Easing the repatriation process

Assistance & Repatriation Review | April 2019

Repatriating the remains of travellers and expatriates who have died abroad calls for close communication between funeral repatriation specialists and travel and medical assistance companies. Robin Gauldie looks at how they can best work together

Each funeral repatriation case presents different challenges, but effective and timely communication is what makes a traumatic time for loved ones that tiny bit more bearable and makes the organisational process that much smoother. With a number of entities involved in organising and paying for matters related to the repatriation of an insured’s mortal remains when such a death occurs abroad, adequate communication between funeral repatriation specialist, assistance company or underwriter and the family of the deceased is essential to the process, says Fiona Greenwood, Operations Director at Rowland Brothers International, a UK-based international repatriation specialist. “Everything we do is designed to mesh with emergency assistance protocols and wrap around the family’s needs,” she told ITIJ. “Communication is the essential component.” 

In a nutshell, says Deborah Andres of Flying Home, a Singapore-based funeral repatriation specialist, the repatriation company takes over co-ordination from the moment they are awarded the case, including payment to in-country partners and all documentation. “Assistance companies remain the ‘middle man’ between the families and the insurers, as well as the repatriation company,” she explained. “However, if the family is present then the repatriation company also communicates processes and progress to the family.” In any case, communication must be ‘clear and without false promises’, she says. 
With so many parties with a vested interest in making sure funeral cases run smoothly, it’s no wonder that communication plays such a pivotal role. However, specialist funeral repatriation companies and more general travel and medical assistance providers are not the only elements in the repatriation equation. Consular representatives, local authorities, local hospitals and funeral homes are also involved. “Strong relationships are important with everyone professionally involved in the repatriation chain, and a positive relationship with diplomats is no exception,” said Greenwood. “Even if they do not need to issue papers, families appreciate their reassurance. Our outreach and investment in diplomatic relationships in London is designed to help working relationships around the world.” 
Liaison with all relevant officials, then, is critical. “A core set of documents accompanies the deceased out of one jurisdiction into another, but some arrangements are more complicated than others, for example with consular death registration, consular permits, or sealing the coffin,” explained Greenwood. “Attention to detail, the ability to see the bigger picture and an experienced multilingual team can make all the difference.” 
Communication between teams, patience and a clear understanding of everyone’s scope is what everything boils down to, says Andres. And good relationships, often built up over time. “Everything is easier when the local embassy knows you,” added Alberto Simone Pozzoli, CEO of Servizi Funebri Pozzoli Srl in Italy. “They can guarantee for you, they can make everything easier and faster.” 
Going through the process
Attention to detail, the ability to see the bigger picture and an experienced multilingual team can make all the difference
Understanding the processes and considerations that need to be carried out and taken into account by all parties involved in the repatriation of mortal remains (RMR) can help each of those parties to understand how it complements the others. If an insured dies while on vacation, holiday companies and travel insurers will likely be involved at some point in the process, and for expatriates and other longer-term residents who pass away overseas, different situations may require alternative solutions. “Long-term residents abroad often have a pre-need funeral plan to cover their funeral costs in resort or for repatriation in their home country,” explained Greenwood. “If employees of NGOs or large multinationals are affected, we can be appointed directly by them or by an assistance company working with them, and communication is often intense between all parties.”
With any such RMR case, though, there are specific factors that must be considered. “First and foremost, you’re transporting a deceased person’s remains, so legal requirements come into play and there are key actions that must be handled by a licensed funeral services provider,” said Justin Tysdal, CEO and Co-Founder of Seven Corners, a US-based travel insurance and specialist benefit management company. “When we get a call that an insured has passed, we first determine the location of the body. Typically, it is in a hospital, and most hospitals already have an established relationship with a funeral services provider.” If a body is at a house or other such location, Tysdal’s company asks the family if they have a preferred funeral service provider. “If not, we do our own research to locate one. Often, the family doesn’t know, because the deceased has passed while travelling.”
In the case of accidental death, the coroner at the location where the person has died would normally retrieve the body from the scene except where ‘heroic measures’ required transportation to a hospital. “The funeral services provider initiates transportation of the body to the funeral home, which relies on [us] to relay the family’s wishes to them,” said Tysdal. “Our global assist co-ordinator reviews the benefits with the family in detail and explains what is covered.” 
A key question for the family, Tysdal says, is whether they want burial or cremation: “For a burial, the funeral services provider prepares the body appropriately and transports it from the funeral home to the airport and plane. They have special credentials that allow them to do this. Another funeral services provider receives the body at the destination and delivers it to the receiving funeral home. Once the funeral home in the home country receives the body at the airport, we are no longer responsible.” For cremation, Seven Corners pays for the container the body is on before the oven, as well as a container to transport the ashes. “Most family members opt for the basic container covered by the insurance plan,” said Tysdal. “It’s discreet, so they can carry it on their lap or place it in their luggage.”
Religious and cultural preferences must also be taken into consideration at this point – both those of the family and of the locations in which the insured has passed away and to which they are being repatriated. “For example, in many countries, such as Greece and many Arab countries, cremation is not allowed,” explained Pozzoli. “In others, it is not possible – Malta, for example, doesn’t have a crematorium yet. In these cases, we can satisfy the wishes of the family by cremating the body in a nearby country; for example, in Bulgaria for Greece or in Italy for Malta. Otherwise, we have to push the family for cremation in the homeland.” 
In mid-March, however, Greece passed a decree that could see the first crematorium built in the country, despite opposition from the Orthodox church – a move that will help ease the burden on over-crowded cemeteries. Greece’s prime minister is behind the reforms, as are a number of key city mayors, including Athens’ mayor, Giorgos Kaminis, the city in which the crematorium will likely be constructed. Thessaloniki’s mayor has also openly supported the building of a crematorium, following his personal experience of having to transport his late wife’s body across the border to Bulgaria for cremation. 
strong relationships are important with everyone professionally involved in the repatriation chain
Furthermore, assistance providers and specialist funeral repatriation providers have to accommodate uncommon requests as best they can. 
Tysdal recounts a case in which a father asked that his daughter not be embalmed before transportation; he wanted all preparations done in the US due to religious reasons. “Making accommodations like this depends on the country where the body is located and the receiving country,” he explained. “For this case, the US embassy stepped in to make this happen for the family.”
Indeed, one of the most fundamental issues when handling RMR cases is managing the families’ expectations, agrees Andres. “So, when talking to the insurance company or family, an assistance company can confidently say that the repatriation may take up to three weeks.” Once the assistance company has awarded the repatriation company the case, the repatriation company will take over co-ordination and keep all parties informed of the progress step by step, she explained. “However, having said that, next of kin are usually anxious and demand answers and feel the need to call and check in with the assistance companies. The assistance company should remain calm and confident that the repatriation company is going through the due processes as quickly as it can.”
Delay issues
Despite all parties’ best efforts, delays can be unavoidable, however. The location where the death occurred, the destination that the remains will be returned to, the nationality of the deceased if different to the destination, and their religion, says Andres, are all factors that can greatly affect the time taken for a repatriation. All the while, the assistance company is often under pressure to answer questions from relatives and get answers from the repatriation company. “However, on the funeral side, there are many variables to consider,” she told ITIJ. “At times, the replies may seem too slow for the assistance company.” 
Determining cause of death can be another complicating factor, with suicide and drug involvement commonly excluding funeral repatriation cover, notes Tysdal. “If a situation arises where the cause of death is questionable, we have to wait for completion of activities, which could include autopsy, investigation, or other requirements,” he said. “For questionable situations, our claims team reviews appropriate documentation before approving benefit payments. Obtaining a death certificate from the funeral services provider is part of the claims process. It is helpful in determining the cause of death but can take time. We have had cases where we had to wait a month for a death certificate.”
Documentation to accompany the deceased must include a death certificate and obtaining a final or interim death certificate can be time consuming, agrees Greenwood. “Local procedures vary, especially in terms of who can register the death. Our local funeral partner keeps in touch and ensures that arrangements start as soon as the deceased can be released.”
timely payment to the funeral repatriation company is always appreciated
In terms of varying local procedures, depending on the location where the death occurred,  there may not be a consulate or embassy nearby, so documentation needs to be couriered to the nearest embassy, explains Andres. “Embassy hours vary depending on the country they represent, so it may take two or three days for them to process the documents then courier them back to the funeral home, after which the documents need to go to the ministry of foreign affairs to get their approval.”
In some countries, cultural variations around working norms can cause delays too. “For example, if a death occurs in Spain on a Friday, where – unlike us in Singapore – not all companies work 24/7 and government agencies are closed over the weekend, documentation will be delayed, even though the funeral repatriation company has no issue with doing its part,” said Andres. Once the documentation is received, it may need to be translated, which may take another two to three days; and only when all documents have been approved and translated can flight arrangements be made. Some commercial carriers will only take a casket if their flight is not full, she adds.

Other documents accompanying the deceased must also include a freedom from infection certificate, and epidemic outbreaks can present further obstacles to the repatriation process. During the 2013-16 Ebola outbreak, coffin repatriation out of affected countries was prohibited and only cremated remains could be repatriated abroad, Greenwood notes.
Finding a common language in which to communicate can also be an issue, even in the developed world, says Pozzoli: “It often happens that the staff of local funeral homes may be really professional, but they don’t speak English or any other well-known language. It can happen not only in remote areas, but in developed countries like Germany, Russia or Italy. We have multi-lingual staff, but problems can come when local funeral homes must deal with the family of the deceased on the spot.”
Unexpected costs
While the cost of repatriation includes normal transportation of the deceased from place of death to funeral home and then to the airport, as well as embalming, dressing, basic casket, packing, documentation and administration fees, extra costs may include shipping of personal effects, a local autopsy and additional storage fees if required, religious rites, passenger tickets, additional legalised copies of death certificate, translations, upgrading the casket model, and, if the deceased has dual nationality, additional documentation or payments may be required. Such additional requests are subject to approval by the assistance and/or insurance company, says Andres.
Unforeseen additional processes and costs can be a headache for funeral repatriation companies, she notes: “If a death occurs in a remote area, the timeframe for the repatriation will be greater, as will the charges involved, as usually one needs to engage a private mode of transportation from that area to the nearest major city. If death occurs in a Muslim or Jewish state, the deceased may need to be transported to another city for embalming for repatriation on a commercial carrier. If cremation is requested, we may need to transport to the closest city that allows cremation.”
These additional transportations incur extra costs, which usually require authorisation from the assistance or insurance company. “The funeral repatriation company is constantly making payments on behalf of the assistance company or family,” explained Andres. “In return, timely payment to the funeral repatriation company is always appreciated. Sometimes, in the past, we have had to wait almost six months to a year for repayment.”
Setting financial expectations is as important for the assistance company as it is for the family, especially if cover is limited or could be declined, says Greenwood: “Some details are known when we are instructed; others only become apparent when we start work. For example, the precise location of the deceased, cause of death, details of personal effects, storage charges, and larger-than-average deceased requiring a larger-than-average coffin. All these can affect cost, but regular communication ensures smooth repatriation.”