Medical Evac - getting you out

19 October 2010

Medical Evac can literally mean the difference between life and death. But what does it involve and what should you consider when putting medical evac insurance in place?

Medical Evac can trace its roots back to the early 1970s. Prior to that, expatriates were generally viewed as rough, tough, wild adventurers who never got sick. Getting injured was simply part of the deal.

The world changed as the ’70s progressed. The international work place became more fragmented. Local oil and petroleum companies took over the bulk of operations, with Europeans and Americans supplying expertise; rather than using company-men they sub-contracted to self-employed consultants. Where the oil industry led, other industries followed. The result was growing numbers of expatriates who were very well paid but who had little or no local support.

The need for international private medical insurance was self-evident. However a secondary point was also clear; what happens if there is no suitable healthcare available locally? With better communications and more sophisticated light aircraft and helicopters, Medical Evac became a reality.

Today there are a number of major companies involved in Medical Evac including International SOS, Cega Air Ambulance, Specialty Assist,  Medjet, Global Rescue and First Assistance. If you take international medical insurance with an evacuation option, the Medical Evac will almost certainly be covered by one of these firms.

In some cases (such as International SOS) the company operates its own fleet of aircraft. In others (such as Specialty Assist) it will partner with local and international air rescue companies and may use mainstream scheduled flights. Both methods have their pros and cons.

The companies using their own aircraft offer a general consistency of service, where those “broking” the transport to other companies can often be more flexible.

In reality, which is best, will depend a lot on circumstances:
• Where the injured party is?
• What the problem is?
• Where is the most suitable place for treatment?

Having spent time talking to highly experienced medivac doctors, our conclusions are:
1. Being transported by an air ambulance might seem to be an ideal solution but the cramped conditions of a small plane can cause problems with looking after the patient en route. In addition, smaller aircraft may need to fly at low levels and “hop” between locations. Many doctors would prefer to use commercial aircraft if at all possible.
2. In most cases Medical Evac by air is the best solution, but don’t think of it as the only solution. In one case in the Caribbean, the evac was carried out by powerboat because the insured was a scuba diver with suspected “bends” and flying higher than 2,000 feet would have had potentially fatal results.
3. Listen to the advice given by the assistance team doctors. The initial reaction is often “I want to get out of here – get me home!”. The doctors are highly experienced and have probably dealt with a similar situation in the past. If they recommend staying in a local hospital or having treatment locally it’s unlikely to be on the grounds of saving money. Like any doctor their driving force is patient wellbeing.
4. Be aware of the red tape. Despite medical emergencies moving from country to country may involve immigration issues. The Medical Evac company will be aware of this and whilst a lay-person might expect to be evacuated to country “A” it might be impossible because of visa controls. In the past we had a situation where newborn twins needed to be evacuated from Ukraine. The obvious choice for treatment would have been Germany but because of EU border controls (the mother and therefore the twins were Ukrainian with no visa for the EU), entry may have taken days. The Evac company arranged immediate transfer to the American Hospital in Istanbul – excellent modern facilities, highly qualified doctors and no border delays.
5. Medical evacuation is an essential benefit for expatriates, wherever you are. Even if you normally work in a country with good facilities there is always the situation where a business trip or holiday leaves you exposed in a remote or inhospitable country.

Bellwood Prestbury are independent global insurance brokers. If you need advice about which company might be most suitable for you or your employees, depending on where they are working or travelling, simply call our knowledgeable team on +44 (0) 1242 584 558.

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