Analysis: International PMI in a crisis

A spokesperson for insurer CIGNA International Expatriate Benefits offers reassurance, saying that “help would kick in automatically for any medically necessary treatment required for those based in a location that experiences a natural or man-made disaster”.

This may include clinical advice, situation updates, point-of-contact information, and medical treatment or evacuation.

“Like most insurers, CIGNA won’t pay for preventative treatment or evacuations that weren’t medically necessary.”

Brokers and clients can never know for sure how their insurer will respond, until they make that emergency call.

Only a minority of insurers have the underwriting and logistical flexibility to offer a full range of international private medical cover in both disaster and war zones, says David Pryor, senior executive director at MediCare International.

“We are one of the few to offer genuine passive war risk protection,” he says. “Put simply, this means if a client is caught up in a war zone, we will offer cover for injury or sickness provided they are not active participants. If a client is injured and needs medical attention, this will be provided.”

In Libya, for example, the precise method of evacuation will depend on circumstances on the ground.

“If airlifting the client out of the country in a private air ambulance isn’t possible,” he says, “our international assistance provider will try to negotiate either a military airlift or a transfer to a military ship, then arrange onward passage to the nearest country where appropriate medical treatment is available.”

Pryor promises the same response regardless of whether man or nature is to blame.

“We covered clients caught up in the Japanese tsunami, where the local infrastructure was seriously damaged and medical facilities unavailable,” he says. “As with war zones, if civilian flights cannot be used for evacuations, we will turn to the military for help.”


Clients have a duty to understand what protection their insurer offers.

“They must read policy documents carefully and understand the nature of their cover, as once caught in a war or natural disaster, it is too late,” Pryor says.

Now Health International covers treatment following a natural disaster, including evacuation and repatriation across all its products. If the policyholder has a critical life-threatening medical condition, its 24/7 emergency helpline will contract an emergency assistance service to evacuate urgent cases to the nearest medical facility, says business development director Tim Mutton.

“We also have local clinical teams on the ground in the UK, Dubai and Hong Kong, so we can tap into their knowledge to to provide the best possible care,” he explains.

Now Health will also cover innocent bystanders for injuries sustained from terrorism, war and illegal acts.

As the world becomes more turbulent, insurers are responding by beefing up their cover. Morgan Price International Healthcare’s individual and corporate GlobalCrisis plans now cover evacuation due to political or natural disasters, says managing director Jon Carpenter.

Morgan Price covers injuries or illnesses sustained during a natural disaster such as an earthquake or hurricane “as per a normal medical expenses”, Carpenter says. It will also cover innocent bystanders caught up in war and civil unrest.

But it sets a financial limit of £30,000 for the policyholder on terrorism claims. Again, brokers and their clients must be aware of all the nuances.

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