall plan limits, more than doubling the maximum it will pay on its UltraCare Comprehensive plan to US$4 million, and increasing all plan limits by between 50 and 135 per cent. Stephen Hartigan, CEO, commented on the changes: “With the survivability of cancer improving all the time, we want to make sure that our UltraCare members receive top-quality cancer treatment anywhere in the world – knowing that we are committed to picking up the bill in full – with no ifs or buts.” Paul Weigall, group sales and marketing director for the company, added: “As well as improvements to cancer care cover and outpatient benefits, we have also increased plan limits across the board to ensure our UltraCare plans more than meet the needs of our international members wherever they are in the world. We realise that the cost of international health insurance is a concern for many members and we are committed to holding premium increases on our plans to well below the level of medical cost inflation.”In other news, InterGlobal recently won two awards at the annual Health Industry Counter Fraud Group – IPMI company of the year, and Personality of the Year, which was won by Jim Stedall, group head of claims and service. The judges said: “Jim has had an enormous impact on the insurance industry’s fight against fraud and waste. He is a natural leader and has fantastic vision.” For more about how IPMI providers are fighting the fraudsters, please see the feature on p.26.

Willis chooses Bishop Willis Group Holdings, the global risk adviser, insurance and reinsurance broker, has appointed Michelle Bishop as client development manager for international private medical insurance. Michelle will work within the UK Employee Benefits practice to help clients with globally mobile employees navigate the international employee benefits landscape. Michelle joins Willis from Aetna International, where she was account manager for the UK intermediary team. Having held a variety of roles in the medical insurance market, Michelle brings with her valuable international knowledge to complement and further expand the capabilities of the Willis UK Employee Benefits team overseas. Commenting on Michelle’s appointment, Tony Powis, CEO of Willis UK Employee Benefits, said: “As UK organisations increasingly look to capitalise on international growth opportunities, Willis has expanded its team to support the specific challenges faced by HR professionals in the provision of benefits across a difficult and highly regulated environment. We are delighted that Michelle

has joined our specialist healthcare team. Michelle brings a wealth of knowledge that further enhances our offering to multinational employers who are looking to reduce their employee risk exposures through the design, implementation and management of their overseas programmes.”Michelle Bishop

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23IPMI NEWS

Recent articles from Australia and Austria have both highlighted the issue of government funding for international students, with both countries aiming to tighten up the rules on providing free or reduced-cost healthcare services to these visitors. In Australia, the Standing Council on Health said: “Ministers expressed growing concern abut the treatment costs for refugees, international students and tourists in public hospitals. The commonwealth asked states and territories for further details and agreed to work closely with jurisdictions on this issue.”Student visas in Australia require applicants to take out health insurance, with the policies made available to students having to comply with the Deed for the Provision of Overseas Student Health Cover provision. The Deed provides students with the same level of cover that an uninsured Australian would benefit from, although they are required to pay privately or wait at least a year before they can be treated for a pre-existing condition or pregnancy. A report in The Australian newspaper points out that some public hospitals are refusing to admit pregnant international students even after the year is up, citing access rules

that prioritise beds for local people.In Austria, meanwhile, there is a growing focus on ensuring that foreign nationals living and working in the country pay a fair contribution to the country’s health system.Michael Kirchberger, general manager of local insurer VbK Versicherungsservice, said: “It is more important now than ever that these people get individual insurance contracts at their own initiative to protect themselves from the financial consequences of illness.” He added: “Austria has a jungle of different rates, high premiums and stringent health checks, which make it not easy for the customer to find the

right insurance package.” VbK Versicherungsservice, continued Kirchberger, recently introduced a new policy specially designed for embassies and international organisations with interests in Austria, which takes into account the needs of expat workers, and also what the Austrian Foreign Ministry wants foreign nationals to be covered for.

Aviva enhances cover optionsFollowing a detailed clinical review of its international medical cover, Aviva has announced significant improvements to its International Solutions product, which take effect from 1 February. According to the company, the improvements will provide new and existing customers with enhanced standard benefits, wider geographic cover, greater flexibility, and a new tailored Gulf Solutions policy for customers based in that region. The enhancements have been decided upon following a detailed clinical review of the cover.The company has now divided International Solutions into two areas, as opposed to six; policies will be available as Worldwide or Worldwide (excluding the US and Caribbean), with their prices based on comparative risk and medical costs as opposed to geographical location. International Solutions policies will also now carry an International Cancer Pledge, under which treatment and palliative care will be offered, as well as cover for aftercare – including money for prostheses and wigs. In, out and day patient care options have also been enhanced to include the costs of organ transplants and harvesting, and to increase rehabilitation cover. Additional benefits for pregnancy cover and home nursing have also been included, along with condition management for acute phases of congenital conditions, such as the management of HIV and AIDS. Customers will also have the ability to upgrade their core cover with further options, as well as value options for complete flexibility to help with premium reduction, such as options for different levels of excess, reduction of outpatient cover or removal of certain core benefits. Aviva is also flattening its intermediary commission for new and renewal group business to 15 per cent.The new Gulf Solutions policy, meanwhile, is for group customers with employees based in Kuwait, Oman, Qatar or the United Arab Emirates (UAE), or individual customers living or working in Oman or the UAE. This cover represents the second phase of Aviva’s product development for the region, building upon the success of Emirates International Solutions.

International students targeted for cover

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International Travel Insurance Journal

26 FEATURE

Crunching

commentators put the figure at $1 in every $10 lost to fraud and higher estimations are around 15 per cent for international private medical insurance (IPMI) providers. Regardless of the figures, if those involved in the travel and healthcare insurance industries do not manage fraud effectively, financial losses will occur, premiums will rise, reputations will be damaged and stakeholder confidence lost.

Fraud triangleThere are three key elements to any fraud. These are:• Motive/pressure; • Rationalisation; • Opportunity.Some of these elements are areas where the insurer can make a difference, while for others there is not a chance. For example, the fraudster will have a perceived financial motive or pressure and whether

it is perhaps debt, lifestyle or just pure greed, there is little the industry can do to influence this.A fraudster will attempt to rationalise or justify their actions, which is easier for dishonest people. The ‘honest’ fraudster will use excuses such as, ‘everyone does it’, ‘there is no victim’, ‘I haven’t claimed before’ or ‘nobody will get hurt’. There are only limited

steps, most of which are centred on publicity and education, that the industry can take to try and change the mindset of a potential fraudster. Reducing the opportunity to commit fraud is the area in which businesses in the travel and health insurance industries have most control. The fraudster must believe that their activities will go undetected and

weak internal controls, poor oversight, inadequate procedures and lack of action open the flood gates for those intent on committing crime against insurers.There is not a ‘one-size-fits-all’ solution to the problem, and whilst the best defence is to improve organisational procedures, it is often difficult to strike a balance between tackling fraud and making effective commercial decisions. Every business within the travel and health insurance industries will, of course, have its own organisational requirements, but the good news is that there are tried and tested measures that can be tailored to suit.

Assessing the gaps Fraud risk varies according to the nature and size of the business and a risk assessment should help identify where the problems are. A risk assessment is a detailed forward-looking survey of the business

Reducing the opportunity to commit fraud is the area in which businesses in the travel and health insurance

industry have most control

During 2013, there were many articles relating to fraud published

in ITIJ. For most in the travel insurance industry, this comes as no surprise, as with the current economic crisis, the healthcare and travel insurance industries are falling foul of both organised and opportunistic crime on an unprecedented scale. With the global recession taking hold, fraud is on the rise and as other industries such as banking and public sector bodies are making life more difficult for those committing crime, fraudsters are turning to what is viewed perhaps as an easy target – the insurance industry.With global healthcare fraud loss rates estimated in a recent report by PKF and the University of Portsmouth to be on average 7.29 per cent per annum, fraud is costing the health insurance industry billions per year and, as a threat to the business, must be one of the key risks to be managed. Some global

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FEATURE 27

to identify as many potential threats as possible and evaluating them to determine which require action, and the priority for that action. The results of the assessment should be included within the company’s ‘risk register’ and regularly reviewed and updated. This will ensure the organisation is in a position to respond to fresh threats and challenges and to form the basis for fraud risk management activity. Continuous evaluation is vital when it comes to fighting fraudsters, as methods used to defraud travel and health insurers change constantly and, as threats are dealt with, fraudsters will find new and innovative methods to commit crime in the hope of doing so undetected. Counter-fraud activity can be implemented at any point during the evolution of a business, but it must evolve as the business develops. The only way to ensure a counter-fraud programme is truly effective is to consider it as an integral part of the

overall company risk management structure.A sound fraud risk management model will focus on five key areas. These are illustrated above, and include prevention, deterrence, identification, disruption and action.

Creating a cultureAn effective step in the creation of a proven counter-fraud programme includes ensuring that fraud risk is considered to be an integral part of organisational risk management strategy. This is best achieved through the establishment of a strong ethical anti-fraud culture and development of a fraud policy, which should be promoted throughout the organisation. It is not just claims fraud where insurers are vulnerable, so this approach should include all staff, regardless of their role. An integrated strategy for prevention and control will enable a holistic and complementary

approach to fraud countermeasures and a well-publicised fraud response plan will ensure clarity of process. Fraud can be complex and an inclusive approach across the business will ensure a cohesive effort, providing greater opportunity for success.The development of an ownership structure is essential for the risk management strategy to work. Clear lines of responsibility with the appropriate authority will ensure an effective, centralised and co-ordinated approach. Make sure everyone in your organisation knows who is responsible for dealing with fraud and how to report it. Clear lines of communication are essential for delivering the message and for ease of reporting. A reporting ‘hotline’ and implementation of a whistleblowing policy will encourage individuals to come forward and report instances of fraud and abuse. Policy should also emphasise the opportunity to report anonymously and without fear of victimisation or discrimination. An organisation should establish a sound control environment with adequate levels of suitably trained staff and supervision, together with sound operational

procedures such as authorisation and transaction controls, segregation of duties, documented procedures and ‘real time’ process maps. The implementation of a fraud awareness programme will ensure all staff know what fraud is, how to identify it and what to do once it has been detected. Staff should be educated as to both the general and specific threats facing them in their particular business areas and how to spot potentially fraudulent activity. Whether or not enquiries are conducted ‘in house’ or outsourced, only appropriately trained staff should be appointed to investigate cases of suspected or alleged fraud. In the UK, there is now a British Standard Code of Practice for the provision of investigative services. BS 102000 provides recommendations for the conduct, management, staffing and operational accountability for the provision of investigative services. The British Standard defines an investigator as ‘a person contracted to conduct investigative services, who must be both compliant with relevant legislation and competent to undertake such activities’. Competency can be mapped to training,

weak internal controls, poor oversight, inadequate procedures and lack of action open the flood gates for

those intent on committing crime against insurers

Fraud continues to plague the travel and health insurance industries around the world. UK-based expert Gary Sommerford offers information and advice to insurers seeking to set up or augment their current anti-fraud measures to better control the increasing cost of fraudulent activities

Prevention:stop incidents of fraud occurring

the numbers

Deterrence:deter potential fraudsters from even attempting

fraudulent activity

Identification: identify high-risk activities

and weaknesses in the control environment

Action: implement effective

strategies that will reduce the likelihood of costly civil actions or potentially time consuming and disruptive

investigations.

Disruption: make life as

difficult as possible for the fraudster

A sound fraud risk management model will focus on five key areas:

International Travel Insurance Journal

28 FEATURE

qualifications and assessment. Investigative activities include fraud and loss investigations, the investigation of bribery, the taking of statements and, most importantly, insurance investigations.Just recently, the British Home Secretary announced that from October 2014, anyone conducting investigative activities will need to be licensed. Dean Hyde, director of RMH Training and chairman of the Association of Incident Fraud and Claims Investigators (AIFCI), who was heavily involved in the development of the BS, commented: “At a recent stakeholder meeting hosted by Skills For Security and attended by representatives of the Home Office and the Security Industry Authority (SIA), the SIA intimated that the new licensing would be based on the activity of the investigator and not the individual’s job role. This would mean that anyone carrying out any activity which is covered in the Codes of Practise in the BSI Standard would have to be licensed regardless of job title.” Clearly, this could have a massive impact on the investigation of fraud within the UK insurance industry – a question to ask yourself now is: do your investigators comply with the BS, and as of late 2014, are they licensed?A professional investigation that establishes the facts will enable informed decisions to be made and organisations will need to consider if they are going to apply sanctions to those concerned and what those sanctions might be. This is likely to be decided on a case-by-case basis and could range from criminal charges, regulatory reporting or business sanctions such as the withdrawal of cover for a policyholder or in the case of a provider, removal from network.Lastly, but by no means least, insurers will need to consider their options in respect of financial redress. The ideal situation is to not allow money to leave

the business in the first place, but inevitably there will be some circumstances where recovery action may need to be taken. This may be as simple as requesting restitution from the person concerned, but more complex cases could be costly if not managed effectively and legal advice may need to be sought.No matter what approach is taken to tackling fraud and abuse, policies and procedures can become obsolete very quickly. Monitoring and evaluation should be a continuous process to identify any potential weaknesses, thus allowing systems to adapt to a changing environment.

Come togetherIndustry collaboration is an area where some health insurers have made headway over recent years, with the introduction of initiatives such as the Global Healthcare Anti-Fraud Network (GHCAN). In 2011, the UK’s Health Insurance Counter Fraud Group (HICFG), in co-operation with the National Health Care Anti-Fraud Association USA (NHCAA), Canadian Health Care Anti-

Continuous evaluation is vital when it comes to fighting fraudsters, as methods used to defraud travel and health insurers

change constantly

Fraud Association (CHCAA), European Healthcare Fraud and Corruption Network (EHFCN), and Healthcare Forensic Management Unit South Africa (HFMU) formed an alliance – the GHCAN – which saw the partnering countries and regions signing the GHCAN Memorandum of Understanding. The Gulf Healthcare Anti-Fraud Association (GHAFA) is also soon to join this important alliance. HICFG director Raymond Collins explained: “The HICFG, supported by the Association of British Insurers, offers members an array of services and software to assist the business

units and staff dedicated to preventing fraud, waste and abuse within healthcare,” adding: “The HICFG maintains a network and pathway to its domestic partners such as NHS Protect as well as the Global Healthcare Anti-Fraud Network, which consists of similar organisations globally.”Travel insurers have perhaps not been so proactive in moving together towards such a targeted approach, but with studies suggesting that over 65 per cent of travel claims are now healthcare related, there has never been a better time for travel insurers to collaborate with their health insurance colleagues in order to prevent and detect fraud and abuse. Ray Collins agrees and welcomes any travel insurers wishing to join the HICFG to take advantage of the sharing of health insurance fraud data and industry initiatives. Industry collaboration is an area that, if

exploited to its full potential, will have a real impact on countering fraudulent activity and reducing financial losses.UK-based IPMI provider InterGlobal is one organisation that has embraced the ideas of both a structured counter-fraud programme and industry collaboration. Not only has its in-house fraud team won industry awards for their efforts, but they were able to offer one of the lowest increases in annual premiums during 2013. CEO Stephen Hartigan commented: “We were able to signal below-the-

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FEATURE 29

rate-of-inflation price increases, in part due to the success of our counter fraud initiatives.” Hartigan added that as part of their efforts to create an anti-fraud culture, to deter potential fraudsters and provide confidence to legitimate customers: “We also make our policyholders aware of what we are doing to combat fraud.” Thus, the company provides its customers with details of what fraud is, how customers can help protect themselves as well as the company, and how they can report fraud. Another insurer tackling fraud head on throughout their operations is IMG Europe, which has seen real benefits from a structured and proactive approach to fraud risk management. Carl Carter, managing director of IMG Europe and chairman of the Association of International Medical insurance Providers (AIMIP), said: “Medical insurance fraud is a hidden cost on all policies, it is an issue for the whole industry and it comes in all shapes and sizes. It is our duty to do all we can to combat fraud and we take this duty very seriously. We have found that by working with key specialists and partners in the industry and via our dedicated anti-fraud

team and systems that we have seen both oneoff and on-going successes in our fight against fraud whether from individuals, medical facilities or organised gangs.”So as you reflect on the latest new gadgets being given away as gifts to

some of your less than honest policyholders this Christmas, or the cosmetic surgery disguised as an ingrowing toenail you funded, do not despair; there is something you can do about the rising cost of fraud. Make a New Year’s resolution that you will keep – don’t let 2014 be prosperous for the fraudsters. Budget for fraud, protect your business and have a Happy New Year! n

The only way to ensure a counter-fraud programme is truly effective is to consider it as an integral part of the

overall company risk management structure

Gary is an independent consultant providing counter fraud, risk, investigations and cost containment solutions for the insurance industry, both in the UK and overseas. He is a successful senior manager with over 27 years’ experience in the execution and management of a full range of counter fraud and risk work, investigative services, cost containment and associated training. Gary is a qualified Home Office Deputy Senior Investigating Officer, National Interview Advisor, Advanced Interviewer and Accredited Counter Fraud Specialist. He is also a Member

of the Institute of Leadership and Management and a Graduate of the City & Guilds Institute (London). Gary was awarded the title of 2012/2013 Investigator of the Year by the Health Insurance Counter Fraud Group (HICFG) at the Global Healthcare Anti Fraud Summit.

International Travel Insurance Journal

30 FEATURE

THREAT FORECAST: 2014 � e coming year will see business and leisure travel continue to increase. Frances Nobes looks at 2014’s predicted travel hotspots and the risks associated with each

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FEATURE 31

January’s post-Christmas blues present an ideal time to think about an upcoming holiday – somewhere exotic and warm with a blend of relaxation, adventure, culture and cuisine. It’s also a time for businesses to surface from their Christmas hibernation and scour the globe for new opportunities.Demand for business travel is expected to increase yet again in 2014 as the global economy shows signs of improvement. A survey by the Global Business Travel Association predicts a 7.2-per-cent rise in business travel spending in the coming 12 months, to approximately $288.8 billion. While business travel will increase, the survey also showed that 53 per cent of business travellers would pay to bring a friend or family member on their trip, while 46 per cent said that they would extend a business trip in order to include some leisure and tourist activities. The tourism industry will also continue to fl ourish in 2014, with a global value of approximately $6.8 trillion, and an expected increase of four per cent year-on-year. The opening of new fl ight routes, new hotels and the eternal search for the as-yet-undiscovered gem (be that business opportunities or leisure bliss) has contributed signifi cantly to this growth. However, increased travel can also lead to an increased exposure to a range of threats that face business and leisure travellers alike. Being aware of these risks is the fi rst step towards mitigation.Crime is the greatest threat to travellers. Whether visiting your own capital or journeying to far-fl ung destinations, tourists and business professionals are more likely to be a victim of crime than any other threat. Petty theft is particularly common, and most often takes place in crowded areas such as local markets, tourist hotspots, transportation hubs and other busy or popular areas. However, different locations also present different threats, all of which have the potential to affect individuals abroad.

AmericasBrazil will be one of the most talked about holiday destinations in 2014. The hosting of the FIFA World

Cup in 12 cities across the country between 12 June and 13 July will draw hundreds of thousands of fans, in addition to the six million tourists who are lured to Brazil each year by the beautiful scenery, beaches, Carnival and iconic tourist attractions such as the statue of Christ the Redeemer. Visitors may also travel to nearby countries as part of a larger travel itinerary, with Peru and Uruguay tipped to be popular destinations. Peru’s stunning ancient sites – most famously Machu Picchu – and its reputation as ‘the gastronomic capital of South America’ make it a prime spot for adventurous tourists. Uruguay has also been nominated as a destination to watch in 2014, with the capital Montevideo considered as Argentinean’s favourite summer capital. The combination of relaxing beaches and restaurants, bars and nightclubs in Colonia del Sacramiento will undoubtedly attract tourists in 2014. Uruguay’s low-risk rating will add to its appeal, although the recent legalisation of cannabis (growing, buying and selling with some restrictions) may provoke some protests, although these are likely be infrequent and of low-impact. It is important to note, however, that the new legislation will not apply to visitors.Those looking for a more adventurous holiday could also look to Nicaragua, which has followed in the footsteps of neighbouring Costa Rica and attempted to re-brand itself as an exciting holiday destination. Its extraordinary mix of volcanic ranges, rainforests full of interesting wildlife and quaint villages provides an appealing option for those looking for an undiscovered haven. However, these destinations all present risks for travellers. With the exception of Uruguay, crime presents a credible threat to visitors. Petty theft, including bag-snatching, pickpocketing and theft of valuable items such as jewellery, cameras and smartphones, is a persistent threat to tourists in this region.In Brazil, express kidnappings are becoming increasingly common. These incidents involve the short-term abduction of an individual, usually by criminal groups, while they are robbed of their possessions and/or

forced to empty their bank accounts from ATMs. These incidents usually last for less than 24 hours and the victims are released unharmed. Additionally, following protests during the FIFA Confederations Cup (FCC), it is likely that further protests based on socio-economic concerns will take place during the FIFA World Cup. These protests are expected to be less violent and better controlled in part due to the $2.2 billion that the Brazilian government has already invested in security for the event. However, those travelling to the World Cup should be cautious of counterfeit tickets and merchandise, which will likely be rife.

AsiaAsia continues to prove an attractive region for travel, with the draw of the Orient and the promise of

an exotic experience. Indonesia and Myanmar are both expected to see an increase in tourism during 2014. Indonesia’s 18,000 islands offer everything from beaches to volcanoes to exotic wildlife. Bali and Borneo will continue to attract tourists, especially those from Australasia, but lesser-known islands will also emerge for those looking for something more remote. The combination of friendly people, unfamiliar culture and spectacular beaches will draw more people to this archipelago. However, as with a number of other countries in Southeast Asia, there is a threat of terrorism from local and international extremist groups seeking to establish an Islamic state in the region, including some groups that have been linked to al-Qaeda. However, no serious incidents involving foreign nationals have occurred in recent years, as most groups target

it is likely that further protests based on

socio-economic concerns will take place

during the FIFA World Cup

»

International Travel Insurance Journal

32 FEATURE

national security forces. Indonesia is also located in one of the world’s most active seismic zones, the Pacifi c ‘Ring of Fire’, and is prone to various natural hazards, including earthquakes, tsunamis and volcanoes. Flooding is also a concern between November and March.Myanmar has already seen a boost in tourism, with tourist numbers increasing by 30 per cent to 1.8 million last year. New fl ight schedules and improved infrastructure will make visiting Myanmar increasingly attractive to slightly more daring tourists. The vast array of temples, most notably the Swedagon Golden Temple, and the country’s history, will no doubt attract more visitors in 2014. However, the risk of civil unrest, particularly linked to socio-economic or political issues, is high in Myanmar, with a number of recent incidents when protests have become violent and resulted in injury and the destruction of property. Provided tourists avoid such demonstrations, however, these should not prohibit trips to the country.For business travellers, India will prove a popular destination, especially for those involved in the textile, communication and services industries. Although crime may be a cause for concern to visitors, there is also the potential for terrorist attacks due to the persistent tension regarding the control of the Kashmir region, as well as from Islamist extremists opposed to the government. However, such incidents are infrequent and are unlikely to affect travellers to the country.

AfricaThe excitement and fun of safaris will continue to draw millions of people to Africa in 2014. Top destinations include South Africa and Kenya, where there are well-established safari operators and facilities. Despite the Westgate Mall attack on 21 September 2013, Kenya will remain an attractive destination for those seeking safari adventures,

although extra precautions may be taken. Although the risk of terrorist incidents in Kenya remains high, the Westgate attack highlighted the diffi culty in predicting the method, placement and timing of these attacks. Furthermore, in the face of this threat, Rwanda and Uganda could become increasingly popular safari spots, as new visa regulations will allow tourists to travel between Kenya, Rwanda and Uganda more freely. With half the world’s remaining mountain gorilla population, Rwanda may become the new add-on for a full safari experience in 2014. For businesses involved in the oil and gas industry, countries such as Nigeria will continue to play a signifi cant role in their operations. The Sahel region (Mauritania, Mali, Niger, Chad and Sudan) has also been favoured by these organisations due to their natural resources. However, while travel to these areas is possible, visitors will face a variety of threats. The most signifi cant of these will be the threat of kidnapping. Nigeria accounts for 70 per cent of Africa’s kidnappings, and 25 per cent of kidnappings worldwide. It is expected that Nigeria will see an increase in kidnappings in 2014, with criminal and Islamist groups using kidnapping as a form of fi nance and a means of applying political pressure. Perpetrators have been known to specifi cally target extractive industry workers for their perceived wealth and confl icting ideological beliefs. Similarly in the Sahel region, kidnapping remains a concern, with porous borders, ineffective policing, continuing socio-economic diffi culties and organised groups allowing an escalation of this threat.

EuropeCity breaks will remain popular across Europe. Riga, the capital of Latvia, will be the European City of Culture in 2014. The city presents an ideal location for a long weekend away, and will be prepared for an increase in tourism in the coming 12 months. Its City of Culture status is likely to lead to a greater interest

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FEATURE 33

in the country, which presents very few diffi culties or risks for visitors. The economic downturn in Europe has affected a number of countries, including Latvia – all of which have experienced some increase in protest activity as a result of increasing socio-economic diffi culties. However, such demonstrations need not prevent visitors travelling across Europe. Along a similar vein, cities such as Budapest and Prague will continue to receive a high number of tourists in 2014. Russia’s hosting of the Winter Olympics and Paralympics from 7 February until 16 March, as well as a Formula One Grand Prix in October, will also draw international visitors to Eastern Europe. Both events will take place in Sochi, located just a few hundred kilometres from the North Caucasus – a volatile separatist region beset by Islamist extremism and extensive criminality. To combat this, security in the vicinity of the Olympic Park will be incredibly high, including a vast surveillance network. Despite this, crime will still be the greatest threat to visitors, including a recent increase in burglaries and carjackings. As mentioned regarding the Brazil FIFIA World Cup, counterfeit tickets and merchandise will most likely be endemic. Organised crime may be rife in Russia, but this should not have too direct an effect on visitors to the region.

MENAThe Middle East and North Africa (MENA) has long been associated with extractive industries. The huge array of natural resources in the region makes it ripe for investment and exploitation by both national and international organisations. However, 2014 may see a shift in operational procedures after a range of incidents highlighted the importance of appropriate security measures for these companies. The attack on an oil and gas plant at In Amenas in Algeria, in which 39 hostages were killed, highlighted the need for crisis procedures as well as pre-emptive steps, such as a greater awareness of local threats and site vulnerabilities. As a result of the attack, Statoil released a document that extensively outlined the challenges to the site as well as weaknesses and critical improvements to security measures. There is a sustained risk of such terrorist attacks in this region, along with signifi cant political instability. Industries operating in this region have seen a demonstrable need to ensure there are appropriate security

measures in place to mitigate this risk. For tourists, the region holds many hidden gems, including ancient ruins and a wealth of historical interest. However, persistent civil unrest across the region has adversely affected the tourism industry, with Egypt being one of the most affected countries. The tourism industry has suffered considerable losses due to the ongoing civil unrest as a result of political instability, which has caused many potential visitors to shy away from the area. In July and August last year, tourist arrivals dropped by 45 per cent, with estimated losses since the army takeover of $1 billion per month. However, the southern Sinai resort towns, such as Sharm el-Sheikh, remain comparatively safe and offer a variety of activities to tourists. 2014 will be another challenging period for Egypt’s tourism industry, with those reliant on the industry for jobs and investment attempting to persuade visitors to return to the region.

Hazard awarenessDespite the risks outlined in this piece, the vast majority of trips abroad, be they for business or pleasure, are completed without serious incident. By raising travellers’ awareness of these issues, individuals are able to take responsibility and ownership of their safety and security when travelling. Basic steps such as ensuring that adequate insurance and contingency plans are obtained can go a long way towards changing a crisis to an inconvenience. n

Organised crime may

be rife in Russia, but this

should not have too

direct an effect on visitors

to the region

Frances Nobes is red24’s global risk analyst and is responsible for producing timely and accurate security and intelligence reports on a variety of issues for the company’s corporate clients and insurance partners. Frances has a Masters in International Relations from the University of St Andrews and a post-graduate Masters in Intelligence & International Security from King’s College London. Before joining red24, Frances worked as a researcher for the National Defense University in Washington, DC, and as an intelligence analyst for a security consultancy fi rm.

International Travel Insurance Journal

34 PROFILE

ITIJ spoke to Richard Smith, managing director of Travel Insurance Facilities Group (TIFG), about the main issues facing UK insurers at the moment, including medical screening and controlling the increase in fraudulent claims

Where were you born, where were you educated and where do you live now?I was born in Woolwich, London but grew up in Midhurst, West Sussex. I went to school in Midhurst, college in Chichester and university in Canterbury, completed my MCMI in Ashford and a received a Chartered Manager award via the CMI in London. I now live in Tudeley, Kent.

When did your involvement in the UK travel insurance industry begin? I was o�ered and accepted a role with Inter Group Insurance Services in 1997. Like many people, insurance wasn’t my �rst career choice, but I soon realised the opportunities were far wider and more

exciting than the overall public perception of our profession.

How did you progress to your current position?I spent four years at Inter Group, where I began working life in the administration team, soon discovered I had a natural passion for the travel insurance sector and was fortunate enough to get to experience all aspects – from sales to assistance. �e travel bug really got me, and I decided I wanted to experience working in another country and changed industry. �us, I accepted an opportunity to go and set up an o�ce in New Hampshire, US, for an Oracle Applications consultancy �rm who were expanding. After I had seen the inside of hundreds of conference centres across America, I realised that the grass wasn’t greener across the Atlantic and missed the insurance world and the people within it. �e insurance sector is a very close-knit community and I came back to the UK speci�cally looking for another role in travel insurance. I was o�ered an account manager role with �e Travel Protection Group. Shortly after I joined, the company was split and sold to Travel and General, part of CSP Holdings. My role was transferred to Travel and General, where I spent three years as a broker in the City. One of the underwriters that I worked closely with was looking for a travel underwriter, so in 2004 I joined Travel Insurance Facilities (TIF) plc. I immediately saw the scope of the underwriting role, and was quickly promoted to underwriting director. By 2008, I took up my current position as managing director.

TIFG describes itself as a ‘specialist travel insurance full lifecycle service provider’; what does this mean in practise?Initially, TIFG outsourced all of its service provisions to various companies across the UK. Following a review of our business model, we could see that this was in fact ine�cient for both customers and the business. So we began to ‘in-source’ our services and established a number of wholly owned subsidiaries to handle various processes, especially claims and assistance, which is the shop window of any insurance company. So now, as well as an underwriting business, we have a dedicated in-house claims team, an emergency assistance company, a medical screening operation with an award-winning 1-2-1 medical screening system, and a ‘behind the brand’ a�nity schemes division, working with leading B2C and B2B products. Keeping services in-house gives us greater control of the processes and services that our customers receive, with the majority coming into contact with all of our services. A number of our business partners contract with us solely to use an independent part of the business, such as claims handling or medical screening. As well as the service provision, we also have an e-commerce team, which works with our broker partners to assist them with various direct-to-customer services, including white-labelled and bespoke websites, PPC and SEO management and e-commerce strategy and brand direction through our dedicated brand management team.

How did the introduction of the UK Consumer Insurance Act (CIA) a�ect your company?Our medical screening tool, Protectif medical screening, was already fully compliant as the screening is led by the medication the customer is taking, plus the underwriting criteria has been assessed by medical experts. We rate the individual’s condition and ask more questions than other insurers in the sector. �is means that the foundation of the screening is based on fact, not opinion. Over the years, before implementing the medication-led screening, we saw large numbers of travellers unintentionally under-declare the position of their health to us. A lot of people do not class themselves as still having the condition once it is controlled by a medication. Clearly, as a travel insurer, we still need to know about the condition and under the UK CIA, a genuine under-declaration would be the responsibility of the insurer to cover.

Travellers Healthcheck is one of the services o�ered by TIFG. As the travelling population continues to age, do you think medical screening will continue to increase in importance? I believe medical screening to be a very important tool in underwriting travel insurance risk, and �nd it interesting that other countries, such as Germany, do not use medical screening within the travel underwriting criteria. �e pricing is based on age, destination, duration and cancellation value. As such, a person without a medical condition would pay the same premium as someone who does have pre-existing

medical conditions. �e development of screening has enabled insurers to be more speci�c and targeted when rating risk, and without doubt, has led to premiums for people without conditions to reduce dramatically. However, medical screening should not be used as a barrier to prevent people from getting insurance. We have successfully used medical screening to assist people with conditions to �nd a�ordable travel insurance and indeed have worked with brokers to create schemes especially for this demographic. Our medical screening tool has made a signi�cant impact on loss ratio performance, but not at the expense of availability within insurance products or cover.

Travel insurance underwriting has been tightened up in recent years as the industry has struggled to maintain slim pro�t margins. Do you think that customers still have access to su�cient levels of travel insurance cover at a reasonable price? Travel insurance is usually bought on price. �is is a huge problem for the industry, as most insurance providers are struggling to provide products that meet the cover expectation of the customer, and at a price they are willing to pay. �e travel insurance market is so competitive that those that compete for volume of business usually do so at the expense of cover. A prime example of this has been the increased number of products that have a very high excess. I am not sure that travel insurance products should have standard excesses as high as £250. �is has become an adopted approach of many intermediaries as a method of providing more price-competitive rates within any given distribution channel. While the customer

has the option of choosing products and can decide against such a high excess, many do not research the product as thoroughly as they perhaps should, and as such end up with a product that does not meet their expectations or their true needs.I do believe that customers can �nd excellent products with extensive cover levels at good value. But consumers must understand that this will rarely be the cheapest product on the market. Unfortunately, because most customers do buy on price, they will often end up with a product that is cheap but does not o�er the right cover which paying a few pounds more might give them. �is is the industry’s conundrum: how do we help customers buy product on cover and suitability rather than just on price? �e key for me is in the marketing of the products. If, as an industry, we focused the attention more on cover and less on price, I believe the customers would have a better chance at getting a suitable product.

Fraudulent claims are an ongoing problem for the global industry. What has been your experience of fraudulent travel insurance claims, and how does your company work to combat fraudulent activity?While there is a known element of fraud surrounding baggage claims, speci�cally exaggerated loss or blatant outright fraud, the bigger issue challenging the industry at the moment surrounds overtreatment or overcharging by foreign clinics and hospitals. We take a very �rm view on overtreatment and overcharging and utilising both proactive and reactive cost containment to ensure that we only pay for treatment that is necessary and reasonable given the medical situation. �is is yet another bene�t of in-sourcing – having such control over the process saves us hundreds of thousands of pounds annually, and helps us to ensure our products are competitively priced.

Has business process outsourcing and the use of TPAs grown within the global travel insurance industry in recent years? Brie�y, why is this and what are the key bene�ts of BPO/TPAs?Most travel underwriters/insurers go through phases when it comes to in-sourcing and outsourcing. It is a considerable expense to in-source, but the bene�ts of a well-run in-house team is obvious. For TIFG, having these services and teams has proved to be a very good move, not least through the control of the service and ability to truly cross report and feedback the knowledge from each division into the overall performance of the business. For example, being able to analyse claims and feed this back into the medical screening process has enabled us to re�ne the business in a way that outsourcing would never have allowed.

What are you most proud of – both personally and professionally?�e birth of my son, Lucas, in 2008 was a particularly proud day. I love being a dad. I am very proud of TIFG as a company. It has been great to see it grow and develop. It is satisfying to be able to o�er travel insurance products to people where it actually makes a huge di�erence to them, perhaps because they otherwise wouldn’t have been able to travel. Some of our products aimed at people with medical conditions like Insurancewith.com and Insurecancer.com generate the most amazing customer feedback. Being able to help individuals and families have the chance to experience something they thought they had lost or would never be able to do again – a simple holiday - just because of a medical condition is truly satisfying.

What do you enjoy doing in your spare time?�ere really isn’t a great deal of spare time at the moment, what with work and family commitments, but when I do get some R&R, I really enjoy skiing, riding motorcycles, walking, reading and drinking a glass (or two) of red wine. n

If, as an industry, we focused the attention more on cover and less on price, I believe

the customers would have a better chance at getting a suitable product

Rising to the challenge

36 SERVICEDIRECTORY To have your company listed in the Service Directory email: dave@itij.com

AMREF Flying DoctorsDr Bettina Vadera – Medical Director

Wilson Airport, LangataRoad, PO Box 18617, Nairobi, KENYA

tel: fax:

+254 20 6000 090+254 20 344 170

email: website:

emergency@flydoc.org www.flydoc.org

Assistance Médicale AfricaineDocteur Hage – Général Manager

Box 9962, Libreville, Gabon, GABON

24/7 tel: fax:

+ 241 07 88 80 80+ 241 44 10 20

email: website:

amafrique@yahoo.framafrique.com

Netcare 911 InternationalJacques Pienaar – Fixed Wing Operations Manager

Riverview Park, Janadel Avenue, Midrand, SOUTH AFRICA

tel: fax:

+27 10 209 8392+27 10 209 8405

email: website:

flight@netcare.co.zawww.netcare911.co.za

Medico Rescue24/7 Flight Desk

Pointe Noire, CONGO

tel: fax:

+41 22 939 22 53+41 43 430 21 48

email: website:

flightdesk@ea-gcs.comwww.medicorescue.com

West African Rescue AssociationFlorian Zagel – Managing Director

Klotey Cresent 6, North Labone, Accra, GHANA

24hr tel: fax:

+233 243 666 111+233 21 781 259

email: website:

assist@westafrican-rescue.comwww.westafrican-rescue.com

AIRGURUS Ltd. Co. Capt. Harry Lero – President & CEODelta Air Hangar, General Aviation Area, Manila Domestic Airport, Pasay City, 1300, PHILIPPINES24/7 tel:

+632 781 0727+632 781 0787

email: website:

info@airgurus.comwww.airgurus.com

AeroMed Asia Inc.Cindy Wong / Lorraine Paul – International Account Management

SINGAPORE BANGKOK THAILAND

tel: fax:

+603 7965 3883+603 7629 8810

email: website:

ops.kul@aeromed-asia.comwww.aeromed-asia.com

CareFlight Group Peter Elliott – Manager, Tasking & logistics

PO Box 5078, Robina Town Centre, Qld, AUSTRALIA

24/7 (int) tel: fax:

+61 7 5553 5955+61 7 5553 5965

email: website:

ops@careflight.org.auwww.careflight.org.au

CareFlight InternationalPaul Smith – National Manager

Locked bag 2002 Wentworthville NSW 2145, AUSTRALIA

tel: fax:

(+61) 2 9893 7683+61 2 9689 2744

email: website:

international@careflight.orgwww.careflight.org

Flying Doctors AsiaPrithpal Singh – CEO , Director313 Old Bird Cage Walk, #01-15/02-16, Seletar Airport, SINGAPORE24hr tel:

fax: +65 9297 7757+65 6483 5407

email: website:

prithpal@flyingdoctorsasia.com www.flyingdoctorsasia.com

Medic’Air International 每递安国际Dr Huaqun Gao – Medical Director

885 Renmin Road, Huaihai China Building, Room 808, 200010 Shanghai, CHINA

tel: fax:

+86 2163 558289+86 2163 558285

email: website:

operations@medic-air.asiawww.medic-air.com

Medical WingsDr Sura Jaidwatee, M.D. – Medical Flight Manager222 Room 3259, Bangkok International Airport, Viphavadee-Rangsit Rd, Sikan, Donmuang, Bangkok 10210, THAILAND

tel: fax:

+662 247 3392+662 535 4355

email: website:

dr.sura@aircharterthailand.comwww.medicalwings.com

MJETS LimitedMr. Sukit Kaewamorn – Director of Sales Private Jet Terminal, Don Mueang International Airport, 222 Viphavadee-Rangsit Road, Don Mueang, Bangkok 10210, THAILAND

tel: fax:

+66 2792 9444+66 86 991 7512

email: website:

charters@mjets.comwww.mjets.com

ADAC Ambulance ServiceRobert Glueck – Marketing & Sales Director

Hansastr. 19, D - 80686 Munich, GERMANY

tel: 24h Alarm:

+49 89 76 76 52 85+49 89 76 76 50 05

email: website:

info-ambulance@adac.dewww.adac.de/ambulance

AIRLEC Air EspacePaul Tiba – Managing Director

Zone Aviation Générale, 33700 Mérignac Cidex 05 FRANCE

24Hr tel: fax:

+335 56 34 02 14+335 56 55 98 18

email: website:

paul.tiba@airlecairespace.comwww.airlecairespace.com

AAA Alpine Air Ambulance AGJürg Fleischmann – CEO

P.O. Box 233, CH-8058 Zürich Airport, SWITZERLAND

tel: 24/7 tel:

+41 44 813 09 09+41 44 813 10 10

email: website:

soscenter@air-ambulance.chwww.air-ambulance.ch

Augsburg Air AmbulanceRoland Schoberth – Director

Roseggerstr 17, D-86368, Gersthofen, GERMANY

tel: tel:

+49 821 299 1020+49 821 299 2030

email: website:

info@ambulanzflugdienst.dewww.ambulanzflugdienst.de

Capital Air CharterLisa Humphries – Sales Director

Hangar 68, Exeter International Airport, EX5 2BA, UK

tel: fax:

+44 845 055 2828+44 1392 350 039

email: website:

info@capitalaircharter.co.ukwww.capitalaircharter.co.uk

DRK AssistanceAndreas Speich – Managing Director

Aufm Hennekamp 71, 40225 Düsseldorf, GERMANY

tel: fax:

+49 211 301805-0+49 211 301805-21

email: website:

info@drkassistance.comwww.drkassistance.com

European Air AmbulancePatrick Schomaker – Director Sales & Marketing

175A, rue de Cessange, L-1321, LUXEMBOURG

24hr tel: fax:

+49 711 7007 7007+49 711 7007 7009

email: website:

alert@air-ambulance.comwww.air-ambulance.com

Euro LinkDr. Friedrich Renner – Aeromedical Specialist / Medical Director

General Aviation Terminal, 85356 Munich Airport, GERMANY

tel: fax:

+49-89-6137 2103+49-89-6137 2106

email: website:

info@FlyEuroLink.dewww.FlyEuroLink.de

FAI – rent-a-jet AGVolker Lemke – Director Sales & Marketing

Flughafenstrasse 100, D-90268 Nuremberg, GERMANY

tel: fax:

+49 911 36009 31+49 911 36009 59

email: website:

lemke@fai-ag.dewww.rent-a-jet.de

GlobalMed InternationalGert Muurling – CEO & Medical Director

Auf Roedern 7c, 56283 Pfaffenheck, GERMANY

tel: fax:

+49 6742 897 425+49 3212 100 5018

email: website:

info@globalmed-international.euwww.globalmed-international.eu

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CATEGORY KEY CLAIMS MANAGEMENT INSURERSAIR AMBULANCE CLAIMS SUBROGATION MEDICAL ESCORT ON COMM. AIRLINEAIR AMBULANCE INTERIOR COMMERCIAL REPAT SPECIALISTS MEDICAL PROVIDERAIRCRAFT PERFORMANCE SOLUTIONS CRITICAL CARE PATIENT TRANSPORT MEDICAL SCREENINGASSISTANCE COMPANIES FUNERAL DIRECTORS RE-INSURANCECATASTROPHIC CLAIMS SPECIALIST HEALTHCARE CLINICS TRAVEL AGENTSCOST CONTAINMENT HOSPITALS WEB & DESIGN SERVICES

37SERVICEDIRECTORYcall +44 (0) 117 925 5151 To make an alteration to a listing email: dave@itij.com

Jet Executive International CharterIrena Dimitrijevic – Marketing & SalesMündelheimer Weg 50, D-40472, Düsseldorf, GERMANY“Homebase FRA & MUC”

tel: fax:

+49 211 602 7775+49 211 602 77766

email: website:

sales@jetexecutive.comwww.jetexecutive.com

Malteser Service CenterJohannes Hoischen – International Network and Repatriation

Malteser Service Center Kalker Hauptstr. 22-2, 51103 Köln, GERMANY

tel: fax:

+49 221 98 22 333 +49 221 98 22 339

email: website:

ambulance@malteser.orgwww.malteser-service-center.de

Medair InternationalAndrew Lee – Managing Director

Gate One, Malta International Airport, Luqa, LQA 3290, MALTA

tel: 24 hrs:

+356 2133 1008+356 9994 3111

email: website:

www.medair.co.zaandy@medair.co.za

Medic’Air InternationalDr Herve Raffin – General Manager

35 rue Jules Ferry, 93170 Bagnolet, Paris, FRANCE

tel: fax:

+33 141 72 1414+33 148 57 1010

email: website:

operations@medic-air.euwww.medic-air.com

North Flying a/sJesper Kragelund – Sales Manager

North Flying Terminal, Aalborg Airport, DK-9400, Nørresundby, DENMARK

tel: fax:

+45 9632 2900+45 9632 2909

email: website:

jkr@northflying.comwww.northflying.com

Quick Air Jet Charter GmbHKarl-Peter Griesemann – CEO

Hangar 3, Cologne Airport, 51147 Cologne, GERMANY

tel: fax:

+49 2203 955 700+49 2203 955 7020

email: website:

ops@quickair.dewww.quickair.de

Redstar AviationDr. Mustafa Atac – CEOAnkara Caddesi Cimen Sok. No: 13, Bulutlar Is Merkezi B-Blok Kat:2 D:4, 34912 Kurtkoy Pendik Istanbul, TURKEY

tel: fax:

+90 216 560 0 772+90 216 560 0 770

email: website:

redstar@redstar-aviation.comwww.redstar-aviation.com

Swiss Air-Rescue (Rega)Stefan Becker – Head of Corporate Development

Rega-Center, PO Box 1414, CH-8058 Zurich, SWITZERLAND

tel: fax:

+41 44 654 33 11+41 44 654 33 22

email: website:

stefan.becker@rega.ch www.rega.ch

Tyrol Air AmbulanceEva Kluge – Head of Sales and Marketing

PO Box 81, A-6026, Innsbruck Airport, AUSTRIA

tel: mobile:

+43 512 22422840+43 676 83422840

email: website:

eva.kluge@taa.atwww.taa.at

Acute Air AmbulanceCourtney Preston – COO

240 SW 34th Street, Fort Lauderdale, FL 33315, USA

toll free: fax:

+800 855 0404+480 287 9154

email: website:

ops@acuteair.comwww.acuteair.com

Aeromedevac Air Ambulance Adam Williams – President

Gillespie Field Airport, 681 Kenney Street, El Cajon, CA 92020, USA

toll free: fax:

+(800) 462 0911+(619) 284 7918

email: website:

awilliams@aeromedevac.comwww.aeromedevac.com

Air Ambulance SpecialistsTom Cox – General Manager

8001 South InterPort Blvd., Suite 150, Englewood, CO 80112 , USA

tel: fax:

+1 720 875 9182+1 720 875 9183

email: website:

info@airaasi.comwww.airaasi.com

Global Jetcare, Inc.Bart Gray – President

16479 Runway Drive, Brooksville, FL 34604, USA

tel: fax:

+1 352 799 7771+1 352 799 7776

email: website:

bart@globaljetcare.comwww.globaljetcare.com

JET ICUMike Honeycutt – President

2561 Rescue Way, Brooksville, FL 34604, USA

tel: fax:

+1 352 796 2540+1 352 796 2549

email: website:

email@jeticu.comwww.jeticu.com

Life Flight International Inc.Chris Connor – Vice President104-1962 Canso Rd. North Saanich, BC CANADA V8L 5V5 Victoria International Airport (CYYJ)

tel (int): tel (NA):

+1-250-655-1630+1-800-661-2183

email: website:

info@lifeflight.cawww.lifeflight.ca

Latitude Air AmbulanceJeff McIntosh CANADAUSA

tel: fax:

+1 289 426 1133+1 289 426 1134

email: website:

24.7@latitude2009.comwww.latitude2009.com

REVA IncStuart Hayman – CEO

1745 NW 51 Place, Hangar 73, Fort Lauderdale, Florida 33309, USA

tel: fax:

+1 954 730 9300+1 954 485 6564

email: website:

operations@flyreva.comwww.flyreva.com

Skyservice Air AmbulanceDavid Ewing – VP International Business DevelopmentMontreal/PE Trudeau Int Airport, 9785 Avenue Ryan, Montreal (Quebec), H9P 1A2, CANADA

tel: fax:

+1 514 497 7000+1 514 636 0096

email: website:

alert@skyservice.comwww.skyservice.com/airambulance

Africa AssistDiana Sharp – Director

Suite 18, Private Bag X10016, Edenvale,1610, SOUTH AFRICA

tel: fax:

+27 (0) 83 300 3927+27 (0) 86 519 2198

email: website:

Assist24@africa-assist.co.zawww.africa-assist.co.za

AIMSBernadette Breton – Managing Director

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

tel: fax:

+27 11 783 0135+27 11 783 2950

email: website:

operations@aims.org.zawww.aims.org.za

AMREF Flying DoctorsDr Bettina Vadera – Medical Director

Wilson Airport, Langata Road, PO Box 18617, Nairobi, KENYA

tel: fax:

+254 20 6000 090+254 20 344 170

email: website:

emergency@flydoc.orgwww.flydoc.org

Assistance Médicale AfricaineDocteur Hage – Général Manager

Box 9962, Libreville, Gabon, GABON

24/7 tel: fax:

+241 07 88 80 80+241 44 10 20

email: website:

amafrique@yahoo.framafrique.com

CONNEX Assistance Dr. Helmy El Tanahy – CEO

Office 11, Floor 1, 6 El Sad El Aali st, Dokki, Cairo, EGYPT

tel: fax:

+202 3 336 0005+202 3 762 0003

email: website:

alarm@connexassistance.comwww.connexassistance.com

Medical Services Organisation (MSO)Vernon Pillay – Operations Director - International Division

PO Box 1578, Gallo Manor, 2052, SOUTH AFRICA

tel: fax:

+27 (0)11 259 5403+27 (0)11 259 5001

24hr email: website:

international@mso.co.zawww.mso.co.za

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38 SERVICEDIRECTORY To have your company listed in the Service Directory email: dave@itij.com

West African Rescue AssociationFlorian Zagel – Managing Director

Klotey Cresent 6, North Labone, Accra, GHANA

24hr tel: fax:

+233 243 666 111+233 21 781 259

email: website:

assist@westafrican-rescue.comwww.westafrican-rescue.com

Active Care ManagementDavid Rivelis – Senior Vice President

3600 Rhodes, Windsor, ON, N8W 5A4, CANADA

tel: fax:

+(519) 945 8256 #4226+(519) 251 5165

email: website:

info@active-care.cawww.active-care.ca

ASSIST-CARD Federico Tarling – Chief Service OfficerASSIST-CARD Building, 175 South West 7th Street, Suite 2407, Miami, FL 33130, USA

tel: toll free:

+1 305 381 9959/69+1 800 874 2223

email: website:

Federico.Tarling@assist-card.comwww.assist-card.com

GORAL ASSISTANCE CANADA INC. David Ohayon – Local Manager

2335 Stevens St, VSL, Montreal, QC H4M 1H1, CANADA

tel: fax:

+1 514 4481343+1 514 4481835

email: website:

info@goralassist.ca www.goralassist.com

SelectCare WorldwideMagdi Riad – President

2100 - 250 Yonge Street, Toronto, Ontario M5B 2L7, CANADA

tel: toll free:

+1 866 261 4441+1 416 340 7152

email: website:

magdi.riad@selectcareworldwide.comwww.selectcareworldwide.com

World Travel ProtectionAbasse Asgaraly – Director, Global Partnerships

400 University Avenue, 15th Floor, Toronto, ON, M5G 1S7, CANADA

tel: fax:

+1 416 205 4646+1 416 205 4676

email: website:

abasse.asgaraly@wtp.cawww.wtp.ca

Asian Assistance (Thailand) Co., Ltd.Susanne Mørch – Managing DirectorViphavadi Tower, 51/3 Ngamwongwan Road, Ladyao, Bangkok 10210 THAILAND

tel: fax:

+66 2 941 1540 +66 2 941 1550

email: website:

contact@asian-assistance.comwww.asianassistance.com

AP Companies KAZAKHSTANElmira Turmagambetova – General Manager

4, 148 Mamir, Auzovskiy region, Almati, KAZAKHSTAN

tel: + 7 727 350 52 76 email: website:

KZT@ap-companies.comwww.ap-companies.com

Assistance OnlineAngela Cheng – Head of Operations

Zendai Cube Edifice 6/F, 58, Changliu Road, Pudong, 200135 Shanghai, CHINA

tel: fax:

+86 21 6854 1008+86 21 6854 1009

email: website:

Angela.Cheng@assistance-online.com.cnwww.assistanceonline-china.com

Customer CareLouise Heywood – Marketing and Business Development Manager

Level 2, 15 Mount Street, North Sydney NSW 2060, AUSTRALIA

tel: fax:

+61 (0)2 9202 8222+61 (0)2 9202 8220

email: website:

enquiry@customercare.com.auwww.customercare.com.au

EMS Assist Pilipinas Corporation (ASIA)Ella Tabulina – CFO & General ManagerUnit 1202 Ecotower 32nd Street corner 9th Avenue The Fort, Bonifacio Global City Taguig,1634, PHILIPPINES24/7tel:

+632 478 9111+632 556 1262

email: website:

ops@ems-assist.comwww.ems-assist.com

First AssistanceMary-Jo McDonald – CEO

PO Box 17-310, Greenlane, Auckland, NEW ZEALAND

tel: fax:

+64 9 356 1650+64 9 525 1278

email: website:

rescue@firstassistance.co.nzwww.firstassistance.co.nz

Global Assistance & HealthcareMario Babin – Chief Executive OfficerCilandak Commercial Estate - # 111 GC, Jl. Raya Cilandak KKO, Jakarta 12560, INDONESIA

tel: fax:

+62 21 299 78 999+62 21 299 78 9555/66

email: website:

global@global-assistance.netwww.global-assistance.net

Global Doctor ChinaMs.Jessica Fang – Operations ManagerUnit 808/811, Level 8, No.88, Bai Zi Wan Nan Er Road, Chaoyang District, Beijing, P.R.,100022 CHINAtel: fax:

+86 10 5815 1188+86 10 8775 9138

email: website:

alarm@globaldoctor.com.auwww.globaldoctor.com.au

ADAC Ambulance ServiceRobert Glueck – Marketing & Sales Director

Hansastr. 19, D - 80686 Munich, GERMANY

tel: 24h Alarm:

+49 89 76 76 52 85+49 89 76 76 50 05

email: website:

info-ambulance@adac.dewww.adac.de/ambulance

AP CompaniesNatalya Butakova – Business Development Manager

17 Varshavskoye Shosse, Moscow 117105, RUSSIA

tel: fax:

+7 495 989 1120+7 495 989 1130

email: website:

natalya@ap-companies.ruwww.ap-companies.ru

ARC Europe SAAlexander Zerzaihi – Network Director

Avenue des Olympiades 2, 1140 Brussels, BELGIUM

tel: fax:

+32 2 706 6661+32 2 706 6601

email: website:

alexander.zerzaihi@arceurope.comwww.arceuropemedical.com

AXA Travel InsuranceRichard Zann – Global Commercial Director

The Quadrangle, 106-118 Station Road, Redhill, Surrey, RH1 1PR, UK

tel: tel:

+0800 028 3336+0203 2840 879

email: website:

enquiries@axa-travel-insurance.comwww.axa-assistance.co.uk

CNASCarole Luisy – Managing Director

80 rue des alliés, 38100, Grenoble, FRANCE

tel: fax:

+33 438 49 83 49+33 438 49 83 40

email: website:

carole.luisy@cnas-assistance.comwww.cnas-assistance.com

DRK AssistanceAndreas Speich – Managing Director

Aufm Hennekamp 71, 40225 Düsseldorf, GERMANY

tel: fax:

+49 211 301805-0+49 211 301805-21

email: website:

info@drkassistance.comwww.drkassistance.com

Global Assistance a.s.Petr Bold – General Manager

Dopraváku 749/3,184 00 Prague 8, CZECH REPUBLIC

tel: fax:

+420 266 799 770+420 266 799 797

email: website:

ops@1220.czwww.1220.cz

Global Voyager Assistance - RussiaCostas Danilenko – CEO

PO Box II, 125124 Moscow, RUSSIA

tel: fax:

+7 495 775 0999+7 495 775 0998

email: website:

cdanilenko@gvassistance.comwww.gvassistance.com

Global Voyager Assistance - Black SeaOxana Razorenova – General Manager

77-79 Nezhinskaya Str., 65023, Odessa, UKRAINE

tel: fax:

+38 048 7373 441+38 048 7373 442

email: website:

gmbs@gvassistance.comwww.gvassistance.com

IFRA Assistance GmbH – AustriaMr. Christian Steindl M.D. – CEO

IFRA Assistance GmbH, Schießstattring 21, A-3100 St. Pölten, AUSTRIA

tel: fax:

+43 (0) 2742 49 11+43 (0) 27 42 89165

email: website:

office@ifra.atwww.ifra.at

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39SERVICEDIRECTORYcall +44 (0) 117 925 5151 To make an alteration to a listing email: dave@itij.com

MD Medicus Assistance GmbHSven Scharff – International Network Manager

Industriestr. 2a, 67063 Ludwigshafen, GERMANY

tel: fax:

+49 - 621 / 5490 171+49 - 621 / 5490 029

email: website:

assistance@md-medicus.netwww.md-medicus.net

Malteser Service CenterJohannes Hoischen – International Network and RepatriationMalteser Hilfsdienst gemeinnützige GmbH Malteser Service Center Kalker Hauptstr. 22-2, 51103 Köln, GERMANYtel: fax:

+49 221 98 22 333 +49 221 98 22 339

email: website:

ambulance@malteser.orgwww.malteser-service-center.de

Marm AssistanceFırat Olgun – CEOGrup Center Is Merkezi, Mustafa Akyol Sok No. 158, Yenisehir Mah, Kurtkoy 34912, TURKEY

tel: fax:

+90 216 560 07 24+90 216 560 07 07

email: website:

marm@marm.com.trwww.marmassistance.com

med con team GmbHMichael Weinlich – Managing Director

Gerhard-Kindler-Str.6, 72770 Reutlingen, GERMANY

tel: fax:

+49 7121 433 660+49 7121 433 619

email: website:

operations@medconteam.comwww.medconteam.com

Medicall AGArmin Bucher – CEO

Zurichstrasse 38, CH-8306 Bruttisellen, SWITZERLAND

tel: +41 44 655 16 67 email: website:

mservices@medicall.chwww.medicall.ch

MRI AssistDenise Rogers – Network Manager

C/Porto Pi, 8. 07015 Palma de Mallorca SPAIN

tel: fax:

+34 971 919 244+34 971 919 255

email: website:

info@medicalresponse.eswww.mri-assist.com

ONE AssistLinda Norman – Client Relationship ManagerPalma C/Cardenal Rossell No.1, Esc. A 2˚. Desp 8-9, Palma de Mallorca 07007, SPAIN

tel: 24 tel:

+44 (0) 1992 708 700+44 (0) 1992 444 337

email: website:

enquiries@oneclaims.comwww.oneclaims.com

Save Assistance FranceFranck Molinier – Director of Business Development6 Rue Jean-Pierre Timbaud, Le Campus, Bat. B1, 78180 Montigny-Le-Bretonneux., FRANCE

tel: 24 tel:

+33 13062 6752+33 13062 1122

email: website:

molinier@saveassistance.comwww.saveassistance.com

SavitarMaria Berkova – General Manager

25/1, Trubnaya str., 7th floor, 127051, Moscow, RUSSIA

tel: fax:

+7 495 987 1775+7 495 987 1776

email: website:

svg@savitar-gr.comwww.savitar-gr.com

SOS InternationalLene Hasting Toft – Head of Marketing and Communication

Nitivej 6, DK-2000 Frederiksberg, Copenhagen, DENMARK

tel: fax:

+45 7010 5055+45 7010 5056

email: website:

sos@sos.dkwww.sos.dk

TBS Team 24 d.o.oEdvard Hojnik – General Manger

CROATIA, SLOVENIA, SERBIA, MNE, BH, KOS, MAC

tel: fax:

+386 2616 5819 +386 2618 5800

email: website:

info@tbs-team24.comwww. tbs-team24.com

CONNEX Assistance JLT Lara Helmi – International Network Director#204 Gold Crest Executive Tower, Jumeirah Lake Towers, Dubai, UNITED ARAB EMIRATES

tel: fax:

+97 14 368 36 25+97 14 420 49 12

email: website:

dubai@connexassistance.comwww.connexassistance.com

GORAL ASSISTANCE LTD Marcel Kadoche – International Network and Development Manager

Maskit 27 str. Herzeliya Industrial Park 46733, ISRAEL

tel: fax:

+972 9 9579930+972 9 9579931

email: website:

info@goralassist.com www.goralassist.com

Dr Colin Plotkin & Sons Consulting INC.Dr Colin Plotkin – Managing Director

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

tel: fax:

+1 604 241 9677+1 604 241 0733

email: website:

colin@plotkinconsulting.comwww.plotkinconsulting.com

Global Excel ManagementJohn Spears – VP Sales and Marketing

73 Queen St, Sherbrooke, QC J1M 0C9, CANADA

tel: fax:

+1 819 566 1130+1 819 566 8447

email: website:

corpinfo@globalexcel.comwww.globalexcel.com

Frontier International Group, IncGitte Bach – President and CEO1024 Bayside Drive, Suite 144, Newport Beach, California, 92660-7462, USA

tel: fax:

+1 949 429 7130+1 949 666 6520

email: website:

bach@frontierintl.comwww.frontierintl.com

AIMSBernadette Breton – Managing Director

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

tel: fax:

+00 27 11 783 0135+00 27 11 783 2950

email: website:

operations@aims.org.zawww.aims.org.za

Medical Services Organisation (MSO)Vernon Pillay – Operations Director - International Division

PO Box 1578, Gallo Manor, 2052, SOUTH AFRICA

tel: fax:

+27 (0)11 259 5403+27 (0)11 259 5001

24hr email: website:

international@mso.co.zawww.mso.co.za

Assistance OnlineAngela Cheng – Head of Operations

Zendai Cube Edifice 6/F, 58, Changliu Road, Pudong, 200135 Shanghai, CHINA

tel: fax:

+86 21 6854 1008+86 21 6854 1009

email: website:

Angela.Cheng@assistance-online.com.cnwww.assistanceonline-china.com

AP CompaniesNatalya Butakova – Business Development Manager

17 Varshavskoye Shosse, Moscow 117105, RUSSIA

tel: fax:

+7 495 989 1120+7 495 989 1130

email: website:

natalya@ap-companies.ruwww.ap-companies.ru

ChargeCare InternationalChristiane Burniston – Managing Director

Monument Business Park, 1D Park Offices, Warpsgrove Lane, Chalgrove, Oxford, UK

tel: fax:

+44 1865 400 007+44 845 003 9923

email: website:

admin@chargecareinternational.co.ukwww.chargecareinternational.co.uk

Euro Center Holding Lisa Resling Halpern – Global Commercial Director

Križíkova 36a,186 00 Praha 8, CZECH REPUBLIC

tel: +420 221 860 330 email: website:

commercial@euro-center.comwww.euro-center.com

Marm AssistanceFırat Olgun – CEOGrup Center Is Merkezi, Mustafa Akyol Sok No. 158, Yenisehir Mah, Kurtkoy 34912, TURKEY

tel: fax:

+90 216 560 07 24+90 216 560 07 07

email: website:

marm@marm.com.trwww.marmassistance.com

ProAmica LtdMargaret Devlin – Administration Services ManagerProAmica Ltd, General & Medical House, Napier Place, Peterborough, Cambridgeshire, PE2 6XN UK

tel: fax:

+44 (0)1733 362 880+44 (0)1733 362 881

email: website:

info@proamica.comwww.proamica.com

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

Dr Colin Plotkin & Sons Consulting INC.Dr Colin Plotkin – Managing Director

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

tel: fax:

+1 604 241 9677+1 604 241 0733

email: website:

colin@plotkinconsulting.comwww.plotkinconsulting.com

Europ Assistance – Global Corporate Solutions (GCS) – ITPA Division

Reid Cawston – Vice President, Sales150 Commerce Valley Drive West, 9th Floor, Thornhill, Ontario, L3T 7Z3, CANADA

tel: fax:

+1 905 669 4333+1 905 669 2318

email: website:

sales@tpa.ea-gcs.comea-gcs.com

Frontier International Group, IncGitte Bach – President and CEO1024 Bayside Drive, Suite 144, Newport Beach, California, 92660-7462, USA

tel: fax:

+1 949 429 7130+1 949 666 6520

email: website:

bach@frontierintl.comwww.frontierintl.com

Global Excel ManagementJohn Spears – VP Sales and Marketing

73 Queen St, Sherbrooke, QC J1M 0C9, CANADA

tel: fax:

+1 819 566 1130+1 819 566 8447

email: website:

corpinfo@globalexcel.comwww.globalexcel.com

Global Medical ManagementRaija Itzchaki – COO

1300 Concord Terrace, Suite 300, Sunrise, Florida 33323, USA

tel: fax:

+1 954 370 6404+1 954 370 8613

email: website:

info@gmmi.comwww.gmmi.com

Olympus Managed HealthcareSteven Jacobson – CEO

777 Brickell Avenue, Suite 410, Miami, Florida 33131, USA

tel: fax:

+1 305 530 8600+1 305 530 0766

email: website:

sjacobson@omhc.comwww.omhc.com

OneWorld AssistTaka Katsube – Director Assistance & Cost Managment

10th Floor, 6081 No.3 Road, Richmond, BC V6Y 2B2, CANADA

tel: fax:

+1 604 303 2113+1 604 276 4593

email: website:

tkat@oneworldassist.comwww.oneworldassist.com

SelectCare WorldwideMagdi Riad – President

2100 - 250 Yonge Street, Toronto, Ontario M5B 2L7, CANADA

tel: toll free:

+1 866 261 4441+1 416 340 7152

email: website:

magdi.riad@selectcareworldwide.comwww.selectcareworldwide.com

Star Healthcare NetworkGigi Galen – President

237 West 35th Street Suite # 604, New York, NY 10001, USA

tel: fax:

+ 1 212 581 8228+ 1 212 581 8272

email: website:

ggontheroad@aol.comwww.starhealthcarenet.com

UnitedHealth InternationalPhilip Brun – Vice President of Sales & Service

3100 SW 145 Avenue, Miramar, FL 33027, USA

tel: fax:

+1 954 378 0694+1 954 378 0771

email: website:

philip_brun@uhc.comwww.uhgi.com

Frontier International Group, IncGitte Bach – President and CEO1024 Bayside Drive, Suite 144, Newport Beach, California, 92660-7462, USA

tel: fax:

+1 949 429 7130+1 949 666 6520

email: website:

bach@frontierintl.comwww.frontierintl.com

Global Assistance & HealthcareMario Babin – Chief Executive OfficerCilandak Commercial Estate - # 111 GC, Jl. Raya Cilandak KKO, Jakarta 12560, INDONESIA

tel: fax:

+62 21 299 78 999+62 21 299 78 9555/66

email: website:

global@global-assistance.netwww.global-assistance.net

Global Excel ManagementJohn Spears – VP Sales and Marketing

73 Queen St, Sherbrooke, QC J1M 0C9, CANADA

tel: fax:

+1 819 566 1130+1 819 566 8447

email: website:

corpinfo@globalexcel.comwww.globalexcel.com

ONE ClaimsLinda Norman – Client Relationship Manager

1-4 Limes Court, Conduit Lane, Hoddesdon, Hertfordshire EN11 8EP, UK

tel: fax:

+44 (0) 1992 708 700+44 (0) 1992 450 717

email: website:

enquiries@oneclaims.comwww.oneclaims.com

SelectCare WorldwideMagdi Riad – President

2100 - 250 Yonge Street, Toronto, Ontario M5B 2L7, CANADA

tel: toll free:

+1 866 261 4441+1 416 340 7152

email: website:

magdi.riad@selectcareworldwide.comwww.selectcareworldwide.com

Star Healthcare NetworkGigi Galen – President

237 West 35th Street Suite # 604, New York, NY 10001, USA

tel: fax:

+ 1 212 581 8228+ 1 212 581 8272

email: website:

ggontheroad@aol.comwww.starhealthcarenet.com

Voyageur Aeromedical TravelMarc Lucas – Director

Voyageur Buildings, 43 Colston Street, Bristol BS1 5AX, UK

tel: fax:

+44 (0)117 927 3554+44 (0)117 925 5940

email: website:

marc@voyageur.co.ukwww.voyageur24.com

To have your company listed in our service directory

contact the sales department now:

dave@itij.co.uk or telephone: +44 (0)117 922 66 00

ADACChristoph Ullrich – Director of Purchase / International Network

Hansastr. 19, D - 80686 Munich, GERMANY

tel: 24hr Alm:

+49 89 7676 2912+49 89 7676 5005

email: website:

christoph.ullrich@adac.dewww.adac.de/ambulance

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41SERVICEDIRECTORYcall +44 (0) 117 925 5151 To make an alteration to a listing email: dave@itij.com

GlobalMed InternationalGert Muurling – CEO & Medical Director

Auf Roedern 7c, 56283 Pfaffenheck, GERMANY

tel: fax:

+49 6742 897 425+49 3212 100 5018

email: website:

info@globalmed-international.euwww.globalmed-international.eu

Life Flight International Inc.Chris Connor – Vice President104-1962 Canso Rd. North Saanich, BC CANADA V8L 5V5 Victoria International Airport (CYYJ)

tel (int): tel (NA):

+1-250-655-1630+1-800-661-2183

email: website:

info@lifeflight.cawww.lifeflight.ca

LIFESUPPORT Patient TransportGraham Williamson – CEO

VANCOUVER, BRITISH COLUMBIA & HONOLULU, HAWAII

tel: fax:

+1 250 947 9641+1 877 288 2908

email: website:

graham.williamson@LifeSupportTransport.comwww.LifeSupportTransport.com

Medical WingsDr Sura Jaidwatee MD – Medical Flight Manager222 Room 3259, Bangkok International Airport, Viphavadee-Rangsit Rd, Sikan, Donmuang, Bangkok 10210, THAILAND

tel: fax:

+662 247 3392+662 535 4355

email: website:

dr.sura@aircharterthailand.comwww.medicalwings.com

Redstar AviationDr. Mustafa Atac – CEOAnkara Caddesi Cimen Sok. No: 13, Bulutlar Is Merkezi B-Blok Kat:2 D:4 34912 Kurtkoy Pendik Istanbul, TURKEY

tel: fax:

+90 216 560 0 772+90 216 560 0 770

email: website:

redstar@redstar-aviation.comwww.redstar-aviation.com

Voyageur Aeromedical TravelMarc Lucas – Director

Voyageur Buildings, 43 Colston Street, 43 Colston Street, Bristol BS1 5AX, UK

tel: fax:

+44 (0)117 927 3554+44 (0)117 925 5940

email: website:

marc@voyageur.co.ukwww.voyageur24.com

AMREF Flying DoctorsDr Bettina Vadera – Medical Director

Wilson Airport, Langata Road, PO Box 18617, Nairobi, KENYA

tel: fax:

+254 20 6000 090+254 20 344 170

email: website:

emergency@flydoc.orgwww.flydoc.org

StandbyMDAlex Sánchez – Managing Director

777 Brickell Avenue, Suite 1370, Miami, Florida 33131, USA

tel: fax:

+1 305 459 4882+1 305 421 5575

email: website:

asanchez@hcsaccess.comwww.standbymd.com

Voyageur Aeromedical TravelMarc Lucas – Director

Voyageur Buildings, 43 Colston Street, Bristol BS1 5AX, UK

tel: fax:

+44 (0)117 927 3554+44 (0)117 925 5940

email: website:

marc@voyageur.co.ukwww.voyageur24.com

V Creative DesignSteve Annette – New Media Director

Voyageur Buildings, 43 Colston Street, Bristol BS1 5AX, UK

tel: fax:

+44 (0)117 929 4636+44 (0)117 925 2040

email: website:

info@vcreativedesign.co.ukwww.vcreativedesign.co.uk

CATEGORY KEY CLAIMS MANAGEMENT INSURERS

AIR AMBULANCE CLAIMS SUBROGATION MEDICAL ESCORT ON COMMERCIAL AIRLINE

AIR AMBULANCE INTERIOR

COMMERCIAL REPAT SPECIALISTS MEDICAL PROVIDER

AIRCRAFT PERFORMANCE SOLUTION

CRITICAL CARE PATIENT TRANSPORT MEDICAL SCREENING

ASSISTANCE COMPANIES FUNERAL DIRECTORS RE-INSURANCE

CATASTROPHIC CLAIMS SPECIALISTS HEALTHCARE CLINICS TRAVEL AGENTS

COST CONTAINMENT HOSPITALS WEB & DESIGN SERVICES

Albin International Repatriation LimitedEmerson De Luca – Managing Director

George Alfred Dyer House, 51 Neptune Street, London SE16 7JP UK

tel: fax:

+44 20 7313 6920+44 20 7313 6999

email: website:

info@albininternational.comwww.albininternational.com

Flying Home Pte LtdMr Ang Ziqian – Director

Blk 4 Lorong 8 Toa Payoh #01-1345A, SINGAPORE

tel: fax:

+65 6253 0001+65 6353 5801

email: website:

enquiry@flyinghome.comwww.flyinghome.com

Funeral Home AURIGA Ltd.Helena Sulikova – Chief of International Department

B. Nemcové Street 1052/1, 412 01 Litomerice, CZECH REPUBLIC

tel: fax:

+420 724 257 899+420 416 732 582

email: website:

helena.sulikova@pohrebni-auriga.czwww.funeral-assistance.cz

Memora InternationalVanda Castro – Manager

C/ Sancho D' Avila 2 08018 Barcelona, SPAIN

tel: fax:

+34 914 849 400+351 214 706 491

email: website:

info@memorainternational.comwww.memorainternational.com

Mortuary Brussels Airport | Worldwide Funeral Repatriations part of DELA

Greta Plas – Repatriations Manager

Ringlaan 49, 1930 Zaventem, BELGIUM

tel: fax:

+32 2 720 80 00+32 2 720 88 22

email: website:

repatriations@dela.bewww.repatriations.com

Rowland Brothers InternationalFiona Greenwood – Manager, International Department

299-305 Whitehorse Road, West Croydon, Surrey CR0 2HR, UK

tel: fax:

+44 20 8684 2324+44 20 8684 8000

email: website:

info@rowlandbrothersinternational.co.ukwww.rowlandbrothersinternational.co.uk

Broward Health International Dominick Destefano – Business Development

1608 SE 3rd Avenue, Ste 503-B, Ft Lauderdale, FL 33316, USA

tel: +1 954 397 8867 email: email:

Dubaldo@browardhealth.orgSbaig@browardhealth.org

UC San Diego Health System InternationalLuis Felipe Arango – Managing Director UCSDHSI

136 W. Dickinson Street, Room 121, San Diego, CA 92103-8222, USA

tel: fax:

+1 619 471 0466+1 619 543 5282

email: website:

larangopardo@ucsd.eduhealth.ucsd.edu/international

Vejthani HospitalLauranee Sirikasem – Assistant Marketing Director

1 Ladprao Road 111, Klong-Chan Bangkapi, Bangkok 10240, THAILAND

tel: fax:

(+66)-2-734-0000(+66)-2-370-1596

email: website:

Lauranee.s@vejthani.comwww.vejthani.com

AMREF Flying DoctorsDr Bettina Vadera – Medical Director

Wilson Airport, Langata Road, PO Box 18617, Nairobi, KENYA

tel: fax:

+254 20 6000 090+254 20 344 170

email: website:

emergency@flydoc.orgwww.flydoc.org

CareFlight Group Peter Elliott – Manager, Tasking & logistics

PO Box 5078, Robina Town Centre, Qld, AUSTRALIA

24/7 (int) tel: fax:

+61 7 5553 5955+61 7 5553 5965

email: website:

ops@careflight.org.auwww.careflight.org.au

CareFlight InternationalPaul Smith – National Manager

Locked bag 2002 Wentworthville NSW 2145, AUSTRALIA

tel: fax:

+61 2 9893 7683+61 2 9689 2744

email: website:

international@careflight.orgwww.careflight.org

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Peculiar attraction

As news came out that a hotel in Prague has opened its nuclear bomb shelter to guests, ITIJ was curious about other ‘alternative’ attractions on offer around the world, finding that there really is a holiday destination for everyone, no matter what their tastes! Returning briefly to the hotel in Prague, though, visitors are given the chance to tour the nuclear fallout shelter, built in the 1950s, which served as the headquarters for leaders from the Warsaw Pact countries. The bunker once housed a hospital - useful for assistance companies to note if the world is coming to an end and there are clients in Prague – as well as a room for electric shock treatment, although hopefully companies won’t be needing that for their clients! In related news, carved into the hillside of Budapest overlooking the Danube, there is a cave complex that once housed a hospital that cared for Hungarian civilians and soldiers during World War II.It’s not just in Eastern Europe, though, that secret nuclear bunkers are becoming tourist attractions – in Essex, UK, a reinforced bungalow hides an entrance tunnel designed for use during a nuclear emergency housing a BBC studio that was once capable of making broadcasts to the entire nation. In Scotland, beneath a small farmhouse cottage and behind hermetically sealed, three-ton blast-proof doors, lies an early warning radar station. In London, tourists are given the chance to look around Churchill’s War Rooms, used by him and

his Cabinet during air raids of World War II. In Saint-Omer, France, an underground facility built near the shores of northern France between 1943 and 1944 as a base for launching V2 rockets, is now open for visitors to visit, with a large history and science museum under the concrete dome containing exhibits on missiles and France’s periods under occupation.In the US, the government built an underground facility beneath the Greenbrier, a resort hotel in West Virginia, that would house Congress in the event of a nuclear holocaust. Built in 1955, the bunker was stocked for around 30 years, but never used, and can now be toured by visitors to the hotel.

Tourism failsNot every tourism venture can be as successful as former nuclear war bunkers, though, as the recent sale of a huge airport in central Spain proves. Built at a cost of €1 billion, the airport, just outside Madrid, has not received a commercial flight since 2011 and has just been sold by its owners for €100 million. Another airport that suffered a similar fate is Montreal-Mirabel International Airport in Canada, which was built at a cost of $1 billion and was expected to handle some 50 million passengers yearly. Sadly, it never managed to pass the three-million mark, and was abandoned as a passenger airport in 2004.A slightly optimistic venture by Kim Jong-un of North Korea is aiming to make the country into a skiing destination, with him personally overseeing the construction of the Masik Pass Skiing Group, which will reportedly have 68 miles of ski runs. The leader has also announced plans that would see the transformation of a former industrial port into a beach resort. One of the more long-term tourist plans in North Korea is the Ryugyong Hotel in Pyongyang – construction of the 105-storey hotel began in the 1980s, but came to an end when funds ran dry. Re-started in 2009, the current plan is to open the hotel to tourists in two to three years’ time – but don’t hold your breath!Another country that has announced plans to become a major tourist hub, but has more than one political or logistical reason why its ambitions will most likely not be realised, is Turkmenistan, run by all-controlling president Gurbanguly Berdymukhamedov. He spent hundreds of millions of pounds turning Awaza into a world-famous beach destination, described by a UK journalist

as ‘the most ill-conceived resort ever built’. The journalist’s wonderful honesty didn’t stop there: “While you rarely actually taste the petroleum tang from the nearby refinery, it surely offsets the health benefits of the iodine-enriched seawater. Though the sea is something that the hotel staff, ever loyal to the schemes of their president, continually extol, swimming is tricky: even in June the Caspian waters are cold.” He added: “Other drawbacks? Awaza’s spanking new ‘international’ airport only take domestic flights; getting a visa is a feat; taps deliver rust-coloured water – and then there’s the small matter that this former Soviet republic is run by one of the world’s most closed and repressive regimes.”Dubai, though, has to take the prize as the world’s hotspot for ambitious tourism projects – some of which have even been completed! One of the biggest plans to be shelved is ‘the world’ – which was going to be an archipelago of islands built artificially to look like the world when viewed from above. Only one of the islands has been bought so far, though, and critics are saying that some of the constructed islands are now returning to the depths of the ocean. Plenty of other projects

in Dubai have also been put on hold – including Dubailand, which was purported to be twice the size of Disney World, and the Arabian Canal, which would have been the largest canal in the world … had it ever been built. Perhaps not being completed is not the end of the world for a tourist attraction, though, as the incomplete Neuschwantstein Castle in Bavaria, Germany, which attracts over a million tourists each year, shows. Built by Ludwig II in homage to Richard Wagner, the castle remains unfinished, but beautiful nonetheless. Joining the ranks of the incomplete but still popular is the Sagrada Familia in Barcelona, which, 130 years after construction began, remains unfinished.

International Travel Insurance Journal

42 REGULARS

Grapevine

Gaudi’s Sagrada Familia

Neuschwantstein Castle in Bavaria

www.itij.com

43ONTHEMOVE

www.itij.co

RSA Ireland CEO quitsPhilip Smith, CEO of RSA Insurance Group plc’s Irish unit, has resigned from the company in the midst of an internal investigation into the insurance company’s accounting practices. In an emailed statement, Smith wrote: “My family and I have been truly traumatised by recent events, and I have taken this most difficult of decisions in the best interests of my family.”Smith has been CEO of RSA’s Irish business since 2007.

US-based One Call Medical Transports announced in December that Michael Key has been named as its new director of business development. In his role, Michael will oversee the development and growth of new business as well as maintain existing customer relationships.Michael comes to One Call Medical Transports from AirMed International, where he most recently served as the director of business development. During the past 16 years with AirMed International, Michael served in several roles, including chief flight nurse, clinical co-ordinator, and director of

medical services. During his tenure at AirMed he worked directly with air medical transport, medical escort, and travel assistance companies. He will continue to serve as a board member of the UStiA (United States Travel Insurance Association). Cole Bachelder, president of One Call Medical Transports, said of the appointment: “We are proud to welcome Michael to our leadership team here at One Call Medical Transports. His industry knowledge, contacts and experience will help to fuel

our continued growth while further strengthening relationships with all of our customers”.

Cooper Gay Swett & Crawford (CGSC) has announced the appointment of industry veteran Peter Gorman as interim CEO of its North American subsidiary Cooper Gay Re following the departure of Ron Carlier. Gorman has over 22 years’ reinsurance market experience and was previously executive vice-president of Cooper Gay Re, based in New York.Shaun Hooper, president and CEO of CGSC North America, said: “Our core vision for the Cooper Gay Re business remains unchanged and its delivery will

continue under Peter’s leadership. We thank Ron for his service and wish him continued success in his future endeavors.”Toby Esser, CGSC Group CEO, said: “Cooper Gay Re is led by a very experienced and highly skilled management team, which demonstrates our plans for the long-term continuity and development of this business. Peter is well known in the market and will provide the depth of leadership required to build this important element of the CGSC group.”

New MD for AvantiUK-based Avanti Insurance Limited has welcomed Elaine Cozens as its new managing director (MD). With her Master’s degree in Business Administration

from the University of Essex, Elaine has over 20 years’ senior management experience. She previously ran her own office removal and storage company before joining previous MD and owner Glen Smith at Avanti Insurance and Healthcare

Partners as operations director, a position that Elaine has held for the last three years. Glen Smith is now chief executive of the company, which will allow him to focus on specific areas of the group’s activities in more detail.

After almost four years with the Financial Ombudsman Service in the UK, Natalie Ceeney is leaving the post of chief ombudsman. Chairman of the FOS Sir Nicholas Montague made the announcement, saying: “In the close to four years since joining, Natalie has taken the service from dealing with an annual workload of 150,000 cases to over 500,000 cases – with the organisation trebling in size under her leadership in response to the challenges of PPI [Payment Protection Insurance]. The board and I are grateful for her achievements as head of the ombudsman service.”As deputy chief ombudsman, Tony Boorman has taken charge of running the service until further notice.

UK-based healthcare provider BMI Healthcare has announced the appointment of a new international director, with the aim of expanding the business into Middle Eastern, Asian and North African markets. To this end, Scott Feldman has joined the company, having previously worked for the company in senior marketing and business development roles. In his time with BMI, Scott has helped develop a number of initiatives that were subsequently rolled out nationally, most notably the specialist GP conference strategies that have, BMI Healthcare said, helped to drive the growth of cardiology, gastrointestinal and orthopaedic revenues at its core hospitals. Prior to joining BMI Healthcare, Scott

was head of marketing at HCL Healthcare, Europe’s largest healthcare recruiter.In his new role, Scott will be working closely with BMI Healthcare’s international liaison officers, consultants and hospital executive directors to further improve BMI Healthcare’s offering on the international stage. The firm said that he plans to expand his team to exceed the needs of international patients being treated in BMI Healthcare hospitals and build closer relationships with insurers and embassies.Commenting on his appointment, Scott said: “I am delighted to have taken up the position of international director at BMI Healthcare. This role offers a unique opportunity to broaden the scope and ambition of how BMI Healthcare positions itself on an international stage. Building upon the success of my predecessor, I have, in the past few months, been looking at how we can further explore new and existing markets in the Middle East to reach new patients and partners. I am confident that we can continue the rapid growth of international patients and improve the level of complex and high acuity work being brought to BMI Healthcare hospitals in the UK.”

New president for Aon Benfield USAon Benfield, the global reinsurance intermediary and capital advisor of Aon plc, has announced the appointment of Kelly Smith as president of its US business. Kelly will report to Bryon Ehrhart, CEO of Aon Benfield Americas. Kelly joined Aon in 1989 and has had a significant role in building Aon Benfield into the world class firm that it has become, said the company. She was most recently executive managing director of Aon Benfield US, where she led client teams responsible for managing more US property catastrophe limits than any other team in the business, said the firm. Her expertise extends far beyond property catastrophe business, she also manages some of the industry’s most significant casualty and professional liability reinsurance programmes, said Aon. In addition to her client responsibilities, she also managed Aon Benfield’s Chicago office.Bryon Ehrhart, CEO of Aon Benfield Americas, said: “Kelly Smith has built and led teams that have driven highly differentiated results for our clients. Kelly is a proven leader in our business and I look forward to the benefits our clients will experience through her new role.”Kelly Smith added: “I am looking forward to working with all of our Aon Benfield colleagues across the US and continuing to seek ways to help them assist our clients maximise their performance and help them grow.”

Kelly Smith

Scott Feldman

Natalie Ceeney

Elaine Cozens

Michael Key

BMI Healthcare looks overseas

One Call names Key as director of business development

FOS leadership changes

CGSC selects interim CEO