Imagine needing urgent medical attention in a country where you only have a rudimentary grasp of the language or don’t know where the nearest hospital is.
But, as more companies look to expand into the global market and even small organisations can boast offices worldwide, it is now common for people to live and work abroad. And considering the horror stories that often surround foreign medical treatment, it would be assumed any sensible company would provide employees with the most comprehensive cover available. But is this actually the case?
Not according to medical assistance company International SOS, which, based on its own experience, claims that a third of companies sending employees to work abroad fail to provide them with adequate assistance (medical advice, monitoring people while hospitalised, evacuation and repatriation).
Intermediary Judith Latham, of Private Medicine Intermediaries, thinks this figure is actually slightly generous. She says: “The reason for this lack of cover is that people often mistake international PMI for travel insurance, which is only an emergency health cover product and is not designed for people living and working abroad. Travel insurance does not cover areas such as consultation or outpatient treatment and the price limits are far lower than on an international PMI policy.”
Steve Bell, business development director from international PMI provider Morgan Price International Healthcare, adds that companies’ lack of knowledge about the places they send people is also a factor in inadequate PMI provision. “I would agree that around a third of companies don’t give overseas employees enough medical cover, but that is certainly not by choice,” he says. “Most organisations are sensible enough not to send people to dangerous countries. But in any major city, London more than most, there are bad areas as well as good and you need guidance on this. Likewise, with companies that cover overseas employees as if they were working in the UK – this might be fine for Europe but not necessarily for those in more remote regions.”
International SOS also states that one in 10 foreign nationals working abroad is located in a remote area. It highlights the cost of transporting these people to suitable medical facilities and of treating those in politically unstable areas for serious injuries such as stabbing or gunshot wounds.
However, Latham says: “That type of thing has never been a huge issue for us. We have only ever dealt with one client in what you might call a `dangerous’ country and that person did not encounter any problems. Although airlifting is a more realistic prospect, we have only ever had one instance of someone needing an air ambulance.”
And, she adds: “The hospitals in `remote’ places like India are actually far better than people expect them to be nowadays.”
As an international PMI provider with customers across 180 countries, BUPA International has had claims experience of gunshot wounds in Johannesburg, a bomb blast in Nairobi and even mudslides in Venezuela. But director Bill Ward says he believes International SOS’s findings in this area reflect that company’s role as an evacuation specialist – which, by its very nature, deals with people in high-risk areas.
“About a third of our customer base buys evacuation cover,” he says, “but I wouldn’t say this is particularly related to the environments in which they live. In our experience, a retired pensioner living abroad is just as likely to want to be evacuated back to Britain for treatment as is someone in a remote or dangerous area.”
Ward is also keen to warn companies against seeing evacuation cover as an alternative to international PMI. “Organisations buying evacuation cover for their overseas staff are getting a single service rather than management of the entire risk,” he says. “Companies often see evacuation cover as cost-effective until one of their staff actually becomes ill. The person will be dropped off at a hospital – but all the other healthcare bills will be left for the company to settle.”
So, despite the fact that the statistics from International SOS are coloured by its own experience, several experts in the international PMI market agree that a third of companies are not giving overseas staff enough medical cover.
But, according to Latham, the situation is improving. She explains: “Far more people are working abroad now than, say, 18 months ago, and I predict that international PMI will be a major growth area over the next few years. Not just because companies are becoming aware of the value of international PMI, but because brokers are becoming aware of the potential of selling it.”