Travel sickness

When people emigrate, healthcare is the last thing on their minds. Andrew Apps argues that the industry must keep clients informed of foreign medical customs to avoid any hiccups

To move abroad is to take a step into the unknown. Everything is new: a new home, new car, new schools for the children, new friends, new shops, new bars and restaurants. Much of this new life will be challenging and exhilarating - which is one of the reasons why more basic needs can often get pushed to one side and forgotten.

Health is one of the areas that suffers in this way. People who are busy and healthy are not likely to have doctors and healthcare insurance at the top of their shopping list. After all, one only needs a doctor when one needs a doctor.

But illness is a fact of life and the consequences of falling ill in a foreign land where a person has no grasp of how the system works or how much treatments cost can be altogether devastating.

So what can the insurance industry do about it?

Some may argue that it is not the industry's concern. The task of insurers and brokers is simply to sell appropriate healthcare insurance and if policyholders fail to do the right research to secure the protection they and their families need, then it is their lookout.

This is the sort of attitude that gives the industry a bad name and, worse still, it makes healthcare insurance more difficult to sell. Instead, the industry needs to work harder at selling policyholders the cover they need and providing them with the help and information they need to ensure their medical provision is trouble-free.

Unknown hazards

The first thing that both brokers and insurers need to get away from is the 'one-size-fits-all' mentality. No client should walk out of their broker's office without knowing the features and benefits of the product they have bought and having the reassurance that it provides precisely the cover they need in their new country of residence.

The summaries (see box - left) of the startlingly different healthcare arrangements in Hong Kong and Nigeria serve to illustrate the need for caution in advising on policy content. Hong Kong has a first-class medical infrastructure with facilities that will be completely familiar to western travellers. Private care provision is excellent and extensive, although it can be expensive. Nigeria, on the other hand, lacks basic healthcare facilities and westerners will find many areas of provision unacceptable. Moreover, the further one travels from the main economic centres, the worse it gets.

In poor or developing countries, like Nigeria and Eastern Europe, where the healthcare infrastructure is generally underfunded, the first step for policyholders is to find a good doctor and build up a close personal relationship. This will provide a much-needed introduction to the healthcare services available including the better clinics and hospitals in town. In many emerging markets, private clinics are opening up all the time. They may look very attractive and modern, but they are often unregulated and the standard of healthcare may be questionable. In Nigeria, for instance, there are currently only five or six private clinics that match up to Western standards. This means that there is a heavy demand for places and consequently prices are high. To gain access to the top clinics one will normally have to pay an annual membership and any treatment is charged on top of this fee.

In Hong Kong, where there are hundreds of private clinics of a very high standard, the dilemma is more about which one to choose for a specific medical condition.

Access to this sort of knowledge is absolutely vital when a serious claim occurs. Normally, insurers are well placed to help the client and advise on which hospitals and clinics to select and, more importantly, which ones to avoid at all costs. Some insurers work only with an approved network of hospitals, selected for their high standards of care and service. Most policyholders prefer this arrangement because it considerably reduces the risk of suffering poor treatment or service.

There are many other areas where insurers are able to offer invaluable advice. Repatriation is undoubtedly one of them. The decision to evacuate a patient with a serious medical condition calls for clear heads and fast thinking.

Direct settlement of bills is another important feature for clients. Patients without a complete grasp of local practices or language of the country can be very vulnerable to inflated invoices and unforeseen extras. In some countries someone can walk into a clinic and, if they look like a westerner, are considered 'fair game'. Furthermore, most people go into hospital for treatment - not to negotiate hospital bills. Insurers who work with approved networks of clinics and hospitals usually offer a direct settlement facility. And it is worth noting that even if the treatment is not covered under the policy, the insurer will have a good idea of where the best place to go would be and how much the cost of treatment should be.

This is particularly important if a client has opted for cover that excludes minor conditions or outpatient treatment, or if they are not covered at all because of a pre-existing condition. Most reputable insurers will not leave their clients to fend for themselves in difficult circumstances when they are not covered.

Web advice

Finally there is no shortage of valuable information on the internet to help clients with their healthcare queries. Embassies are a good place to start.

International health insurance providers also put out information and advice on their websites, though the quality varies considerably.

Getting helpful and even life-preserving information to clients is not that difficult. With a little more thought and co-operation the industry can dramatically add value to the service it provides.

Andrew Apps is the global sales director for Goodhealth Worldwide

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